HomeMy WebLinkAbout28514-ZFORM NO_ 4
T0~'~ OF SOUTHOLD
BUILDING DEP~TMENT
office of the Building Inspector
Town Hall
Southold, N_Y.
CERTIFICATE 0P 0CCUP~iqCY
No: Z-30448
Date: 09/20/04
T~IS CEP~TIFIES t~at the building ADDITION & ALTERATIONS
Location of Property: 320 SAILORS IfEEDLH RD
(HOUSE NO.) (STREET)
County Tax Map No. 473889 Section 144 Block 5
Subdivision
Filed Map No. __ Lot No. __
I~ATTITNCK
Lot 28
(H~LET)
conforms substantially to the .Application for Building Permit herezofore
filed ~ this office dated JUNE 7, 2002 pl~rsuant to which
Building Permit No. 28514-Z dated JUNE 28, 2002
-was issued, and conforms to all of the requirements of Ehe applicable
provisions of the law. The occupanc5' for which this certificate is issued
is ADDITIONS & ALTEP3~IONS TO EXISTING SINGLE F~4ILY DWELLING AS APPLIED
FOR _
The certificate is issued to CHRISTINE HOWLEY
(O~a~R)
of ute aforesaid building_
SUFFOLK COUNT~fDEPARTMENT OF~EALTKi~PI~ROVAL N/A
ELEC~i~RICAL CERTIFICATE NO. 1116782 10/09/03
PLUMBERS CERTIFICATION DAT~U 08/02/04
JOSEPH FJ~_ADIO
Rev. 1/81
zed ~ignmture
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
28514 Z Date JTINE 28, 2002
Permission is hereby granted to:
CHRISTINE HOWLEY
56 HIGHLAND AVEAIgE
MONTCLAIR,NJ 07042
for :
ADDITION AND ALTEP~ATIONS TO AN EXISTING SINGLE FAMILY DWELLING
AS APPLIED FOR, FLOOD PMT INCLUDED
at premises located at
County Tax Map No. 473889 Section 144
pursuant to application dated JUNE
Building Inspector to expire on DECEMBER
320 SAILORS NEEDLE RD
MATTITUCK
Block 0005 Lot No. 028
7, 2002 and approved by the
28, 2003.
Fee $
Authorized Signature
ORIGINAL
Rev. 5/8/02
F~rra No. 6
TOSVN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
F_ LDG. EE?7.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be fdled in by Iype~n'iter or ink and submitted to the Building Department ~ith the follmving:
A. For new building or new use:
1_ Fina~ survey ~f pr~crty with a¢anrate ~ccati~n ~f aii bui~dings~ pr~perty ~ines~ streets~ and unnsual natural ~r
topographic features.
2. Final Approval from Itcalth Dcpt o£ water supply and sewcrage<lisposa[ (S_9 form).
3. Approval of electrical h~stallation from Board of Fire Undenvriters.
4. Sworn statement from plumber certif55ng 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 Complim3.~ce from architect or engicger resoonsible for the building.
6. Sfibmit Plmmi~g ~ba~d Approval of completed sit~ ~lan requirement s_ ·
B,.~For e~s~g bufldin-~e April 9,~lg-57)-ao~-~afe..'~..ing~ses,~or bu~li.n~ and~'-'pre cxis~ing'rtaad uses:
1. Accurate ~rvey of ~ropert~ shoxving all property 1/nes, s~rects, bt~ilding and unusual natarai or topographic
features.
2. A Properly'completed application and cousent to inspect s£gned by the applicant. If a Certificate of Occupancy is
deni~x~ the Building Inspector shall state the reasons therefor in xwiting to the applicant.
C. Fees 1. Certifi?ate 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, Businesseg $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 Cestificate of Occupancy - Residential $ l 5_00, Commercial $ l 5.00
New Cousl~-uction:
Location of Property:
Dato_ '~ J ]/"/
Old or Pre-e.'dsting Building: ~ (check one)
House No. Street
O e,o,O erao o e y:
Suffolk County T~ Map No 1000, Section Bilk
8ubdi~ion Ffl~ Map.
P mi o. 2 5_ 6l q
Health Dept. Approval:
Planning Board Approval:
Request for:
Fee Submitted: $
Date of Permit. Applicant:
Temporary Certificate
Lot
Hamlet
Underwriter~ Approval:
Final Certificate: ~'~. (check one)
' Applicant Signature
Town Hall, 53095 Main Road
P.O. Box 1179
Southold. Ne,;,, York 11971-0959
Fax (631) 765 9502
Telephone (631) 765-1B02
BUILDIlqG DF~PARTMENT
TO~rN 01~ fiOUTHOLD
CERTII~ICATION
Date:
(Please print) '-'
Plumber: %d°~'//~,f,O-T- O
,/. ." ,~/l~ase print)
lead.
- - S-worn to--before me this o~./
day of ~/1.~/{,/ , 20
Notary Public. /t~,55-t. LO
Count5,
certify that the solder used in the water supply system contains less than 2/10 of 1%
~' (Plumbers Signature)
By THIS CERTIFICATE OF COMPLIANCE THE
N,EW YORK BOARD OF FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET- NEW YORK, NY 1OO38~L
CERTIFIES THAT
Upon the application of upon premises owned by
JELCO ELEC. CONTR. INC. CHRISTINE HOWLEY
366 HARRISON AVENUE 320 SAILOR NEEDLE ROAD
MASSAPEQUA, NY 11758, MATTITUCK, NY 11952
Located at 320 SAILOR NEEDLE ROAD MATTITUCK. NY 11952
Applicalion Number: 1116782 Certificate Number: 1116782
Section: Block: Lot: Building Permit: BDC: NS11
Described as a ResidemiaI occupancy, wherein the premises electrical system consisting
wiring, described below, located in/on the premises at:
electrical
devices
and
First Floor, Second Floor, Attached Garage, 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 October. 2003.
Name QTY Rathe Ratin~ Circuit Type
Emergency Equipment
.Alarm
and
Sensor 9 0 Smoke
Sensor 2 0 Carbon Nlouoxide
Appliances and Accessories
Exhaust Fan 4 0 F.H.P.
Elecwic Heater Baseboard 2 0 1.0 K%kr
Fttmace 2 0 Gas
Air Conditioner 1 0 30.000 BTU
Air Conditioner 1 0 42.000 BTIJ
Dish Washer 1 0 1.2 KW
Wiring and Devices
Receptacle 48 0 General Purpose
Switch 48 0 General Purpose
Fixture 78 0 Incandescent
Fixture 2 0 Fluorescent
Arc Fault Circuit Interrupter 12 0 15 amp
Paddle Fan 2 0 seal
Receptacle 1 0 20 amp Lannd~
ContinuedonNextPage 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 O,F FIRE UNDERWRITERS
BUREAU OF ELECTRICITY
40 FULTON STREET - NEW YORK, NY 1OO38
CERTIFIES THAT
Upon the application of upon premises owned by
JELCO ELEC. CONTR. INC. CHRISTINE HOWLEY
366 HARRISON AVENUE 320 SAILOR NEEDLE ROAD
MASSAPEQUA, NY 11758, MA]q'ITUCK, NY 11952
Located at 320 S~,ILO .R NEEDLE ROAD MA'i-I'ITUCK. NY 11952
Application Number: 1116782 Certificate Number: 1116782
Section: Block: Lot: Building Permit: BDC: NS11
Described as a Resident~l occupancy, wherein the premises electrical system consisting
electrical devices and wiring, described below, located in/on the premises at:
First Floor, Second Floor, Attached Garage, Outside, Afdc,
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 October, _00.~.
Name QTY Rate Ratin~- Circuit Type
Dirrm~ers 10 0
Receptacle 9 0 GFCI
Service
1 Phase 3W Sen'ice Rating 300 Amperes
Service Disconnect: 1 100 cb
Sendce Disconnect: 1 200 cb
Ivleters: 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.
DONALD G. FELLER ARCHITECT
11725 Main r~ - BO× 1692 - Mattitt~¢k. NY 11952 - 631-298.5453. Fax 298.138~
:MarCh 24, 2004
Mr. Gary Fish
Town of Southold Building Department
Town Hall, Main Road Southold, NY
Re:
HOWLEY RESIDENCE
320 Sailors Needle Rd, Mattituck
B.P. # 28514 Z
Dear Mr. Fish:
I have examined the Mechanical Room fresh air venting at the above mentioned
project, and l can verify that is in compliance with NYCRR provisions .....
OWNER
TOWN OF SOUTHOLD PROPERTY RECORD CARD
S W
SUB. LOT //
TYPE OF BUILDING .' ...
LAND
/fao
NEW
FAR-M
Tillable 1
tillable 2
rilloble 3
~Vaodlond
Jwompl~nd
~rushland
-louse Plot
'of al
SEAS.
IMP.
iVL.
I TOTAL
I BU..II.DING
BELOW
Value Per
Acre
FARM
[~ATE
Value
COMM. CB.
MISC. Mkt, Value
FRONTAGE ON WATER
'FRONTAGE ON ROAD
,DEPTH
BULKHEAD
DOCK
!
Acre
;... ,,,
NORMAL
Id,
TRIM
Bldg.
:xtension
"xtension
~orch
.~arage
Patio
Total
Basement
Ext. Walls
Fire Place
Type Roof
"Recreation Room
Dormer
Driveway
Bath
F~oors
Interior Finish
Heat
Rooms ]st Floor
Rooms 2nd Floor
DinetteI":
FIN. Bm ~T.
IR.
DR. .'.,'
BR.
Board Of Southold Town Trustees
SOUTHOLD, tier,' YOI:'K
DATE: L.l:~',' 4, -01_'i
ISSUED TO
,SHFPSi-iliE H,3?,LET
Pursuant to the provisions of Chapter 615 of the Laws of
the State of New Yorlq 1893; and Chapter 404 of the Laws of the
State of New York 1952; and the Southold Town Ordinance en-
titled "REGULATING AND THE PLACINC~ OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBLIC ~NDS and ~
REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM
LANDS UNDER TOWN WATERS;", and in accordance ~ith ihe
Resolution of The Board adopted at a meeting held on .z:prd 25,
2,;,)~ , and in consideration of the sum of $ -,),".,]0 paid by
Cl-,vi~tine H,:,'tc-,'
Of [latttt,~. ~-- N.Y. and subject fo the
Terms end Conditions listed on the revere side hereof,
of Soulhold To~n Trustees authorizes end permits the following:
i,j,Jiti,:,n: t,;, e:,:i~ti~,c ~ing!c-t2r,-,il7 d,eliil~. .~t th4. t-,ea~'e~t p.z, it-,t
e:<~5i~ng 5t~',ic~',.tre ~5 c.l.]' fi'ow, the 15~iiki-~eB,j; pi',7, pose.fi ~jditi)n
n.) cic.ecr than ci.5' to b,J. iP.r~eid.
a[[ in accordance wi~ fhe detailed ~pecfficaHons as pte~n~ed in
fhe odglnafin9 applicaIion.
IN WIJNESS WHEREOE, The ~aid Board o{ TmCees ~te-
by cause~ i~$ Gorpora~e Se~l ~o be affixed, and ~b~e pre~n~ ~o
be subscribed by a majority of ~he said Board as of ~hls date.
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER
1-4738-00890/00007
PACIL[TY/PROG RAM NUMBER(S)
PERMIT
Under the Environmental
Conservation Law
EFFECTIVE DATE
Februan,/28, 2002
EXPIRATION DATE(S)
February 28, 2007
TYPE OF PERMIT · New [] Renewal [2, Modification [] Permit to Construct [] Permit to Operate
O Ailisle 15, Title 5: PretecQon of Waters
[] Article 15, Title 15: Wa[er Supply
[] Article 15, Title 15; Water Transport
[] Article ~5, Title 15: Long island Wells
[] Artiole 15, Title 27: Wild, Scenic and
Recreational Rivers
[] Article 17, Titles 7, 8: SPDES
[] Article 19: Air Pollution Control
[] Article 23. Title 27: Mined Land
Reclamation
[] Article 24: Freshwater Wetlands
· Arbc[e 25: Tidal Wetlands
[] Artic]e 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
[] Article 34: Coastal Erosion
Management
[] Article 36: Floodplain Manegemenl
[] Articles 1, 3, 17, 19, 27, 37; 6NYCRR
380: Radiation Control
[] 6NYCRR 608: Water Quality Certifica-
tion
[] Adicle 27, Title 7; 6NYCRR 360:
Solid Waste Management
PERMIT.ISSUED TO
Christine Howle~'
ADDRESS OF PERMIqq-BE
ITELEPHONE NUMBER
(9731783-8361
56 Highland Avenue, Montclair, NJ 07042
CONTACT PERSON FOR PERMI%['ED WORK
Catherine Mesiano, 12 Mill Pond Lane, East Moriches, NY 11940
TELEPHONE NUMBER
(631)878-8951
NAME AND ADDRESS OF PROJECT/FACILITY
Howle¥ Property. 320 Sailor's Needle Road, Matt[tuck, NY
COUNTY
Suffolk
TOWN
Southold
WATERCOURSE
James Creek
NY-i'M COORDINATES
E: 707.9 N: 4539.5
DESCRIPTION OF AUTHORIZED ACTIVITY
Construct additions to existing single family dwelling, abandon existing septic system and instal[ new septic system.
All work is to be done in accordance with the attached plans stamped NYSDEC approved on February 26, 2002.
By acceptance of this perm;[. [he permittee agrees that the permit is contingent upon strict compliance with the ECL, alt applicable
regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as pert of this permit.
PERMIT ADMINISTRATOR:
Mark C. Carrara,
Deputy Permit Administrator
AUTHORIZED SIGI'4ATURE
,KAF) I ADDRESS
Region 1 Headquarters
Bldg. 4-40. SUN',', Stony Brook, NY 11790-2356
Page 1 of 4
ApplLcan~
Architect/'
SCTM ~:
District:l,O00 Secion: 't-~ ~ )ck
Lot:
.... '- Dalc
!.'~ Reviewed.
¢ Da(e
Proj¢cl ' Subdivision
S;ngl~ ,£ ~CF.'~-ar: P. aqmrcd
Project'Descdption: ~S /
Suffolk County Health' Dept
New York State D, E. C.
.Toxin Trustees
Town Zoning Board. approval:
Town P[annittg Board approval: - ',,/'/
Flood Plane Elevation 777
Flood Zone:
Pecmit .
Towh Of'Sbutt~;61~l
P.O Box 1179
Southold, NY 11971
* * * RECEIPT * * *
Date: 06/18/02
Transaction(s):
Septic Permit - Construct - Resid.
Receipt~; 0
Name:
ClerklD:
Mesiano, Catherine
12 IVlill Pond Lane
East Moriches, NY 11940
BONNIED
Internal ID: 56953
BUILDING DEPT.
?.INSPECTION
[~/']~ FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
INSPECTOR
,/
765-1802
BUILDING DEPT.
INSPECTION
[ ] F~NDATION 1ST [ ] ROUGH PLBG.
[ c,~ FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[
REMARKS:
] FIREPLACE & CHIMNEY
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ -~ FOUNDATION 1ST [ R~~'~'~Oi
UGH PLBG,
FRAMING
[ ] FINAL
& CHIMNEY
REMARI4
: 11 ~INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION/-
[ ] FOUNDATION 1ST [~OUGH PLBG.
[ ] FOUNDATION2ND [ ]INSULATION
[ ] FRAMING [ ]FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS: ?~.S-~,_~:/ ~ /~v~
DATE
INSPECTOR
7G5-~802
BUILDING DEPT'.
INSPECTION
[ [ ] RO~G.
[ [ ~ INSULATION
[ [ ] FINAL
[ ] FIREPLACE & CHIMNEY
REMA~:
] FOUNDATION 1ST
] FOUNDATION 2ND
] FRAMING
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST
[ ] ROUGH PLBG.
[ ] FOUNDATION 2ND
[ ] FRAMING
[ ] INS~ION
[/,~INAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INS~UL~-I~!
[]FRAMING [~,IN~_~')
[ ] FIREPLACE & CHIMNEY [ ] FIRE, SAFETY INSPECTION
DATE.__
-~-INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ I FOUNDATION 2ND [ ]I/NS~~
[ ]FRAMING [P'] FII~AL~/,~//~
[ ]FIREPLACE & CHIMNEY[ ] FIRE'SA'FETYINSPECTION
REMARKS:
DATE
TO~I iW OF SOUTHOLU
BUILDING DEPARTMEN'~'
TO~VN HALL
SOUTHOLD, NY 11971
TEL: (631) '765-1802
F_~X: (631) 765-9502
Examined
Disappro; ed a'c "
-'- -ZBUILDING PERMIT APPLICATION CHECKLIST
"~'~% ', Do yon trove or Feed the following, before apptyh~g?
, '.. Board of Hcalth
3 sets of Building Plans
Plan'nMg Board approval
Smwey
rEI~MIT NO. ~ S~-.5' ,-/f/~_5 Check
Septic Fern
N.Y.S.D.E C. /
Trustees
contact: CATHERINE MESIANO, INC.
>' %iiLL POND LANE
?h ¢MORICHES, NY 11940-1222
- :¢ ,--'0
:c:'/,
", !! }F
APPLICATION FOR BtrlLDING PERMIT I · ·
I , "' -gr-::'~: 0
· /
Date
I StmJcTIoSs
a. This applJ cation MUST b6 completely filled in by ts?e~vriter or in ink and submitted tq the BuiliSing~ Inspector with 3
s ets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan shewina location of Iot and of buildings on premises, relationship to adjoining premisei :or public streets or
areas: mid water, vays. :.
c. Ihe work cm.'ered by this application may not be coinmenced before issuance of Building Permit.'-~
d. Upon approval of this application, the Build/ng Inspector will issue a Building Permit to the applic"~ht. Such a perrrfit
shalJ be kept on the prem/ses available for inspechon throughout the work. ·
e No building shall be occupied or used in whole or in part for an5' purpose what so ever until the Building hxspector
issues a Certificate of Occupancy
f. Ex co' building permit shall expire if the work authorized has not commeneedwithin 12 montl~ after the date
issuance or has nor been com¢leted wfthin 1 $ months from such date· If no zoning amendments or other regulations affecting the
P * op _rt5' ha .'e b ~en enactco i., ,he inte.qm, th~ Building Inspect,,r m% a,uthorize, 'ku ~uSdng, the extension of ff~e Fei Q~t .ct, n
addition six months. Thereafter, a new perrr~t shall be required. ,~
APPLICATION IS HEREBY MADE to the Building Dpffartment ,for tire issuance of ~ Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk C~o~', New' 5 ork, and other applicable Laws, Ordinances or
P.e~alations, for the cc, ns!p_~ction of buildin~, additions, or alterations or for removal or demolition as herein described· The
applicant a~ees to comply ,,riCh all applicable laws, ordinances, building code, housing code, and regulations, and to adrrdr.
authorized inspectors on pre~q~ses and in build/ag for neceasaD' inspections.
(Signature of applicant or name. ifa corporatic,~.)
(Mailkng address of applicant) [
State whether applicant is o',xinet, lessee, agent, archite~, engineer, general contractor, electrician,, plumber or builder
(As on the tax roll or latest d/~d)
If applic~t is a corporation, signature of duly authorized officer ·
(,Name and title of corporate officer)
Builders L/cease No. ~ .
Plumbers License Ne.
Electricians License No.
O.her Trade s License Ne.
Location of land on whic~ proposed worl,hwill be done: _
House Numb~ S~eet
Connb' Tax Map No. 1000 Section
Subdivision
Hamlet
Lot
Block,
Filed M,ap No.
(Name)
'.. State existing use and occupant' of premises-and intended use and occupancy of proposed construction:'
a. £xistingnseandoeenpancy ~l'r'~l~ d~2a.-,~,J~!
b. Intended use and occupancy
Nature of x~ork (check which applicable).: New Buildin~
Repair Removal Demolition
Estimated Cost ,~_~-O,.D~O Fee
If dwelling, number of dwelling units
If garage, number of cars
Addition X Alteration
Other Work
(Description)
(To be paid on filing this application)
Number of dwelling un/ts on each floor
5. If business, commercial or mixed occupancy,, .specify nature and extent of each t)pe of use.
? Dimensions of existing structures, if any: Front Z 2.. ~' Rear ~ g. 2. ' Depth
Height ~,.~ Number of Stories
Dimensions of same structure with alterations or additions: Front I
Depth Heigh[ Number of Stories
Dimensions of entire new.construction: Front Rear
Height Number of Stories
Size of lot: Front '~. (~[ ' Rear ¢ 2.0~' Depth
~1.
Depth
,_/$, / ,
/
10. Dale o f Purchase Name of Former Owner
I 1. Zone or use di.qrict in which premises are situated
12. Does proposed construction x4olate any zoning law, ordinance or regulation? YES
13. Will lot be re-~aded? YES.__ NO__Will excess fill be removed from premises? TES NO
14. Names of Owner of premises Address
Name of Architect '~o ~ ¢'~_.~o,, ' ' Address_
Name of Contractor ~ . . ldress _ 'hone No.
. 15 a. Is this property within 100 feet of a tidal wetland or a fi:eshwater wetlmad? *YES ~// N O __
· * IF YES, SOU~HOLD TOWN TRUSTEES & D.£.C. PERMITS MAY BE REQUIR_ED.
b. Is ti:ds proper~: within 300 feet ora tidal wetland? * TES __ NO__
· IF YES, D E.C- ~ER2X~ITS IvL~Y BE REQUIRED.
~::
16. Provide surt-ev, to scale, xsdth accurate foundation plan and distances to property lines.
1 -. If. elevation at an} point on properb' is at 10 feet or below, must provide topographical data on
Phone
phone No_
STATE OF >JEW YORK)
SS:
COUNTY
C~T~ ~,¢, ~- }t~ ,~x ,~.~ , · be/2g ,dui>' sworn, deposes and says.
that
(s) he
is
the
applicant
(Name"o:[ mcliadduaI sliming contract) above named,
(S)Heis the
(ContraCtor, A=ent, Corporate Officer, etc.)
of said owner or ov.'ners, and is dmly authozdzed to peri'om or have performed the said work and to make and file this application:
that ali statements contained in tNs application ~re tree to the best of Ns kmowledge and belief: and that t c u ork ~; '11 be .
performed in the manner set forth in the application filed therewith.
Sworn to before me tbJs
Young & Young p
Sd�o
N.Y.S.D.E.C. LOT COVERAGE
400 Ostrander Avenue, Riverhead, New York t190f 2
SECTION SEWAGE DISPOSAL SYSTEM 631-727-2303
BY IMPERIOUS STRUCTURES
Alden W. Young, RE, & L.S. (1908-1994) aE$
• TOTAL AREA = 22,840 SF. ED
• WETLAND AREA = 1,600 S.F. Howard W. Young, Land Surveyor 5jgg
Thomas C. WOlpert, P,OjGA ..Sud Engineer €.8
ROI:ert C. Tast, Architect 'Tol
• TOTAL UPLAND AREA = 21,240 S.F. Ma crR T.GRADE FIFILxpuspp} w,
,Y HEALTH DEPARTMENT USE
EXISTING IMPERIOUS STRUCTURES FINISHED nReLE EE-e.z TMAX' E-=s2 EL>9,9 EL-Top
HOUSE = 1819 S.F. r MIµ '
ASPHALT DRIVEWAY = 634 S.F. z' MAx p 1M 1x, o
FRAME SHED = 15 S.F. IE-ze �I pFLOW UNE
SHOWER = 17 S.F. (.) TDD so Fr (V IOD sD. Fr. . 1' PVC
EIpE WALL AREA 9pE WALL AREA �j G..L1
WOOD DECK = 32 S.F. agcxlxc POOLS MST PDDL
,a_57 IC=sa e' mx
• PROPOSED IMPERIOUS STRUCTURESRO '
1 STORY ADDITION = 216 S.F. p' Mw 1/e - T
SCREENED PORCH = 108 S.F IE=ve scanc�nnK W L� 3g
aipUNO WATER EL�1 2 G
COVERED PORCH = 256 S.F. —
1st k 2nd STORY ADDITION = 575 S.F. ''aa
K'9g
• TOTAL = 3,672 S.F. � 4
• 3,672 S.F. - 21,240 S.F. = 173% €ateIy:
P.dY
bghF
Lot 12 SI €v
ao?a
subdivisionNOTE i
(va
SO/t Lake Village" AREA = 22,840 SQ. FT. a �=
ALANDMcg0 BY w' Nos nuAEEN T A • SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF
N.Y,SU.E.O. ON 07/ DSUFFOLK COUNTY ON MAY 10, 1940 AS MAP N0. 1310 �a:_F
LANoWARo Ds S OF
N J • VERTICAL DATUM = N.G.V DATUM (M.S.L. 1929)
O PROPOSER�� 0/o/NEAP BY � • THIS PARCEL IS LOCATED IN FIRM ZONE AE (EL=B) AS INDICATED
� . N
I �H 1 STORY �• ON FLOOD INSURANCE RATE MAP PANEL NUMBER 36103CO482 G
ApoinaN o Yo LAST DATED MAY 4, 1998
' o S 82'50'00" E _ SGR' 0vEE0p ao "'=
CR- _ ECR n y.; s� ENGINEER'S Q
°� r nUm NH5 P oRCH
E° 23' ENGINE CERTIFICATION
(Vacant) I WER 3:r- -- _ ___
4 #, 4 E+13=" • 1 HEREBY CERTIFY THAT THE WATER SUPPLY AND SEWAGE
1 x0e m @- x DISPOSAL SYSTEMS FOR THIS PROJECT WERE DESIGNED BY ME OR
%AsrxALr - uOOD DE�rc
a, .•4 A f`
T p1°�W"Y n 2 sTaiY - '" Q Aya o�?ji UNDER MY DIRECTION AND CONFORM TO THE SUFFOLK MUNTY O
A FRAME HousE ,pps`acs N DEPARTMENT OF HEALTH SERVICES CONSTRUCT] _ S.IN
f._ TOO • CARAC{
{'✓) 11 PE EL=10.6} ^ °d N EFFECT AS OF THIS DATE.
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PROPOSED °RO"Oesm A6 �,H
P• 2 a�:
c" cr hry Tel A 2nd 6Tgry 4 q ^ (n HOWARD W. YOUNG N.Y.S. LS. N0. 4589 $� `
`q THOMAS C. WOLPEfET, N.Y S. P.E. N0. 6148 0+ 61 A.. ti aYd,
tiv .NS M ooma a io 3 Q• / s@3g
,�6G. PROPOSED SQ•> i° BE 54 'A
SYS TEM �• v o �pROFESS�UVV� 9
s9a`po
pMPED i�c. E3�e
E (L' SYSTE"MRY / ABANDONEp AN°/OR xREM00VEp !IIS, A�90 B€,3-
N 79 9550^ Y " Lot 11 I,
---_A_^---= o SURVEYOR'S CERTIFICATION
op� µ.15.°N • WE HEREBY CERTIFY TO CHRISTINE HOWLEY THAT
THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE CODE OF
/JrP`11 S` PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE
G, lba/b 1�h6 ASSOCIATION OF PROFESSIONAL LAND SURVEYORS.
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HOWARD W. YOUNG, N.Y L.S. NO. 45893
Nry 45893
g`L SFpLANDS�F`
TEST HOLE ;0 GE,<3
eg
DATE: 10/11/01 Q O'
y SURVEY FOR ale
m�
EL=B.9 0.0' gpg
MIXED SAND CHRISTINE HOWLEY
AND LOAM
PALE BROWN p�e3
INE TO LOT 11 "SALT LAKE VILLAGE" =has
MEDIUM SAND
P) 50' At Mottituck, Town of Southold setK
BROWN BAY
CL
ORGANIC CLAY Suffolk County, New York
(OL)
PRO" fi0 County Tax MOP Ostrlct 1000 seetmO 144 Bock 05 Lot 28
SILTY SAND
SMI BOUN0 ^ RY SURVEY o
GW EL-1.2 7]'
WATER IN
BROWN
SILTY SAND
(SM)
1}0'
WATER IN
PALE BROWN
FINE SAND g' ]
(sF) GENERAL AMENDMENTS DEC. 10, 2001 a ,oa
190" MAP PREPARED JAN. 11, 2001 `z^�
Red
MONUSET ■ MONUMENT PWAK
ND 0 STAKE SEr A= STE FOUND SCALE 1 = 40'
FTMENT gAa
q JOB N0. 2000-0567 BSS 3Fs
DWG. 2000_0567 ����
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R_
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NN,"' PROVIDE ANTI-SCALD AND/OR
�7�, TING
THERMAL SHOCK PREVEN PLUMBER CER7MICATION
HOTE, DEVICES AS TO PART. 902.6(K)
ON LEAD CONTENTBEFORE
BUILDING CODE.
1 4' v RiPf"I'"A I,, Is,
r CERTIFICATE OF OCCUFANCV
SOLDER USED IN WATER
77
S SUPPLY SYSTEM CANNOT
NOA Sri, IP friz - lG,,o4 PLUMBING
Ez�lrc mj- zl�6 F-9 - Jr. EXCEED 2110 of I% LEAD.
ALL PLUMBING WASTE U
Ilt WATER LINES NEED
TESTING BEFORE COVERING
M t��Tk
A-Lom.F�""Ar, b.SXA�T WAL-EE5 If copper tubing is used T
ZZI VI-0 Twi3O rx"v- C"W_z W1`7WL4 IcVFS191E�0 for water distribot,og
!T1611 flk-yv4pno
-Z It, IF.R - 1&1.1,4 system; piping sha!I be
of types K or L only LLJ i
UNDER, WRITERSCERTIFICAIE
1 11 F il Al I I C
TM V*� 6,-6,04 REQUIRED
FL00DZ0NE_j,5fj
C) I ll-A I CI Lf
FORal CIL CL r-L R 21 COMPLY WITH CHA
fo PTWtm46w
FLOOD DAMAGE PREVENT"
SOUTHOLD TOWN COM
>,4 PJA
PROVIDE 1/4 HR. FIRE
RATED SEPARATION TO
-Z
T tZ, CF6J`4I_ tv�rna N.Y. STATE BUILDING CODE.
Q2T DO NOT PROCEED WITH
m. Tri,
FRAMING UNTIL SURVEY
r PROVIDE OPENINGS FOR OF FOUNDATION LOCATION
EMERGENCY ESCAPE AS HAS BEEN APPROVED. di
I RED BY PART. 714 OF
�-A MUTE BUILDING CODE. EDAS D
B
TIN A By,A�_
PROVIDE SMOKE-DETEC OTIFY BUILDING D PARTMENT AT
765-1802 9 AM TO 4 PM FOR THE
'Z ALARM DEVIC,ES FOLLOWING INSPECTIONS-.
11 i
AS TO PART.72 . 1. FOUNDATION - TWO REQUIRED P
N.Y.S BUILDING CODE. FOR POURED CONCRETE -0
I ROUGH - FRAMING & PLUMBING j,-_1 0
& INSULATION W-'
4. FINAL - CONSTRUCTION MUST ln� ",
OCCUPANCY OR BE COMPLETE FOR C.O. Cz
ALL CONSTRUCTION SHALL MEET
USE IS UNLAWFUL THE REQUIREMENTS OF THE N.Y.
WITHOUT CERTIFICATE STATE CONSTRUCTION & ENERGY
OF OCCUPANCY CODES. NOT RESPONSIBLE FOR izc%
DESIGN OR CONSTRVCTJON ERRORS
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