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Home My WebLink About27453-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28995 Date: 10/16/02 · ~{IS CERTIFIES that the building ADDITIONS & ALTERATIONS Location of Property: 700 BROADWATERS RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax ~4ap No. 473889 Section 104 Block 10 Lot 2.1 Subdivision Filed Map No. __ Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6, 2001 pursuant to which Building Permit No. 27453-Z dated JULY 6, 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 ADDITION, WOOD DECK ADDITION AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. ·"ne certificate is issued to JOSEPH V & JUDITH P ZALNER (OWNER) of the aforesaid building. S~-FFOLK CO[]lqT"f DEPART~qT OF H]~J~{ APPROVAL ELRt-£KICAL CERTIFICA~ NO. PLUMBERS c~TIFICATION D~A'~O 09/24/02 N/A 1072477 08/20/02 KEVIN REMPE PLUMBING Rev. 1/81 d Signature FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N~Y. CERTIFICATE OF OCCUPANCY No: Z-28996 Date: 10/16/02 T~IS CERTIFIES that the building ALTERATION Location of Property: 700 BROADWATERS RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 10 Lot 2.1 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 6, 2001 pursuant to which Building Permit No. 27453-Z dated JULY 6, 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 RELOCATION AND NEW FOUNDATION ON AN EXISTING NON-HABITABLE ACCESSORY GARAGE AS APPLIED FOR. · 9/e certificate is issued to JOSEPH V & JUDITH P ZALNER ( OWNER ) of the aforesaid building. SUFFOLK COUNTY DEPARTMEI~T OF I{E~LTt{ APPROVAL ELE~-£~ICAL CERTIFICATE NO. PLUMBERS CERTIFICATION D~r~3 Rev. 1/81 N/A 1072477 08/20/02 N/A FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII,DING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27453 Z Date JULY 6, 2001 Permission is hereby granted to: JOSEPH V ZALNER 68-39 MANSE STREET FOREST HILLS,NY 11375 for : ADDITION AND ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR WITH NYS DEC, TOWN TRUSTEE'S APPROVALS INLUDES FLOOD PERMIT at premises located at 700 County Tax Map No. 473889 Section 104 pursuant to application dated APRIL Building Inspector. BROADWATERS RD CUTCHOGUE Block 0010 Lot No. 002.001 6, 2001 and approved by the Fee $ 757.20 Authorized Signature Rev. 2/19/98 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 76S-1802 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. New Construction: Location of Property: 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 Certificate Occupancy- New dwelling $25.00, Additions to dwelling $25.00, Alter~,i6h~ 1. of Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $~5:00, Businesses 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. !i~ I~ 0 v//' (check one) Old or Pre-existing Building: House No. Street Hamlet Owner or Owners of Property: ~'-c..h~ 6~ Suffolk County Tax Map No 1000, Section Subdivision PermitNo. ~["TqS:~ DateofPermit. '7!G!O~ Block Filed Map. Lot: Applicant: Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $. Underwriters Approval: Final Certificate: (check one) "~'"'~'-~JApp licant Signature P. 0 Box S.(M,~P~olr~. P~edv YQdq Ft~ (510) 78,S.t 823 OFFICE OF THE BUILDING INSPECTOR TOWN OF 80UTHOLD C B AT Z F X C AT :r Q,.N., .uI~d~......t .o.+ ,g'7'/,5'3 ,, (pie&lO pr nt contl~nl 2ell thin 2/lO of It lel~, Svorn Lo before lite County NEW YORk BOARD Of FIRE UNDERWRITER BUREAU Of ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 Upon the application of upon premises owned by G & S ELECTRICAL CONTR. JOE ZALNER BOX 215 700 BROADWATER ROAD SOUTHOLD, NY 11971, CUTCHOGUE, NY 11935 Located at 700 BROADWATER ROAD CUTCHOGUE, NY 11935 Application Number: 1072477 Certificate Number: 1072477 . was inspected in accordance with the National Electrical Code and the detail of [he installation, as set forth belOw found to be in compliance therewith on the 20th Day of August, 2002. i Name QTY Rate Rating Circuit Type ; Alarm and Emergency Equipment Sensor 2 Carlx)n Monoxide Appliances and Accessories Cooking Deck 1 7.5 KW Dish Washer 1 1.2 KW Exhaust Fan 2 F.H.P. ~ Furnace 1 F.H.P. J i Hydro Massage Tub, Residential 1 Air Conditioner 1 4 Wiring and Devices i, " Outlet 55 Fixture Receptacle 41 General Purpose Switch 48 General Purpose I ~ Fixture 55 Incandescent Receptacle 1 20 Special Receptacle I 30 Special i Paddle Fan 4 seal Receptacle I 1 ' I Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicaie . ' BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITER BUREAU OF ELECTRICITY 40 FULTON STREET- NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by G & S ELECTRICAL CONTR. JOE ZALNER BOX 215 700 BROADWATER ROAD SOUTHOLD, NY 11971, CUTCHOGUE, NY 11935 ' , Application Number: 1072477 Certificate Number· 1072477 ri Section: Block: Lot: Building Permit: BDC: NS1 Described as a Residential occupancy wherein the premises electrical system coin§i_~ Ling electrical devices and wiring, described below, located in/on the premises at' First Floor, Second Floor, Detached Garage, Outside, Pool/Spa, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth bel0v~, wds found to be in compliance therewith on the 20th Day of August, 2002. Name QTY Rate Rating Circuit Type Service 1 Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 CB (Swimming Pool): This certificate covers compliance at the date of inspection only. Because of unusual environments it is advisable to h~vi frequent test and/or repairs made by a qualified person. '~ seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location ind~cale 88/23/2882 83:38 5i87346407 SAMUELSSTEELMAN PAGE 0i/0i S A M U E L S & S T E E L M A N August 23, 2002 Gary Fish, Building Inspector Building Department FAX 765 9502 Southold, NY 11971 Re: ZALNER RESIDENCE BP# 27453 Z Dear Gary, Please note that the two flow thru vents on the above referenced project are each 28" x 38", totaling 2128 square inches for both. The size of the crawl space they vent is 941 square feet. Therefore, please note that they are of sufficient size, per FEMA code. Although they are both located on the same side of the house, in the event of a flood they will allow flood water to '?low in", and 'flow out", which is their intention. Thank you very much, Tom Samuels ARCIdlTECT5 2'5235 MAI,"' ROAD CUTCHOGUE, NE~VYORK 11935 (6.11 ) 734-6405 FAX (631) 734.-6407 0G/04/2002 28:32 5167346407 SAMUELSSTEELMAN PAGE 0i/01 S A S T June 5, 2002 Bruno Semon, Building Inspector Building Department FAX 765 9502 Southold, NY 11971 Re: ZALNER RESIDENCE BP# 27453 Z M U E L S & E E L M A N Dear Bruno, Please note that the relocated accessory building has a wood frame floor structure, bearing on the new masonry foundation. In compliance with FEMA requirements, the foundation will contain three (3) flow through vents, each of 128 square inches (384 inches total), thereby exceeding the minimum requirement. Please make the necessary adjustments to the building permit file. Thank you very much, end. ARCHITECTS 2S235 ~MAIN ROAD CUTCHOGUE, NEWYORK 11935 (6~1) 734-6405, FAX (631) 734.6407 87/88/2881 88:28 516734~407 SA~UELSSTEL~AN PAGE 81/01 S A M U E L S & S T E E L M A N July 6, 2001 Building Department Southold Town Hall FAX 765 1823 Re: ZALNER RESIDENCE APPLICATION Att. n: Bruno Semon As per our phone conversation yesterday, please note that the ama of the first floor is 1430 square feet. At one square Inch of 'flow through vent" area per each square foot of footprint, we will provide' approximately ten square feet of vent area (1440 square inches), or three two foot square vents (12 square feet). As per the PLANS, we will also fill the crawl space level with the existing grade on the creek side of the house. Please call with any other questions or concerns. Otherwise we look forward to receivin9 notice that the permit is ready. you help, ARCHITECTS 2S23S MAIN ROAD CUTCHOCUE, NEW YORK 1193.5 (631) 734-6405 FAX (631) 734-6407 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ~C PERMIT NUMBER ~-4758-02781/00001 FACILITY/PROGRAM NUMBER(S) PERMIT Under the Environmental Conservation Law EFFECTIVE DATE February 16f 2001 EXPIRATION DATE(S) February 16, 2005 [I TYPE OF PERMIT · New [] Renewal [] Modification · Permit to Construct [] Permit to Operate I_ D [] [] [] [] Article 15, Title 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island Wells Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wet[ands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER ! Joseph ZaLner (718) 544-4003 ADDRESS OF PERMITTEE 68-39 Manse StreetF Forest Hills, NY 11375 CONTACT PERSON FOR PERMITTED WORK Samuels & Stee[nmnf Architects, 25235 Main Road~ Cutchogu% NY NAME AND ADDRESS OF PROJECT/FACiLITY Zalner propertyr 700 Broadwaters Road~ Cutchogue LOCATION OF PROJECT/FACILITY SCTM # 100-104-10-2.1 11935 TELEPHONE NUMBER (631) 7-54-6405 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk SouthoLd Broadwaters Cove DESCRIPTION OF AUTHORIZED ACTIVITY: Construct 6' x 20' addition to existing single family dwelling, convert first floor living space to single car garage, construct steps to deck and steps to front entrance to house. 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: Mark C. Carrara (CIG/) AUTHORIZED SIGNATURE ADDRESS Bldg. #40¢ SUNYr Stony Brookr NY 11790-2356 ,.Jj// IDATE February 16, 2001 Page 1 of 4 STATE OF NEW YORK ) COUNTY OF SUFFOLK ) -~.~ 0_... ~..~/~i¢~,i~' , being duly sworn, deposes and says: That deponent is over the age of 18 years, and resides at ~r~ /~.~ ~c~--~on day That the ~ of ~'~ nent, being the architec~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). A~ff nginee - Sworn to before me this day of Notary Public PATRICIA RICHARDS Notary Public, State of Haw York No. 01RI6042467 Qualified in Suffolk County Commission Explraa May 30, 2002 cc: applicant Board Of $outhold Town Trustees SOUTHOLD, NEW YORK DATE: ..hlnx,:. _.21.,.2.a00 ISSUED TO JOE & JUDY ZALNER Authorizatio. Pursuant fo the provisions of Chapter 615 of the Laws of the State of New York, 1893; and Chapter 404 of the Laws of the State of New York 1952: and the Soufhold ToWn Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS 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 wlfh the Resolution of The Board adopted afa meeting held on l)~.9.~..e..~.l~..e..r....21' 200.0 ....... and in consideration of the sum of $....150.,.0.0 ....... paid by Samuels & Steelman Architects on behalf, of Joe & Judy.. Of .Cu.tcholz. u.¢,.-..--.; .......................................... N. Y. and sub?ct to the Terms aha~ Cond,tions listed on the reverse side hereof, of Soufhold Town Trustees authorizes and permits the following: to construct a 120 sq. ft, addition lo S~E; dorner of house rework first and second floor plan rise existing interior first flo6r;area 'fo~, single car garage. With:the Conditions that before any. kind ~f ~'-radir~ and lands~gpina: is .dOne float ' all in eccoritance w,th the detailed specificat,6ns ~s presented ~n ithe orlg;natJng apl~licatJon. ' ~l~e ap licant, show~ ~he . F~ WITNESS WHE~)r~, ~p:th~'j~ba>4 f~r, a~pro~ral. me sam~oara ot~rusmes r~ere- bv'ca~iseS"Its COiporate Seal robe affixed, and these p,resents .to 'b~ suBsCribed by a 'majority of the sald Board as of th~s date, ___ -.-'"-" Trustees S A M U E L S & S T E E L M A N June 3,2002 Bruno Semon, Building Inspector Building Department Town Hall Southold, NY 11971 Re: ZALNER RESIDENCE BP# 27453 Z Dear Bruno, Enclosed please find: 1) 2) 3) 4) Three stamped prints of a revised SITE PLAN, showing a new location for the accessory building, which is a non-habitable structure Approvals for the same work from the DEC and the Southold Town Trustees Three stamped FOUNDATION PLANS of the new work Check for $75. Please make the necessary adjustments to the building permit file. Thank you very much, T~ Samuels encI. ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 (631) 734-6405 FAX (631) 734-6407 Albert J. ~I~rupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 March 22, 2002 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Thomas Samuels Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: JOE & JUDY ZALNER 700 Broadwaters Rd., Cutchogue SCTM#104-10-2.1 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5249 to move the existing accessory building back to 63' from the wetlands line. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, /' Albert J. Krupski, Jr. President, Board of Trustees AJK:lms , MBER ~.~r~8" 02781/00002 /3/~ ~ L I TY/PROGRAM NUMBER(S) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE February 27, 2002 EXPIRATION DATE(S) February 27, 2006 TYPE OF PERMIT · New [] Renewal [] Modification · Permit to Construct [] Permit to Operate [] [] [] [] [] Article 15, Title 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island We[Is Article 15, Title 27: Wi[d, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wet[ands · Article 25: Tidal Wet[ands [] Article 27, Title 7; 6NYCRR 360: So[id Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT iSSUED TO TELEPHONE NUMBER Joseph Zalner (718) 544-4003 ADDRESS OF PERMITTEE 68-39 Manse Street, Forest Hills, NY 11375 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Thomas Samuels, 25235 Main Road, Cutchoguet NY 11935 (631) 734-6405 NAME AND ADDRESS OF PROJECT/FACILITY Zalner property, 700 Broadwaters Road, Cutchogue LOCATION OF PROJECT/FACILITY SCTM #1000-104-10-2.1 COUNTY Suffolk TOWN Southold WATERCOURSE Broadwaters Cove NYTM COORDINATES DESCRIPTION OF AUTHORIZED ACTIVI'rY: Remove existing septic system, add 25 cubic yards fill material, install new septic system, relocate accessory building, remove existing frame shed, install new drywells, and relocate driveway. All work must be done in accordance with the attached plans stamped NYSDEC approved on 2/26/02. 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: Mark C. Carrara (CKW) ADDRESS Bldg. #40, SUNY, Stony Brook, NY 11790-2356 DATE February 27, 2002 Page 1 of 4 Albert J..Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson March 22, 2002 BOARD OF TOWN TRUSTEES TOVgN OF SOUTHOLD Town Hall 53095 Route 25 P.O. Box 1179 $outhold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 Mr. Thomas Samuels Samuels & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: JOE & JUDY ZALNER 700 Broadwaters Rd., Cutchogue SCTM#104-10-2.1 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, March 20, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Pemdt #5249 to move the existing accessory building back to 63' from the wetlands line. T'nis is not a detemdnation from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees S A M U E L S & S T E E L M A N March 21, 2002 Mike Verity, Chief Building Inspector Building Department Town Hall southold, NY 11971 Re: ZALNER RESIDENCE BP# 27453 Z Dear Mike, Enclosed please find three stamped prints of a revised SITE PLAN, showing a new sanitary system, and the relocation of the existing accessory building. You will also find approvals for the same work from the sUffolk County Dept. of Health Services, New York State Dept. of Environmental Conservation, the Southold Town Trustees, and the Town Clerk. As you know, approval of the SCDi-lS was required by your department for the final Certificate of Occupancy. It was they who required a new sanitary system for the project. Please amend the above referenced permit as per the revised FLOOR PLANS (three stamped sets enclosed). Please make the necessary adjustments to the building permit file. Thank you very much, encl. ~, Z I 2O0Z ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 (631) 734-6405 FAX (631) 734-6407 Albe~ J. Krupskf, President James I'fdng, Vice-]President A.rtie Foster Ken PoLiwoda Peggy A. Dickerson ~E 02 Town Hall 53095 Route 25 P.O. Box 1179 Southo]d, New York 11971-0959 Telephone (831) 765-1892 Fax (631) 765-1366 BOARD OF TOV~N TRUSTEES TOWN OF SOUTHOLD March 22, 2002 Mr. Thomas Samuels Samuels & Steelman Axchitects 25235 Main Road Cutchogue, NY 11935 RE: JOE & JUDY ZALNER 700 Broadwaters Rd., Cutehogue SCTM#104-10-2.1 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, Match 20, 2002: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Permit #5249 to move the existing accessory building back to 63' from the wetlands line. This is not a deten'nination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, Albert I. K.rupski, Jr. President, Board of Trustees AJK:lms 05/30/2002 01:57 5167345407 $~HUELSSTEELHP, N NEU YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION P~G~ 03 DEC PERMIT HUMBER 1-4738-02781/00002 FACILiTY/PROGRAM ~UMBER(S) TYPE OF PERMIT · MeN I~ ReneueL [] PERMIT U~der the En¥ironmentaL Conservation LaN EFFECTIVE DATE February 27, 2002 EXPIRATION DATE(S) February 27, 2006 Modification · Permit to Construct [] Permit to Operate Il' l Article 15, Title 5: Protection of Ua:ers 6NYCRR 608= Uster Quality Certification [] Article 27, Title 7; 6NYCRR 360= so[id Waste Management Article 15, Title 15: Water Supply Article 15, Title 15:'Water' Transport Article 15, Title 15: Long Island ~eLLs ArticLe 1~, TitLe 2?: VfLd, Scenic and Recreational Rivers [] Article 17, TitLes ?, 8= SPOeg [] Article 19: Air Pollution Control Article 23, Title 27: Mined Land Reclamation [] Article 2~: Freshaater Wetlands · Article 2S~ Tidal Wetlands [] Article 27, Title 9; 6~¥CRR ~7'5; Hazardoue Ueste ~enagement [] Article ]~: Coastal Erosion Management [3 Article 36: FLoodplain Management 0 Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Con:roi PERH]T JSSUED TO Joseph ZaLner ADDRESS OF PERHITTEE TELEPHONE NUMBER (718) 544-4OO3 68-39 Manse Street, Forest Hills, NY 11375 CONTACT PERSON FOR PERMITTED ~ORK Thomas Samuels, 25235 Main Road, Cutchogue¢ NY NAME AND ADDRESS OF PROJECT/FACiLITY 11935 TELEPHONE NUMBER (631) 7-J4-6405 _ZaLner property, 700 Broadwaters Road, Cutcho~ue LOCATION OF PROJECT~FACILITY SCTM #1000-104-I0-2.1 COUNTY SuffoLk TO~N I WATERCOURSE $outhotd 8roadNaters Cove DESCRIPTION OF AUTHORIZED ACTIVr['Y: NYTM COORDINATES Remove existing septic system, add 25 cubic yards fill material, install new septic system, relocate accessory building, remove existing frame shed, install new drywells, and relocate driveway. All work must be dons in accordance with the attached plans Stamped NYSDEC approved on 2/26/02, By acceptance of this permit, the permitter agrees that the permit fs contingent upon strict compliance ~ith the ECL, all applicable regulations, the General Conditions specified (see page 2 g 3) and any Special conditions included as part of this permit. I"PERMIT ADMINISTRATOR: ADDRESS Mark C. Carrara (ClCI,J) J BLdg. ~g, SUNY. i Stony Brook, NY 11790-2356 .. February 27, 2002 I Page 1 of 4 Reference # R10-01-123, Zelner SPECIAL CONDITIONS OF APPROVAL 1. The installation of the sewage disposal system must be supervised and certified by a licensed design professional (Form WWM-073 enclosed). 2. This permit and plan is subject to approval by the Town of Southold for grading and drainage. 3. It should be noted that the septic tank is not permitted in the driveway area and the sewer line, which is shown to be over 50 feet long, requires a clean-out in accordance with standards. 4. Also the pipe inverts should be checked prior to construction to assure adequate separation distances from the leaching pools to groundwater. It may be necessary to consider the septic tank in the "island" area to avoid pumping (no closer than old system to surface water). 5. Existing cottage is not to be used as a dwelling unit. 07/05/2801 22:25 5167346407 ~z~UEL.~STEELMAH PAGE 01/01 S A M U E L S & S T E E ~ M A N July 6, 2001 Building Department $outhold Town Hall FAX 765 1823 Re: Z. ALNER RESIDENCE APPLICATION At'm: Bruno Semon As per our phone conversation yesterday, please note that the area of the first floor is 1430 square feet. At one square inch of 'flow through vent" area per each square foot of footprint, we will provide approximately ten square feet of vent area (1440 square inches), or three two foot square vents (12 square feet). As per the PLANS, we will also fill the crawl space level with the existing grade on the creek side of the house, Please call with any other questions or concerns. Otherwise we look forward to receiving notice that the permit is ready. you help, ARCH,[TECT5 25235 MAIN ROAD CUTCHOGUE, NEW' YORK 119..t5 (631 ) 734-6405 FAX {631) 734-6407 BUILDING PERMIT REVIEW CHECK LIST APPLICANT NAME: ~--,n L., DATE REVIEWED: .~ /_4' /01 DATE SUBMITTED: -~/g' /01 SCTM#--- DISTRICT: 1,000 SECTION: /04 BLOCK: fo LOT: ..2,/ STREET: ?oo /~.-~,~-~_~ /'/¢-o CITT,,,:r~°~/;55 SUBDIV. NAME:/'~'~'~'~/ PROJECT DESCRIPTION: ADE~ACC OR N/D: I'~/~e't,'7''ez~$¢~$ ' ~ /~-a~e~ ARCHITECT/ENGINEER: ~a,-, .-,..~ FAST TRACK~.~RNO SINGLE SEPA TE CERTIFICATION-REQUIRED: YES o O)NOTES: LOTS 40,000SF -100-24. Lot recognifion.(CREATED before June 30, 1983), UNDERSIZED LO~M JAN. 1997' 100-25. Merger,(A nonconforming at any time after 7/!/83) ZONING: PERMIT ESTIMATE AMOUNT:_$ .~Ot5 X .00 PERMIT USE: EXISTING: --~) INTENDED: ZONINGDISTRICTOg0, AC, CONFORMIN~RNO REQUIRED LOT SIZE: ~ SQFT. WHERE ACTUAL LOT SIZE FRO~i~ ACTUAL LOT SIZE: e9 2/.TO SQFT. REQUIRED RED REQUIRED ST 1 FOUND: FRONT:.~O ' PROPOSED:ToO ' SIDE YD: Zg' '/.~--s/' PROPOSED:7t~/ '/ ' REAR: ~'C) ' PROPOSED.~ 2~D FOUND: FRONT: ACTUAL: ' SIDE YD: '/ ' ACTUAL: '/ ' REAR: ' ACTUAL: ' LOT COVERAI3E: ALLOWED:~ % EXISTING: sf % NEW: sf % TOTAL: 3t >? sf4g % CORNER? ~OR NO WAT E~-FRONT? ~R NO DESCRIPTION: ~ r~oa~,-~ FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: /dOe FLOOD ZONE: PERMIT #:RI0- AGENCY PERMITS REQUIRED FOR REVIEW INCLUDED IN APPLICATION TOWN SPETIC PERMIT: YES or NO SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE:__/ /__ ~...~APPROVALS REQUIRED: NEW YORK STATE DEC: PRE-DEC 9/1/7~E~ or NO ~2.~-~,z-,~sz///oooot SOUTHOLD TO~ TRUSTEES: ~orNO ~4~ //~ TO~ ZON~G BOA~ APPROVAL~S or~ ' ' TO~ PLAN. BOARD APPROVAL: YES o~ TO~ HISTORICAL PRE (SPL~): YES or~ NYS ENERG R NO : EGRESS: VENT: LIGHT: BUILD~G PE~S OPEN/EXPIRED: BP 4~o -Z / C/0 Z- ,_ HAVE PRE C~: Y OR N BP -Z / C/0 Z- . ,. FEE STRUCTURE: FOUNDATION: ~ SF FIRST FLOOR : ..2.2 ;>..> SF SECOND FLR : /4~q' SF TOTAL: .~.7~ / SF rOT( 37 /I SF)- ( &..~9 SF)= ~25)// SF X $ ,~ =$ ~'~.~a~ +$ INIT OTHER TOTAL FEE FEE FEE . Albert J. Kr~pski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD July 26, 2001 Mr. Tom Samuels Samuels & Steelman 25235 Main Road Cutchogue, NY 11935 RE: Joe & Judy Zalner 700 Broadwaters Road Cutchogue, NY SCTM#104-10-2.1 Dear Mr. Samuels: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday. July 25, 2001. RESOLVED, that the Southold Town Board of Trustees grant an Amendment to Permit #5249 for a new sanitary system. However, this permit does not constitute any other permits from other agencies. If you have any questions, please call our office at 765-1892. Sjocer. ely_ ~, Albert J. Krupgki, Jr. President, Board of Trustees AJK/cjc CC: DEC Health Department Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 27,2000 Samuel & Steelman Architects 25235 Main Road Cutchogue, NY 11935 RE: JOE & JUDY ZALNER 700 BROADWATERS ROAD CUTCHOGUE, NY SCTM# 104-10-2.1 Dear Mr. Samuels: The following action was taken by the Board of Town Trustees during a Regular Meeting, held on November 21, 2000. regarding the above matter. WHEREAS, SAMUELS & STEELMAN ARCHITECTS on behalf of JOE & JUDY ZALNER applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated November 3, 2000 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 November 21, 2000 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 structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, 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 JOE & JUDY ZALNER to construct a 120 sq. ft. addition to S.E. corner of house, rework first and second floor plan use existing interior first floor area for single car garage. With the conditions that before any kind of grading and landscaping is done that the applicant show the plans to the Board for approval. 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 project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued witin six months of the date of this notification. 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 when project is started and on completion of said project. FEES: NONE Very truly yours, Albert J. Krupski, Jr. President, Board of Trustees AJK/cjc cc: DEC ~ealth Department Dept. of State Building Dept. Board Of $outhold Town Trustees SOUTHOLD0 NEW YORK DATE: ..1~x...21.,2~.00 ISSUED TO ...JOE .& J~DY ZALNE!~ .................. uthoriza ion Pursuant to the provisions of Chspter 615 of the Laws of the State of New York, 1893; and Chapter 4(H of the Laws of the · State of New York 1952; and the Southold ToWn Ordinance en- titled ."REGULATING AND THE PLACING OF OBSTRUCTIONS 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 e meeting held on ~..°..~.~.~.k~.~...21, 200.0 ....... and in ¢onslderation of the sum of $....1.50.,.0.0 ...... paid by $~mue!s...~....~t~el~.~T)...Arct~tec~s on. beh~....9..~....J..q~...~:..>l..u...c~¥....Zalne] of .Gu.tcho.g.u.e., ................................................ Iq. Y. and sub,[ect to the Terms aaa~ Cond~tlons listed on the reverse s,de hereof, of Southold Town Trustees authorizes and permits the following: to construct a 120 sq. ft. addition to S,E. ~orner of house rework first and second floor plan Use exis't~ng interior first floor area 'fo~ single car garage. With the conditions that. before any. kind of ~radin~ a~d lao.dsC~ping; is don~ ~l~at all in accordance with the detailed speciticah6ns as presentea ,n :the or;gJnafing apPl;cafion. ~t~e applicant, show the__pj~r~s IN WITNESS WHEREOF, ~ne sa,aeoara by'caUses its Corporate Seal fo'be affixed, and these presents .to be subscribed by a 'majority of the said Board as of this date. - ' Trustees NEW YORK STATE DEPARTMENT OF ENVtRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE February 27, 2002 EXPIRATION DATE(S) February 27, 2006 [] Renewal [] Modification · Permit to Construct [] Permit to Operate Article 15, Title 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island Welts Article 15, Title 27: Wild, Scenic and Recreational Rivers 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wet[ands · Article 25: Tidal Wet[ands [] Article 27, Title 7; 6N¥CRR 360: So[id Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles I, 3~ 17, 19, 2?, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Joseph Zatner (718) 544-4003 ADDRESS OF PERMITTER 68-39 Manse Street, Forest Hi[Is, NY 11375 CONTACT PERSON FOR PERMITTED WORK Thomas Samuels, 25235 Main Road, Cutchogue, NY 11935 TELEPHONE NUMBER (631) 734-6405 NAME AND ADDRESS OF PROJECT/FACILITY Za[ner property, 700 Broadwaters Road, Cutchogue LOCATION OF PROJECT/FACtLITY SCTM #1000-104-10-2.1 COUNTY Suffolk TOWN Southotd WATERCOURSE Broadwaters Cove NYTM COORDINATES DESCRIPTION OF AUTHORIZED ACTIVITY: Remove existing septic system, add 25 cubic yards fill material, install new septic system, relocate accessory building, remove existing frame shed, install new drywells, and relocate driveway. All work must be done in accordance with the attached plans stamped NYSDEC approved on 2~26~02. '~ ~'~ i ,, i I By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, alt applicable regulations, the Genera[ Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: Mark C. Carrara (CKW) AUTHORIZED SIGNATURE IADDRESS Bldg. #40, SUNY, Stony Brook, NY 11790-2356 DATE February 27, 2002 Page i of 4 Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 03/21/02 Transaction(s): Septic Permit - Construct - Resid. Receipt: 9952 Subtotal $10.00 Check#: 09952 Total Paid: $10.00 Name: Samuels, & Steeiman 25235 Main Rd Cutchogue, NY 11935 Clerk ID: BONNIED Internal ID: 51484 ? ;' JUDITH T. TEI~RY TOWN CLERK REGISTRAR OF VITAl. STATISTICS MARRIAGE OFFICER RECORDS MANAGEMENT OFFICER FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 Fax (5161 765-1823 Telephone (5161 76%1801 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)]. Southold Town Clerk August 25, 1993 APPLICATION # PAGE i 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 sign): 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 Certdlcate 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 Admlni~trator or his/her representative to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN A'Iq'ACHMENTS TO _ THIS APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE, TRUE AND ACCURATE. (APPLICANT'S SIGNATURE) ' DATE , SECTION 2: PROPOSED DEVELOPMENT (To be completed by APPLICANT~ NAME ADDRESS APPL c rT/-/v 6" dmdbT TELEPHONE 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(931 APPLICATION # PAGE 2 OF a DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY [] New Structure [~ddition teration [] Relocation ~emolition El Replacement STRUCTURE TYPE ~Residential (1-4 Family) [3 Residential (More than 4 Family) [] Non-residential (Floodproo£mg? [] Yes) [] Combined Use (Residential & Commercial) [] Manufactured (Mobile) Home (In Manu- factured Home Park7 [] Yes) ESTIMATED COST OF PROJECT B. OTHER DEVELOPMENT ACTIVITIES: [] Fill [] Mining [] Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) - El 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 ADMINISTRATOR) The proposed development is located on FIRM Panel No ....... Dated The Proposed Development: [] Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). [] Is located in a Special Flood Hazard Area. FIRM zone designation ks 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 lb'st floor, details of floodproofmg of utilities located below the fa'st floor and details of enclosures below the first floor· Also, , , El 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 f'fll elevation Ft. NGVD (MSL). 12] Floodproof'mg 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 £mdlng 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 attached to and made part of this permit. ' · The permit is issued subject to the conditions SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated 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. APPEALS: Appealed to Board of Appeals? El Yes [] No Hearing date: Appeals Board Decision --- Approved? [21 Yes Conditions [] No APPLICATION # PAGE 4 OF 4 SECTION 6:, AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Como!iance is issued) The following hfformation 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 floodproof'mg 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 commtmi0fs local law for flood damage prevention. INSPECTIONS: DATE BY DEFICIENCIES? [] YES E] NO DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES7 [] YES El NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: 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 El VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # ,19 SIGNED: DATED: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # ,19__, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93) S A M U E L S & S' T E E L M A N January 29,2002 Building Department Town Hall southold, NY 11971 Re: ZALNER RESIDENCE BP# 27453 Z Attn: Gary Fish Please amend the above referenced permit as per the revised FLOOR PLANS (three stamped sets enclosed). The principal revision is to the exterior walls; we have now replaced all exterior wall framing on the house with 2x6 studs, which are in the exact location of the formerly existing 2x4 stud walls. This change has resulted in a stronger, more integral structure, especially since many door and window locations were changed. It will also allow us to insulate the walls with R-19 fiberglass batts, and thereby improve the house's overall energy rating. The existing concrete block foundation and first floor joist framing was found to be sufficient, and so remains. All other aspects of the work comply with the dimensions and details of the CONSTRUCTION DOCUMENTS, as originally permitted. Please make the necessary adjustments to the building permit file, and prepare to make a framing and plumbing inspection at the request of the general contractor, Fred Seifert. Thank you very much, ARCHITECTS 25235 MAIN ROAD CUTCHOGUE, NEWYORK 11935 (631) 734-6405 FAX (631) 734-6407 765-1802 BUILDING DEPT. [ ] INSPECTION FOUNDATION 1ST [ ~'~ROUGH PLBG. ] FOUNDATION 2ND [ ]INSULATION FRAMING [ ] FINAL []FIREPLACE&CHIMNEY REMARKS ?~) ~CF_~~ DATE / / INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F~JNDATION2ND [ ]INSULATION [~./JFRAMING [ ] FINAL [ ] FIREPLACE & C~HIMNEY INSPECTOR 765-t802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] RO/UGI~PLBG. [ ] FOUNDATION 2ND [/~'"INSULATION [ ] FRAMING [ ] FINAL []FIREPLACE&CHI?NEY .,..... REMARKS: ~~/~c~~ DATE //~/~ ~'INSPECTOR / '/ BUILDIN~ DEPT. INSPECTION [ ] FOUNDATION 1S'T [ ] ROUGH PLBG. [ ] FO~NDATION2NI) [//.,~INSULATION' [ ] FIMMII~ [ ]FINAL [ ] FIRIFLAOE & GHIMNEY ~ DATE INSPECTOR SPECTION ION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY RF~.MARKS: ~ - DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I~ATIoN [ ] FRAMING [,,/] FINAL [ ] FIREP/~E & CHIM~NEY 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION2ND [ ]INS~LATION [ ]FRAMING [/~J~ FINAL [ ] FIREPLA~,I~ & CHIMNEY RE~A/~KS:/~J~ DATE INSPECTOR ~..~~~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY · DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ,,~ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ~ / DATE INSPECTOR :PE~ION REPORT - : ' ~ ~ CO~4ENTS ROUGH FRAI4E & PLUI~IItG (2NO) INSULATION PER N. Y. STATE EI~ERGY CODE BUIL'DING DEPARTMenT TOWN HALL 11971 TEL: 765-11102 Examined ~//_.y~ ,20~/.. Approved ,'~/~ ,20Za/ Disapproved a/c Building Inspector DUII,DIINO PEK.MIl AI~I~LIIJA'fiDN (/~HECK.LI5 Do you have or need ~e follo~g, before applyinE Bo~d of Heal~ 3 sets of Building Plans S~ex Check S~ Fo~ ~.Y.S.D.E.C. T~stees Contact: Phone: '-) 5 1.../--0 ('~0 ~'- APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date/ ; } . ,20 O J a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 ' sets of plans, accurate plot plan to scale. Fee according to sct/edule. b. Plot plan showing location of lot and of buildings ~n'premises, relationship to adjoining premises or public streets or areas, and waterways. 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 a permit shall be kept on the premises available for inspection througho.ut'the work. e. No building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupan is issued by the Building Inspector. APPLICATION IS HEREBY MADE to the Building. Department for the issuance of a Building Permit pursuant to the Building 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 coinply with all applicable laws, ordinane'.es, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neeessa~ inspections... ~ '" ~- . .. N~(~~if a corporation) (Mailing address of applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ., Name of owner ofp~emises ~Y'O-S~p/'~.~ '~' ~J'Mt~r- ~l~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authoriz..'bd officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: ?cr roaclooM g-d ' House Number Street County Tax Map No. 1000 Section Subdivision P0a$5ox) ~_DjaJc5 (Name) Hamlet 'Block t0 Lot Filed Map No. Lot stare ex~snng.use ana occupancy of premises and intended use and occ_,upan,cypfProposed a. -Exis/ing use and occupancy .., ,~'l~q~.. ~l'lai, J'{A~ ~<~'~XI ¢Jel,'lO,-.-9-,. construction: b. intended use and occupancy ~ggl'%--~ Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~ e~(5'bI ~ Ifdwelling, number ofdwelling units ~ If garage, number of cars 6q~-sk Fee Addition Other Work Alteration (Description) (to be paid on filing this application) Number of dwelling units on each floor --- If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~1-( }CRT. Rear ~z (ID 15'-/'. Height ~,D (~1'-, Number of Stories -'TcOO Dimensions of same structure with alterations or additions: Front ~ ~r'T'., Rear Depth ~/ FT7 Height ~1 ~'~. Number of Stories -'T'cO O Depth Name of Former Owner --7'Oa4-; I10 1. Zone or use district in which premises are situated ID- .~(...~ 2. Does proposed construction violate any zoning law, ordinance or regulation: b,~ C) 3. Wilt lot be re-graded K~ Will excess fill be removed from premises: 4. Names of Owner ofprem, ises ~.lyx, I,.,x. Address ~ 4-~S PhoncNo.'-~l~-5~/c/'~~ Name ofArchitect.5//~00~ ~ -.,%k,a~~ Address O,,dr_.,/a~ Phone No Name of Contractor Address ~ Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES L,-""' NO · rF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED;/ ,. Dimensions of entire new construction: Front 1~,) 155T~ Rear ~ I ~'T' Depth {o 657.-. Height ~! ~-'i- Number of Stories -/~ O '. Size of lot: Front ?'z~ ('~T". Rear _'z~5'" 155"T'. Depth 2~ I -~T"- 0. Date of Purchase 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK) SS: :0LrNTY 0F_CD~. ~r ) -/7q-O//4~ O, ~ZP..F/4.,g~e-'/-~ · being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, ~)He is the ~ff. SJ'} J~ (Contractor, Agent, Corporate Officer, ere,) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; mt all statements contained in this application are true to the best of his knowledge and belief; and that the work will be :rformed in the manner set forth in the application filed therewith. worn to before me this or/ il 2o01 Notary Public PATRICIA RICHARDS Notary Public, State of New York No. 01RI6042467 Q~J~lifled in Suffolk County Comml~sion Expires May 30, BROADWATERS PLAN PROPERTY: 700 BROADWATE~S ROAD CUTCHOGUE, NEW YORK JOE & JUDY ZALNER FOREST HILLS, NEW YORK 11375 SCALE; 1' - EEO SPECIAL CONDITION lNG PLAN AND/OR PLOT PLAN 1384) ROA NO~E AVenUE RNERHEAD NEW¥~K 1't~1 Z LM NOTE: EoGE O,F WETLA~ A$ ~1~ ~ FLAGGED mY EN-CONSULTAHT$ INC Z O PROPOSED NEW SEPTIC SYSTEM I I~ili (3) 8' D4~ X 2' D~EP EXPANSION POOLS ~u .~. TEST HOLE DATA ( ~11/2~1j 11AM ~ ~. 4.s F~ BROVm S.-TY SA~ S" q FT $~LTY SANO 14FTj FINE TO MEDIUM ~&N~ SP / SEPTIC PROFILE J