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Home My WebLink About29701-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNT-rL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO'. 29701 Z Date S -PTEMBER 5 , 2003 Permission is hereby granted to: THOR B & KARE PETTERSEN 1120 JACKSON' Lp�UDING MP_TTITUCK,N 11952 for : CONSTRUCTION OF A NEW SINGLEMILY DWELLING AS APPLIED FOR at premises located at 970 JACKSONS LANDING MATTITUCK County Tax Map No. 4 3889 Section 113 Block 0006 Lot No. 002 pursuant to applic tion dated AUGUST 22 , 2003 and approved by the Building Inspect& to expire on MARCH 541orized 2005 _ 0 Fee $ /990 . 00 / i' d, Signature ORIGINAL Re-v . 5/8/02 BUILDING PERMIT EXAMINER CHECKLIST DATE REVIEWED: T /t"- /03 APPLICANTTI�o2 �Mvsakl DATE SUBMITTED: /Zj�03 SCTM#DISTRICT: 1,000, SECTION: 113 , BLOCK: __.._, LOT: SUBDIVISION:`Soc. ADDRESS:,110 & ,rte#L'rJCITY: a,"j , ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP -Z/C/0 Z- , INFO bo /BP -Z/ C/0 Z- , INFO BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED Y" NOTES: OIL ✓ LATS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after REQ. LOT SIZE: ACT. LOT SIZE:Zgt. REQ. LOT COV. p2b 7. ACT. LOT COV. we REQ. FRONT_ 3S PROP. FRONT--,.4 REQ SIDE 1012S- ACT. SIDE REQ. REAR 33– PROP. REAR woo' REQ. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: Q o. 'S.F,D ESTIMATED PROJECT COST: 225 tT/ENGINEER: WATER FRONT? go _DESCRIPTION: •-•lo PANEL # AIDS 1 FLOOD ZONE:Asjl HOUSE ovr APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: 0 or NO, (BED #): AtDTE: 5 / 15/ 3 PERMIT #: ►tlo-o3•cr,41S TOWN SEPTIC RE'CEIPTO. or N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or C) DTE: / / PERMIT #: SOUTHOLD TOWN TRUSTEES: YES or t DTE / /_ PERMIT#: TOWN ZONING BOARD APPROVAL: YES oro DTE: / / PERMIT #: TOWN PLAN. BOARD APPROVAL: YES or _ DTE: _ / _/ PERMIT #: TOWN HISTORICAL PRE (SPLIA): YES oro NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: W� o „ FEE STRUCTURE: FOUNDATION: 10 SF FIRST FLOOR: _ 13�-� SF SECOND FLOOR: ' p SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE I. 3( 6so SF)- g( 9(7 SF)= �,v� SF X $ -3L) '� ViLk) +$ 1 +$ = s qr 2. ( —SF)- (__ SF)= SFX $ =$ +$ +$ = $ 3. (—SF)- SF)= SF X $ =$ _+$ +$ = $ FINAL TOTAL: $ "1� NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: / Ground Snow Load: 45 / Wind Speed: 120MPH ✓ Seismic Design Category:B Weathering: Severe Noo*400' Frost Depth:36"-,/—Termite:M-H ,O/Decay: S-M Design Temp: 11 ✓ Ice Shield Underlay: YES ✓ Flood Hazards: USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/ �S _�J► FULL FRAMING DF-SIGN ELEMENTS:&N HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS- Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: YIN DESIGN LOAD CALCULATIONS: tV/N LIVE:t:/°' DEAD:ON SNOW:ON SEISMIC(SiN WIND& WINDOW AND DOOR SCHEDULE: MISSLE TEST REQUIREMENTS/N - EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE:�'/�i —'MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM:ON LOCATION OF FIRE PROTECTION EQUIPMENT: Y N TRUSS DESIGN: Y/N l� CERTIFICATION: Y/N iv lot ENERGY CALCS:QN TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) lvWill ur avuInvLL b UILLAN UPbKMl1 A ?Ll(;ATION C;HEC;KLIS BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. Q�61 Check Septic Form N.Y.S.D.E.C. Trustees Examined s ,20 3 Contact:. T. Martz Jr. Approved , 20a_ Mail to: Disapproved a/c A Phone: (631)-878-8443 4Buil Inspector APPLICATION FOR BUILDING PERMIT � T Date Airj3st 181 , 2003 -' 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 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 a Certificate of Occupan is issued 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 nd regulations, a admi authorized inspectors on premises and in building for necessary inspections. (Signature of applica or name if a ration) 145 Ry 9m Avenue NY 119 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect,engineer, general contractor, electrician, plumber or builder a rr/genal amtractor Name of owner of premises Theodore C. Martz Jr. (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: gma.s'rire= T Mattltuck House Number Street Hamlet County Tax Map No. 1000 Section 113 Block 06 Lot 02 Subdivision_,7a,-rte Tom;m Filed Map No. 5280 Lot 9 (Name) Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy vet land ` b. Intended use and occupanc residetitial structure 3. Nature of work (check which applicable): New Building X Addition Alteration Repair Removal Demolition Other Work 1. Estimated Cost $225,000,00 Fee (Description) (to be paid on filing this application) If dwelling, number of dwelling units 1 Number of dwelling units on each floor If garage, number of cars _ 2 �. If business, commercial or mixed occupancy, specify nature and extent of each type of use. r/a 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 55' Rear 55, Depth 26, Height Number of Stories-9 Size of lot: Front_ i6p, Rear 160, Depth 160, 0. Date of Purchase 7/01,/03 Name of Former Owner M-jx and 1�x Pettersen. 1. Zone or use district in which premises are situated R20 2, Does proposed construction violate any zoning law, ordinance or regulation: no 3. Will lot be re-graded yes Will excess fill be removed from premises: YES NO 145 Rye=Aye. .Add 4. Names of Owner of premises Theodore C• Martz Jrress Mlle, NY 1'949Phone No. (631)-878-8443 Name of Architect victor Cuneo Address NY 177Blhone No (631)-261-Z744 Name of Contractor Theodore e. Martz Jr. Address hone No. (631)-878-8443 5. Is this property within 100 feet of a tidal wetland? *YES NO x • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 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) SS: 'OUNTY OF 51zEfolk ) Theodcre C. Martz Jr. being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, 3)He is the am2r/axtractcr (Contractor, Agent, Corporate Officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; iat all statements contained in this application are true to the best of his knowledge and belief, and that the work will be �rformed in the manner set forth in the application filed therewith. worn tore me this �_day of_ UCA U S! 2063 Theodore C. Martz Jr. Notary Public Signature of Applicant WM ► "a'�.0 bk S.C.T.M. NO. DISTRICT- 1000 SECTION: 113 BLOCK: 6 LOT(S):2 ELEV. 27.0t ELEV 5.0t _ TOP SOIL YJ n..I LOWM SAND 2- 2003 NAR 10 A 11: 5b 4- COARSE GROUND SAND WATER GRAVEL c 14' t TEST HOLE /1 TEST HOLE /2 AS "m ON OLEO SAP AS SHOWN ON FILED MAP -• \' LAND N/F OF COUNTY OF SUFFOLK S 01"25-20" E \ 160.00, EL 10.3 \ EL 5.8 \ LOT 9 \ p b 8 LOT 10 \ FgSFMF \ \ DWELL W/PUBLIC WATER \ RECHARGE AND PARK b PROP AREA EL(12.0) i CK EL(11.5) \ ss.o. \ VACANT 100' PROPOSED GARAGE 2 STY FR. tt q EL(13.0) c \ d$ 3s.o' COVERD PORCH (13.0) ■ \ z s , > t i y � W ;70AI/ X > O EL 778.37' 13 2 EL 10.1 N 01.25,20" 1I 160.00' JACKSON'S (50') LANDING ASP T PAVEMENT - TOWN MAINTAINED WATER MAIN MILL ROAD DWELLINGS �- W/PUBLIC WATER 100' 1 THE WATER SUPPLY, WELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD 06SERVATIONS AND OR DATA OBTAINED FROM OTHERS AREA: 25,600 S.F. OR 0.59 ACRES ELEVATION DATUM: _ ASSUMED__________________ UNAUTHORIZED ALTERA77ON OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: LOT 9 CERTIFIED TO: THEODORE C. MARTZ JR.; MAP OF: JACKSON'S LANDING FILED: MARCH 28, 1969 No.5280 SITUATED AT: MATTITUCK TOWN OF: SOUTHOLD KENNETH M. WOYCHUK L.S. SUFFOLK COUNTY, NEW YORK Land Surveying and Design P.O. Boz S, Mattituck, New York, 11952 PHONE (831) 298-1588 FAX (631) 298-1588 FILE # 22-209 SCALE: 1 ,,.30, DATE: FEB. 22, 2003 N. Y. S. LIC NO. 50227 maintaining the records of Robert J. Hennessy