HomeMy WebLinkAbout29270-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30243 Date: 06/16/04
THIS CERTIFIES that the building ACCESSORY
Location of Property: 350 WILLIS CREEK DR MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 115 Block 17 Lot 17.10
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated APRIL 4, 2003 pursuant to which
Building Permit No. 29270-Z dated APRIL 8, 2003
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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR.
The certificate is issued to JAMES E & KAREN A HOEG
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. 3494 05/21/04
PLUMBERS CERTIFICATION DATED N/A
Au i d Si nature
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. 29270 Z Date APRIL 8 , 2003
Permission is hereby granted to:
JAMES E & KAREN A HOEG
350 WILLIS CREEK DR
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN INGROUND SWIMMING POOL AS APPLIED FOR PER
ZBA DECISION #5239
at premises located at 350 WILLIS CREEK DR MATTITUCK
County Tax Map No. 473889 Section 115 Block 0017 Lot No. 017 . 010
pursuant to application dated APRIL 4, 2003 and approved by the
Building Inspector to expire on OCTOBER 8 , 2004 .
Fee $ 150 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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,Alteratioris 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.
New Construction. Old orI Pre
�-existing Building: (check one)
Location of Property: w `
House No. Streets—� " Hamlet
Owner or Owners of Property: ��1,' ` :44n77
Suffolk County Tax Map No 1000, Section J� Block 1 �7 Lot
Subdivision p Filed Map. Lot:
Permit No. 1 Date of Permit. 4– Applicant:
r
Health Dept.Approval: Underwriters Approval: QS6WA RO'1V,, C (�
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: he e)
q P �'Y
Fee Submitted: $ a5.00
J#Iature
h Nassau Suffolk Electrical inspections; Inc.
5A Canal Street+Center Moriches,New York 11934• Td:631-•878-3500•Fax: 631-878-3764-
b
Application:3494 Date:. 5/21/03
issued to: Heog
Address:. 350 Willis Creek Dr
s Village`: Mattituek Introduced By:Delano Electric Licg-4354 E'
was examined and approved up to the above date and was in compliance vc'ith the NEC
Attic 1st Floor FWdertiat El RO0 Det Gates
Baserrlertt �dftoor Carxrt7er�aat[ FUT Addtion
- Switches Receptacles Fixtures G.F.I. Timeelock Pool Panel
2 t 2 t Baa
Gve rt Carbon
Fans Dishwasher Washer/Amps Dryer/Amps, Range/Amps. Monoxide
Furnace Gil Gas Heat Zones Smoke Bell
Detectors Transformers
' 5
Rough Insp: Meter Amps Phase Motors
5/2/03
Final lnsp: 5/21[03 1-1172[7
O
a t-�
tl►erEquipment: tngraund Pnol
s �
i
ut,Pes
This certificate must not be altered
in any manner
Section: 115 Block: 17 Lot:17.1
i
.ew Ycvk State Department of Environmental Conservation
Building 40 - SUNY, Stony Brook, New York 11790-2356
Telephone (516) 444-0365
Facsimile (516) 444-0373
a
John P. Cahill
LETTER OF NON-JURISDICTION Acting Commissioner
Date: January 23 , 1997
James & Karen A. Hoeg
243 Fairview Circle
Middle Island, New York 11953
Re: 1-4738-01485/00001
Hoeg Property � 243 Fairview Circle, Middle Island
Dear Sir/Madam:
Based on the information you have submittedthe,
Department of Environmental Conservation has determined that the
property landward of the staked haybale line as shownNew York State
prepared by Kenneth F. Abruzzo, dated November 15 °n the survey
Article 25 jurisdiction. , 1996, is beyond
Therefore, in accordance with the current Tidal Wetlands Land U
se
Regulations (6NYCRR Part 661) no permit is re
Wetlands Act. , quired under• the Tidal
Please be advised however, that no construction
sedimentation, or disturbance of any kind may take place seaward o,
f
the tidal wetlands jurisdictional boundary,
without a permit. It is your responsibilityas indicated above,
necessary precautions are taken to to ensure that all
other alteration or disturbance to the ground surface or vegetation
prevent any sedimentation or
within Tidal Wetlands
project. Such Jurisdiction which may result from
area between theyt dale wetlaour
ns nd jurisdictional boundary include and
work
project (i . e. a 15 ' to 20 ' wide construction area) r recdtinoua
temporary fence, barrier, or hay bale berm.
g
Please be further advised that this letter does not relieve you of
the responsibility of obtaining any necessary permits or
from other agencies.
approvals
Very truly yours,
-'' Z,
Permit Administrator
cc: Glenn Just, J.M.O. Consulting
File
Bureau of Marine Habitat Protection
D E C E � V E
MAR 1 9 2003
NYSDEG- REGION I _
ENVIRONMENTAL PERMITS
swiKing
Pools
471 Route 25A• Rocky Point, New York 11778•631-744-8100
Fax 631-744-8292
March 19, 2003
Town of Southold
Building Department
53095 Main Road
Southold, NY 11971
Re: James and Karen Hoeg
350 Willis Creek Drive
Mattituck,NY 11952
1000-115-17-17.10
To Whom It May Concern:
Per your request, I made a visit to the NYSDEC office at Stony Brook University today
to clarify whether any DEC restrictions exist on the above mentioned piece of property
with regard to the construction of an in-ground pool. The representative at the counter
pulled the file and reviewed the Letter of Non-Jurisdiction, dated January 23, 1997. Per
that letter(attached), all property landward of the staked haybale line is beyond DEC
jurisdiction. No construction or disturbance of any sort can take place seaward of that
line. I have indicated the haybale line on the attached survey dated January 3, 2000,
distances taken from the survey prepared by Kenneth Abruzzo dated November 15, 1996.
The DEC representative verified that the haybale line on the January survey is accurately
depicted and that the proposed pool location is fine.
Please be assured that Swim King Pools will not violate any DEC or Town restrictions
during construction of the proposed pool and will advise the homeowners with regard to
any patio or deck work they may do at a later date. Please feel free to call me if you have
any other concerns or questions regarding this application.
Sincerely,
E
M em ch
Expe i , King Pools
i
i MEMBER
NATIONAL
SWIMMING POOL
INSTITUTE
I
0 l
WE SUBSCRIBE
TOARIGID -`--'-".�."..."".".___.__._..._...._.._.._w_...._._._. _____._... _._..__ _.__r._r..._.._ .__.._._._._._.__....__.....�.._ y
CODE OF ETHICS
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
DATE: September 26, 2002
TO: James and Karen Hoeg
350 Willis Creek Drive
Mattituck,NY 11952
Please take notice that your application dated September 25, 2002
For permit for construction of an accessory in-ground swimming pool and an accessory barn (shed) at
Location of property: 350 Willis Creek Drive,Mattituck,NY
County Tax Map No. 1000 - Section 115 Block 17 Lot 17.10
Is returned herewith and disapproved on the following grounds:
The proposed construction on this non-conforming 49,876 square foot lot in the AC District, is not
permitted pursuant to Article III Section 100-33, which states;
"In the Agricultural-Conservation District and Low-Density Residential R-80 R-120, R-200
and R-400 Districts accessory buildings and structures or other accessory uses shall be located
in the required rear yard."
The proposed accessory in-ground swimming pool and accessory barn (shed) is noted as being
partially located in the side yard.
Following the proposed construction total lot coverage will be+/- 8 percent.
Note to Applicant: Any change or deviation to the above referenced application, may require
further review by the Southold Town Building Department.
L----------��- ' -------
Cc: ZBA, File Authorized Signature
DEPARTMENT OF THE ARMY
NEW YORK DISTRICT. CORPS OF ENGINEERS
JACOB K. DAVITS FEDERAL BUILDING
NEW YORK. N.Y. 10278-0090
crLY TO
December 31, 1996
Eastern Permits Section
SUBJECT: Application Number 96-15110-L2 by James and Karen Hoag
James and Karen Hoag
243 Fairview Circle
Middle island, New York 11953
Dear Mr. & Mrs. Hoag:
On December 31, 1996, the New York District, U.S. Army Corps
of Engineers, received a copy of the Joint Application for Permit
you recently submitted to the New York State Department of
Environmental Conservation requesting authorizationto onstruct
a single-family dwelling landward of the spring high tide line
and wetlands adjacent to an HarbornViewdatcreek
Mattituck"�iat Mattituck,
te is
identified as Lot 10,
Town of Southold, Suffolk County, New York. The delineation of
state-regulated tidal wetlands as show appears wn on the surveyaccurapronathe red by
Young & Young, dated November 15,
basis of topographic information shown on said survey.
Our review indicates that sns�ructioothe raotivitieswork
inoor over
not
appear to include dredging or co
any navigable waters of the United States, the placement of any
dredged or fill material in any waters of the United States
(including coastal or theinland course,aelocation,rthe condition orishment capacityfOf
any work affecting the Permit will not be required.
such areas, a Department of the Army p
Care should be taken so that any fill or construction
materials, including debris, do not enter the waterway tobecome
a drift or pollution hazard. You are to contact appropriate
local government "officials to ensure that the subject work is
performed in compliance with their requirements.
If any questions should arise concerning this matter, please
contact Denise Butts, of my staff, at (212) 264-3913 .
Sincerely,
resW.
�aggerty
Ctern Permits Section
Town Hall
Albert Jj Krupgkii'presidefit
Names Bing;Vied-'Pftsideiit c FF���
53095 Route 25
���, CQ P.O.Box 1179
Artie Foster = Gy� Southold,New York 11971-0959
Keen Poliwoda 'y :
765-1892
Peggy A.Dickerson Telephone(631)
!.F Fax(631)765-1366
y�
BO OF WN TRUSTEES
WN SOUTHOLD
i
January 23, 2003
1Vlr.&Mrs. James E. Hoeg (
350 Willis Creek Drive
Mattituck,NY 11952 t4
i
RE: SCTM#115-17-17.10 ,�1
350 Willis Creek Drive
1tlattituck, NY i
9 r';
t.
Dear Mr.&Mrs.Hoeg:
The following action was taken by iSouthc Town Board of Trustees at their Regular
Meeting held ori Wednesday, Janu 27 200
RESOLVED, that the Southold To Board ZTrustees Approve an Amendment to Permit
#5038 for pool and shed with th ttditio f dryfvell for the backwl.
ash for the poo
If you have any questions,please ur offs at 765-1892.�
i.
Sincerely,
Albert J. Krupski, Jr. }
President,Board of Trustees I+
cc: Building Department ,!!
AJK:cjc
i
t,(
• TEST HOLE
SANITARY DETAIL �Q
Au�tQSEWAGE DISPOSAL -2 POOL 2'116 Taillom
"OUSE .N.T.S. AND LOAM .
• �11�1t�' tAt40! AO' /
nNly,m aN10E R►4
.. 14.6 14.2 14.1 SAND i►S�M,
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• ►M6+�2. 1E-11:o tE-t!A OROIA/0.4
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I[tyNvKlnS taco rx pN�� wAtER tN aQ�.
1
15.0'
ry
N
16.15 15.24
Lot 9 I
(Dwelling With Public Water)
12.5a ( ILQ I 11
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}1 14. 14.70 ..
2a 1
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N
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72.2 OW OF EdEi��\ENS teats�/
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3.16 . / i '• I 7
Lot 11 '
X OF UPLAND COVERAGE With Public Water) NOTE: ■-MONUMENT FOUND A-STAKE SET O-REBAR FOUND ,
HOUSE WITH (Ow6ttag 1. SUBDIVISION MAP FILED IN THE OFFICE OF THE-CIERK OF
SUFFOLK COUNTY ON AUG, 21, 1987 AS FILE NO. 6377.
DRIVE 2.
WAY 2757 S.F.ARCH = 3418 S.F.
DRIVEELEVATIONS SHOWN HEREON ARE FROM ACTUAL SURVEY POOL 600 S.F. AND ARE REFERENCED TO N.C.V.O. (M.S.L. 1929).
,
CONC. PATIO 712 S.F. -LATH SET 3. THIS PARCEL IS LOCATED IN FIRM ZONE AE BASE
TOTAL 7687 S.F. --14---EXISTING CONTOURS ELEVATION 8.0 AS INDICATED ON FLOOD INSURANCE
14.45 -EXISTING SPOT ELEVATION RATE MAP PANEL NUMBER 360813 04626 0 LAST DATED
rLAND, �LL4 �,pp SPOT ELEVATION MAY 4, 1996 ZONE A4 IS CONTIGUOUS WITH THE 8
5CI+HBALTHB 1:tA'f CONTOUR SHOWN HEREON.
�PMA�VALGF�lq�A SURVEY FOR:
r- T ONLY
alit 5
99 JAMES E. HOEG & KAREN A. HOEG
LOT 10 "HARBOR VIEW AT MATTITUCK"
FCAt#fA7F9Q7DdwP HBDRpOnLq At: MATTITUCK Town of: SOUTHOLO
� v Suffolk County, New York
". sir s� 9p
0",' k1. 1000 115 17 17.10
Suff. Co, Tax Map: ,
D,6trkt .Seatlon Ielaa6 ,L4t
CERTIFIED TO:
Young & Young, Land Surveyors JAMES E. HOEG
400 Ostrander Avenue, Riverhead, Neu York f1901 KAREN A. HOEG
F ZONAL TITLE INSURANCE COMPANY-OF NEW YORK
516-727-2303 OLALN
�G�1.1S MOVED PROPOSED HOUSE :AUG. 27, 1999
STAKE FOR D.E.C. INSPECTION :JULY 6, 1999
Alden N. Young, P.E d L.S. (/906-1994) O y :MAY 20, 1999
• Howard A. Young, Land Surveyor DATE :NOV, ' 1998
.Thomas C. /'oipert, 11'roJeasional Engineer SCALE :1"-40'
John Sehnurr, Land Surveyor �!' JOB N0. :98 - 0961
G SHEET NO..I OF,)
Q "FIOEC-961.DWC'
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4s"a0N N tl"NMKY n A M!
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....�. ..Wa N N!tllaafa V M[IINOMa Nf11N11N1. a IE[dl YH IIION naa aIfPYA1NA '
04/04/2003 11:27 6317659064 ZONINGAPPEALSBOARD PAGE 02
`APPEALS BOARD MEMBERS
Southold Town Hall
Lydia A.'Tortora Chairwoman 53095 Main Road
Y -
Gerard P. Goehri ager at P.O.Box 1179
George Horning O Southold,New York 11971-0959
Ruth D. Olivay�► Off` ZBA Fax(631)765-9064
Vincent Orlando 'Telephone(631)765-1809
http://southoldtown,northfork.net
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS, DELIBERATIONS AND DETERMINATION
MEETING OF MARCH 12, 2003
Appl, No. 5239—JAMES AND KAREN HOEG
Property Location: 350 Willis Creek Drive, Mattituck; Parcel 1000-115-17-17.10.
SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under
consideration in this application and determines that this review falls under the Type II
category of the State's List of Actions, without an adverse effect on the environment if
the project is implemented as planned.
PROPERTY FACTS/DESCRIPTION: The applicants' 49,876 sq. ft. parcel is located on
the west side of Willis Creek Drive in Mattituck and is improved with a two-story frame
dwelling with garage.
BASIS OF APPLICATION: Building Department's September 26, 2002 Notice of
Disapproval, citing Section 100-33, in its denial of a permit for an in-ground swimming
pool and as built accessory shed in an area other than the required rear yard.
FINDINGS OF FACT
The Zoning Board of Appeals held a public hearing on this application on February 20,
2003, which time written and oral evidence were presented. Based upon all testimony,
documentation, personal inspection of the property, and other evidence, the Zoning
Board finds the following facts to be true and relevant:
AREA VARIANCE RELIEF REQUESTED: Applicants wish to construct a 20' x 46' in-
ground swimmingpool and an as built 18' x 18' accessory shed behind the existing
dwelling in yard locations, which are near or partly within side yards (see hand-sketched
diagrams marked by applicants on the January 8, 2001 survey prepared by Young &
Young, L.S.). The setbacks of the pool are proposed at 15 feet from the northerly side
line at its closest point and greater than 100 feet from the tie line along the high-water
mark. The side setback of the accessory storage building (shed or barn) is proposed at
6 feet (on an angle to the southerly side line at its closest point).
REASONS FOR BOARD ACTION: On the basis of testimony presented, materials
submitted and personal inspections, the Board makes the following findings:
1. Grant of the area variance will not produce an undesirable change in the character of
the neighborhood or a detriment to nearby properties. By the nature of the appeal and
statements made during the hearing by board members to the applicant, no further side
yard obstructions or reductions will be allowed on either the north or south side yard.
04/04/2003 11:27 6317659064 ZONINGAPPEALSBOARD PAGE 03
Wage 2—March 12,2003
Appl.No,5239—J.and K.Hoeg
115-17-17.10 at Mattituck
The applicants' request is within reason because there is a 50 ft. non-disturbance buffer
which takes up much of their rear yard area.
2. The benefit sought by the applicants cannot be achieved by some method,feasible for
the applicant to pursue, other than an area variance. The proposed location of the pool
is very close to the applicants' existing garage and stone driveway, which provides easy
access for service and maintenance.
3. The variance granted herein is not substantial because the applicant is utilizing a
reasonable area, near or within a portion of the side yard, and use of this area is forced
due to the non-disturbance buffer shown on the survey dated 1/8/01.
4. The alleged difficulty has not been self-created because the rear of the home lies
very close to a non-disturbance buffer, which places construction at side yams, near the
existing dwelling.
5. No evidence has been submitted to suggest that the proposed additions will have an
adverse impact on physical or environmental conditions in the neighborhood.
6. Grant of the requested variance is the minimum action necessary and adequate to
enable the applicants to enjoy the benefit of a swimming pool and storage building,while
preserving and protecting the character of the neighborhood and the health, safety and
welfare of the community.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the
balancing test under New York Town Law 267-B, motion was offered by Member
Goehringer, seconded by Chairwoman Tortora, and duly carried to
GRANT the Variances as applied for and shown on the hand-sketched locations
prepared by applicant marked on the January 8, 2001 survey prepared by Young
&Young.
This action does not authorize or condone any current or future use, setback or other
feature of the subject property that may violate the Zoning Code, other than such uses,
setbacks and other features as are expressly addressed in this action.
Vote of the Board: Ayes: Members Tortora (Chairwoman), Goehringer, and Orlando_
(Member Oliva was absent due to illness, and also absent was Member Homing of
Fishers Island_) This Resolution was duly adopted 3-0).
Lydia A. ToWrii, Chairwoman—Approved for Filing
4/ d 103
7ss.isoz
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS TION
[ ] FRAMING INAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
/Z
DATE ,�- 1 o INSPECTOR ZIL --4 <
F M INSPECTION REPORT DATE CONIlYIENTS , .
FOUNDATION(1ST) J y
--------------
C
FOUNDATION(2ND)
z
O
ROUGH FRAMING& �
PLUMBING - H
INSULATION PER N.Y. H
STATE ENERGY CODE
CIS Y7 ,
n
FINAL
ADDITIONAL CONmn2,TS
O
. Z
tvm
O
z
2. State existing use and occupancy of premises and intenued use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy �/l� 612DU��0 c'S�yi/11/y1i/r�l� D L-
3. Nature of work(check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost �pO(9 °O 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
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 Depth
Height Number of Stories
9. Size of lot: Front lI . D� Rear !Z2, /O Depth a(of1 �d
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
W R Sw i rt1
13. Will lot be re-graded?YES NO ✓ Will excess fill be removed from premises? YES ✓ NO t17;4}tCC�5
14. Names of Owner of premises1ES SUE 6 Address_ W& 1�r� 2E�K1�one No.
Name of Architect Aeb hE InJeM05 Addressip/ G4,VA, —o �4 Phone No 4`028"- 'r-x3 7
Name of Contractor e R- Address ��l ToNo. 7yN— g�a0
PL
a c5W IWl r/19C� CS OXY D/AUT
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ✓ NO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this_property within.300 feet of a tidal wetland? *YES NO SEC A TTI' e H E-t�
* IF YES,D.E.C. PERMITS MAY BE REQUIRED. LF7TTF/2 PF A30,#-3--JuIe15D
�. Fj2m OEC,
i
16. Provide survey,to scale,with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF3A��
�Z�y T, being duly sworn,deposes and says that(s)he is the applicant
I(Name of individual signing contract)above named,
(S)He is the
(Contractor,Ag t,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
day of 20_D�
Notary Public Si tore of Applicant
t4OFtEEtA,.- %G5YK
OF
IAL1F(r� COOKV
No,
SOIHAOAS�3
RV SIOP!EY�IRESy'4'��
To oF souTHo L, ., �: .
�— - - ` --� BUILDING PERMIT APPLICATION CHECKLIST
BRING DEPART F
TOWN HALL r Do you have or need the following,before applying?
2 5 3 �'. y*
SOUTHOLD,NY 11971 Board of Health
TEL: (631) 765-1802 ;._..1.
3 sets of Building Plans
; Planning Board approval
FAX: (631) 765-9502 _� QLD Survey
www.northfork.net/Southold/ PERMIT NO. 70'7 Check
Septic Form
+N.Y.S.D.E.C.
Examined ,20 Trustees
Conti t:
Approved ,20 Mail to: Sit71 lUl l 5
Disapproved a/c L{7) RBLVV �0l6ot
Phone: 944- $100 11778
Expiration--- 20_�/_ L.N�
Building Inspector
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS Date - o?Q- d !, 20
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
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 throughout the work.
e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
£Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
property have been enacted in the interim,the Building Inspector may authorize,in writing,the extension.of the permit for an
addition six months. Thereafter,a new permit shall be required.
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 inspections.
(Signature applictiFoiname,if a corporation)
.(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
t�0WX-A0- ^L3/
Name of owner of premises -AAMEIS -4 KY} EA3 -fpm
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No. 021
Plumbers License No.
Electricians License No. aLo
Other Trade's License No.
1. Location of land on which proposed work.will be done:
35o IAIILZ-16 0,A?EC-4 ,e �lrfTrlTLtsr
House Number Street Hamlet
County Tax Map No. 1000 Sectionl Block 19 Lot � �, � L
Subdivision hA9,56k V 1E0 AT MAn jT2 k-Filed Map No. Lot I D
(Name)
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24" MAX 38' BARS p p T.I 0 N A L. ST E P
SECTION S- 3 = � -- TYPE !.
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3 STEPS
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WALKS TO BE SIAOM- NON SKID TYPE. SLOPED * _
AWAY FROM POOL S;,T>�_r_,_rHG POOLS, �RC-
WATER DISPOSAL SHALL eE LIMITED TO OWNERS
16z 32I1b 132 I 8 8 �1I s•L I 4 I ; 5m IIE.S00 PROPERTY TD SUIT LOCAL REGULATIONS = ROUT. 25A
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s�LAND �
FINAL SURVEY ;JAN. 8, 2001
NOTE: ■ =MONUMENT FOUND �s=STAKE SET QQ =REBAR FOUND SURVEY FOR:
O=MONUMENT SET
1. SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF JAMES E. HOEG & KAREN A. -HOEG
SUFFOLK COUNTY ON AUG. 21, 1987 AS FILE NO. 8377.
2. THIS PARCEL IS LOCATED IN FIRM ZONE AE BASE LOT 10 "HARBOR VIEW AT MATTITUCK"
ELEVATION 8.0 AS INDICATED ON FLOOD INSURANCE ,qt; MATTITUCK Town of. SOUTHOLD
RATE MAP PANEL NUMBER 360813 0482G D LAST DATED
MAY 4, 1998 ZONE A4 IS CONTIGUOUS WITH THE 8 Suffolk County, New York
CONTOUR SHOWN HEREON.
Suff. Co. Tax Map t000 tts 17 1 x.10
Di$l(ICl sec flus) 810,:4 Lot
CERTIFIED TO.
Young & Young, Land Surveyors JAMES E. F OEG
y KAREN A. HOEG
400 Ostraauder Avenue, Riverhead, New York 11901 FIDELITY NATIONAL TITLE INSURANCE COMPANY OF NEW YORK
516- 727---2303 LOCATED FOUNDTION :JAN. 3, 2000
PENERAL AMENDMENTS ;DEC. 15, 1999
OVED PROPOSED HOUSE :AUG. 27, 1999
�,' ,• t_ . �� fjTi ,i!Ffl.,p.E.C. INSPECTION :JULY 6, 1999
Alden TV. Young, P.E d L.S. (1908-1994) 1� %' :MAY 20, 1999
Howard W. Young, Land Surveyor DATE :NOV. 15, 1996
Thomas C. W01pe7't, Professional Engineer SCALE : 1" =40'
John S'chnurr, Lund Sio-veyor JOB NO. : 96 - 0961
SHEET NO. : 1
HOEG 961.DWGF 1
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