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HomeMy WebLinkAbout26982-ZFORM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28710 Date: 08/14/02 · I~fS C~TIFIES that the building NEW DWELLING Location of Property: 2503 C~uMP MINEOLA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 9 Lot 9.4 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2000 pursuant to which Building Permit No. 26982-Z dated DECEMBER 19, 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 2%ND REAR COVERED PORCHES, REAR SECOND FLOOR DECK, AND COVERED SIDE DECK AS APPLIED FOR. ·"ne certificate is issued to EDWARD M & ARLENE R FOX (OWNER) of the aforesaid building. SUFFOLK COU~F~Y DEPi~RT~D~qT OF ~[F~%L~{i%PPRO~rAL R10-00-0087 08/12/02 ELEC~I~ICAL CERTIFICAT~ NO. 1044512 04/09/02 PLU)~BERS CERTIFICATION DAT~43 05/22/02 TALBOT PLUMBING & HEAT Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28711 Date: 08/14/02 %~{IS C~TIFIES that the building ACCESSORY Location of Property: 2503 CAMP MINEOLA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 122 Block 9 Lot 9.4 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2000 pursuant to which Building Permit No. 26982-Z dated DECEMBER 19, 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 INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. T~e certificate is issued to EDWARD M & ARLENE R FOX (OWNER) of the aforesaid building. SUFFOLK COUA~TY DEPARTMENT OF HEALT~ APPROVA/~ N/A ELE~rRICAL CERTIFICATE NO. 1047997 PLUMBBq~S CERTIFICATION D~£D N/A 04/24/02 ~//ed~ignat,re Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28712 Date: 08/14/02 T~£S CERTIFIES that the building ACCESSORY Location of Property: 2503 CAMP MINEOLA RD MATTITUCK (HOUSE NO.) (STREET) (HAMLET) Coux~ty Tax ~4ap NO. 473889 Section 122 Block 9 Lot 9.4 subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 2, 2000 pursuant to which Building Permit No. 26982-Z dated DECEMBER 19, 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 POOL HOUSE WITH ROOF OVER SLATE PATIO AND ATTACHED OUTDOOR SHOWER STALL AS APPLIED FOR. The certificate is issued to EDWARD M & ARLENE R FOX (OWNER) of the aforesaid building. SUFFOLK COUNTYDEPARTMENTOF~R~J~T~APPROVAL ELEC~fRICAL CERTIFICAI~ NO. PLUMBERS CERTIFICATION D~£~D N/A 1047997 04/24/02 N/A ed Si~ature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIT~ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26982 Z Date DECEMBER 19, 2000 Permission is hereby granted to: EDWARD M & ARLENE R FOX APT 8E NEW YORK CITY,NY 10021 for : CONSTRUCTION OF A 3 BEDROOM SINGLE FAMILY DWELLING WITH AN ACCY 20X40 INGROUND POOL & POOL HOUSE AS APPLIED FOR WITH TRUSTEE & DEC APPROVAL. at premises located at County Tax Map No. 473889 Section 122 pursuant to application dated NOVEMBER Building Inspector to expire on JUNE 2503 CAMP MINEOLA RD MATTITUCK Block 0009 Lot No. 009.004 2, 2000 and approved by the 19, 2002. Fee $ 807.70 Rev. 5/8/02 ORIGINAL gene OF SOUTHOLD APPI,ICATIOW FOR CERTIF{CA~[ O~ OCCU'PAN~, ~ls ~pficalion nms~ ~ fi![~ in by type~'rit~ or ink end s~bmir~d to Ibc Buitd,~g l)cp~t ~ith the fo{~: A~r~v,l o[elect~ca[ ~stallmion flora Bo.d of F~ 5, C~ bufl~i~, ind~-~l building, m~liple re~i~e~ ~ similar b~ldin~ ~u Campl~ce ~l ~hit~t at ~eg r~ibl~ for ~ building. S~{t ~g ~ App~val ofco~lei~ sRO plan req~te~tm. 1. Aca~te ~ ofpm~y s~wmg all ~y ~ifl~, str~s, ~ildi~ a~ un~! f~. · is dem~, 1he ~uildi~ Ins~Ior s~all ~atc thc reasons th~efor in ~iting lo the ~p]ic~. I, Ce~fl~le of~pancT - New dwelling $25.~., ~ditio~ to dw=tl~ $25.~), 2 C~ficMe of~ey on Pr~xi=tiug ~l~ng- Copy ofC~i~catc ofOccu~qncT - $25.00 4. U~i~ C~ifi~te ofO~u~cy - / Nt.~ CousU'ucli~m: ___ ~" Old or Pre~xi~tin8 Duilding: (c~k~e) ~ou~ No. St~c~ Lot o ~.. q. 4 SUffolk C~aty Tax Map No t~). Sectim~ .... }~.~ ....... Bl~k ~_ Su~iviaion ......... F~I~ Map. ~t N0. ~ ~ ~ ....... Date oF Pcb]it, .. A~li~nl: Pl~*~g ~*~r~ Approval: ........................... Request ilar: Tempora~ Ccetxfica, c ........... Final Cc~'tificate: ....... / (¢h~ck one) P.O. Box 11~ BOltJ>ltqO DGPART~GNT TOWN O~ (631) CERTIFICATION Date: 5"/ Building Permit No.__ ~ ~ q ~ ~,~ Owner: ~1~-~ g'o x (please print) Plumber: ~ ~rtl'< 4ot~[,<~ . (please print) I ce~i~ ~at the solder used in the water supply system contains less ~an 2/I0 of 1% lead. , Sworn to before me this dayof ~ , 20~ Notary Public, 5&{./~L/~ County Nora,2/Public - State of New York NO. 07MU6057891 Qualified in Suffolk County My Commission Expires Apr 30, BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD Of FIRE UNDERWRITERS BUREAU Of ELECTRICITY 40 FULTON STREET - NEW YORK, NY 1OO38 CERTIFIES THAT Upon the application of upon premises owned by g & S ELECTRICAL CONTR. ED FOX BOX 215 2503 CAMP MINEOLA ROAD SOUTHOLD, NY 1197i, MATTITUCK, NY 11952 Located at 2503 CAMP MINEOLA ROAD MATTITUCK, NY 11952 Application Number: 1044512 Certificate Number: 1044512 Section: 1000 Block: 122 Lot: 09-9.4 Building Permit: BDC: NS11 as a Residential occupancy, wherein the premises electrical system consisting Described electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Outside, Attic, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 9th Day of April, 2002. Name QTY Rat___~e Rating Circuit Type ~ Appliances and Accessories Oven 1 4.9 KW Exhaust Fan 1 F.H.P. Furnace 1 4 F.H.P. Ak Conditioner 2 Air Conditioner 1 3 Air Conditioner 1 3.5 Motors 111 F3.53 Panels 2 60 1 Wiring and Devices Outlet 66 Fixture Receptacle 63 General Purpose Switch 68 General Purpose seal Fixture 66 Incandescent C°ntinued °n 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 indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITEI $ BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by G & S ELECTRICAL CONTR. ED FOX BOX 215 2503 CAMP MINEOLA ROAD SOUTHOLD, NY 11971, MATTITUCK, NY 11952 Located at 2503 CAMP MINEOLA ROAD MATTITUCK, NY 11952 Application Number: 1044512 Certificate Number: 1044512 Section: 1000 Block: 122 Lot: 09-9.4 Building Permit: BDC: NS11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: ~ Fkst Floor, Second Floor, Outside, Attic, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 9th Day of ^pall, 2002. Name QTY Rate Rating _Circuit Type Receptacle 1 20 Special Receptacle 1 30 Special GFCI Circuit Breaker 10 Service 1 Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 CB Meters: 1 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 indicated. ~_ BY THIS CERTIFICATE OF COMPLIANCE THE a NEW YORK BOARD OF FIRE UNDERWRITERS _~ the BUREAU of OF ELECTRICITY owned ~ 40 FULTON STREET - NEW YORK. NY 10038 ~ CERTIFIES THAT r~ I  Upon application upon premises by G & S ELECTRICAL CONTR. ED FOX.=-1 2503 CAMP MINEOLA ROAD BOX 215 SOUTHOLD, NY 11971, MATTITUCK, NY 11952 Located at 2503 CAMP MINEOLA ROAD MATTITUCK, NY 11952 Application Number: 1047997 Certificate Number: 1047997 Section: 122 Block: 09 Lot: 9.4 Building Permit: BDC: NSll Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, POOL HOUSE, Outside, Pool/Spa, was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was found to be in compliance therewith on the 24th Day of April, 2002. Name QTY Rate Rating Circuit Type ~ Appliances and Accessories · Furnace 1 F.H.P. ~ Time Clock/Switch 1 40 Amps !m~Pool/Spa Bonding 1 Panels ~ 1 50 6 ~ Wiring and Devices ~ Outlet 11 Fixture ~ Receptacle 5 General Purpose ~ Switch 8 General Purpose ~ Fixture I 1 Incandescent ~ Receptacle 1 20 Special ~ Receptacle 2 GFCI [] seal ~ 1 of 1 ~ This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Albert J. Krupsld, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1852 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD February 24, 2000 Ms. Tanya Lachenmeyer Land Use Ecological Services Inc 2576 Sound Ave. Baiting Hollow, NY 11933 RE: EDWARD FOX SCTM #122-9-9.4 Dear Tanya, The following action was taken by the Southold Town Board of Trustees at their Regular Meeting on February 24, 2000: RESOLVED, that the Southold Town Board of Trustees grant an Amendment to Permit #5084 to reflect a new dwelling configuration and location, sanitary design, stone terrace instead of decking, a pool house and the addition of a 55' non-disturbance buffer located to the north of the proposed improvements, with condition that drywells and backwash be _for pool and haybales be placed at the 55' setback line. However, this permit does not constitute any other permits from other agencies. ~ If you have any questions, please call our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees aJK/djh cc. Bldg. Dept. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD November 3, 1999 Ms. Tanya Lachenmeyer Land Use Ecological Services, Inc. 2576 Sound Ave. Baiting Hollow, NY 11933 Re: Edward Fox SCTM#122-9-9.4 Dear Ms. Lachenmeyer: The following action was taken by the Board of Town Trustees during its regular meeting held on October 27, 1999 regarding the above matter: WHEREAS, Land Use Ecological Services, Inc. on behalf of EDWARD FOX applied to the $outhold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated August 12, 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 October 27, 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 structure complies with the standard set forth in Chapter 97 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 approve the application of EDWARD FOX to construct a single-family dwelling, deck and pool, and approx. 125 c.y. of clean fill required for proposed septic system with the condition that there be haybales at 55' except for the driveway, before construction and shown on a new set of plans. 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. ~wo 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 Dept. of Health Building Dept. Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. EDWARD FOX ISSUED TO DATE: Nov. 3, 1999 Aut'l ari atian Pursuant fo the provisions of Chapter 615 of the Laws of the State of New York, 1893: and Chapter 404 of fha Laws of the State of New York 1952: and the Soufhold ToWn Ordinance eh- rifled ."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 a meeting held on 99 19 ...... and in consideration of ;the sum of $ !SQ~.~0 . pald by Land Use Ecological Services for Edward Fox Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Construct a singfle-family dwelling, deck and pool, and approx. 125 cy. of clean fill required for proposed septic system with the condition that there be haybales at 55',except for drivewa] construction and shown on a new set of plans. all in accordance wlfh the detailed speciflcaflons as presented in the originating appllcafion. by IN WITNESS WHEREOF, The said Board of Trustees here- causes its Corporate Seal to be affixed, and these presents to subscribed by a majority of the sald Board as of this date. ' -- T~$1ee$ "'New York State Department of Environmental Conservation D,~vision of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www.dec.state.ny.us John P, Cahlll Commlmmloner April 11, 2000 Mr. Edward Fox 445 E. 80th Street, Apt. 8E New York, NY 10021 RE: 1-4738-02395/00001 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 care- fully. 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 be conspicuously posted at the project site and protected from the weather. Very truly yours, D~rleen M. Ger~no Environmental Analyst I DMG:cg enclosure DEC PERMIT NUMBER 1-4}38-02395/00001 FACILITY/PROGRAM NUMBER(S) TYPE OF PERMIT · New PERMIT Under the Environmental Conservation Law NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION IEFFECTIVE DATE April 11, 2000 EXPIRATION DATE(S) April 11, 2003 [] 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 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 Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: So[id Waste Managenlent [] Article 27, Title 9; 6NYCRR 3}3: 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 Edward Fox (212) 755-5390 ADDRESS OF PERMITTEE 445 East BOth Street, Apt. 8E New York, NY 10021 CONTACT PERSON FOR PERMITTED ~/ORK Tanya Lachenmeyer - Land Use Ecological Services, Inc. 2576 Sound Avenue, Baiting Hol[ow NY 11933 NAME AND ADDRESS OF PROJECT/FACILITY Fox Property R.O.W. off Camp Mineo[a Road~ Mattituck LOCATION OF PROJECT/FACILITY TELEPHONE NUMBER (631) 727-2400 SCTM #1000-122-09-9.4 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Peconic Bay & James Creek DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a single family dwelling with garage and porches, sanitary system, pervious driveway, pool, pool house, and stone terrace. Utilize 125 cubic yards of fill for the sanitary system. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, ail applicable regulations, the Genera[ Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: George W. Hammarth DMMG ADDRESS Bldg. #40, SUHY, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATUJ~E ./7' I DATE J Page 1 of 5 April 11, 200D I New .York State Department of Environmental Conservation NOTICE 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 natu.r.e, and ex!ent of work appro,v, ed and an.y. Depa. rt.mental .c. ond~t~ons on It, contact the Regional Permit Administrator I~sted below. Please refer t© the permit number shown when contacting the DEC. Permit Nu m b er /-2-//'~¢3 fi/" ¢ c~ 3 Expiration Date (~/- ///- ~ O O_~ Regional Permit Administrator JO__~N ~/~ PAVAC!C NOTE: This notice is NOT a permit 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 May 11, 2001 Mr. Edward Fox 445 East 80th Street, Apt. 8E New York, NY 10021 RE: 2503 Camp Mineola Rd., Mattimck SCTM#122-9-9.4 Dear Mr. Fox: The Southold Town Board of Trustees reviewed the survey dated June 24, 1999 and last revised May 10, 2001 and determined the proposed septic system 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. President, Board of Trustees AJK:lms Cc: Building Dept. Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (516) 765-1823 Telephone (516) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD STOP WORK ORDER TO:Edward M. Fox YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT: 2503 Camp Mineola Rd. Mattituck NY TAX MAP NUMBER: 122-9-9.4 Pursuant to Section 45-8 of the Code of the Town of Southold, New York, you are notified to immediately suspend all work and building activities until this order has been rescinded BASIS OF STOP WORK ORDER:Trustees approval required for Septic. CONDITIONS UNDER WHICH WORK MAY BE RESUMED: Trustees approval. Failure to remedy the conditions foresaid and to comply with the applicable provisions of law may constitute an offense punishable by fine imprisonment or both. DATED: 5/9/01 Edward Forres~r 765-1802 BUILDING DEPT. INSPECTION [/,/] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY. REMARKS: ~ ~c.~.,~_~.~~~/_ ~,~ INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] F/OUNDATION 1ST [ ] ROUGH PLBG. [ ,/] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE&CHIMNEY REMARKS: ~ ,.DATE INSPECTOR./_/~.,c,, 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGH PLBG. [ ] I.~UI,ATION [ ~]/FINAL []FIREPLACE&CHIMNEY R£MARKS: ~/~ DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST ['~OUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~~llNO [ ]FINAL [ ~ FIREPL~E & CHIMNEY DATE INSPE~O /,~ ,~ / ~~ 765-1802 ~~/_~ ~"~ BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] Rou/u~aH~LBG. [ ] FOUNDATION 2ND [~]~INSULATION [ ]FRAMING [ ]FINAL [ ] FIREPLACE & CHIMNEY REMARKS: FIELD INSPECTION REPORT FOUNDATION (1ST) DATE {{ {{ {{ {{ {{ II II Il Il il II FOUNDATION (2ND) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE Il II II il II II II II Jl 1I II II II Il II II II Il II H CO~ENTS Il Il Il II FINAL II Ii ADDITIONAL C~NTS: FORH NO. I 'I'(}~N OIr SOIITlIOl.i) 'I'O~N IIAI.I. SOUTIIOI.I}, N.Y. 1191 I TEl.: 765- 11102 Ex~-,,,i ~1 ................. , 19 .... Approv~×l ~'. ........... , Zlll)t2~. Pe,,it No. .. ............ I) i .qhl~,'oved a/~ (Ikfi I d lng Innl~-~:tor) APPI.1CA~'ioN FOE BUII.1)ING PERHI'F 1 NSTRUC'F IONS BOAIH) OF IIEAI.Tll ............... 3 SETS OF PL^NS ~, .............. SURVEY ....................... CIIECK ......................... SEPTIC FORH ................... NOTIFY: c^,.,.. T,,::,,~.,s,o,4~,r~ .,5. ,^,,. .... n. 'lhin application! ,mT.st I)e cT~,~letely fillc~l iTT by typc~riter or in ink mgl mflmitt~ to tl~ Ikfilding lnsl~ctor will 3 ~t, or plans, ncmrnte plot l,i~n to ~ale. F~ accordi~ to sd,~le. I,. Plot plnn ~ir~ l~atim of lot mil of I~tildi,~9 m pr~ni~9, relation~,ip to roi.joining pr~i~n or struts or areas, m~l ~ivi~ a ~klnil~l ~k~riptio~ of lay~,t of pro~rLy ,~mt I~ dr~ m the di,~ ~sich is l~Ort of d. IJl~l nff,r~al of this a~lic~ti~, tim Ikdldit~ Ins~ctor s~ill ismm a ~iiding Pemit to the applicant. ~1, Al'~.lC&'rl(~ IS I~ )~ to tl~ lkfildi~ lk~rt,unt for the i9~e of a ~dlding Pemlt ~]rm~3nt to the ~,iati~s, for tl~ co~st~ti~ of h,ildi~9, m~iti~s or alterati~s, or for r~al or ~liti~, 8s I~rein re{~]lati~s, m~l to minit m~ll~ri~ insl~tors u~ IT~i~s a~l in I~fihling for ~ces~ry ins~ctiu~s. .... ......... 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I~plh ...~.~.~.. ~bi~,, ...... ~.~.. ~: ...... .,,~ ,,~ ,,,,.i.. .... ~ ........... ,). .,,. ,,r ,~,,,:],,,,~ ..... ~.~.?.F ....... ~,,., ,,r ,~,,,,,~ ~ ........................................ I~. .ill Iol: I., ,eBr~ ...... ~ ........ .ill e~:e.s fill I~ 14. ~,,~s ~W (~r of proni~n .~ ................... ~klres~ .~~..~'.~.' .... ~.,,~ .r ~.,, ~:~,,~ .~.~ .................. m,~,~.. ~/.~ ............ 15. Is Il,is l. Olm~ty within ~) f~t of a t:i~b~l ~tlm.l? a YI~ .......... fi) .......... alF ~LS. ~IHIIX~ ]U~ 'I~II~.S IT[INI'I' F~Y 'I~[ "'J~'~:ale clearly ~.1 distinctly nil I~,ildlnSs, ~tl~r exlsl;ing or propel, m.I i,xlicate all ~t-I~:k dltmn~ions [~,n ptl~ix~ly li~s. ~i~ st~t n,~l bl~k i,,~i~r or ,~scrlptlm~ accoTding Io ~1. n~ ~ street ,.~ms arxl itxlicate sJ~llr~r inlerior or corr., lot. PATRICIA RICHARDS Notary Public, State of New York No. 01RI6042467 Qualified in Suffolk County ...... Co.mmlasion Expires May 30, 2002 ..... Al,Id ic;,n! ) CONCRETE FOUNDATION ;46"- W pECONIC BAY ~/LJ4,~t ,r 0.4 'E. c~JCK FOLLY suRVEY OF pRoPERTY SITUATED AT IVIATTITUCK TOWN OF sOUTHOLD SUFFOLK CouNTY, NEW YORK S.C. TAX No. t000-122-09 -g-4 SCALE 1"=50' JUNE 24, 1999 AUGUST 2, 1999 ADDED PROPOSED S~-F LATH FOR NYS.D.E AUGUST 30, 1999 REVISED SITE PLAN jANUARY 12, 2000 JULY 11, 2000 ADDED pROPOSED ~A~ER sERVIC~ JANUARY 30, ~001 UNDER CONSTRUCTION sURVEY AREA = 62,799.52 sq. ft. (%0 TIE LINE) I .442 oc. CERTIFIED TO_: FIRST AMERICAN TITLE INSURANCE coMPANY OF NEW YORK TITLE No. 151-s-B577 NORTH FORK BANK /~¢.-,~ EDWARD M. FOX A. Ingegno Land Surveyor Fox (631)727-~7~7 p HOt~E {651 )727-2090 t4 / i 7 ~r~ .A f~IJP41~O VACANT SURVEY OF t,ROi'ERTY M AT'ITFU C K TOWN OF SOUTHOLB sUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-122-09-9'4 SCALE 1"=50' JUNE ?.4, ~999 AUGUS]' 2, 1999 ADDED PROPOSED HOLJ~[ AREA = 62,799.52 sq- ft. [TO TIE LINE) t .442 ac. pBCONIC B~ TEST HOLE DATA HOLt; DUG BY ~'I;L~-O'~'I~ ON JUNE 2, NFtRST A TITLE INSURANCE cOMPANY OF NEW YORK TITLE No. 15t-5-8577 NORTH FORK BANK EDWARD M. FOX T T tngegno Surveyor Title 5ur~eY~ - 5ubdM~'o~s - ~e ~s - C~~ ~t Fax (516) p~E (516)727-2~ ~ ~ L~ AT p.O. ~, ~w Y~ 1193