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HomeMy WebLinkAbout26581-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28359 Date: 04/19/02 THIS CERTIFIES that the building NEW DWELLING Location of Property: 190 JACKSONS LANDING MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 113 Block 4 Lot 4 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 3, 2000 pursuant to which Building Permit No. 26581-Z dated JUNE 15, 2000 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH FRONT COVERED PORCHES, REAR DECK, SCREENED PORCH, UNFINISHED SECOND FLOOR AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM A MALLINS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-99-0207 04/05/02 ELECTRICAL CERTIFICATE NO. N 569038 09/10/01 PLUMBERS CERTIFICATION DATED 10/29/01 COASTAL PLUMBING & HEAT Au orized Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26581 Z Date JUNE 15, 2000 Permission is hereby granted to: DEBENEDITTIS (MALLINS) 190 JACKSONS LANDING MATTITUCK,NY 11952 for CONSTRUCTION OF A NEW 2 STORY ONE FAMILY DWELLING WITH ATTACHED TWO CAR GARAGE AND FULL BASEMENT AS APPLIED FOR. at premises located at 190 JACKSONS LANDING MATTITUCK County Tax Map No. 473889 Section 113 Block 0004 Lot No. 004. 1 pursuant to application dated JUNE 3, 2000 and approved by the Building Inspector. Fee $ 1,715 .00 Above fee includes $100.00 flood permit Authorized Signature COPY Rev. 2/19/98 �1 Form No.6 }� TOWN OF SOUTHOLD Q �� BUILDING DEPARTMENT TOWN HALL 765-1802 . F S UTH LD APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. Commercial building, industrial building,-multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings(prior to April 9, 1957)non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines,streets,building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant.If a Certificate of Occupancy is denied,the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy-New dwelling$25.00,Additions to dwelling$25.00,Alterations to dwelling$25.00, Swimming pool$25.00,Accessory building$25.00,Additions to accessory building$25.00,Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building- $100.00 3. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential$15.00, Commercial$15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: 1!�/Z%Gam,,.. Suffolk County Tax Map No 1000, Section X1./3 Block ` Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. Applicant: Health Dept.Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: c/ (check one Fee Submitted: $ (p _�3 Applicant Signature BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: Oe- Pax Reviewed: Architect/ Q Date Engineer: !ae Submitted: 9 SCTM#: District: 1.000 Section: /13 Block: _ Lot: Project Subdivision Location: J�- i��o a'�t- -4 . ! 't4t�l`� Name: . . Single&separate Requi certification: (Yes(No)Z J Req. Req. Zoning District: l [Lot size: Actual: 1 [Lot coverage Proposed: 1 Req. ry Req. / Req. [Front Yard J Proposed: [Side Yard �� Proposed: 1 [Rear Yard Proposed: ] Project Description: /`"A AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. 810- V-040-7 New York State D. E. C. l• 17,38'0 Z q0000( Town Trustees ? Town Zoning Board approval: _x Town Planning Board approval: K Flood Plane Elevation??? Flood Zone: Notes: BASCO mu7 AQ Cor 2704 s E 5er,u(T ��, �RAGB ��Oc� 3433 SF &499 �Isa Mhc�vIvF,m6k,alSew 2q0a SR C gSS� s� f, SE x .2a = I5(to 1 '� 1500 THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1195221 BUREAU OF ELECTRICITY F 40 FULTON STREET, NEW YORr'NY 10038 Date SEPTEMBER 10,2001Application No. on file ''%�� N 569038 THIS CERTIFIES THAT PEPWIT NO. 26581 only the electrical equipment as described below and introduced by the applicant wed on the above application number is in the prenEiges of WILLIAM A. MALLINP, 190 JACKSONS LANDING, MATTITUCK. in the following location; ® Basement 12 1st Fl. ® 2nd FL GARi "'_'C!L!A1 Section Block lot was examined on SEPTEMBER 07,2001 and found to be in compliance with the National Electrical Code. FIXTUREFIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS �� RECEPUCLES SWITCHES INCANINSCENJ FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT. K.W. AMT. K.W. AMT. N.P. 94 43 72 82 12 1 4.E 1 3.7 6 F DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT.1 TIME CLOCKS ULL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K.W. OIL M.P. GAS M.P. AMT. NO. A.W.G. AMT. AM►. AMT. AM►S. TRANS. AMT, M.P. SYSTEMS OF OF AMT WATTS NO.OF FEET 9 F 3 - 6 SERVICE DISCONNECT NO.OF S E R V I C E METER NO. CC COND. A.W.6. A.W. A.W. AMT. AMP. TYPE EQUIP. 1•2W 1 0 3W J R JW J t 4W PER a OF CC.CO . NO.OF HI-LIS NI• �' InIp1ULf OF NEUTRAL 2 200 CB 1 X 2 2/0 2 2/0 OTHER APPARATUS: HOUSE & DOCK-1 Co2 DETECTOR-1 WELL PUMP M-1 PADDLE FANS-4 WIRLPOOL BATH-1 STEAM GENERATOR WITH 40A DISCONNECT-1 -200 A TRANSFER SWITCH-1 AIR CONDITIONERS-2 1-5 TON & 1-2 TON-2 l <<< Continued on Page 2 >>> GENERAL MANAGER Per Thlt ce"cate mutt not be altered In any manner;return to the office of the Ward It`Inoo4m"ctott may be Identified by their,credtntlalt. COPY FOR BuiLbING D PARTMENT. THIS COPY OF CERTIFICATE MUSt NOY.-Bt ALTERED IN ANY MANNER. THE NEW YORK BOARD OF FIRE (UNDERWRITERS » PAGE 2 1195221 BUREAU OF ELECTRICITY I 40 FULTON STREET, NEW YORK, NY 10038- SEPTEMBER 10,2001 p fi (' ; N,569038 Date A lication No. on le THIS CERTIFIES THAT App NO. 26581 only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of f; WILLIAM A'. MALLING, 190 JACKSONS LANDING, MATTITUCK; Y in the following location; ® Basement [I ist Fl. 132nd Fl. GAR Section Block Lot was examined on SEPTEMBER 07,2001 and found to be in compliance with the National Electrical Code. FIXTUREFIXTURES RANGES COOKING DECKS OVEN$ DISH WASHERS EXHAUST FANS OUTLETS RECEPTACLES SWITCHES FNCANDESCENI FLUORESCENT OTHER AMT. K.W. AMT. K.W. AMT: K.W. AMr. - K.W. AMT. N.►. DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RECTI. TIME CLOCKS BELL UNIT HEATERS MULTI OUTLET DIMMERS- ! OIL M.P. GAS H.P. AMT. NO. A.W.G. AMT. AMP. AMT. Amps; TRANS. AMT. N.I. SYSTEM$ NO.OF FEET AMT.. wATTs SERVICE DISCONNECT NO.OF S E R V I C E METER NO.Of CC CONC. A.W.6. A: A.W. AMT. AMP, TYPE EQUIP. 1 R ZYY 1 R SW .3 R SW J e 4W PER e - OF CC.COMP. "0.OF MW 9 M; NO.O0 fauTRAu OF NEUTRAL OTHER APPARATUS: MOTORSe1-5 H.P. ,1-2 H.P. ,2-F H.P. PANELBOARDSL2-1 CIR. 60 G.F.C.Ir-10 SMOKE DETECTOR:-8 S.C.S.ASSOC.INC. LIC.#717-E L P.O. BOX 503 ST. JAMES, NY, 11780-0503 GENERAL MANAGER 11 Per This cerlMcate must not be altered In any manner;return to the office of the Ward It"orreat. Ctcrt'rr�oy be Idonfidod by Moir credeMlali. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE; MU$T'NQ";grz .,4,t$hED IN ANY MANNER. Town Hall,53095 Main Road y Z Fax(516)765-1823 P.O. Box 1179 0-0 • Telephone(516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N DATE: /D- 021 -O / Building Permit No. owner: j) ► I l ,AVn m 1411 , n) g (please print) Plumber: Ca915—N1 Q1umb %�4 t N� �'�w5 Si 3f67 - ? (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. V (PlumbersSignature) Sworn to before me this T12 day of IfL'C�.kr')x , -I r Notary Public, County .. ELANE NOTARY PUBLIC,State of New Yak No.52.4743590,SO*County Coner*Ow Evian Fakm 28,yB9 1 DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K. JAVITS FEDERAL BUILDING • NEW YORK, N.Y. 10278-0090 REPLY TO October 7, 1999 ATTENTION OF Eastern Permits Section SUBJECT: Department of the Army Permit No. 10GP-1999-11820 William A. Mallins c/o Land Use Ecological Services, Inc . 2576 Sound Avenue Baiting Hollow, New York 11933 Dear Mr. Mallins : We have completed our review of the above application. From the information submitted it appears that the proposed work is authorized by our General Permit for Non-Commercial Mooring Structures (NYDGP-10) a copy of which is enclosed. Your work should be performed according to the conditions of this General Permit . You are required to submit to this office the dates of commencement and completion of your work. Enclosed are two forms for you to use to submit the required dates . Notice is hereby given that the permittee should recognize that a possibility exists that the structure permitted herein may be subject to wave wash from passing vessels . The issuance of this permit does not relieve the permittee from taking all proper steps to insure the integrity of the structure permitted herein and the safety of boats moored thereto from damage by wave wash and the permittee shall not hold the United States liable for any such damage . It should be noted that this permit does not relieve you of the obligation to obtain any State or local approvals for your work. If, for any reason, a change in your plans or construction methods is found necessary, please contact us immediately to discuss modification of your permit . Any change must be approved before it is undertaken. Sincerely, _ Yw a es W. Haggerty ef, Eastern Permits Section Enclosure DEPARTMENT OF THE ARMY NEW YORK DISTRICT, CORPS OF ENGINEERS JACOB K.JAVITS FEDERAL BUILDING NEW YORK, N.Y. 10278-0090 REPLY TO ATTENTION OF CENAN-OP-RH IMPORTANT This letter must be completed and mailed to the Harbor Supervision & Compliance Section at the above address following completion or cancellation of work authorized under the permit. Permittee: William A.Mallins Permit No. 1999-11820 Date Permit Issued: October 7, 1999 Expiration Date: July 18, 2000 Waterway: Mattituck Creek City & State: Mattituck, Town of Southold, Suffolk County, New York Check and complete applicable item(s) listed below: Work was completed on Work will not be performed on the project. Deviation from work authorized in permit is explained below. Other (explain) O� ign ure of Permittee Dat Fold this form into thirds, with the bottom third facing outward. Tape it together and mail to the address below or FAX to (212) 264-4260. Place Stamp Here Department of the Army New York District Corps of Engineers Jacob K. Javits Federal Building ATTN: CENAN-OP-RH New York, New York 10278-0090 .u- Albert J. Krupski,President �QgUFFO(�-c Town Hall James King,Vice-President �O �lj 53095 Main Road Henry Smith y< P.O.Box 1179 Artie Foster co Southold, New York 11971 COD x Ken Poliwoda p Telephone(516) 765-1892 Fax(516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD December 21, 1999 Mr. Dan Hall Land Use Ecological Services, Inc. 2576 Sound Ave. Baiting Hollow, NY 11933 RE: WILLIAM A. MALLINS SCTM#113-4-3&4 Dear Hall: The following action was taken by the Board of Town Trustees during its Regular Meeting held on Wednesday, December 15, 1999 regarding the above matter: WHEREAS, Land Use Ecological Services, Inc. on behalf of WILLIAM A. MALLINS applied to the Southold Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated October 7, 1999, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 15, 1999, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety, and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approved the application of WILILAM A. MALLINS to construct a single-family dwelling. House and garage is proposed to be 3,465 sf., and asphalt drive is proposed to be 750 sf. House is to be setback a minimum of 75' from the tidal wetlands line and sanitary system is to be setback 125', all with the condition that haybales be placed down at the edge of the 50' buffer area. BE IT FURTHER RESOLVED, that this determination should not be considered a determination made for any other department or agency which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. FEES: None Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms cc: DEC Health Dept. Building Dept. mac,• ���h� •'' �'� �� •per. '��(. y ,�jj'�°`'`'�. Board Of Southold Town Trustees , * ; SOUTHOLD, NEW YORK '!. yA Dec. 21, 1999DATE: .PERMIT NO. 6099 ¢ r 1 WILLIAM A. MALLINS ' ISSUEDTO ............................ ........................................ 4 i Pursuant to the provisions of Chapter 615 of the Laws of �• the State of New York, 1893; and Chapter 404 of the Laws of the t � State of New York 1952; and the Southold Town Ordinance en- ` titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS 3 IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;`_ and in accordance with the Resolution of The Board adopted at a meeting held on ...Dec. 15.,.. 19..9.9...., and in consideration of the sum of $.....15.0.,.0.0... paid by S„ Land Use for William A. Mallins Mattituck 3r of ..... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: y' Wetland Permit to construct a single-family dwelling. House and�3 garage is proposed to be 3,465 sf. and asphalt drive is propose . to be 750 sf. House is to be setback a min. of 75' 'from the tidal wetlands line and sanitary s ste is t be setback 1251, all with# all in accordance with the detaileT specifications as presented in the or inatin a Ica on. the contetion tial aybales be placed down at the edge of the 50' buffer II�MYNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. s 12 -T i y »a c=n _ Trustees k ♦f r� 1 l � !T`-iL NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ,.x0001 EFFECTIVE TE May 12, 2000 ,,,/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental Conservation Law May 31, 2010 TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate I 1 ■ Article 15, Title 5: Protection ■ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER William A. Maltins (631) 588-9369 ADDRESS OF PERMITTEE 7 Innis Avenue Lake Ronkonkoma, NY 11779 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Land Use Co., 2576 Sound Avenue Baiting Hollow, NY 11933 (631) 727-2400 NAME AND ADDRESS OF PROJECT/FACILITY Maltins property, Jackson's Landing, Mattituck LOCATION OF PROJECT/FACILITY SCTM #1000-113-4-3,4 COUNTY TOWN WATERCOURSE NYTM COORDINATES West Suffolk Southold IBranch of Mattituck Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a single family dwelling, sanitary system, garage, deck and pervious driveway. Place approximately 1000 cu. yds. of clean fill for residence and sanitary system. Construct dock, ramp and float. Clear pathway to access dock assembly. All work is to be done in accordance with the attached plans stamped NYSDEC approved. L- 11 By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS George W. Hammarth (MMR) Bldg. #40 SUNY Stony Brook NY 11790-2356 AUTHORIZED GNA URE DATE Page 1 of 5 May 12 2000 1 I f New York State Department of Environmental Conservation Co Divisiop of Environmental Permits, Region One c`° Building 40-SUNY, Stony Brook, New York 11790-2356 UMO Phone: (516)444-0365 • FAX: (516)444-0360 7Website:www.dec.state.ny.us John P.Cahill Commissioner May 12, 2000 Mr. William A. Mallins 7 Innis Avenue Lake Ronkonkoma, NY 11779 RE: 1-4738-02449/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to conspicuously posted at the project site and protected from the weather. Sincerely, Akle- Marga�t M. Rork Environmental Analyst MMR/ls Enclosure C=S M W Mer or MEC~ Y PYAKY MNW NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-02449/00001 May 12 2000 FACILITY/PROGRAM NUMBER(S) P E RM I T EXPIRATION DATE(S) Under the Environmental Conservation Law May 31, 2010 TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate I � ■ Article 15, Title 5: Protection ■ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER William A. Malli n (631) 588-9369 ADDRESS OF PERMITTEE 7 Innis Avenue Lake Ronkonkoma NY 11779 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Land Use Co. 2576 Sound Avenue Baiting Hollow NY 11933 (631) 727-2400 NAME AND ADDRESS OF PROJECT/FACILITY Mallins property, Jackson's Landing Mattituck LOCATION OF PROJECT/FACILITY SCTM #1000-113-4-3,4 COUNTY TOWN WATERCOURSE NYTM COORDINATES West Suffolk Southold Branch of Mattituck Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a single family dwelling, sanitary system, garage, deck and pervious driveway. Place approximately 1000 cu. yds. of clean fill for residence and sanitary system. Construct dock, ramp and float. Clear pathway to accessdock assembly. All work is to be done in accordance with the attached plans stamped NYSDEC approved. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS George W. Hammarth (MMR) Bldg. #40 SUNY Ston 7okNY 11790-2356 AUTHORIZED SIGNA UREPage 1 of 5 Ar� 12 2000 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION • NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, agents,and assigns for all claims,suits,actions,damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits,approvals, lands,easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility,including relevant records,is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL.Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify,supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities(HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg#40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. DEC PERMIT NUMBER PAGE 2 OF 5 1-4738-02449/00001 APERMIT.TW,rev.6/99 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15(TITLE 5), 24, 25,34 AND 6NYCRR PART 608 (TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Department to remove or alter the structural work,obstructions,or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S.Army Corps of Engineers, U.S.Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly,without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any'portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 8. If granted under 6NYCRR Part 608,the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977(PL 95-217)provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved survey was prepared by Philipp A.Hattemer Jr.last revised 3/21/00,the site plan and cross-section was prepared by Land Use Ecological Services last revised 3/30/00 and the sanitary system plans were prepared by Eileen Bennett on 9/16/99. DEC PERMIT NUMBER PAGE 3 OF 5 1-4738-02449/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices enter tidal wetlands and or protected buffer areas. 2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 4. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration,whichever comes first. The approved methodologies are as follows: a. Stabilization of the entire disturbed area with appropriate vegetation (grasses, etc.). 5. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. 6. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. 7. If seeding is impracticable due to the time of year,a temporary mulch must be applied and final seeding performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. 8. All fill shall consist of"clean" sand, gravel, or soil (not asphalt, flyash, broken concrete or demolition debris). 9. No excavation of the beach is authorized for the purpose of obtaining fill or stone materials. 10. There shall be no discharge of runoff or other effluent into any tidal wetland or adjacent area. 11. The ground area cleared for construction of a path or boardwalk is limited to a maximum width of six(6)feet. The path or boardwalk itself is limited to a maximum width of four(4)feet. 12. Cover material used for footpath is limited to natural wood/bark chips, stone, gravel or sand. 13. Dock or timber catwalk shall not exceed 4 feet in width and shall be a minimum of 3'/feet above grade*over tidal wetland areas(*as measured from ground to bottom of dock sheathing). 14.The use of wood treated with pentachlorophenol in the construction of structures that will be in contact with tidal waters is strictly prohibited. 15.Dock reconstruction or replacement or seasonal installation shall not involve expansion or substantial modification of existing structures or facilities. 16. Floats and ramps may not rest on or be stored in any vegetated tidal wetland. 17. No dredging,excavating or other alteration of shoreline or underwater areas is authorized by this permit, nor shall issuance of this permit be construed to suggest that the Department will issue a permit for such activities in the future. 18.Docks/catwalks/floats may not(a)extend laterally beyond property lines,(b)be placed so that docked boats extend over adjacent property line, (c) interfere with navigation, (d) interfere with other landowners riparian rights. 19. Pilings may not: (a)extend beyond property lines, (b)be placed so that docked boats extend over property lines, (c) interfere with navigation, (d) interfere with other landowners riparian rights. DEC PERMIT NUMBER PAGE 4 Of 5 1-4738-02449/00001 • NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 20. To protect the values of the tidal wetlands,a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 50 linear feet landward of the tidal wetland boundary. 21. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area 50 linear feet from the tidal wetland boundary at commencement of regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation. 22. Roof runoff must be directed to drywells a minimum of 75 linear feet landward of the most landward edge of the tidal wetland boundary, and must be installed a minimum of 2 feet above seasonal high groundwater. 23. Driveways and parking areas shall be constructed of pervious material. 24. Roads, driveways, and/or parking areas shall be graded to direct runoff away from tidal wetlands and protected buffer areas. 25. Sanitary system (bottom of tank and leaching pools) shall be located a minimum of 2' above seasonal high groundwater. 26. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated tidal wetlands associated with West Branch of Mattituck Creek are located at Jackson's Landing,Mattituck, County Tax Map Number: District 1000, Section 113, Block 4, Lot 3,4, otherwise known as the properties of William A. Mallins, and his heirs, assigns, or successors. This property is subject to the provisions of New York State Environmental Conservation Law(ECL)Article 25 or its successor,and the conduct of regulated activities may occur only pursuant to ECL Article 25 if prior approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor. Regulated activities include, but are not limited to the erection of any structure(s); excavation; dredging grading and filling; clearing of vegetation; and application of chemicals." This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit. A copy of the covenanted deed or other acceptable proof of record,along with the number assigned to this permit,shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager, Bureau of Habitat, SUNY Building 40, Stony Brook, New York 11790-2356. 27. Maximum piling size shall be 4"x 4"on catwalk and 4"x 6"on float. 28. The ramp,float and pilings shall be removed no later than December 1 of each year and installed no earlier than April 1 of each year. DEC PERMIT NUMBER PAGE 5 OF 5 1-4738-02449/00001 9&M-1 (&8-n-9d , New York State Department of Environmental Conservation Am AM vNOTICE 1111111111111V v The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number 3S JOHN W. PXVACIC Expiration Date S1,311 NOTE: This notice is NOT a permit v 4� 4 ITH T. TERRY 7ci��m Hall. 51095 MainRoa<J I ,JLID = P.O. 11ox 1171) TOWN CLERK ~ '' t Southold. Nc,,.• York 1 1')71 REGIsfRAR OF VITAL,sTAnmics .►� iC� `�~ Fax (s l6) 765-1921 MARRIAGE OFFICER _ TcicPhonc (516) 765_IxOI REcoat)s MANAGEMENT OFFICER X41 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain )Development Permit Application" [FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93) ] . TOWN OF SO-jTf+OLD �Ju T. Terr Y Southold Town Clerk August 25, 1993 APPLICATION # PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sien): 1. No work may start until a permit is issued. 2. The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable - inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO THIS APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) DATE b 0 SECTION 2• PROPOSED DEVELOPMENT (To be completed by APPLICANT) NAME ADDRESS TELEPHONE APPLICANT 1. E. G31 . BUILDER ENGINE6 l PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION r PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE ❑ New Structure ❑ Residential (1-4 Family) ❑ Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofing? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECT S B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. ,SECTION 3 FLOODPLAIN DETERMINATION (To be completed by LOCAL ADINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: ❑ Is VM located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). O Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED (To be completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale,and specifications, including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the fust floor,details of floodproofing of utilities located below the first floor and details of enclosures below the fust floor. Also ❑Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway Will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5• PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B.❑ Is not in conformance with provisions of Local Law # , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION # PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? ❑ Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement in Coastal High Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ONO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: r Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: ❑ NEW BUILDING ❑ EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY_ CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_ SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) M-1802 BUILDING DEPT. INSPECTION [ ZFOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: Aa=,.,��-'mac ry DATE INSPECTOR - -7 dZ5-9/en � ,,# ---1 P , [,V S�� i6f" , --.1 765-180 UILDING D INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY ARKS: DATE INSPECTOR � BUILDING DEPT. INSPECTION [ ] "FOUNDATION ATION 1ST [ ] ROUGH PLBG. [ 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: z, DATE � 3 � � INSPECTOR-ZIL 'I f'" 'BM.isox UILDING DEPT. A INSPECTION [ FOUNDATIONIST [ ROUGH PLBG.c.WU4G,ea�w� [ ] FOUNDATION 2ND [ ] INSULATION [ j FRAMING [ ] FINAL / [ ] FIREPLACE 8 CHIMNEY REMARKS: ,DATE INSPECTOR-/ilze-;7' ass-saos suiwINo oar. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] F UNDATION 2ND [ ] INSULATION [ F"1NG [ ] FINAL [ FIREPLACE REPLACE 8 CHIMNEY REMARKS: ,DATE o� INSPECTOR BUILDING DEPT. INSPECTIO [ ] FOUNDATION iST ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION I 1 FRAMING [ ] FINAL [ ] FIREPLACE CHIMNEY REMARKS: � i S DATE � �� INSPECT M-11W2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R H PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY RE ARKS• �G /7T - DATE .Z INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION 1 FRAMING [,11-"FINAL [ ] FIREPL & CHIMNEY cr REMARKSA 016 : li 3 DATE INSPECTOR ' T65-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2NDIN LATION [ ] FRAMING [ FINAL -i [ ] FIREPLACE & CHIMNEY REMARKS: DATE /-INSPECTOR WA- Me WR �1400 1 1 / 0 • 1 00-M _.. 11 1 1 1 1 .► . t BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: (f CALL . . .?�??.. y�- . . . Examined................... 20.... `` � MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved...�0..'.IS' .... Permit No. .................................... Disapproveda/c .................................. .................................... .....................................?L'f;CATION . ...... 44 uilding Inspector) '..•.. FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . 20. . . . INSTRUCTIONS a. Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. not plan showing location,of lot and of.buildings on premises, relationship to adjoining premises or public streets or areas, and giving,a detailed'description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be comienced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATICK IS HEREBY MALE to the Building Department for the issuance of a Building Permit pursuant to the Buildi g Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building cc4e, irxasi;;g cvue, v.d regulations, and to admit authorized inspectors on premises and in building fo necessa ns ions. .. ...... .. ........... (Signature of applicant, or name, if a corporation) ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder .............................t......f...................................................................................... Name of owner of premises ... 11�14rn. It��lq 5.................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. �?J 7�6.�� ......... Plumbers License No. ........ Electricians License No. ...... ........ Other Trade's License No. .................... 1. Locationofland on which proposed work will be done............................................................... ..........I \Q .................. cksc Q's...::a►,d�r�c�.a... 0.c :4 ' :�4.....lU�, :......................... House Number StreetLL�� Hamlet L County Tax Map No. 1000 Section .... 1� ....... Block ....:I.. ... Lot .:' ...#' / rrori-h .)`icew Subdivision ... XI4Qi414.......... Filed Map No. Fltf-na,.5.aZo lot ... .... ...... . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................. b. Intended use and occupancy ..................................... r<e}>a;r Removal ............. Denolition ............ Other Work 4. Estimated Cost .. {J'.��000 ....... f ...... (Descript on) (to be paid on filing this application) 5. IE (Lielling, nu►i�er of dwelling units ..Q) ....... Number of dwelling units on each floor If garage, uber of cars U2)- qY:�........................... ................ m 3. If business, ccmnercial or mixed occupancy, specify nature and extent of each type of use....... 7. Dimensions of existing structures, if any: Front:. Height „,.- - Rear .... .. .... Depth ......... ...... - . Number of Stories Dimstructure Dimensions of sane stcture with alterations or additions:.'Front.•- Rear Depth .................... Height .................... Number of Stories Rear .............. 9. Dimensions of entire new construction: Front-t�Q.a ;�?4_,,,,, Rear t r( Depth }..'IiQ-R# }}eight }yQ�.�cG��,,tnc4ut�l ... -jtcZ'4 Number of Stories . .. ... . Size of lot: Front . .x89.1.......... Rear ..... .. Deptht 94' 0. Date of Purchase ..................... Name of Former Owner ............... ...................... }. Zone or use district in which premises are situated ...................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: ..[�Q,.•.,,,,.,,,,, 3. Will lot be regraded ... ......... Will excess fill be removed from ••..- :. Names of Owner of premises wl��1A►71�4�:«.l►?5........, premises: YES Address P� No. Name of Architects[eZCJ•.�nn ........... U� .SJ' au• ......... ...... Address kt�» , :t:h�l 4tu.. Phone No.�`.{:1�5 Name of Contractor �............ Address 41f� �Q �bZOS. ��.s.Phone No.b3.�. �.• 5. is this property within 300 feet of a tidal wetland? * YES .�..... �I�S fit° w �.3 1 o *IF YES, SOUIIIOID TOWN TR ISRES PM41T MAY BE W!,Qn M. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions rum property lines. Give street and block nunber or description according to deed, and show street names and indicate tether interior or corner lot. SCS S-I �F C6NSTRucZ-io�1 �v m E/JT4& %l'IE o N Y( SS UNIT OF ... - .................beim; duly sworn, deposes and says that he is 1 ame of imlividual signing c ►tract y t1e applicant g g ) eve ruaned, isthe .. ..a�ne.r.................................................................................... (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ilicati0n; that all statements contained in this application are true to the best of his knowledge and belief.; and t the work will be perfonred in the manner set forth in the application filed therewith. -)rn to before me this . ... ..day of ........ Zotary Public ELAINE f CKF..R NOTARY PUBLIC. State of New York (Signature of Applicant)- No.52.47435917,Suiiolk County Commission Expires February 28, 1 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . .;�O..� . . . . Examined.................. 20.... MAIL TO: . . . . . . . . . Approved... ..�S� Qom? Permit No. �P J I . Disapproved a/c .................................. .... ......... . ........ Building Inspector) LICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 2O. . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the TAiilding Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to schedule. . b. , Plot plan showing location of lot and of.buildings on premises, relationship to adjoining premises or public streets or areas, and giving,a detailed description of layout of property must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MATE to the Building Department for the issuance of a Building Permit pursuant to the Buildi Z Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, mudding came, ixu;i ,g Calc, arR regulations, and to admit authorized inspectors on premises and in building fo necessa ns ions. .. . ...... . .. . ............... (Signature of applicant, or name, if a corporation) ................................................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, 'engineer, general contractor, electrician, plumber or builder .............................t.'....f.I...................................................................................... Name of owner of premises ... it4taTh Ra 0Ln S................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer) Builders License No. J r?J?C16.J-+1 T......... Plumbers License No. .33I.-7-.j?........ Electricians License No. .....7i.2JE........ Other Trade's License No. .................... 1. Location of land on which proposed work will be done..........................:..................................... . .\Q.................�1Q4 s4?n;S ..Lar,c(:ir)c1.4... a 4 ?� �4 ....11A� ......................... House Number Street Hamlet Canty Tax Map No. 1000 Section .... J.�-)....... Block ....Lj.......... Int .. -.. ' YY'marc,h'�45.19 C, Subdivision ...:3-M-� Rut[1[ 9.......... Filed Map No. E!l€.na,.S.aSv Int .. . ........... (Name) 2. State existing use and occupanxy of premises and intended use and occupancy of proposed construction: a. E�cisting use and occupancy ............................................................................. b. Intended use and occupancy ....................................... nel)a. r ............ VemovaI ... Demolition _... .._ Other Work . ..,.-._-J.. .......... (Description) 4. Estimated Cost .. 5�1 000 • fee .................................. "- (to be paid on filing this application) 5. If dwelling, nnrber of dwelling units ....... number of dwelling units on each floor ................ l If garage, nudger of cars C2).C.gy;S.-........ G. If business, commercial or mixed occupancy, specify nature and extent of each type of use,,.,,.. . ............ 7. Dimensions of existing structures, if any: Front' . ....... Rear -....-- ... Depth height Nuriber of Stories ......, Dimensions of sane structure with alterations or additions: Front ............... Depth Rear ............... p ......•.•........... Height .. Number of Stories .: ............. 3. Dimensions of entire new construction: FrontslOa �?4...... Rear . x .10}':(4.r. Depth f..Y,Q�01. fie ig}tt }y- �L�,,n-givrgi �( ,.( Nrni)er of Stories .... �`............... �0 r�'dq�, 1- Size of lot: Front r .......... Rear .}. � ............ Depth .. .LR 4.......... 10. ixaCe of Purchase ..................... L1.'me of Former Owner 11. Zone or use district in which premises are situated ......................................................... ............... 12. Does proposed construction violate any zoning law, ordinance or regulation: .................. 13. Will lot be regraded ...ls~l,....- -•-.. Will excess fill be removed from premises: YES 14. Nares of Owner of premises U)AiP'Lr0 :4:1h65 ........ Address {�� ...................... Phone No. ........ Nene of Ardritect�lleenR•.0 �11f1 ................. Address Q 3 fQj1h�i fr�}Q 7 /1 SX-t _ D._ Phone No. Nome of Contractor COI1lk'F04 9A. N y• Itct(o� �t ....}1... .... Address 1.T•7�S..f�yQ W1�QAS..!g VC.r.Phone No.10.3 �. 5. is Utis property within 300 feet of a tidal wetland? * YCS , ..... R1�lwS µow 17.3 l(7 *IF YES, SLIM D MV TR MM-3 PM41T MAY BE IMgn M. PA ......... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions -ram property lines. Give street and block nLuber or description according to deed, and show street names and indicate Aiether interior or corner lot. SC:—� S-I �SY= C6YUSTRU�Z-1or�J G��-u�r�-�E.N4'S UVIE Of. is. YI SS CUN1Y Of ................beiry; duly sworn, deposes and says that he is the appl.icanrL lore of individual signing c tract) rove Tvined, e is Che .. .?Y\................................ ..ett. _. ................................................. Contractor, agent, corporate officer., c.)) F said owner or owners, and is duly audiorized to perform or have performed the said work and to make and file this ,Vl.ication; that all statements contained in this application are true to the best of his knowledge and belief; and tat the work will be per.Conned in Lite manner set forth in the application filed therewith. corn Lo iRfore rre this -."S.11 ........day of W14 ........:20W.... Notary Public ELAINE �.CItFR ""' •- , NOTARY PLIBCIC. State of New York (Signature of Applicant) No. 52-4743590, Su!iuik Cocnty Cummissiao Expires February 28,.19 Tr2S HoA- EL IO U O- -3, SO4 r L.0pf,.., 3'- 9 500,Nn < GRrti(s� �m 9'- S U41-10 - sANo. Gpa-iffL SS, / 4 rn rn \ / � G ;U- . r i O o(t- Go q w IA At 101Q � 1 7. 1t �` r N Q o n O ' C 7 3s- ' t cnr O � O u I ! O FIJI Z o ST c P 1 v' � r` p n � D L C so O O O �l ck a c 6' � 5 0' �.. ZS • 15� 30" W C9, � w Lo p� AREA: 48 121 = 1. 1 ACRE UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED.AND ON HIS BEHALF TO THE TITLE COMPANY.GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON AND TO THE ASSIGNEES OF THE LENDING INSTITUTION.CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY THE OFFSETS OR DIMENSIONS SHOWN HEREON.FROM THE PROPERTY LINES TO THE STRUCTURES.ARE FOR A SPECIFIC PURPOSE AND USE.THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES.ADDITIONAL STRUCTURES.OR ANY OTHER IMPROVEMENT PUBLIC WATER AVAILABLE ❑: WELI WATER ❑: INDIVIDUAL SANITARY SYSTEM ❑: SANITARY SEWER COLLECTION SYSTEM AVAILABLE ❑ ELEVATIONS TO -.— DATUM: OFFSETS TO FOUNDATION'. UTILITY EASEMENTS IF ANY NOT SHOWN. U.S.STD.MEASURE SURVEY OF: __L 0_T S _ I _12- __-_ - _ CERTIFIED TO: MAPOF: JACKSON' S LANDING FILED 28 MARCH 1969 FILE NO : 5280 S.C. TAX MAP _ 1000_-- 113 - 4- - 31 4 SITUATED AT: _ - MATT 1 T-UC- K - ---- - - TOWN OF SOUTHOLD . SUFFOLK CO., N.Y. ------ - ------- © COPYRIGHT 1999 BY : PHILIPP A. HATTEMER JR. LAND SURVEYOR — EAST PATCHOGUE , N.Y. 11772 TEL . 286 — 2112 FAX . 286 — 3808lot 1is 30' 95326 JUNE 99 N SCALE __ FILE NO __ DATE /IEviSrw : �`f/SS N.vs.LICNO. 4741 -rrzS-r Ht&-rt EL 10 U p� 0 �e rA O�. a. co °° �� a° Cr CD 3 � � nr` 0 2 •� N R c L fill ^D Oo ►6 �� zs.7 So G, L O I r O 1 , 7.9 57-9 i O �! ¢ \ _ O c z to z r ( r �/ ++ D O I 9 £/ � 1 N I 13 0 ' •� � ° � ' 1 r v.cn CA O fh co Cz ' � ZZ-3 • y f S Q � I � O Z w F to O � L OO " I 1-1 o ..ncl cl S Z^ � Q ��' -� L ' moi\ ► - 0 c- s• CJ7 .. ISO) "It) a 2 • so solo * �€ a a 5 �{ ^ V AREA: 48,121° • 1. 1 ACRE UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW .-.--•^ ' COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON AND TO THE ASSIGNEES OF THE LENDING INSTITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY THE OFFSETS OR DIMENSIONS SHOWN HEREON,FROM THE PROPERTY LINES TO THE STRUCTURES,ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES,ADDITIONAL STRUCTURES.OR ANY OTHER IMPROVEMENT PUBLIC WATER AVAILABLE ❑; WELL WATER ❑; INDIVIDUAL SANITARY SYSTEM ❑; SANITARY SEWER COLLECTION SYSTEM AVAILABLE ❑ ELEVATIONS TO DATUM: OFFSETS TO FOUNDATION: UTILITY EASEMENTS IF ANY NOT SHOWN: U.S.STD.MEASURE CHICAGO TITLE SURVEY OF: L�_._$ J + 2 _- _- CERTIFIED TO: --MAP OF: JACKSON' S LANDING INSURANCE--COMPANYII FILED 28 MARCH_ 1969FILE N0_ -5280- - -_- WILLIAM A.-MALL I NS- S.C. . MAILINS-S.C. TAX MAP: __1000 -- 113 -- -4-' - 3i4 - ----- -- -_- SITUATED AT: - MA T T I T U C K TOWN OF SOUTMOLD_ SUFFOLK CO , N.Y. © COPYRIGHT 1999 BY : PHILIPP A. HATTEMER JR. LANG SURVEYOR - EAST PATCHOGUE , N.Y. 11772 ��'���� � TEL . 286 - 2112 FAX . 286 - 3808 " 26 JUNE 99 r SCALE.-I _ s-3_�- - FILE NO 9 s '- - DATE - -- r N.YS.IIC NO. 47412 F6L'ouf a7-i0/U z6c. $/z(-/ev REVI $dn �i m0 Ito CDV b0 (A OD 041 Z °, N n nwn 2 Oc A r 0 Z 50.5' D O N 24.1' n ° N N Om M` a N OkNcw�A y n 4" I C 0 7. 0 o W O i z' vi 0 nl 0 m M �b rn Y\ n 0 MAIIV W p 41yZ� w„AT ER LINE � 0 ff.-z: - — 51.5' >-- a Z�o-o uOvm N D � a vZ a U !0 1 b Z O w G) O m o i rn o c a 198. 89. 0 50 O 25 . 181 -5D S W w o' AREA: 48,121 • 1. 1 ACRE UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 SUBDIVISION 2 OF THE NEW YORK STATE EDUCATION LAW COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY CERTIFICATIONS INDICATED HEREON SHAT L RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON AND TO THE ASSIGNEES OF THE LENDING INSTITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS EASEMENTS AND OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY THE OFFSETS OR DIMENSIONS SHOWN HEREON.FROM THE PROPERTY ,INES TO THE STRUCTURES.ARE FOR A SPECIFIC PURPOSE AND USE.THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES ADDITIONAL STRUCTURES.OR ANY OTHER IMPROVEMENT PUBIICWATFRAVAIIABIF ❑, WFI: WATFR ❑. NDIVIDUAL SANITARY SYSTEM ❑. SANI'ARY SEWER COLLECTION SYSTEM AVAILABLE ❑ ELEVATIONS TO DATUM OFF SETS TU I OUNDAT ION_ UTILITY EASEMENTS IF ANY NOT SHOWN'. U.S.STD.MEASURE SURVEY OF: LOTS 12 2 CERTIFIED TO: CHICAGO TITLE MAPOF: JACKSON ' S LANDING INSURANCE COMPANY, FILED 28 MARCH 1969 FILE NO : 5280 WILLIAM A. MALLINS S.C. TAX MAP: 1000 - 113 - 4- - 3, 4- SITUATED AT: MATTITUCK TOWN OF SO UT HOLD , SUFFOLK CO., N.Y. © COPYRIGHT 1999 8Y : PHILIPP A. HATTEMER JR. LAND SURVEYOR - EAST PATCHOGUE , N.Y. 11772 TEL . 286 - 2112 FAX . 286 - 3808 FINAL : 8 - 25 - 2001 SCALE 1 " • 30' FILE No 9 5 7 �aTF 26 JUNE 99 - --- NY' T'C NO, 47412 , 4 1 PLUMBER,CER77FICATION ONLEADCONTENTNEFORE CERTrFifCATiOfOCCtAPANCY I � iOLDERI`IEEDpUM91TER aup wmI 1 V=EDP,/fOOF f%LEAD. ' . Tom„ '1- 1fc0PPer1ubinpblNed for webr dbtrbuNg eyetem;PIPInO Mef be I. mbPnKaLen Ar, Cl ' PRO=ANTi;OAIO AND/OR DENWI AS To FM PD2.l TIIFRMAL UIDCK PREVEIVTINO ,� DE zee o9' t It 0. 0 / �� . µ b\ �� - pp u , ,* rf a,rr A, Z �OG15.T�0 I If iWANERLRIESNEEO� 0 �dW \ 4' DSTINBSEFDRECOVERI ,' 4� i I'Y*rt50 dl F1.7 ,� r. A I� lF�v-•��daa) I ( `' -C - ��*t 1Im y,�.,, si 6) 16'+ r0t''0gO P� ., 5 0 4 1' LEALNIFib Ycnl "- tai - 1,gA IIIftLAS I -- - .7� y� }� I �^ I �n"�y..+'W,•, J .' �. ''' *,,', \ �/� \ `� -_ -� - %v I i V I air `"s. F I 5 ,- SIT r-- -� � \ �, 2G'-b' � 6 o ,.:o � � �-^ o&X 4' 06EY` + I, , • '' � �K,,=' ., \ � \ Im,-a- I�-o• 1 I ur~Gl�wupaaL I, OVf�IGC-T Io �ti 6i � 'N��ITs;e v� "`F�k I T .,- \�\�. T� .\ w 2G�'t✓R .. .N I I / ��Lb 4, f-�Rfi-F �Vrk7lol- / � 8 5 �uT}} ✓J�VA?IaFJ I � • /v v - � pd� pL, K ' Iq o • � � � � _ fi``'t � FED- I ,. u A,J^��'.y" �. -_ _- .. _ ' ��• '� 'I / �a � � �- P Izf`,I-� - S • a I � FIs-d' -0 1f2 0 � o, w na-Is yy 3 't I1I'o� fi 2 . \ . . . ........ .. MMIIEDAS NOTED � I DAlxB.F.S al�SSI z'' I ' � � Burµ FEE: 515. •G�f'Prfr/ , �� `n• __' �-.._ Wk7eR- 8L 2,0 NOT! BUILDING DEPARTMENT AT P 5o° cry' + —'�— _ � 7eE-1802 9 AM TO 4 PM FOO THE W Ioo.00 - /��TEs 1. LLOWING FOUNDATION -TIONS: ) Fl 53' 115.00 ' S 'O.Ec, t FOUNDATION - TWO REQUIRED � ANo 5»TROI-p To�'N �a>'`t�o FOR POURED CONCRETE ? „N- - pr' -I-rzus�E�s Rrfa S.c.p. Fb S, 9c-GaM i7s 2 ROUGH - FRAMING & PLUMBING p.p�r-noNP.�. 'S[Te 11,36DI A-l7oN FtNQ Z INSULATION ' 75 �.AN17WPk-O L.IMIt OP ,cTkn nl S, 4. FINAL - CONSTRUCTION MUST TIDAL WE-(11.FFlIJv' AS 1�'�5�` BE COMPLETE CONSTRUCTION S e </y ltd DELI IEATECO C3V LOPM �` b goy{MAI. . 6-50-91 ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~' STATE CONSTRUCTION & ENERGY ' CODES. NOT RESPONSIBLE FOR 9allo # Q DESIGN OR CONSTRUCTION ERRORS jy OCCUPANCY OR . ��T `�I-1•K- op 'M�'f'�" I � K- 11l� II��r� LAWfUL. .,_�. I t�, - USE IS UN spµ° ¢ W� eL•u WITHOUT CERTIFICATE �E OF OCCUPANCY FLOOD 5 rtONTHOLD' 'IOVIIN COD4 44 IOO FLCOO SSU.ParrR I, SITZ: ri- 14F-01-M4-ric,4 Is �,X%o oµ da)Pme,? PI2r-PAI�en 0 6oµToole-S �, - p+ILIPP �• 4AT-raMA*, TF-, 1,A 40 suKv� >bP FAQ PATI FoG�� , rl �, - Q -PQ PP C7 GSI G10u S � � �5 (o1AL DuFi � Pl DO NOT PROCEED WON FRAMING UNTIL RJAW plDEIINNIBNUwe OF FOUNDATION LOBATION ' HAS BEEN APPROVEIL C�RTIflCA71011 aF 8AS61��Nti 1 : lL b f-L&VA'(lOrf IS 989.L11Rbf] w� I I FT, ( I. I Aoa-E ) -•� 2, 5VG7�-f PRAM I ses >sf't'�DtIZ�+ A5 �Pfs I � Z � ?fk� MPI' by MFK41,1- 19GIps4 FILE. 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G.�aE-L'. -'L. 6 I-- SPvK PA�.'P?Yts I fd1-' 6} elR G.u[�t�/•e%1=.6 j, I ' 11 wt wlnr aui+ axrlr.'J>; ,(tYG•) ovulz. rr iyl lam. v. c+ - wr.�z NA r. gym,kms, r 6 �1 N 15 HI 8.ASF,M 611 11 I'LDO W- 1 GV rdP-- alS'Jo CiPP�fY-� � Rf='�i•E!� - ' . 9 �LA13 514ALL 66 5&1Cl i ro, ro°xv"w-�'i�M- � �- w�rwtbl•r-�s , —. E Lf mr to N I I o R G R F 1 fdR u rip'? rwr$a sari " .OI - - {----- -- - --- _ - " _ - -- - -- _ Pa ' Rml ZJI u wllx ' �n ' P{rif>a2erNtr+, _ me .2 1- - - ' ul-ls o� Ir i! q E+.g ql� l l - - _ - . Pp�viou4t,^ tesr,ttlt i Fa2I?�IQ rP. Frlrt ,P - FRAMING Nfl i." All Lumber ill be ridMk µamped'Doo' Fi[.I awN 9lnroturs grade {may I rte. r Stide,Blri4Il sgde'rmI ' .�i No. 2 or:bgN+t, �l2Vol ,q);'ryfn. Q A�. x L 0 , the to . � ' !!$ la:'llnd, , if the Total.,TI x"Ir lu:Aemne gtr l o str MriieI hhe — !ar;! !tiw+goea '' g t ,P on Naling is tare (D) on -the WI 4'^N!o.: ed .. �;' 2. Ali tobe;AP74,raad.ex s1 Ig"ntin. thickaen. deaf ' for ,thabaiidl anvtf A t ". w SP oPo casabas vlih tldi!6 - � vY cadR, �14W"ai e� Vie-: t ;dltY A► ?alt i. All sutipoaring tabs APA,rat+kl�C�9�C.aapostal1 ,y-min. thidtaps: � � ty `.' e p 'ltf bmLwe}'M. I Att'edges of plywood to I i's4t tl6ewiM�bi?olilne. Glue ud',Heil TWENiAA( i 1�y Iny'vloek'�s g':!dthe• Her un(11 (ht plywoodsubtiooringrtbboor plate. - � � � � � � ARFv► D-VALUE � q �x X11�� - � lam, cotlttlie Uvnr to j'. AT1 USED n, .:d IE e A. ROOF/CEILING {A' .v t r .y� s"it „: 4. All Neidea 6' G sad over sludt bi mppottad with double uprights 9' 82�f _ '- oy, 0 and over with triple uprights; All lyedal Ahab be a minimum of "" "" �y M9m deo. Da nsi(aefda bin tile,dnvvieyls , ( P B. NET ,NAL +.�. . a4el 2}2x8 or w shown oh dra LS 2'Ir q5 r tntlsii pgsd uigelllet 'Ah their arrab other. . ., A teas per d.., S. N.Y.S. code or as,noted u :A" IDI minimum. ProviSolid blocking provided Ow aft Johns and door ded 2�" epees _ _ �C. GLAZING for dr atwlditnl hi''rcob: .., , „ , ' - _1110dou Nfrdor 7)43 'a P 6. Double flaming around`pN opeatngs(skylights, etdus, etc.) or ae noted Skylights lu,A4I N1W11t 1Ai V�tffipriU`�a neinrmWn o+p1Y of 2 lona - on drawings, Ot. Ft0oR5 ;eglWin fa '; ' °+ 7. Double up Saming under all pools and parallel partitions or as now TjsCcdbt 4 �I _ anddawwcr* W 41 to`plotinU any on drawings. D2. WellBASUPorivie:CAR HALL$ Well Parinater' g. All flesh wood connections Eapoian #hours Onda FeiE # ot ions 'shelf be Retened with rated. Nell-U-Yaiw ,� �, " - „•,�". ' "` 1 ,' jtiidjrateaonthe lint, Wta iheeg`, � metal connectors, . ' Depth of Well U-Value - - p tha��faRPm^edbwFetdi4Poun galor.Gridre Inches ' t� I tion liult[ b t t to theattediti d tTw Mehl". 9. Nailing schedule shell be as per the N.F.S. building code as a 00 minimum All 2x6 studs shell receive 5-i0d mills at sill and plate. AN D3. SLAB INSULATION : Ppu' MFoti d ' ' exteriornulsahlhbagsvaaired. , ; Slab Pariaetar ir , to - 4✓ waA MriNU {Ik awrpt pe Itis agn fne}r r k Insutat10 It—Val E i6r4La141e t4Is M i fOit1Ork waN ttre`berat 61en4y b Feet 4 10.Plywood sheathing'to.be aniled with 8d (r}4' O.C. exterior edges,and E. INFILTRATION CDNiitol 6d(a} l2"O.C. hntemadiale. Conditioned Ft.- I ttL (1q �I�r Wall until' Allioofr rafters sutra x hla�etueted f it j0 coat of PortndNlptl'V 11. All roof ra@ be altic�red to the plate and stud with galvanized F. SM FACING GLAZING al��' of hcF'ep brlpi�eM4 O ape, t4t to be ibt ark grgtMdrauloq rllerl architect ff grqurtdcntigr CialdiN type conoeeton by "fBCO" at,appmved equal. Fat timber i , Ipile tbundationa, provide hurricane,clips at all perimeter joist to girder South 'Glass/1 olal Glass PircenE s �P connections. Conditioned F'lodrlAreaee Sq. 1, sq. Ft. 12. All pre-engineered lumber shell b wood-l- , p ng i Basins and LVL products or coal. Afl jobs, ghdero and headers TOTAL TNERNAL RATING 1'2Qfo shag have bearing stif�ners ^lostalled as per manufacturers recommendations. Web stithn«s shell be required at all load and bearing points at a'miahmum. A single 1314"LYL AIM joists dull be required at floor perimeters: liartdfng, storage, and erection of tit- componen shat be as per fearmficmrers recommendations. 13. All multiple LVL products'to Lave 2 rows of W` DIA. Oslvenlzed machine bolts at 12"O.C. Lj r w IacE en ' ern and, ANso iwQ'rlci sag[udrug'dadsil r tti ti P . m t ng i PF�'ol'ttNx�ib(llhaN to,�eugcriieme�xtaofA�I 31gyidp�iZ3Ttlljfht d�herkCl�b 01nRRNta,latealo" {rr - # 4 ,i, ,k $ steno rUoued as to meet the x #r of 30", 41. 111..'' iJ 3 All +nketat) ga'mtlgrle{ ",wilt be'eiijiosed to wesNitt (footiPi� l �� Vet17 l4hU �aoP 4°4VmJ7 711V v PCO _ y 4► �i dnd�WAIb�'rholl bo am elatrerood. -� �-- 4,- No ooi>i a additrvei will he Qel 4ted except as may be necessary fbr Its�1p4rod a eranshos hal r 5 lteiet[oetpp�b+ea be doll of intermediate grade claw billet I' iaael to rflLi dtC at ASTM ACi19-GA4G (yieid I6rgogth 4o.Gdo PI Y b Weldaxi vane pisah plisll uonformtir,,�sl+ec A-ig5 and IhaU have 1'he opa{uaturu l,�de a11� Alatb�y.S.i. r ' j ^°I . ., a oast dowels, Pecketn kaYs -- i� ° at - trt 11 � �Gitnm0. ow, hr a�G n L r,a � ' •q„� tryllle} tet;,ine(eU�� g sad id ltp3 W si�ve8 n �. aptlA#1'af1'lll an X10 7aLA1,7enoo With loon equare- P�"� LA�IJot�Y (�M• �,� I Gr#� I� r�� P/i — Pail f-DRAI N � 9 labs, �shalt be Placed p,r woU comPscsad roes 1111 .98%6 { J bompaetad ' I I I JAI WPB D.ui• �J + '9 I ,1 AU aced-V At�I[bonforge�tatplf caWbha for sten FineddCti+?n. 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