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HomeMy WebLinkAbout27539-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28867 Date: 09/13/02 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2895 EUGENES RD CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 97 Block 3 Lot 20 .1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 12, 2001 pursuant to which Building Permit No. 27539-Z dated AUGUST 9, 2001 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 COVERED FRONT PORCH AND ATTACHED THREE CAR GARAGE WITH NON-HABITABLE ATTIC AS APPLIED FOR. The certificate is issued to THOMAS D & SHARON W GOELLER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-00-0111 07/25/02 ELECTRICAL CERTIFICATE NO. 2565 07/18/02 PLUMBERS CERTIFICATION DATED 08/22/02 MULCO PLUMBING & HEATING ut rize ` 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. 27539 Z Date AUGUST 9, 2001 Permission is hereby granted to: THOMAS D GOELLER 4725 NEW SUFFOLK AVENUE MATTITUCK,NY 11952 for NEW CONSTRUCTION OF A FOUR BED. SIN. FAMILY DWELLING W/ 3 CAR GAR WITH NON-HABITABLE ATTIC ABOVE AS APPLIED FOR W/ TRUSTEE ' S & DEC INC. FLD PERMI at premises located at 2895 EUGENES RD CUTCHOGUE County Tax Map No. 473889 Section 097 Block 0003 Lot No. 020 . 001 pursuant to application dated MARCH 12 , 2001 and approved by the Building Inspector. Fee $ 1, 042 . 20 Authorized Signature COPY Rev. 2/19/98 �i 4_l Form No.6 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT ( 2 a TOWN HALL 765-1802 1 APPLICATION FOR CERTIFICATE OF PANCY 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 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. Copy of Certificate of Occupancy-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential$15.00, Commercial $15.00 Date. S/2 2/f� Z. New Construction: VI /1Old or Pre-existing Building: (check one). Location of Property: Zb '►S Cite_PS C Gff,CP House No. Street � ^, /�/A H� et Owner or Owners of Property: OmQs -' j Oct V, i Suffolk County Tax Map No 1000, Section oa '7 Block 03 Lot 2.o, Subdivision �1 Filed Map. Lot: Permit No. Z _15 3q Z Date of Permit. V g 1 Applicant: I�¢�YYIQS D, C7�C�Q� Health Dept. Approval: 7 2-5102, Underwriters Approval: -71t g IL-) z Planning Board Approvals h/CA . Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ ;25 0,0 j,-if 3 Applicant Signature Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street • Center Moriches,New York 11934 • Tel: 631-878-3500 • Fax: 631-878-3764 Application No: 2565 Date:7/18/02 Issued to: Goehler Address:2895 Eugenes Rd Village : Cutchogue Zip: 11935 Introduced By: ZAR Electric License#:4808-E was examined and found to be in compliance with the National Electrical Code Aiico 1st Floor l] Fledder1tia1IF] Rod W.Garage Basemen!] 2nd floor 0 ComTercid Hot Ttb W Defects 75 t7671 eceptacles Fixtures G.F.I. Microwave Whirlpool 5 59 9 1 Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon Range/Amps Monoxide 1-Exhaust Bath 1 20A 30A 40A 2 Furnace Oil Gas Circulators Smoke Bell Detectors Transformers 1 1 yes 1 1 3 1 6 Other Equipment Meter Amps Phase Motors 1-Range Hood 1 100A UG 1 -Air Handlers 30A Compressors ut,Res / This certificate must not be altered in any manner �p�g�FFO(K�o Town Hall, 53095 blain Road Fax(516)765-1823 P. 0. Box 1179 p 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: �; o�Z ©.Z Building Permit No. o� .53 9z Owner: OP-M2s. e-((f4Z-- (please print) Plumber: (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1$ lead. (Plumbers Signature) Sworn to before me this �— day of Notary Public,Public, County NargffmMM WMM Toy CUnEbLec STATE OF NEW YORK ) ss: COUNTY OF SUFFOLK ) being duly sworn, deposes and says: That d�po�nent is ova the age of 18 years and resides at G 12-, 5 �� � r n� r rl°h �- 7 That on the `7`day of �� / 2000 deponent architect/engineer, licensed by the State of New York, hereby states that s/he accepts full responsibility for the accompanying plans compliance with the New York State Fire Prevention and Building Code (9 NYCRR); said plans pertain to property located at SCTM# 1000- 09? 03 2e street address Architect/Engineer Sworn to befor fine this day of_2 0 2000. Notary Public ERS.SANTO NOTARY No. 1f 90-4916018 Now York C!ualilisd in NayrRK,Cou7ty CooimigioExpirm !/l cc: Applicant New York State Department of Environmental Conservation _ Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (516)444-0365 FAX: (516)444-0360 - John P.Cahill Commissioner Letter of Non-Jurisdiction - Freshwater Wetlands Act Thomas and Sharon Goeller June 29, 2000 4725 New Suffolk Avenue Mattituck, NY 11952 Re: Goeller Property, Eugene's Road, Cutchogue SCTM# 1000-097-03-20.1 Application #1-4738-02685/00001 Dear Mr. and Mrs. Goeller: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: Your proposed project to construct a single family dwelling, septic system and driveway on Eugene's Road in Cutchogue, NY, SCTM# 1000-097-03-20.1 as shown on the survey prepared by Stanley J. Isaksen, Jr. L.S., dated 3/21/00, last revised 5/12/00, is more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required under the Freshwater Wetlands Act (Article 24 of the Environmental Conservation Law). Be advised, that all construction, clearing, and/or ground disturbance must remain more than 100 feet from the freshwater wetland boundary. In addition, any additional work, or modification to the project as described, may require authorization by this Department. Please contact this office if such are contemplated. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Sincerely, Mark C. Carrara Permit Administrator cc: BOH File `^UFfO( Albert J. Krupski, President �Q$ �"C Town Hall James King,Vice-President �� OGy 53095 Route 25 Henry Smith o P.O. Box 1179 Artie Foster W x Southold, New York 11971-0959 Ken Poliwoda 1p Telephone (631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 19 , 2000 Mrs . Sharon Goeller 4725 New Suffolk Ave. Mattituck, NY 11952 RE: 2895 Eugenes Road, Cutchogue SCTM#97-3-20 . 1 Dear Mrs . Goeller: The Southold Town Board of Trustees reviewed the survey dated March 21, 2000 and determined that the construction of a single-family dwelling, garage, and septic to be out of the Wetland jurisdiction, under Chapter 97 of the Town Wetland Code. However, any activity within 75 ' of the Wetland line would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call . Sincerely, opeI14. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms Albert J. Krupski, President �> DN Town Hall James King,Vice-President OG 53095 Route 25 Henry Smith P.O. Box 1179 Artie Foster o < Southold,New York 11971-0959 Ken Poliwoda w Z O Telephone (631) 765-1892 ?'��� � Fax(631) 765-1366 BOARD OF TOWN TRUSTEES - TOWN OF SOUTHOLD July 10, 2001 Mrs. Sharon Goeller 4725 New Suffolk Ave. Mattituck, NY 11952 RE: 2895 Eugenes Rd., Cutchogue SCTM#97-3-20.1 Dear Mrs. Goeller: The Southold Town Board of Trustees reviewed the survey dated March 21, 2000 and last revised June 19, 2000 and determined the construction of a single-family dwelling, garage, and septic, to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code. However, any activity within 100' of the Wetland line would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Albert J. Krupski, Jr. Y President, Board of Trustees AJK:hns APPLICATION a PAGE 1 of 4 -- TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This fortn is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sit n): 1. No work may start until a permit is issued. 2. The permit may be revoked if any fake statements arc 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 i HIS APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE,TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) zA� DATE e SECTION 2• PROPOSED DEVELOPMENT (To be compacted by APPLICANTI NAME ADDRESS TE] 9 ,f t APPLICANT To `-n /1 d e 1-4 e /Z (f 7 2 S /VC w S r rFe f K f4✓e. w h-ff_t I`^c k BUILDER 5e-f+ Le JrL wS 7 wer t44 5 I P" 02 ;Zee- �i$�0 ENGINEER L A W R er✓G I f{ j L L PROJECT LOCATION: • To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpfully. - F t4 q e'/'e$ t� c Lr( C14 d ur9 Hee- /4-'--- LO I 97 , 'I-NX T t-P Na /Pao- d q 7- 2 .3 -244 ( � Rr7SS �RvM be- be AR. FDP(93) 3s / 22 9 BUILDING PERMIT REVIEW CHECKLIST DATE REVIEWED: /x/01 APPLICANT NAME: DATE SUBMITTED: 3 //1/01 /Y� t SCTM#--- DISTRICT: 1,000 SECTION: 1,-? BLOCK: 3 LOT: 26, / STREET: 2.995 1 ,c �o�/ CITy. ���,e�� SUBDIV. NAME: PROJECT DESCRIPTION: ADD ALT ACC OR /D ARCHITECT/ ENGINEER: T�T,t„� r"5'/`A QTc FAST TRAC : YES RNO SINGLE& SEPARATE CERTIFICATION-REQUIRED: YES OR NO NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN,1997 100-25.Merger.(A nonconforming at any time after 7/1, ZONING: PERMIT ESTIMATE AMOUNT:_$ /( .00 PERMIT USE: EXISTING: 4cet..t 1 INTENDED: Spio ZONING DISTRICT: R4 R80 AC CONFORMIN : YE oR NO REQUIRED LOT SIZE: SOK SQFT. WHERE ACTUAL LOT SIZE FROM?TAx cARD �..rur, � a REQUIRED ACTUAL LOT SIZE 1S : / p 060 SQFT REQUIRED REQUIRED T FOUND:FRONT:II PROPOSED?¢/ ' SIDE YD: .20 '/¢�' PROPOSED: St3 '' $�' REAR: 'PROPOSED 2ND FOUND:FRONT:_' ACTUAL: SIDE YD: / LOT COVERAGE: ALLOWED: o o CTUAL: '/ ' REAR: ACTUAL: �/o EXIST G: sf_/o NEW: sf % TOTAL: sf % CORNER? YES o N WAT ER FRONT? (R:&�Q�: DESCRIPTION:FLOOD COMPL ZONE: rRE FIRM s/1s/so L : /6¢ FLOOD.ZONE. AGENCY PERMITS REQUIRED FOR REVIEW TOWN SPETIC PERMIT: INCLUDE APPLICATION -/ or NO ��/oG /''.e,,v A/ SUFFOLK COUNTY HEALTH DEPT: r NO, (BED#).50& DTE:,/S / Cly PERMIT#:R10 ap—g11/ RE NEW YORK STATE,DEC: PRE-DEC 9/ s YE P NO 61,2m UIRED: SOUTHOLD TOWN TRUSTEES: YE r �',T TOWN ZONING BOARD APPROVAL: S o TOWN PLAN. BOARD APPROVAL: YES o N TOWN HISTORICAL PRE (SPLIA): YES o O NYS ENERGY: YES R NO ✓ HT: R�� EGRESS: VENT: LIGHT: j BUILDING PE S OPEN/EXPIRE HAVE PRE CO'S : Y OR N BP -Z/C/0 Z_ NOTES: AI u t r� S I11cw r c / FEE STRUCTURE: FOUNDATION: SF ° '0I'0I9. Si a --.�--Ao�.�1b.u.�7- FIRST FLOOR : 20M SF SECOND FLR : SF ILIIT OTHER TOTAL TOTAL: FEE FEE FEE I OT( SF)- ¢S36 SF X$..26 =$ X67.A*$ 2.< _ 7,=T3 ' 765.1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �� ®� t zi- D A&') /40/ INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FO DATION IST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: DATE D 3l INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [� ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION FRAMING [ ] FINAL [ FIREPLACE & CHIMNEY /�! ,>14m ARK c aa.► � r �a /st r -Sloe /L+f�cJ �+ .JJE�-' Ta 40sG 1.6;C, / �J 7,-419 /6te5 &++ .e evi cei , e LJ�/0,1tCr per. . DATE ss��z— INSPECTOR GtiJ?� c oe®rs 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ v]/OUGH PLB . [ ] F NDATIO D [ ] INSULATION [ F MING [ ] FINAL [ FIREPI A,CE A CHIMNEY � '� 1 R MARKS: - -,Ly� o-JDATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] R GH PLBG. [ ] FOUNDATION 2ND INSULATION [ ] F NG [ ] FINAL [ FIREPLACE A CHIMNEY/6Z--' 3Ae REMARKS: p� Ite DATE5��� INSPECTO 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO PLBG. [ ] FOUNDATION 2ND [ INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY / r REMARKS: `L af. DATE INSPECTOR �"'� M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU TION [ ] FRAMING [ INAL [ ] FIREPMCE S CHIMNEY l REMARKS: �-�' 3 3 _ J 1 L�✓L•n DATE 1/ INSPECTOR c�-7j3 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: z2 DATE 9110 INSPECTOR -4 FIELD INSPECTION REP OR DATE _-==.,_ _--------------- COMMENTS -- --------------- FOIINDATION ( 1 ) 4su FOUNDATION y' - =-=(2ND) __ __ __ 6/J(6 as..c4ce � �/ad w d rO.vYCO��ietrlG --._ ROUGH FRAME O eon Ni ,� PLUMBING /6 oC /o 42 y0 !a rs IA3ULATION PER N. Y. 1 STATE ENERGY CODE i r FINAL I A _ _— Of Og — o ADDITI C S: Z � OZ �frCr[uYi9 .04l.4 W 4� H � C BOARD OFTH FORM N0. I 3 SETS OF NS _l . TOWN OF SOUTHOLD " " " ' BUILDING DEPARTMENT SURVEY . . . . . . . . . . . . . . . . . . . CHECK TOWN HALL . . . . . . . . . . . . . . . . . . . . . . SEPTIC FORM SOUTHOLD. N.Y. 11971 TEL: 765-1802 NOTIFY: -:5h rt,ot claaae.d— Q CALL2q S-- l g go Examined...... . . . . . . . . . . . ApprovedMAIL TO: . . . . ...... .. .. .... Permit No. 75.3 Q .............. ................. Disapproved a/c ...... .....•........... ............................ .......................................... ...... 7151� � ....... (Building Inspector) ((I AUG JIAPPLICATION FOR BUILDING PERMIT. L I Z e':> 3.GEri. 20.Pp ZD l 1 „ ''�t�I4OLD INSTRUCTIONS �J a. This application must be completely filled in 3 sets of plans, accurate lo[ lao ' typewriter or in ink and submitted to the Building Inspector u P P to scale. Fee according to schedule. b. Plot plan stowing location of lot and of buildings on premises, relationship to adjoining premises or public streets li ation. 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 cam enced before issuance of Building Permit. d. UPxr approval of this application, the Building Permit shall be kept on Che. Inspector will issue a Building Permit to the applicant. Such e. No building shall a occupied available for inspection throughout the work. Occupancy shall have been �p ed or used in whole tr . part for any purpose whatever until a Certificate of granted by the Building Inspector. APPLICATION IS HEREBY M M to the Building � Building Zone Ordinance of the ld Deuar�ent for the issuance of a Building Permit pursuant to the Regulations, for the construction of buildings, Suffolk Camnty, New York, and other applicable Laws, Ordinances or described. the applicant agrees to camp Y additions or alterations, or for removal or demolition, as herein regulations, and to a�;t ar;uSorized 1 with all applicable laws, ordinances, building code, housing code, and pec`ors on premises and Yu bund- Iur necessar ins ,////// •' Y Pec=tions. (S;gnature o�1�applicant, or aP'P rare, if a corporation) ,.. (Mailing address of applicant) /tl Jc State whether applicant is owner, lessee, agent, architect, engineer, Z , general contr , r actor, electrician plumber or bu']de ............. ........... Nam of owner of premises ;S,C Q, .� ..... ...................... ...... .l l a-.✓,1.......... (as on the tax roll or latest deed) ..... ........ ..... If applicant is a corporation, signature of duly authorized officer. (Naand title of co .office.. m .. ............... rporate officer) - Builders License No. ............ Plumbers License No. Electricians License No. p Other Trade's License No. .......... I• location of land on which proposed work willN be aone......s�!C�'Sr...4.�.Eu��vt2s leo ..........................>� ,e s..R :...... House Number + j 1 4 2�.. County Tax Map No. 1000 Section . t Hamlet Subdivision MlyiOr Svj i'y. Block ..�. ......... Int . FiledMap.No. A; 44Z 1 (None) Int ......... 2• State existing use and occupancy Of Premises and intended use and' construction: a. Existing use and occupancyocctrpa�HTp�2AR"pkLIJ.13 VQLCIrt ....'.. JItpY�rgyylos7cBEJI'1L?vq y. b- Intended use and occupancy ✓15 p .ria l✓ ' 4i4Btg � Nature of work (check which applicable): New Building ..�C:.,... Addition .......... Alteration Repair ............ Rm eval .... I)e nlition .. Other Work ...... . . . Estimated Cost .4:m 10OQ......... fee . . ........ .. q (to be paid on filing this application) If dwelling, number of dwelling units .}. 4�Number of dwelling units on each floor Ifgarage, cumber of cars ...IZ. ................................ If business, camercial or mixed occupancy, specify nature and extent of each type of use..,i............... Dimensions of existing structures, if any: Front................ Rear Height ......................... limber of Stories Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Nuber of Stories ....... Dimensions of entire new construction: Front ................ Rear ............... Depth ... ... ..... Height ......................... limber of Stories ..... ...4SeC Gt7 ccC�c�c{ Size of lot: Front .q ig............. Rear .. J /.......... Depth .3:7.1..... ciLfLcr�tpef Su vUP1 ,,r �J Date of Purchase ..4fl�l fl ¢C ... Name of Former Owner ........................ ..... ....... Zone or use district in which premises are situated Am?................................. ............. . Does proposed construction violate any zoning law, ordinance or regulation: ..p Will lot be regraded .................... Will excess fill be remwed from ses: YES ND Names of Owner of premises �GS�CI..tiNt4 m . .... Address �1, e").`�vr�m.1�1 -.10P.1.7. Phone No21���Fzl.t!d l2 Name of Architect La: -q.,�1�(•�;�:LU................ Address �o (3Dx ZOlo7� ejr2P e! Plane No. `-F�7-O!ID0 Nae of Contractor �rA �I?�� . et!l �/.........;. Address T 13bc 1 k7 W2sFfttLvNPfMv lPlone No. Is this property within 300 feet of a tidal wetland? * M ...✓..... NJ .......... Ql (3i3 *IF YES, SOvllira.D MM MMM-3 pMgT MAY BE REQU M. a�facctecf (e -e✓r a ,1 f 0-Lt s+-eeS axd 1�6iL PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions an property lines. Give street and block ember or description according to deed, and stow street names and indicate ether interior or corner lot. NIE OF Nu Y(ft' UNIT OF r•••••••••. •-----.... being (July sworn. de and . deposes says that be is the appl.icanC we of irxlividual signing contract) we m wed, is the Q� ... .................................................... ................... 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 plication; that: all statements contained in this application are true to the best of his knowledge and belief; and at the work will be performed in the manner set forth in the application filed therewith. orn to bef e me this of20 GO 1 _ J.4414- OW Notary Publ c ....... ... .. ...EL ABETHA STA&W)TAPUBUC StaeeotNOWYOdt (Signature of Applicant) No.T "Am t3>��� FIRST FLOOR EL. 12.0 SURVEY OF IN FOUNDA770NJ inve/. 8.0 invW 75 Inv N. 7.7 ti LOT 1 �el. 4.8 MAP OF MINOR SUBDIVISION 3 CROSSOVER PIPE TEST HOLE DATA: APRIL 27, 2000 PREPARED FOR SEPTIC TANK CESSPOOL GROUNDWATER el. 1.8 0X50 PERFORMED BY : MCDONALD GEOSCIENCE SCOTT KAUFMAN o SECTION N. T. S. '` 1N PNPRY SITUATE 11 N N 81' 43' 00" E N/F LOVEI�IO RESIDENCE 3� 30 fD �� 0R o aN EL. 5.3 EXISTING GRADE EAST CUTCHOGUE, TOWN OF SOUTHOLD B6QLT fiV I , IP \ \^ W DARK BROWN SILTY LOAM OL SUFFOLK COUNTY, N. Y. STUMP \ \8 — 1 QC/ BROWN LOAMY SILT ML c� Q MARE 4/ ; \IPWPOSED_ J ROPOSED — 2.J• SURVEYED FOR THOMAS D. GOELLER `ExPANsir�N SHARON W. GOELLER n'A'V 101 Cy/ o9 CPYPOOLS `-' �.. EL. 1.8 3.5_ WATER IN BROWN LOAMY SILT ML / PROP�`�D n �~yJ�t ; i \+ / Sap Tlv 73 O , I 7ANK� IN 73 _� iy J� Q TAX MAP N0. N / ;" ,-'' 0, e %g ; EXCAVATION INSPECTION RE{�MED 1000-097-03-20.1 j l IN 6.3 _ ` \ r*rl FOR SANITARY SYSTEM PROPOSED ' �P Q f �i of 4 BEDROOM tiEALTM DEPARTMENT at` p,� c RESIDENCE GARA �\ SURVEYED 2f MARCH, 2000 '1,```_ 1st fl.. EL 12.0 MIN. ' SCALE 1--60' Q• G7 p� .t AREA - 110.080 SF N/F KAUFMAN OR -1'' WATER IN BROWN FINE TO COARSE SAND SW 3216 ACRES ,,. 0 8 CONTOUR \VACANT ,O jF \ a,6 CON TOUR O TEST�l ~ GUARANTEES INDICATED HERE AN SHALL RUN HOLE I OONLY TO THE PERSON FOR WHOM THE SURVEY O 1 0 LOT 2 IS PREPARED, AND ON HIS BEHALF TO THE No \ 1 FOR S C.D.H.S. USE ONLY 777LE COMPANY. GOVERNMENTAL AGENCY. O LENDING 1NS7I7U770N, IF US7ED HEREON, AND i C 1 O 7b THE ASSIGNEES OF THE LENDING INS777U770N. N/F VIVIANO 2 1 s d rn GUARANTEES ARE NOT TRANSFERABLE TO VACANT ; o I Q -0a .9 AM77ONAL INS777U77ONS OR SUBSEQUENT OWNERS. \ \ NN, PROPOSEq 'd C� UNAUTHORIZED AL TERA 770W OR ADDI770N-TO THIS \ \ WELL) Ct1 ; SURVEY IS A WOLA77ON OF SECTION 7209 OF \ \ \ \ 1 fA d I ) _ O THE NEW YORK STATE EDUCA77ON LAW. \ \ I n 0 COPIES OF THIS SURVEY MAP NOT BEARING \ al9il. r THE LAND SURVEYORS EMBOSSED SEAL SHALL \ -�-- — d � NOT BE CONSIDERED TO BE A VALID TRUE r- '40 IV COPY.-4— 0 - 0n 3 > 1 > ELEVATIONS` SHOWN ARE c rn Y 5d NVGD BM H326 RESET 1968 \ pN Q � 0 � � pELEV.= 13.052-- O0N• M zAGUARANTEED TO MAS D. GOELLER CD d Oa x b" SHARON W. GOELLER M -� m y FIDELITY NATIONAL TITLE INS. CO. 0 SKUNK LA Om Ly BRIDGEHAMPTON NATIONAL BANK o _ - 1 Z ?d YYYYr, TOWN OF SOUTHOLD FID — — _ —�y�� F, � =1,128.33 O p . 0 - 6-7'P56 r r+ m Q 7.1 S 77' 0 1O6.SJW CTI cDD to 6r,n5 7'24 EUGENE'S756 ROAD TE 1,14Q APP x - ' < SURVEYED BY 7.44 cD r 7d n STANLEY J. ,ISAKSEN, JR. 6.61 Wt0LSocArrwvs m > P.O. BOX 294 Itf 6R 7ERs) (DARE BASED _ NEW SUFFOLK, NY 119 Q h OS T RE0UAC11ENTS 63 7 WL/CEN d ANDS VEYOR NYS C ED 492 3 m 2. 19 JUNE , 2000 REVISE SANITARY � �) ON. 1. 12 MAY, 2000 SHOW D.E.C. WETLAND ON, m REVISE LOCATION OF: HOUSE, SANITARY & WELL. 0OC889 FIRST FLOOR EL. 12.0 Harare rr� N el. 9.5t i �S SURVEY OF in v.el. e.J LOT 1 in V.e% a.0 in v.sl. 7.5 In v.N. 7.J o IN FOUNDATION el. 4.6 MAP OF MI NOR SUBDIVISION CROSSOVER PIPE TEST HOLE DATA: APRIL 27, 2000 PREPARED FOR SEPTIC TANK 3 CESSPOOL GROUNOWA TEP, Q el. 1.8 6y X50 PERFORMED BY : McDONALD GEOSCIENCE SCOTT KAUFMAN SECTION N. T. S. �� ORE TSI Nj1PRY SITUATE N N 1' 43" 00" E N/F LOVE 10 RESIDENCE j� 30' 1FD TO EL. 5.3 EXISANG GRADE EAST CUTCHOGUE, TOWN OF SOUTHOLD h ` �� I �'ws ------ BROW �r�� �, �.� DARK BROW SILTY LOAM oc SUFFOLK COUNTY, N. Y. BROWN LOAMY SILT ML Mp�'E �q c;j,// l'\"PIPOSE _ PROPOSED % — 2.J• SURVEYED FOR THOMAS D. GOELLER d P A/ l p/• / C� $POOL S g 07, EXPANSI�N — WATER IN BROWN LOAMY SILT ML SHARON W. GOELLER + %P#OP EL. 1.8 J-5' / SPP TI O V 7.J 77ANK; IN�7.5�r ti i O IN a. / O TAX MAP NO. 60' IN 8.3� 1000-097-OJ-20.1,� � � ` p� I PROPOSED ~ n1 -Mi O 4 BEDROOM YED o o RESIDENCE c a ; \ SURVE ?1 MARCH, ?000 scuE 17-60. AREA - 14aoeo sF NIF\ '8 CONTOUR_,,, I `ACANTUFMAN WATER IN BROWN nN£ TO COARSE SAND SW S?16 OR a,6 CONTOU_R_ 6� o \ fo CiQ �7Y��___ TEST �ryG i I HOLE I Do GUARANTEES INDICATED HERE ON SHALL RUN \ i Q� I LOT 2 ONLY TO THE PERSON FOR WHOM THE SURVEY h p /S PREPARED. AND ON HIS BEHALF TO THE ZONE 'X o FOR S C.D.H.S. USE ONLY 777LE COMPANY. GOVERNMENTAL AGENCY, N/F VI VIAND �� C I O LENDING INS77TU770N, IF LISTED HEREON, AND TO THE ASDOVEES OF ME LENDING j \ 1� Z I GUARANTEES ARE NOT TRANSFERABLE TOTUALYJ. VACANT \ \ k^�I I ADD177ONAL INSTITUTIONS OR SUBSEQUENT OWNERS \ PROPOSEq UNAUTHORIZED ALTERATION OR ADDIAON"TO THIS ZONE wELLI SURVEY IS A WOLA77ON OF SEC77ON 7209 OF \ \ I THE NEW YORK STATE EDUCA77ON LAW. \ I COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED 70 BE A VALID TRUE /• . y I (",, COPY. ELEVA AONS SHOWN ARE O ! \ \ NVGD BM HJ26 RESET 1968 ' I \1 ELEV.= 13.052— i GUARANTEED TO _ I THOMAS D. GOELLER J _ SHARON W. GOELLER 71E TO SKUNK LA FIDELITY NATIONAL ARE INS. CO. FD 4� I ,P , w193.02" =1,128.33" �OIWNEOF SO�HOLDAONAL BANK 7f J 7/ 0 10 6"30 •�C/ 77" 6 SRI 7.42 7.24 EUGENE'S 7.56 ROAD -V0 TE17APP X,140 SURVEYED 'BY 6.61 7.44 HELL STANLEY J. ISAKSEN, JR. SEWAGE DISPOSAL SYSTEMS!PROPOSED LOCATIONS P.0. BOX 294 DESIGNED BY(RANK NOTARO(ARCHIIECNIX.ODI£S) REGISTERED ARCHITECT: ALL DESIGN PARAME7ER5 ARE BASED NEW SUFFOLK, NY 7'19 6 O UPON S(NFOIX COUNTY HEALTH DEPARTMENT REQUIREMENTS E.3 7 S 1 1 & STANDARDS. W /� � / m 3. /O XIUDO ADD FZOGID20/ L/NEEP /Tf @ L/CEN D 4PJD SURE R NorARo uscEHCEo ARCHirEcr NYS C.�J'A 49S Ljj2. 19 JUNE , 2000 REVISE SANITARY AND WELL LOCATION. 1. 12 MAY, 2000 SHOW D.E.C. WETLANDS DETERMINARON, m RENSE LOCAAON OF' HOUSE, SANITARY & WELL. 0OC889 N SURVEY OF LOT 1 IN MAP OF MINOR SUBDIVISION PREPARED FOR SCOTT KAUFMAN C) S1TUATE N N 81 ' 43' 00" E N/F LOVENO RESIDENCE EAST CUTCHOGUE, TOWN OF SOUTHOLD 309.30 ° _ SUFFOLK COUNTY, N. Y. ear 1N O S1UMP 1 SURVEYED FOR THOMAS D. GOELLER Thq� 107. 57 SHARON W. GOELLER v' 7 o + 0 Q W TAX MAP NO.O 1000-097-03-20.1 ZONED R-80 POUR E SURWYED 21 MARCH. 2000 c�Q k" FOUNDA IT ON 82.6' SCALE 1'=60' AREA = 140,060 SF N/F KAUFMAN J.216 CRf5 VACANT I 1 LGT 2 � t N/F VIVIANO %/ ZONE X o 11 VACANT I I O /' ZONE X� \ I kin Cf PT. J cn7 --- ti C I O ELEVATIONS SHOWN ARE W A i NVGD BY H326 RESET 1968 Q) 1 ZONE AE (EL zl w !` ` ELEV.= 13.052 ` 1// 1,3 /D� GUARANTEED TO : -- W I /// THOMAS D. GOELLER SHARON W GOELLER �� 1P TIE TO SKUNK LA FIDELITY NATIONAL TITLE INS. CO. BRIDGEHAMPTON NATIONAL BANK i o 12x TOWN OF SOUTHOLD J � cm 193.02' 1, 128.33' i EL 6.51 � 225.50 76' 50 30' W C- / S 77' OS' 10 W NEAR£Sr WA ® SURVEYED EUGENE'S ROAD J. LAN 1.140 APP O � >u.f/j STANLEY J. ISAKSEN, J P.O. BOX 294 NE SU FOLK, NY 11 6 63 - � 5. 7 OVEMBER, 2001 LOC POURED CONCTERE FOUNDATION. 4. 10 2001 A OD ZONE LINES. J. 19 JUNE , REVISE SANITARY AND WELL LOCA TION. ICEN� D AND R VE 2. 07 JUNE , 2000 REVISE SANITARY AND EARTHWORK. NYS (1C. 1V0. 4,427J LLJ 1. 12 MAY, 2000 SHOW D.E.C. WETLANDS DETERM/NAPON, REVISE LOCATION OF: HOUSE, SANITARY & WELL. LLICC) 0OC889 SURVEY OF LOT 1 IN MAP OF MINOR SUB01 V/S/ON E 3 ��02 PREPARE^ SCOTT KAUFMAN _ J S/T./ATE D 1 ' 43' 01" E N/F LOVENO RESIDENCE309EAST CUTCHOGUE, TOWN OF SOUTHOLD fD .30' P BOLT IN SUFFOLK COUNTY, N. Y. ' STUMP O0 T�qN 70,7' O' I SURVEYED FOR THOMAS D. GOELLER � SHARON W. GOELLER CESSPOOLS, SEP 77C TANK FRAME 0 � TAX MAP NO. HFD) 1000-097-OJ-20.1 Q \ n i 29 5 w �a 29 ZONED R-80 lb D ��� Z0- pRp�E o SURVEYED 21 MARCH, 2000 SCALE 1'-60' 55 QT , AREA = 140,OB0 S� N Wim. N/F KAUFMAN s.216�Ao;Es FFA z >e° p;. __ �0 18x26 VACANT �J� .1/ 22 C 0 — 51 e \ I POND � LQ LOT 2 WA 7ER--f N/F Vl V/ANO LINE a a o VACANT ZONE X m HousE/wELL I � I EL i I � ZONE X ' -- /1 ELEVATIONS SHOWN ARE Qo NVGD BM HJ26 RESET 1968 O 1 ¢ ZONE A E (EL 8) 2 I ELEV.= 13.052 W ^� GUARANTEED TO THOMAS D. GOELLER v I SHARON W. GOELLER ON I p TIE TO SKUNK LA FIDELITY NATIONAL 77TLE INS CO. 1D i o I BRIDGEHAMPTON NA77ONAL BANK ' cm 76' S0 w 193.02' _ -128'33 TOWN OF SOUIHOLD EL 6.51 25.50' S 77' 08' 10" W EUGENE'S ROAD NEARE T WAT 1 LANE 1,140 (APP Ox. SURVEYED B Y *LINO. ISAKSEN, J . 94 7. 13 SEPT 2002 SHOW COVERED PORCH. K, PJY 1 6. 17 JUNE, 2002 ADD WELL,SANITARY & DRIVE 8 5. 7 NOVEMBER, 2007 LOCATE POURED CONCTERE FOUNDATION. 4. 10 JUL Y, 2001 ADD FLOOD ZONE LINES. J. 19 JUNE , 2000 REVISE SANITARY AND WELL LOCATION. ND SU YOR Q7 2. 07 JUNE , 2000 REVISE SANITARY AND EARTHWORK, SU �Ll 1. 12 MAY, 2000 SHOW D.E.C. WETLANDS DETERMINATION, mREVISE LOCATION OF. HOUSE, SANITARY & WELL. OOC889 NSURVEY OF LOT 1 IN MAP OF MINOR SUBDIVISION PREPARED FOR SCOTT KAUFMAN o SITUATE N 81 43' 00" E N/F L0VENO RESIDENCE 309.30' EAST CUTCHOGUE, TOWN OF SOUTHOLD E ear IN1p SUFFOLK COUNTY, N. Y. STUMP O / � ��P�P Mp�E TNq c3ySURVEYED FOR THOMAS D. GOELLER P A 707. // a ro SHARON W GOELLER 9 / CESSPOOLS O // SEPTIC FRAM£ O TAX MAP NO. v I TANK l SHED 1000-097-03-20.1 I y.a � 29. Rl �� Oe pI d 2 N ZONED R-80 SLAT STORY SURVEYED 21 MARCH, 2000 PA 770 RESIDENCE 8 . SCALE 1"=60• AREA z 140,080 SF N/F KAUFMAN OR laxza VACANT 3.216 ACRES POND COVERED PORCH I i W/RAILING LOT 2 / WATER- j i N/F VIVIANO LINE p {" ZONE X HOUSE/WELL Z I VACANT `- I I I WELL - 10 -00 -0 a ZONE X ' f - �o in7 Z I I Q ELEVATIONS SHOWN ARE g I 00 NVGD BM H326 RESET 1968 o ZONE A E (EL 8) z I Q v ELEV.= 13.052 w rn GUARANTEED TO THOMAS D. GOELLER SHARON W. GOELLER FIDELITY NATIONAL I`P° TIE TO SKUNK LA BRIDGEHAMPTON NATIONALBANKITLE BANKO I �" 193.02' =1,128.33' TOWN OF SOUTHOLD EL 6.51 225.50 76- 50 30 W S 770 08' 10 W EUGENE'S ROAD SURVEYED BY STANLEY J. ISAKSEN, JR. P.O. BOX 294 NE ! SUFFOLK, NY 1195 6. 20 JUNE, 2002 FINAL SURVEY 63 -7. - 35 5. 7 NOVEMBER, 2001 LOCATE POURED CONCTERE FOUNDATION. 4. 10 JULY, 2001 ADD FLOOD ZONE LINES. c r W 3. 19 JUNE , 2000 REVISE SANITARY AND WELL LOCATION. LICENS D LAND SU YOR m 2. 07 JUNE , 2000 REVISE SANITARY AND EARTHWORK. NYS C. NO. 492 LLj 1. 12 MAY, 2000 SHOW D.E.C. WETLANDS DETERMINATION, Llj REVISE LOCATION OF. HOUSE, SANITARY & WELL. CQ OOC889 "­-, 41�, ,127 7-,�, , -77 7 77� ,,......... FA ga a _IF ir yof Q! SAO:? "�F yy IF oil 0 gi Nooks,-' try:i too. C wun T� �Q ni -M 1 A 7' FF ANA, I—mn T�tMW Ei F� ------- '�L J� loam pit", K ;Wx: MW Jil, 7!4, ny VAT ub . lz"4 k Q n . Av Mason v v- 7,2477, q r. 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NOT RESPONSIBLF rOF DESIGN OR CONSTRUCTION ERROP", DO NOT PROCEED wi If Copper tubing Is Used FRAMING UNTIL SUR X. for Water distributing OF FOUNDATION system;Of types K csLhall ba HAS BEEN'APPROVE,, swo I I only N . PROVIDE SMOKE-DET PROV ALARM DEVICE IDEW"R. FIRE RATED-SE AS TO PART.T. 72L RATE6 11�,N N.Y.S BUILDING CO: J 'RUJILD NG `0 —i-A N� c R "PENINGS F Z -4— Its. 114F N.Y, TATE BUILDING CO El j T14 A RCME ER �NCY ------ UNDOW Ul REQ IRED BY PA L-A— X 10 ANCY OR PRO NTI-SCALD AND/O UNLA FUL THER' CK PREVENTING UT RT. 902-6(K) CERTIFICATEDEV'CES OF OCCUPANCYI-r N.Y. STATE G CODE. MBI 4 Row wwww" ALLMB'N TE &WATER LINE ED LINE STING BEFORE- ERING 77" ti 4 te 0 IBER CER All J E 01 AD CONTEN, �T_ RE 0 SAtIFICA TE OF 0 C NCY -I&DER USED IN TER PKI I ♦ SUPPLY SYSTEM CAOT EA D., 2110 OF 1% X "Al ............ r wo� I" ii, 01W ko ow I yy 4.2 0" 777� NEW T, C= Lu- _d W22 00 ESSI OF 0 s. W n. tM, -w Mq7rv'T F 7 7 14� rq S i Ai — i - a 1 + AL, ? 4 r 71 41- 1 I _ p + ( E I IA LU ' � _� � � �^/ �--1-";.may `.•J x. ! }_- __ 1LAJr 0322541• V �- �gQFESS{ON OWN - " d - - -0 11000 L 4 r - . _ 4At 1 -Y f PIA c' Y, F it - i - � � � - '`�\j` ._.+T�-•..._-.w+-w.n•+.-.._.rr�__-w«r.-.-.......-.+r+�---'._-__.,.r+-. _.._..n._--.-�,..mow.,_-_...�.e�.._+..•,..w...._- _ 4� f fF'fr, y y t • - - NEW -� ft 1 *�e� W y. W - 2 V - SFO 032254-1 A9OFESSIO kV" x oil,0 IN o , , , - - _ _ _ . . �_ y,- .w., . .. . _ - _ _ _ -- _ - _ - _ _, . .. .. . - 11 . - ,}., . - .tin:" :«o - ft•- _ - _ _ _ - . . , _ e. _ _ - _ _ . _ _ _ , -. -. .. _ _ .. - - - _ • - h- t, k - _ - ;i ' : 11 r .t - - ; A`:3 °yy�- . - - - 5 -i ' q s '+48 - - - - ,. . . - - ,F �" ..�5 _ r - - - - 1Y - - - :x .a;�'.. t; . . * - ::� r . , _ - - '(; _ - t' t _ " - 4 .* Y . - F,:�'i , 6 :1 - - - ,1 9 ,) . , - `?i E .. - }. +F_ ,I I 4 I �'llzr .. - `�. 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FLOOD 9 D ZOn SLY"M CHAPTER N w * i ! FLOOD DAMAGE '4g Tow,,, com IT- OL Ak __ -- ----�r-- UfaAVLrz- w x % t� - t � '; ` - ! ` C +L _ moi'- X14 F` fit ID- it ! t n I ! i I- to AtI _ ;pV '>4 q ; tifi.. - 2 1%144 x - -� `i it � •'t �`'� � Lo ' � � I NEW cc LU i 32254 V i r 411 �— t Sk up ui i i 'j.7.+ �'• ,�'�,�h _- . .._�''_�''_......_ after! 3, It y N, 17a go"0 ez- RMIV 6—sy=- 4 Its F qi A, tA-r-;-W4� +Ljr�21-951 7 f�!4 o!10 U) -fh ]PROWDE-W HR.,FIRE- 'low- A PANT. -(f' ;QN To fw*i� 4D OF Jv 1 , N.Y. STATE ' B. 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