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HomeMy WebLinkAbout27940-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29263 Date: 02/11/03 THIS CERTIFIES that the building ADDITIONS Location of Property: 1335 MARRATOOKA RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 115 Block 11 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated NOVEMBER 8, 2001 pursuant to which Building Permit No. 27940-Z dated DECEMBER 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 RAISED PATIO ADDITION WITH INGROUND SWIMMING POOL AND FENCE TO CODE AS APPLIED FOR. The certificate is issued to THOMAS C & SUSAN S MERIAM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3370 02/04/03 PLUMBERS CERTIFICATION DATED N/A Au.�Aorize& 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. 27940 Z Date DECEMBER 6, 2001 Permission is hereby granted to: THOMAS C MERIAM 15 DORCHESTER ROAD ROCKVILLE CENTRE,NY 11570 for . CONSTRUCTION OF A RAISED PATIO ADDITION WITH INGROUND SWIMMING POOL AND FENCE TO CODE PER DEC AND TRUSTEES CONDITIONS at premises located at 1335 MARRATOOKA RD MATTITUCK County Tax Map No. 473889 Section 115 Block 0011 Lot No. 026 pursuant to application dated NOVEMBER 8 , 2001 and approved by the Building Inspector. Fee $ 661 . 50 J Authorized Signature ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT FEB ( 0 U? TOWN HALL 765-1802 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. 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 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial $15.00 Date. 2/5/03 New Construction: Old or Pre-existing Building: x (check one) Location of Property: 1335 Marratooka Road, Mattituck House No. Street Hamlet Owner or Owners of Property: Thomas C. Meriam Suffolk County Tax Map No 1000, Section 1 1 5 Block 11 Lot 26 Subdivision Filed Map. Lot: Permit No. 27940 Date of Permit. 12/6/01 Applicant: John Schoeck Health Dept. Approval: N/A Underwriters Approval: Enclosed Planning Board Approval: Request for: Temporary Certificate Final Certificate: X (check one) Fee Submitted: $ 2 5 .0 0 is ignature Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street • Center Moriches,New York 11934 • Tel: 631-878-3500 • Fax: 631-878-3764 Application: 3370 Date: 2/4/03 Issued to: Meriam Address:. 1335 Maratooka Rd Village: Mattituck Zip: 11952 Introduced By: Evergreen Electric License#: 4536-E was examined and found to be in compliance with the National Electrical Code Attic 1st Floor Res clenbali Pool Det.Garage Basenent 2nd floor Corrrrerdal Hot Tub Ado9tion Switches Receptacles Fixtures G.F.I. Timeclock Pool Heater 1 2 2-500Watt 2 20A 1-Gas Fans Dishwasher Washer/Amps Dryer/Amps Oven Carbon Range/Amps Monoxide Furnace Oil Gas Heat Zones Smoke Bell Detectors Transformers Meter Amps Phase Motors Other Equipment: Out,Res Z��� This certificate must not be altered in any manner Permit#: 27940-Z Applicant/ Date Owners Naive: 17)ovn s /4evi2Wr Reviewed: 03 of Architect/ �— Date Engineer: Submitted: �i 67 SCTM 0: District: 1,000 Secllon: 115- Block: Lot: a Pv Project /7z J5- �- ,fin Subdivision 6 Location: /la-✓�./oU� KTX• . _ Name: i Sin&Ie & separate Required certification: ,,//��/(Yes/No, Req Zoning Omricc_-� (Lor size: � L� d _.•. ual: 6 l 7 I JIAI coverage ,/,0 le Prolxised Req. / 4 IRey. A ` 1 Req. — (Front Pard Proposed:• � (Side Yard Proposed: ) [Rear Yard 5 0 propos. Project Description: AGENCYRERMITS Permit . REUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. /`x/7 �? Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: e . e4--vt,t1E 4-o I—A lL� 2�V0/ If Joseph A. Ingegno Tel: (631) 727-2090 Land Surveyor oFFices LOCATED AT Fax: (631) 727-1727 P.O. Box 1931 1380 Roanoke Avenue Riverhead, N.Y. 11901 Riverhead, MY 11901-0965 Email:ingegnolandsunieyor@ieaccess.net December 4, 2001 Town of Southold Building Department Main Road Southold, New York 11971 Att: Pat Re: 1000-1IS-11-26 Thomas and Susan Meriam Dear Pat: The proposed swimming pool and patio for the above property are in the X flood zone as scaled from the FEMA Map no. 36103C0482G. Should yo have any questions, please do not hesitate to contact me at anytime at the above numb V truly o AUL Joseph gno, P.L.S. BLDG, DS_PT. Tp�1y OUTHO D djc Albert J. Krupski, PresidentY suf Town Hall James King,Vice-President �,0 L'0 53095 Route 25 `Z� G P.O.Box 1179 Henry Smith y� Artie Foster Southold, New York 11971-0959 � y � Ken Poliwoda Telephone (631) 765-1592 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 26, 2001 Mr. Robert E. Herrmann En-Consultants, Inc. 1329 North Sea Rd. Southampton,NY 11968 RE: THOMAS & SUSAN MERIAM 1335 Marratooka Rd., Mattituck SCTM#115-11-26 Dear Mr. Herrmann: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 24, 2001 regarding the above matter: WHEREAS, En-Consultants, Inc. on behalf of THOMAS & SUSAN MERIAM applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated September 30, 2001, 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 24, 2001, 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 standards 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, .2 NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of THOMAS & SUSAN MERIAM to install a swimming pool and patio; retaining wall and planter; deck addition and steps; and install a pool drywell to contain backwash, with the condition that the pool drywell is moved to the other side, away from the adjacent neighbor, and a row of hay bales are placed down around the project during construction. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency, which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. Fees: None Very truly yours,, Albert J. Krupski, Jr. President, Board of Trustees AJK/lms DEC Bldg. Dept. I4 �a .. .?�+A!'... R.�.4r. •M. .. .• t-Jilt-s•.�R. ,r..�.�s' :�� .Lµ','t L :•T a .. ' ees f'. Board Of Southold Town Trustees �. SOUTHOLD, NEW YORK ` October 26 200 PERMIT NO. _ .__. y3 DATE: ........._ ._ THOMAS &...SUSAN...M.i .RLE�M_._....................................._.._. ISSUED TO .................................. x '� .�1ttl�Ltxt��IftAri �n Pursuant to the provisions of Chapter 615 of the Laws-of the State of New York, 1893; and Chapter 404 of the Laws of the 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 a meeting held on Oct. 24, 20011 and in consideration of the sum of $.......50.00 paid by + Thomas & Susan Meriam ,t .._.......... _..... ................._....................................,............... ...... :5 Cutchogue N. Y. and. subject to the Terms and Conditions listed on the reverse side hereof, CC {{,, T w },yes authorizes and erm is t{,e folio i s' Wetld'� Y t� �n� �rll-a swimming pool patio; rea�i�iing wal and planter; deck addition and steps; install a pool drywell to contain backwash, with the condition that the pool drywell is mo . ". to the other side, away from the adjacent neighbor, and a row of had in bales wag a c'I�ef$ilgd s` ec c o°� as � e8° ist. ' the originating application. it IN WITNESS WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. F01,��0 z Trustees i . Y A � T TRUSTEES Na Issued To16 , _q+fin Mmocate 10J�)o�hl Address ► WS ma "fto6e6 M. M&HiiaclC THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION I TOWN TRUSTEES OFFICE TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 I. TERMS and CONDITIONS lie Permittee Thomas & Susan Meriarn residing at 1335 Marratooka Rd. , Mattituck N. y, as parr of the consideration for the issuance of the Permit does understand and presm'be to the fol- lowing:. 1. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claian for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permitox will, at his or Ler own expense, defend any and all such suits initiated by third parties, and the said Per *ft assumes fall liability with respect thereto, to the complete exclusion of the Board of Trustees of the Tows of Southold 2. That this Permit is valid for a period of 24 mos, whidr is considered to be the estimated time'required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. .13. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-aompliana with,the provisions of the originating application, may be awse for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That if future operations of the Town of Southold require the.removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the. work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold 8. That the said Board will be notified by the Permittee of the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consent% drat may be requited sup- plemental to this permit which may be subject to revoke upon failure to obtain same. t . New Yo' k State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, New York 11790-2356 AM Telephone (516) 444-0365 Facsimile (516) 444-0360 Erin M. Crotty Commissioner October 12, 2001 Thomas & Susan Meriam 15 Dorchester Road Rockville Centre, NY 11570 RE: 1-4738-02784/00002 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, �-tam MarilynPeterson Environmental Analyst MEP/ls Enclosure Suffolk County Executive's Office of Citizen Affairs VETERANS MEMORIAL HIGHWAY • HAUPPAUGE, NEW YORK 11788 DATE ISSUED May 1 , 1984 No 9585-HI SUFFOLK COUNTY . . . . . . . . . . . . . . �IIztiP �.�1m�rII�emPn# l�IIri#rtt�tIIr �-�1tCEx[SE This is to certify that John R. Schoeck r,. doing business as John ' s Swimming Pools Inc , having furnished the requirements set forth in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York, is hereby licensed to conduct business as a HOME IMPROVEMENT CONTRACTOR, in the County of Suffolk. THIS LICENSE EXPIRES . . .may-1.. 19 97 99 01 v __C, ' �,✓ NOT VALID WITHOUT DEPARTMENTAL SEAL Director CA22 36-120.3 93cs NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-02784/00002 October 12, 2001 FACILITY/PROGRAM NUMBER(S) P E RM I T EXPIRATION DATE(S) Under the Environmental Conservation Law October 31, 2006 TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR SUPPLY 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Thomas & Susan Meriam (516) 766-5461 ADDRESS OF PERMITTEE 15 Dorchester Road Rockville Centre NY 11570 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER EnConsultants, Inc., 1329 North Sea Road, Southampton, NY 11968 (631) 283-6360 NAME AND ADDRESS OF PROJECT/FACILITY Meriam property, 1335 Marratooka Road LOCATION OF PROJECT/FACILITY Mattituck COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a 35'x 42'swimming pool, patio, retaining wall, planter, deck additions, steps and a drywell. All work must be done in accordance with the attached plans stamped NYSDEC approved. '<A e /9p/ tt.�, c>� � �3:c�e.('l 10,41 4va,- nof lse 0nloul ard�,,ckJ on °t9�:w{d®/a� ,r' 6c?vy d f.t�(�►�Idciicns� NYsDjE-C- nv A/Y.i'O4C 10rr-414� rs Ice dry✓ , �'a"r /r-,.1e�d cl( / ` c0"le"A /f/f®/r By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS Roger Evans (MEP) Bldg. #40 SUNY, Stony Brook NY 11790-2356 AUTHORIZED SIGNATURE DATE October 12 2001 Page i of 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands,easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records,is subjectto inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification ortransfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg#40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. DEC PERMIT NUMBER PAGE 2 OF 4 1-4738-02784/00002 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 (TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work,obstructions,or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue from any such damage. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S.Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly,without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall,without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 8. If granted under 6NYCRR Part 608,the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a surrey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by: Joseph Inciecino dated 3/21/00 last revised 8/10/01. D 1-4738-02784/00002 EC PERMIT NUMBER PAGE 3 OF 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 2. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than the existing driveway or landward side of house. 3. Necessary erosion control measures i.e., haybales, silt fencing, etc. are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good condition until thick vegetative cover is established. 4. Dry wells for pool filter backwash shall be located a minimum of 100 feet landward of the tidal wetland boundary. 5. There shall be no draining of swimming pool water directly or indirectly into tidal wetlands or protected buffer areas. DEC PERMIT NUMBER PAGE 4 OF 4 1-4738-02784/00002 W20-1 (8187)-9d New York State Department of Environmental Conservation No' NOTIC V The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administrator listed below. Please refer to the permit number shown when contacting the DEC. / / �/ Regional Permit Administrator Permit Number '`7' "1 02- J®HN W. RAVACIC Expiration Date 3 q?- NOTE: This notice is NOT a permit suIuHNo oar. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ 11 TION [ 1 FRAMING [ FINAL j, 1 t� I 1 FIREPLACE & CHIMNEY REMARKS: DATE /1-.0or-ld-3INSPECTOR FISLD INSPECTIQN REPORT DATE COMMENTS FOUNDATION OST) [OUNDATION CL ROUGH FRAME & -PLUMBING r [NSOf.ATION PER. N. Y.- c �.c f STATS ENERGY CODE P VIRAL MDITIONAL CONEWS: S n O O IV VV IN trr JVv1riVLL t= bU1LUIN 11 APPLICA110N CHECKLi6 BUILDING DEPARTMEh} i NOV 8 MD ave or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 i' BLDG.DEPT. 3 sets of Building Plans uJ. Na TEL: 765-1802 t i'Grxa C>s v 1�� �sD f �n Survey PERMIT NO. .52 ,7 9410 Check Septic Form N.Y.S.D.E.C. Trustees Examined .200/ Contact:. Approved ! O 200/ Mail to: Disapproved a/c Phone: Building m+ &anti.,.;.•-` APPLICATION FOR BUILDING PERMIT Date Z — Z - _, 200 / INSTRUCTIONS 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 schedule, b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or area, 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 throughout the work. FVNo building shall be occupied or used in whole or in part for any purpose what-so-ever until a Certificate of Occupar is isVu-ed 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 comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspectio "IMMEDIATELY" 2V ENCLOSE POOL TO CODEOCCUPANCY OR UPON COMPLETION / /(Signa a of applicant or name, if a corporation) BEFORE 'WATER" USE IS UNLAWFUL tj WITHOUT CERTIFICATE /° z &7/-2/ UNDERWRITERS CERTIFICATE OF OCCUPANCY (Mailing address of applicant) 78 Q Gr/�s,—/y.1i,�O7r�t9 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder APPRPVM AS NOtED DATE-_4Z14101 / Name of owner of premises Get EEE- It (as on the tax roll or latest deM)TIFY BUILDING DEPARTMENT AT 765.1802 S AM TO 4 PM FOR THE If applicant is a corporation, signature of duly authonzed officer FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REQUI"ro' FOR POURED CONCRETE (Name and title of corporate officer) 2 ROUGH • FRAMING & PLUW7 NG _ 3. INSULATION Builders License No. 9Jrd — /�-�- 4. FINAL - CONSTRUCTION Mi;3T BE COMPLET9 FOR C.O. Plumbers License No. ALL CONSTRUCTION SHALL MFET THE REQUIREMENTS OF THE N.Y. Electricians License No. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR Other Trade's License No. DESIGN OR CONSTRUCTION ERRORS 1. Location of land on which proposed work will be done: I ` t 135-,5' .P&- M:+711 TVC-k House Number Street Hamlet County Tax Map No. 1000 Section // Block %/ Lot Subdivision Filed Map No. Lot (Name) state existing use and occupancy of premises and intended use and occupancy of proposed construction:_ a. Existing rise andoccupancy e b. Intended use and occupancy Nature of work (check which applicable): New Building x Addition Alteration Repair Removal Demolition Other Work (Description) Estimated Cost 6 o o 0 - Fee i (to be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear ' Depth Height Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner 1 . Zone or use district in which premises are situated ?. Does proposed construction violate any zoning law, ordinance or regulation: 3. Will lot be re-graded�e5 Will excess fill be removed from premises: NO 133s •¢rn K0. 4. Names of Owner of premises / &e/Lict[vr Address Phone No. 6(o 6-0 /b Name of Architect Address Phone No Name of ContractorAddress v'i.R. .v ✓.' Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES _NO 4w • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED J 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) OUNTY 0Fg-;1 ,_. • c2" r:za�e ./L being duly swom, deposes and says that (s)he is the applicant (Nameof" ' a'V > g ontract) above named, i)He is the w (gin +� (Contractor, Agent, Corporate Officer, etc.) f said owner or owners, and 4 duly-authorized to perform or have performed the said work and to make and file this application; at all statements cohtt311ti8415{h:this application are true to the best of his knowledge and belief; and that the work will be erformed in the manner het fSartli"in tht application filed therewith. worn to before me this , cat* day of ` 1, : Notary ublic /' 'gnature of Applicant v � � L�y�nuOdc�i' s 95 ,JAL \ illlu ills \ GsG EL Fuc 1L Gj' 4y\ lsA �fLP� 114 AL FUG G O os \ ➢IIA �I I� A, \ �O O MG t il�c C11 o �m \\ f \ a \ 'G 100.00' ' •'�-F - OL Fuc , UP. 1 .i. • \`\ AL Aik, \ �S '.I • `0 n ` . 0� • \ / 11J, MG B}f A�L C, O' .• , . . J3 0 C �[O L, \ BAPOST FOR 1`P°,44 BACNBRp ov • ° J+'Wc00 Q \, JIIc L4Sf` �1IL .. o„�o .. . ? \• `_'_.4 MC 7��.'f WOOD RAMP METAL ' ` ♦ JAIL NC J� NICK POST MEGL Z' • 11 9:° 1 � Ja rz � CESSPO S � � F1rG FUG POST ' a ROPA,, _° _a u CONC CDVE115� WOCO N FLOATING METAL .. TA. C Nd WALL ,BRI { STETS . . 48' eTo .� , _ •MR9EQ� FUG p O 21.2 � � � A (n A W J c CO Wood % ,srEPs d w lgoon $IFPS ._. - J, FIG �I �0 8 12 v _ b \ UD as r .. se� oy F unlrpoNpmadER �'TTI y _r-mERrvpD WIRES "�� 10.s' pPECK • ze.e' � waoo RA \ mP� `i yy,�' i iI I I ,� r1,• IT . a}/ � �obi ED ^I pXOPI I�0 I \ FRAME iiBOAT HOUSE J O� c ..� .n A 1 L1 11 cA or+ l'` ''_i, y Deo' FO I ARgrv� TO NO FHA6,1 iwi 101 Av • �, �.�-MTaIM pUND I J!�i1! ° 1 aFSN0.BANG�tyO,i� wq i / e E LIL N N 70o, '• e LTER NE VJ WA ARY I o D1 CERTIFIED TO 4 SURVEY OF PROPERTY COMMONWEALTH LAND TITLE INSURANCE COMPANY ' ' ' fMn ''m. TITLE No. RH 8000-1105 w SITUATED AT THOMAS C. MERIAM o, 7T SUSAN S. MERIAM MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK S .C. TAX No. 1000- 115- 11 -26 SCALE 1 ”=30' UNATHORIZED ALTERATION OR ADCRION MARCH 21 , 2000 To THIS SURVEY IS A VIOLATION OF �• EDUCATOR LAW� THE NEW YORK STATE OCTOBER 3, 2000 ADDED TOPOGRAPHICAL SURVEY COPIES OF THIS SURVEY MAP NOT BEARING APRIL 23, 2001 ADDED PROPOSED POOL THE LAND SURVEYOR'S INKED SEAL ORMAY 17 2001 REVISED PROPOSED POOL & PATIO , EMBOSSED SEAL SHALL NOT BE CONSIDERED ?bo°y 2 TO BE A VALID TRUE COPY, JULY 19, 2001 ADDED FLAGGED WETLANDS LINE 0 CERTIFICATIONS INDICATED HEREON SHALL RUNUO• AUGUST 1c), 2001 REVISED PROPOSED POOL AC DECK LEGATION o � ONLY TO THE PERSON FOR WHOM THE SURVEY £ wo OCTOBER 29, 2001 REVISED MAP T5 PREPARED, AND ON HIS BEHALF TO THE ITLE COMPANY. GOVERNMENTAL AGENCY AND 'o, NOVEMBER 20, 2001 REVISED PROPOSED PATIO LENDING INSTTU70N LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. CERTFOATIONS ARE NOT TRANSFERABLE THE EXISTENCE OF RIGHTS OF WAY AREA = 91 ,617.69 Sq. ft. AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. NOT (TO TIE LINE) 2.1 CO. 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM EXISTING ELEVATIONS ARE SHOWN THUS:�O PREPARED Iry AccO60A E wRH THE MINIMUM EXISTING CONTOUR LINES ARE SHOWN THUS: — — — — —s— -- -- — — Joseph A. Ing egno BY THE `°R AN °fNES ASD AABLISHED DOPTED BY THE L.LALS AND PPROVED AND ADOPTEE p FOP SUCH USE BY T NEw YORK STATE LAND tf TITLE AS OCIATION Ir• Land Surveyor4° . s o Title Surveys — Subdivisions — Site Plans — Construction Layout N T. I ' U IV PHONE (631)727-2090 Fax (631)727-1727 �,�'\+ _ b CALLOW -I 3I UI OFFICES LOCATED AT MAILING ADDRESS V" �` „ItI(- BLDG.DEPT. 1380 ROANOKE AVENUE P.0 Box 1931 \`i Y N.Y S DO. NO 49668 A �l f 5 UTHOLD RIVERHEAD, New York 11901 Rlverhead, New York 11901-0966 20-189D r CoP.JO -'1 '. AUTor,np\'nC lye"hI"Ttytftb 1. P\AIwIG IS SMCaw►1 SCNtrMATt.CAILY AL$L . 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