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Home My WebLink About29623-ZFORM NO. 4 TO~ OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUP~2TCY No: Z-30563 Date: 11/16/04 THIS CERTIFIES that the building ACCESSORY Location of Property: 3050 FAIRWAY DR CUTCHOGUE {HOUSE NO.) !STREET) (H.~ILET/ County Tax ~ap No. 473889 Section 109 Block 5 Lot 14.16 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated DULY 29, 2003 pursuant to which Building Permit No. 29623-Z dated AUGUST 4, 2003 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificaEe is issued is ACCESSORY INGRO~ SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR PER ZBA #5262 DATED 1/23/03. The certificate is issued to JAMES J & M3kRGARET M FALLON (O~,TER) of the aforesaid building. SUFFOLK COUlF~Y DEPARR~NT OF ~IV_3%LTH APPROV;kL N/A ELECTRIC~kL CERTIFICATE NO. 3849 09/15/03 PLUMBERS CERTIFICATION DATED N/A 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. 29623 Z Date AUGUST 4, 2003 Permission is hereby granted to: JAMES J PALLON 284 CHASE WAY MANCHASTER NH, 03104 for : CONSTRUCTION OF AN IN-GROUND SWIMMING POOL AS APPLIED FOR WITH FENCE TO CODE AND AS PER ZBA DECISION #5262 at premises located at 3050 FAIRWAY DR CUTCHOGUE County Tax Map No. 473889 Section 109 Block 0005 Lot No. 014.016 pursuant to application dated JULY 29, 2003 and approved by the Building Inspector to expire on FEBRUARY 4, 2005. Fee $ 150.00 ORIGINAL Rev. 5/8/02 Nassau Suffolk Electrical Inspections, Inc. 5A Canal Street * Center Moriches, Ne,,,' York 11934 * Tet; 631-878-3500 * Fax: 631-878-3764 Application: 3849 Issued to: Fallen Address:. Village: Cutchogue Date: 9/15/03 3050 Fairway dr Introduced By: Avey Electric East Lic#:5120-E was examined and approved up to the above date and was in compliance with the NEC Switches Receptacles Fixtures G.F.I. Pool Panel Pool Heater 1 3 I I 1 1 Oven Carbon Fans Dishwasher Washer/Amps Dryer/Amps Range/Amps Monoxide Smoke Bell Furnace Oil Gas HeatZones Detectors Trsnsformers Meter Amps Phase Motors 1-3/4~11/2hp Other Equipment: Inground Pool ~3ut,Res Permit#: 29623-Z This certificate must not be altered in any manner APPEALS BOARD MEMBERS Lydia A. Tortora, Chairwoman Gerard P. Goehringer George Homing . Ruth D. Oliva Vincent Orlando Southold Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971~0959 ZBA Fax (631) 765-9064 Telephone (631) 765 - 1809 http: sou£holdtown.north fork.net BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF JANUARY 23, 2003 Appl. No. 5262- JAMES FALLON 1000-109-5-14.16 STREET & LOCATION' 3050 Fairway Drive, Cutchogue DATE OF PUBLIC HEARING: January 16, 2003 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: Applicants' property is located on the west side of Fairway Drive, in Cutchogue, referred to as Lot 16 on the Map of Fairway Farms. The property is a 41,774 sq. ft. parcel improved with a two-story, single-family dwelling and attached one-stow garage, as shown on the survey prepared June 29, 2002 by Barrett, Bonacci & VanWeele, P.S. BASIS OF APPLICATION: The basis of this application is the Building Department's September 19, 2002 Notice of Disapproval concerning applicant's request for a permit to locate an accessory in-ground swimming pool partly in a side yard rather than entirely in the rear yard as required by Zoning Code Section 100-30A.4. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on January 16, 2003, at 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: Applicant proposes to locate an 18' x 36' in-ground swimming pool, on an angle at approximately 10 feet from the rear northwest corner of the house with attached garage. The setbacks from the pool at its closest points are proposed at 59+- feet from the rear line and 20+- feet from the side lot line. REASONS FOR BOARD ACTION: Based on the testimony and record before the Board and personal inspection, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The neighborhood is a well-established sub- division with relatively large homes situated on about an acre of land. This property is a 41,774 square foot parcel, which allows the proposed setbacks of the accessory structure to meet or exceed the code-required setbacks from the closest side and rear property lines. 2. The benefit sought by the applicant cannot be achieved by some other method feasible to pursue than a variance. The configuration of the property and the siting of the house on the Page 2 - January 23, 2003 ZBA Appl. No. 5252 - J. and M. Fallon Parcel 109-5-14.16 at Cutchogue property are such that the proposed location of the proposed swimming pool, on an angle to the property lines, is in the rear yard, but a small podion in the side yard. The pool visually gives the appearance of being 100% at the rear of the house. Architecturally and visually, the swimming pool would be behind the house. 3. The variance granted herein is not substantial. Only a small portion of the swimming pool will be located in the side yard. 4. The alleged difficulty has been self-created as the applicant was aware of the architectural constraints of the property when it was purchased. 5. No evidence has been submitted to suggest that the relief granted will have an adverse impact on the physical or environmental conditions in the neighborhood. Without a variance, the pool would not be able to be placed in this reasonable location. 6. Grant of the requested relief is the minimum necessary and adequate to enable the applicant to enjoy the benefit of a swimming pool, 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 Oliva, seconded by Member Orlando, and duly carried, to Grant the variance as applied for, as shown on the map dated October 25, 2002, prepared by Proper-T Permit Services. This action does not authorize or condone any current or future use, setback or other feature of the subject property that violates 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, Oliva, and Orlando. (Member Homing of Fishers Island was absent.) This Resolution was duly adopted (4-0). Lyd, ia"A. Tortora, C6airW0man 3/~/03 DEC PERMIT NUMBER 1-4738-03139/00001 FACILITY/PROGRAM NUMBER(S) NEW YORK STATE DEPARTMENT pF ENVIRONMENTAL CONSERVATION ' PERMIT Under the Environmental Conservation Law EFFECTIVE DATE July 22, 2003 EXPIRATION DATE(S) July 31, 2008 TYPE OF PERMIT · New [] Renewal [] Modification [] Permit to Construct [] Permrt to Operate [] Article 15, Titre 5: Protection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport [] Article 15, Title 15: Long Island Wefts [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certifica- tion [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] ArtiCe 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7 6NYCRR 360: So[id Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER James Fallon (603) 626-3076 ADDRESS OF PERMI3-FEE 284 Chase Wa)/, Manchester, NH 03104 CONTACT PERSON FOR PERMITTED WORK Proper-T Permit Services, P.O. Box 017, Cutcho~ue, NY NAME AND ADDRESS OF PROJECT/FACILITY Fallon property, 3050 Fairway Drive, Cutcho~lue COUNTY TOWN Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: 11935 TELEPHONE NUMBER (631)734-5800 SCTM #1000-109-5-14.16 WATERCOURSE NYTM COORDINATES Construct swimming pool and fence. All work must be done in accordance with the attached plans stamped NYSDEC approved. 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 A,~MINISTRATOR: / ADDRESS ,.,' Johr~ ,. ¢~eland (LJS) Re~ion 1 He~.d'~uarters. BIde. ¢f40, SUNY, Stony Brook. NYl1790-2356 AU T[~ O ~rrZED, SIC N ATU RE-) //~ DATE ~,[ ¢ ~' L k~ July 22, 2003 Pagelof4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL ~ONDITIONS 1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices enter 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 100 linear feet from the tidal wetland boundary. 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 150 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 2 of 4 1-4738-03139/00001 NEW YORK STATE D EPA, RTIVIENT O~F ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE $), 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, Jn 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 De pa rtment 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 watemourse 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 Environ mental 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. 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. 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. 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. 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. There shall be no unreasonable interference with navigabon by the work herein authorized. 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. 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. 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 survey. 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 Proper-T Permit Services dated revised 6/26/03. DEC PERMIT NUMBER 1-4738-03139/00001 PAGE 3 OF 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF '.OTHEi~ PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly ag rees to indemnify and hold harmless the Department of Environ mental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in pompliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. 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 shah 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 m a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, incl,uding relevant records, is subject to 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 ali 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 or transfer 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 wribng. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Bimination 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 in accordance with 6 NYCRR Par[ 621. The grounds for modification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the permittee to comply with any terms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued permit conditions, orders of the commissioner, any prowsions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DECPERMITNUMBER PAGE 4 OF 4 1-4738-03139/00001 1000-109-4-8.3 NORTH FORK COUNTRY CLUB, INC. PO BOX 725 CUTCHOGUE, NY 11935 ! t ",~,~'z x'~, .~,,,,~ 1000-109-5-14.16 JAMES AND MARGARET FALLON 284 CHASE WAY MANCHESTER, H 03104 I STREET ADDRESS Of PROJECT SITE: ~ 3050 FAIRWAY DRIVE CUTCHOGUE. NY 11935 FAIRWAY DRIVE VEGETATED WETLANDS BOUNDARIES DELINEATED BY J.E. FITZGERALD. JR. ON 10/25/02 PROJECT PLAN Application regarding the property_ of James & N~-trgare! Fallon. $CTM # 1000-109-5-14.16 Represented by PROPER-T PERMYI' SERVICES P.O. Box 617. Cutchogue. NY 11935 James E. Fitzgerald. Jr. 631-734-5800 Revised June 26. 2003 FORM NO. 3 NOTICE OF DISAPPROV.,kL DATE: September 19, 2002 TO: James Fallen 3050 Fairway Drive Cutchogue, NY 11935 Please take notice that your application dated September 19, 2002 For permit to construct an accessotw' in-~ound swilnmin~ pool at Location of property: 3050 Fair, ray Drive, Cutchogue, NY County Tax Map No. 1000 - Section 109 Block 5 Lot 14.16 Is returned herewith and disapproved on the following grounds: _The proposed accessory in-ground swimming pool, located on a 41,774 square foot parcel in the Residential R-40 District, is not permitted pnrsuant to Article IliA, Section 100-30.A.4, which states; "Accessory buildiogs shall be subject to the same requirements as 100-33 of the Agricultural- Conservation Dislrict," which states, "h~ the Agricultural~Conservation District and Low- Density Residential R-80, R-120, R-200, and R-400 Districts, accessols' buildings and structures or other accesso~-v uses shall be located in the required rear vard, subject to the following requirements: "A. Such buildings shall not exceed eit~hteen ( 18} feet in height." The proposed accessory in-ground swimmine pool is partially located in the side yard. Total lot coverage on lhe property, follo~x lng the proposed construction, would be +'- 6 percent. ' ~...//Aut ~)z/ed S i gnat ur~ Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Bnilding Department. CC: file, Z.B.A. FORM NO. 3 NOTICE OF DISAPPROVAL DATE: September 19, 2002 TO: James Fallen 3050 Fainvay Drive Cutchogue, NY 11935 Please take notice that your application dated September 19, 2002 For permit to construct an accessory in-ground swimming pool at Location of property: 3050 Fairway Drive, Cutchogue, NY County Tax Map No. 1000 - Section 109 Block 5 Is returned herewith and disapproved on the following grounds: Lot 14.16 The proposed accessory in-.m'ound swimming pool, located on a 41,774 square foot parcel in the Residential R-40 District, is not permitted pursuant to Article IIIA, Section 100-30.A.4, which states; "Accessory buildines shall be subject to the same requirements as 100-33 of the Agricultural- Conservation District," which states, "In the Agricultural-Conservation District and Low- Density Residential R-80, R-120, R-200, and R-400 Districts, accessory buildines and structures or other accessory uses shall be located in the required rear yard, subject to the following requirements: "A. Such buildings shall not exceed eighteen (18) feet in height." The proposed accessory in-~ound swimming pool is partially located in the side yard. Total lot coverage on the property, followin~ the proposed construction, would be +/- 6 percent. ~J'Aut }~r~z/ed Signat ur'L~ ~ Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. CC: file, Z.B.A. BUILDING PERMIT EXAMINER CHECKLIST APPLICANT: SCTM# DISTRICT: 1,000, SECTION:. IOc~ . BLOCK: _ BUILDING PE,RS~ llTS OPE..N/EXPIRED: P~R~CO: 5' OR N BP 9tci5 -Z C'0Z-~_2~t'9 ,INFO /BP BPCkq&q)'7---Z C'0Z-~rt_,INFO D,~so.~. ,'BP SINGLE & SEPARATE CERTIFICATION'-REQUIRED NOTES: DATE REVIE~VED: ~ /~/03 DATE SUBMITTED: ~ /2'1/03 ._"-~, LOT: ~ SUBDIVISION: ~,-'--,,am~--'~ '~'4_ ZONING DISTRICT: Cqo CONFORMff~G? ~ -Z/C'0 Z- , INFO -Z / C/0 Z- , INFO LOIS 4,3,0r)0SF -I00 24 Lot recognmon.(CREA'FED betore June 30. 19g3 ), UNDERS[ZPD LOTS FROM J ~N.1997 190-25 Merger. IA noncontbnnmg at an) tm~e after ~Q. FRONT / EROP. FRONT / ACT. S~E ~ ~Q. ~AR ~ PROP. REA~ ~O. HEIGHT PROP. HEIGHT PROJECT DESCRIPTION: ~ ESTIMATED PROJECT COST: - ~ )¢CARCIIITECT ENG~EER: ~/a APPROVALS REQUIRED SUFFOLK COUNTY IIEALTI1 DEPT: YES or,~ED #l: DTE: TOWN SEPTIC RECtEIPT: 5' ~ NEVV YORK STATE DEC: pm~¢ ,~ 1,7~or N~).._ SOUTIIOLD TOWN TRUSTEES: 5~ES TOVVN ZONING BOARD AI'PI>,OVAL~r NO TOWN PLAN. BOARD AI'I'ROVAI.: YES TOWN HISTORICAL PRE (SPLIA): YES ~ - NEW YORK STATE CODE ('OMPIJANCE (SEE PAGE 2): YES or NO PERMIT #: DTE: "~ ,'2Z4 ..~ PERMIT #: DTE4-~ ,',.~.q-~ PERMIT#: DTE: { Z~"~ PERMIT #: DTE: PERMIT NOTE S: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: l. ( SF)- { SF): SF X $ 2. (_ SFi- [ SFi: SF X $ 3. (_ SF)- ( SF)= SF X $ SF SF SF SF SF INIT OTHER TOTAL FEE FEE FEE =$ ..+$ +$ = $ =$ +$ +$ = $ :$ +$ +$ : $ FINAL TOTAL: 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [~'~INAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE ~////~//D~'/ TOXYN OF-SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined <~/// . · 20 Approved ~-'~/~ .20_ Disapproved ac Expiration k~/¢ · 20 PERMIT NO. 2~/~-~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the follow&ng, before applying? Board of Health 3 sets of Building Plans Planning Board approval Check Septic Form N.Y.S.D.£.C. Trustees Contact: Mail to: D0 NOT MAIL Phone: 734-7424 754-76¢5 Building Inspector .,..~ 2~ k~103 APPLICATION FOR BUILDING PERMIT ... ; Date July 29~ 2¢303 ,20 i INSTRUCTIONS a. This application MUST be completely filled in b? t3~ewriter or itt ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plm~ 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 du-oughout rite work. e. No building shall be occupied or used in whole or in part for an.',' purpose what so ever until the Building Inspector issues a Certificate of Occupancy. fi Evew. building permit shall expire if the work authorized has not conm~enced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or or_her regulations affecting the property have been enacted in the interin{ the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. .~PPLICATION IS HEREBY MADE to the Building Department tbr the issuance of a Building Permit pursuant to the Building Zon~ Ordinance of the Towri 6f Southold. Suffolk County. New York, and-other apl~licable Laws, Ordinances or Remalations, for the construction of buildings, additions, or alterations or for removal or demo~Aol as herein described. The apl~licant agrees to comply with all applicable laws, ordinances, buildine code, housine cod~ar~d~} ~iations, and to admit auth°fized inspect°rs °n premises and in buildine f°r necessary inspecti~°ns>' '~ ~~ ' PROPEI%T PEIIAf~ 8ERVI~~ " Post O~ce ]:lOX {~17 ' · a.,~,,mo / (Signature of applk or name, fi8 corporation) Cutc~hoguo, NY 11935-0617 ~ / (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 3~ent Name of owner of premises J~mes Pallon (,As on the tax roll or latest deed) If applicant is a corporation, signature of dui3, authorized officer (Name and title of corporate officer) Builders License No. Plmnbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: D~50 Pairwav Drive, C:utcho~ue House Number Street Count_',' Tax Map No. 1000 Section Subdivision 1 'l' 9 (Name) Hamlet Block ~ Lot FHed Map No. Lot 14.16 o State existi~:g use ~nd occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy $ingle-£a.mily d,,:e~ q ing b. Intended use and occupano/ single £amily dwelling Nature of work (check which applicable): New Building. Repair Removal Demolition 4. Estimated Cost ~;15 ~ O00 5. If dwelling, number of dwelling units If garage, number of cars 6. Addition Alteration Other Work SwirrmtinK (Deschption) 3:150 (To be paid on filing this application) Number et'dwelling units on each floor L~/ If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front 50' Height 25 ' Number of Stories Rear ~7'5 ' Depth ?.R ' Rear Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories Dimensions of entire new construction: Front Rear _Depth Height Number of Stories NO __ NO X Will excess fill be renroved from prenfises? YES 9. Size of lot: Front 167' Rear 205' Depth 225' 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated R-49 12. Does proposed construction violate any zoning law, ordinance or regulation? YES X 13. Will lot be re-graded? YES NO c'~o~aea F~iiun, ~2~4 Chase I'./av, Manc ~s c-,= ("4 Phone~¢-626-3076 14. Nines of Owner of premises ' Address Name of Architect Address Phone No N~eofCon~acto[ C~itu~ 9oo~ Lt~ .AddressPO %~7 q; a~,~,~h,~No. ~_v665 15a. Is this prope~y within 100 feet of a tidal ~e~r ~water,~ ~~ * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this prope~y within 300 feet of a tidal wetland? * YES ZZ NO~ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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 OF ) being dui5, sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named. (S)He is the (Contractor, Agent, Corporate Officer. etc. of said owner or owners, and is dui)' authorized to perform or bare 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 lmowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sw~ar~ to before me t~ /7 day o f [,/J'(J~ ./'% 2~3~ - ~,~ Public ~'DA M~HN NOTARY PUBLIC, State of New Yo~ No. 01BO6020932 ~ ~ Qualified in Suffolk Cou~ Term ExpJres March 8, 20~ · / Signature Of z p/~licant - / SURVEY TITLE NO. MM1321S (~IEEN WAY I bJ Z I I I LOT I I 15 I ~ S 89'12'10" E 225.59' ~ :~o~ .......... FOUND m ~ 0 0 I ~-7~'7' a O (POOL) ~, ~ '~'?~/ / ~175' ~OoL TO ~ ' .4 ~' ~ z ~.~ __~ , I ~MAP ----~10 VV -~H FORK ~ S 8~ ~ _~ ~o.~( o~ NO~' NoW LAND APPROXIMATE LIMIT OF T~DAL WETLANDS SCALED F~OM N.Y.S.O.E.C. TIDA~ WETLANDS MAP 710--540, INDEX NUMBER 4 SM: COASTAL SHOALS, BARS AND MUDFLATS ~ B B i & V ~ 1 P C UNAUTHORIZED OR arrett, onacc an ee e, . RE~SIONS: ADDITION TO THIS SURVEY IS A - VIOLATION OF SECTION 7209 OF [~ CiVILENGINEE~/SURVBYO~/PLANNE~ PROPOSED POOL ~ LIMI~ O~ TWE NEW YORK STATE EDUCA TEL 631/~1111 FAX 631/4~-10~ I LOT 16 eLK.' -- I l SI?UATED AT.r' CUTCHOGUE, TO~.OF SOU~HOLD ~ FILED: FEB. 15, 1974 NO. 6066 CO.SUFFOLK cO~ES o~ ~H~S SU~WY ,AP NOT BEARING THE LAND SUR- CER ~ q2 BB~ PC TIFIED TO. ' ~ ..... vEYOR'S SIGNATURE AND EM ,OSSE~ JOB NO. A020708A ~ ,JAMES d. ~ MARGARDT M. FALLON DA~ JUNE 29, 2002 DR. A.V.R. CH. ~.J.B. SCALE: 1" = 40' DIST. 1000 SEC. 109 BLK. 5 LOT 14.16 TITLE NO. MM1321S 0 0 L~ 0 bJ 0 0 0 0 Ld 0 LOT 15 S 89'12'10" E 225.59' F~.c~ ,,o~u,.~.'r - - 228.4-6' 1'42'10" W ~ND NOW OR FORMERLY oF NORTH F'ORK coUNTRY CLUB GREEN WAY E' "W ~ L.~N~ W o~'O0 20 S °'"3-9.78' Barrett, Bonacci & Van Weele, P.C. CI¥1L E N G IN EE P,S/SU R V E YOlkS/PLA N N E RS LOT 16 BLK. -- MAP OF: FAIRWAY FARMS SITUATED AT: CUTCHOGUE, TOWN OF SOUTHHOLD FILED: FEB. 1974 NO. 6066 CO.SUFFOLK CERTIFIED TO: FIRST AMERICAN TITLE INSURANCE COMPANY~ OF NEW YORK GMAC MORTGAGE CORPORATION JAMES J. & MARGARET M. FALLON DR. A.V.R. CH. W.J.B. SCALE: 1" - 40' REVISIONS: OR JOB NO. A020708 DATE JUNE 29, 2002 DIST. 1000 SEC. 109 EILK. 5 I OT 14.16 zo O0 =.J o o~ , LUo .,_ . lliw~o ~ , o ~O0:lI I jc._ : 0