HomeMy WebLinkAbout27856-Z j 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. 27856 Z Date NOVEMBER 1, 2001
Permission is hereby granted to:
JOSEPH L & WF WALDVOGEL
689 NEW PALTZ RD
HIGHLAND,NY 12528
for
NEW CONSTRUCTION OF A THREE BEDROOM SINGLE FAMILY DWELLING AS
APPLIED FOR.
at premises located at 660 ED 'S RD SOUTHOLD
County Tax Map No. 473889 Section 079 Block 0006 Lot No. 036
pursuant to application dated 'SEPTEMBER 7, 2001 and approved by the
Building Inspector.
Fee $ 1, 066 .20
Aut orized Signature
COPY
Rev. 2/19/98
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FORM NO.3 �=
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
� P ' ._ � •... Y ia3 TOWNIIALL
SOUTH6LD,NY 11971
TEL:'765-1802
BUILDING PERMIT APPLICATION CHECKLIST:
Do you have or need the following,before applying?:
Board of Health?
3 sets of Building Plans
Survey
Check-it 117,
Septic Form `
N.Y.S.D.E.C.
Trustees
Examined /0 1 q 20 Ste$
Approved 0! 20 d/ PERMIT NO, 2�8 SG
Disapproveda/c b'YLerN
j
Building Yspector
A
APPLICATION FOR BUILDING PERMIT
Date ?3 12 9 200/
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
ets of plans, accurate plot plan to sale.Fee according to schedule.
b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
reas, and jiving.4 detailed description of layout of propertymustbe drawn on the diagram which is part of this application.
c. The work covered by this application:may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
hall be kept on the premises available for inspection throughout the work.
e. No.building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
s all have been granted by the Building Inspector.
APPLICATION IS:IIEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
uilding Zone Ordinance of the Town of Southold,;Suffolk County,New York, and other applicable Laws,Ordinances or
egulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described.The
a plicant agrees to comply:with all applicable laws, ordinances,building code, housing code, and regulations,and to admit
a thorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant) 11,741
Sate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician plumber or builder
0
N e of owner of premises X- Jlwei-� t
(as on the tax roll or latest deed)
If ap i tis a corporate signature of dul uthorized officer
4 1A
(Name and title of corporate officer
B ilders License No.
PI tubers License No.
EI etricians License No.
Ot er Trade's License No.
1. Location of land on whi h pro sed work will be do
House Number Street Hamlet
County Tax Map No. 1000 Section 7q $lock 4 Lot 3(,
Subdivision Filed Map No. Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy YGtCc� -t-
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost 15 U, 0 0J Fee
(to be paid on filing this application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage,number of cars n f w
6. If business, commercial or mixed occupancy, specify'nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear y0 Depth 3-6 `
Height ,21r ' Number of Stories P
9. Size of lot: Front J 2 5 ` Rear / Z5 ' Depth / 00
'
10. Date of Purchase i n Co nti�a L- Name of Former Owner
11. Zone or use district in which premises are situated P qo
12. Does proposed construction violate any zoning law, ordinance or regulation: p 0
13. Will lot be re-graded !� r� Will excess.fill be removed from premises: YES V
14. Names of Owner of premises Address Phone No:
Name of Architect Address Phone No
Name of Contractor Address . Phone No,
15. Is this property within 300 feet of a tidal wetland? *YES NO X
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
i16. Provide survey, indicate scope of project,to scale, with distances ,property lines.
17. If elevation at any point on property is at 10 feet of below',must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
l ,nAct o - M CS I, being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the A
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this'j�/�
(o day of — ��. 20 PJ
Notary Public ELIZABETH A STATHtSSignature of Applicant
NOTARY PUBLIC,StateofNew *
No.01 ST6008173;Suffolk Countk
.0
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: /0//0/01
.DATE SUBMITTE
APPLICANT NAME:
SCTM# DISTRICT: 1.000 SECTION: BLOCK: LOT:
STREET: CITY: d SUBDIV.NAME: N
PROJECT DESCRIPTION: 1✓ELJ % s �� ..,�_ �r//,..
ARCHITECT/ENGINEER<�ACA FAST TRACK? I�0
SINGLE&SEPARATE CERTIFICATION-REQUIRED? `7O NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM.JAN.1997 100-25.Mergen(A nonconfomiing at any time after 7/1/83)
ZONING DISTRICT:' .-140 CONFORMING? �O
soo
Q
REQ. LOT SIZEt(o t000 ACT. LOT SIZE: RE LOT COV. 0,� ACT. LOT COV. O v
REQ.FRONT PROP. FRONT�REQ SIDE /olas ACT. SIDE J-95,1 274
REQ.REAR PROP. REAR �` (�- •.�� ..,�,y 2_ y. ;i //w< J 1
WATER FRONT? 0 DESCRIPTION:
PANEL #: FLOOD ZONE: ,
AGENCY PERMITS REQUIRED FOR REVIEW
APPROVALS REO=D:
i,Z �D:
SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED#): DTE:8/6 /6/ PERMIT#:R10=p0 i a 9k5-
NEW YORK STATE DEC:- PMPEC 9/1/75 YES o
SOUTHOLD TOWN TRUSTEES: YES o
.TOWN ZONING BOARD APPROV YES b -- l ,��., �,, v: .._ - r�c� z3� '0"'
TOWN PLAN. BOARD APPROVAL: NES o
TOWN HISTORICAL PRE (SPLIA):• YES or
NYS ENERGY: YES OR NO
EGRESS (18 H min.?4 sq total) VENT(SQ.FT. x 4%) LIGHT(SQ.FT.x 8%)
BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- ,
HAVE PRE C9'S Y OR N BP -Z/C/o Z-
NOTES: *6 0 /fix —e
ic
%
J t
c c� :� /c
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FEE STRUCTURE: FOUNDA ON: /2 o o SF rle-
FIRST FLOOR : /3-1"Z SF --
SECOND FLR : /.3f� SF INIT OTHER TOTAL
TOTAL: O�SF FEE FEE FEE
'OT(390 SF)- SF)= 30��1 SF X$ '3�=$T410. +$ �y +$ _$ lodK 26
WELL WELL
QwF�c/ UA
SURVES SOF PDROPERTY
BAY VIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
60.0:1 p� S.C. TAX No. 1000-79-06-36
SCALE I
NOVEMBER8. 2000
#
CESSPOOLS DECEMBER 6, 2000 ADDED ADDITIONAL WATER SUPPLY & CESSPOOL DATA
O� w 9� FEBRUARY 28, 2001 REVISED PROPOSED SEPTIC SYSTEM LOCATION
wEu 3?SOp, !,•T O AREA = 12,500.00 sq. ft.
., S '' Q 0.287 ac.
00
1p N
Oma 40 •AtkH^ CERTIFIED T0:
WILLIAM LOMBARDI
COMMONWEALTH LAND TITLE INSURANCE COMPANY
\�
r ' CAYATK)N INSPECTION RfcQtIm
kQ 3 (, Kai 8A1�I1�J�1RY B�YS'f'E�A
a ISM or-Am=
x,uas
�y 1. ELEVATIONS ARE NEFE TO AN ASSUMED DATUM
.....................
r:{iiCC:t. ii7 E)OSTINO ELEVATIONS ARE SHOW THUS:,MQ
M
�+ 2. WHO SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE,IS 1. GALLONS.
GALLONS.
CESSPOOL. B3' •_• O '�jppW 1 TANK: B' L.ONO. 4'-3' WN)E. 6'-7' DEEP _.
b• _ Q• 3. MMMUM LEACHOW SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 p ft SDEWALL AREA
:::::: O 1 POOL: 12' DEEP. W Me.
. \ .......... ..... PROPOSED.EXPANSION POOL _
v
2 ®PROPOSED LEACHING POOL
O PROPOSED PTIC
O � � SETANK
J�.
4 h l D 4 THE LOCATION OF WELLS AND CESSPOOLS WWW" HEREON ARE FROM FIELD
O Ap ry Y O A, OBSERVATIONS AND/OR DATA OSTAMED FROM OTTERS. _.
�' , p
Q ° C ` . TEST HOLE DATA PREPARED M AOOOFAVXOE MAN INE MWO M
k�<</ 9s 0e Os � (TEST HOLE DUG BY McQQ LH D GEO CAENCE ON NOVn*" 13. 2000) STANDARDS wR ME APPIiwE MO
. �/ -
HER YOLK STATE LAND
am SPOSN VAN Law OL SY
00. A r ter; `�r�1 i'ii X9.7 l
-Allo BI100N Law BYo BY
mom aw SANG IM
O N.Y.S. Lic. No. 49688
' SEVROH 72M OF THE NEW YORK STATE
EOLMAIM LAIR.
� I$1 q -:• PALE SPOON FSE cam of"a SURVEY LMP HOT SEMM Joseph A. �egno
l' 1� ° '°°°'"� ° ,EMBOSSEDHE O° "m NAL an _ Land Surveyor
1S'� °V° A'/ TD %AUD BTRUEEIALLRD�BE Odle
SlIALL
°�°�Q���, % • OLR.YP'618011 POR wIDM THE SURVEY
Is IMMENNIED,me CESSPOOL QwF J �r� " GOIk pIBASEw'"FANO rNle surveys - SuldNieltor/a - Site Plm. - CaNhUceron Loylwf
•�, •f• IO LlB14D 11I�q�N,r6lt-
�/ j di! TIE aF TI[LpEB1G
N Hi TUIHDN Q�1101!A1E NOF TNTINFERABLE 727- - 7
PHONE 631) 2090 Fax 631 727 172
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WELLCESSPOOL
G' THE ETBssf010E OF NNW,oF WAYS OFFICES Loa70 AT AW.HrIG AGGRESS
wID/OR urns of w l3amm LF
ANY. NBT SIIDMAI ABE NOf OIMRIINFEED. 1389 RQAN01(E INFINIE P.O. Bml 1931
RNEINAD, Now York 11901 RivwFwad. Nw Yak 11901-0966
wEu WELL
SURVEY OF PROPERTY
G SITUATED AT
BAY VIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S 60.0 • S.C. TAX No. 1000-79-06-36
` 40y �• SCALE 1"=30'
NOVEMBER 8, 2000
CESSPOOLS DECEMBER 6, 2000 ADDED ADDITIONAL WATER SUPPLY df CESSPOOL DATA
FEBRUARY 28, 2001 REVISED PROPOSED SEPTIC SYSTEM LOCATION
3
WELL ?ltO AREA = 12,500.00 sq. ft.
S �'�. .. O
0.287 ac.
ks
CERTIFIED TO:
aF
WILLIAM
LAM I
LOMBARD
PHYLLISI
y � F� COMMONWEALTH LAND TITLE INSURANCE COMPANY
vl
� � `�'�' � O 1 r QQ'1�� • °haw.
morrs-
,3, •: ELEVATIONS ARE To AN ASSUMED DAft/Yf
O ..
`^ � .. ::: :::::=�:�:�:�::-:.. ...... . O EKISTIN ElE1MT10116 ARE SHOWN TIAlSs zos
2. MINUM SEPTIC TANK CAPACITIES FOR A 1 TO 4 BEDROOM HOUSE IS 1,000 QALLOMS
CESSPOOL 1 TANK: w LAMO. 4•-3' MADE. 6•-7' DEEP
444 rr:r =:::::: :._ ..•. .
pQ).
3. I MU M IEACHM SYSTEM FOR A 1 TO 4 BEDROOM HOUSE IS 300 eq ft SWEWALL AREA.
/ Pool.; 12' DEEP. A' dia.
EXPAN90N POOL
\ ' °yY
u N PAOPOaED LEACNINO Pool
IS �Q
� 60Q �`� � � � � • ,P \O\t�° ®PROPOSED SEPTIC TANK
4. THE�c ,' Al OBSERVATIONS AANND/OAR DATA OBTAINED HEREON ARE FROM FEW
r OL'0
0 °�y o .h TEST HOLE DATA PREPARED IN ACCOICOiZ WFIN THE MON"
O os� (L� (TEST HOLE DUG BYON NOVEMBER 13. 2000)
FOR atIRY2Ys �ESDIALISIITn
12 4 FOR L*m
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awc mora rwor U M a
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N.Y.S. Lic . 49688
' ry e' UN4/DgR®ALlf7i►TION OR AOOIIION
N �•' 10 1HI5 SUAYEI•w A V10lATI0N OF
• SECOM 7200 OF THE NEW Y=STATE
f2M10w1OF LAW. NOT 8VANG Joseph A. gegn0
�•j,�1 "t- •• �COIAI�y� THE LAL DNZK EYOR'S A�
E°° Lid Surveyor
dca"w"706 mmam mm"OVAL mm
/o
_• lr ONNL amm a
me ON
TWLF OWANY,00106AINfOr_A06NCY AND Title Sways — Subdh abm — SRe Pftw — C rw&ucdm LgpW
Ll LIMED NNNW AND
CESSPOOL CESSPOOL �C</NC J c� TUrm ARE
191000
W7RM M/LE. PHONE (631)727-2090 Fox (631)727-1727
WELL THE E> OF WONT OF WAYS
AND/OR EATW'kEJIT3 OF � OFFICES LOG1ID AT IIA�WG ADDRESS
ANY. NOT SHOWN ARE NOT OUARANi[ED. 1380 ROMIOKE INENUE P.O. Box 1931
RWERHEAD, Now York 11901 Riverhead, Now York 11901-0986
Town Of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 09/06/01 Receipt#: 0
Transaction(s): Subtotal
1 Septic Permit-Construct- Resid. $10.00
Total Paid: $10.00
Name: Mesiano, Catherine/lombardi
660 Eds Rd.
Southold, NY 11971
Clerk ID: LIZS Internal ID:39762