HomeMy WebLinkAbout30184-Z FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-30605 Date: 12/07/04
THIS CERTIFIES that the building ADDITION
Location of Property: 6525 INDIAN NECK LA PECONIC
(HOUSE NO.) (STREET) (HAMLET)
County Tax Map No. 473889 Section 86 Block 6 Lot 24
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated MARCH 19, 2004 pursuant to which
Building Permit No. 30184-Z dated MARCH 19, 2004
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 "AS BUILT" DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED
FOR PER ZBA #5393 DATED 11/6/03 . CONSTRUCTION CERTIFIED BY MARK SCHWARTZ,
ARCHITECT ON 11/29/04.
The certificate is issued to AGNES COMBS
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A
ELECTRICAL CERTIFICATE NO. N/A
PLUMBERS CERTIFICATION DATED N/A
1
Authorized Signature
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. 30184 Z Date MARCH 19, 2004
Permission is hereby granted to:
AGNES COMBS
6525 INDIAN NECK LA
PECONIC,NY 11958
for
AS BUILT DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR PER ZBA, TRUSTEES & DEC
at premises located at 6525 INDIAN NECK LA PECONIC
County Tax Map No. 473889 Section 086 Block 0006 Lot No. 024
pursuant to application dated MARCH 19, 2004 and approved by the
Building Inspector to expire on SEPTEMBER 19, 2005 .
Fee $ 300 . 00
uth riled 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,Alterations 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. 3/2,S_1 0 �Pe
New Construction: Old or Pre-existing Building: Do—r-A!o (check one)
Location of Property: J L d oma^ /,j e. c !c_. � a n � Oc c 0 c
House No. Street Hamlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section O �r & Block O 0 y G Lot C 7-
Subdivision
Subdivision Filed Map. Lot:
Permit No. 3 D/ ?-y Date of Permit. 3 �� �J Applicant: /77 4 14 S G h
Health Dept. Approval: Underwriters Approval:
Planning Board Approval: v
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ o
�
a os
LTqApplicant i afore
-
�y. ?, SoutholdTown Hall
53095-Main Road
Gerard P Goehringer, ,4
, ._ .. P.O.Box 1179:
Lydia.A.Tortora
George Horning ,; • Southold,New York 11971.-0959
Ruth D.Oliva Chairwoman a0 ZBA Fax(631)765-9064
Vinr�d1 l 3rlando Teleph> ne(63J.) 765-1809
httpWsoutttoldtir nortli£cir�c.net
BOARD OF APPEALS
TOWN OF SOUTHOLD
FINDINGS,DELIBERATIONS AND DETERMINATION Nov 1 3 20M
!MEETING OF NOVEMBER 6, 2003
No. 5393- Ra mond and Agnes nes Combs Nell
ak� ��
1?roperty"Lvcatiori. 65251ndiah Neck Lane, Peconic; CTM#86-6-24. ti
SEQRA DETERMINATION- The Zoning Board of Appeals has visited..the,property Under
coiisideratiijn in.this application and determines that this review falls under the Type it
category of the State's Liss: of Actions; without an adverse effect'on the environment if
tFte pxoject is implemented as planned.
,,. PROPERTY FACTS/DESORIPTION: The applicant's 32,492 sq. ft. parcel has 80.22 ft:
frontage;,along the nor h.-side of Indian Neck, Road (a/k/a Indian.Neck.Lane) in Peconic.
Th, ropErty ist iMprbvw,vnth;a one-story frame dwelling and accessory shed as shown
qn the:Fnuary
52009 survey prepared by Stanley J. Isaksen,Jr., L.S. At the northerly
e11X.`of'9ppl earits' property is a tidal wetland and beach area adjacent.to Richmond
Ct`eik.
BASIS:OF APPLICATION: Building Department's. amended July 17, 2003 Notice of
Disapproval, citing
Sections 400=242A, 100-244, and 100-33.in its denial:of a building
pierrf it to:construct proposed:additions to the applicants' dwelling with,side yards at less
than; 4�5 on.one,.side,and,20 feet on the other side, fora total at less than 35.feet when
cot ib.... :and for the existing location of.the as-built shed at less than five(5)feet from
the plroperty fine,
FINDINGS OF FACT
The,Zoning Board of Appeals held a public hearing on this application on September 25,
.2003:acid October 23, 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: Applicants wish to construct alterations and
an addition. to the existing dwelling as shown on the applicants' survey prepared by
$tanley J. Isaksen, Jr., L.S. revised September 12, 2003 showing the addition and
proposed garage, and hand-sketched survey notation by Mark K. Schwarz, A.I.A
confirming showing the area of proposed alterations. Additional details are also shown
on the 10/1/03, (9130/03)construction diagrams prepared by Mark K. Schwartz,Aa.A.
REASONS FOR BOARD .ACTION: On the basis of testimony presented, materials
;{ submitted and personal inspections, the Board makes the following findings:
` Page 2 !November 6,2003 "y .
.29A#M93-R:and A.Combs...
$6-6=24 at Pec6do
k .
1. Grant of the relief requested will not produce an undesirable change in the character:
of the neighborhood'or a detriment to.nearby properties. The Board considered all
,testihndny offered dulrirlg the tvVo public hearings Itis evidence that the home was and
h�ae heart
Irl.its d'resent Ipcated for many.years (since. 1,9 T�.. The apptts:ants tried'to:
oq:l5tre.addlftprial lan'd.to inc�ease,'the4s6tb6ck frotr the,easterl�r p`gpefty line; yVitr out
z. .
; ta7.6.t The- a°.pit 3t.propose: alteratian's with. rec instru'cti�h Af pol~Eiot�s of 'th e
Jexrsfing one f moy home W ich presently has txni'Q bed' r s and only:onO beth. Alsq
proposed is an edd'itton fora bathroom, IaUndry radIvn. alnd 'other 'l'atrng spA.m sand
rage, as shown On',the architect's, recent plans Th' dwelling has e�ctsl'ed uiiith.
ga .
t>Ionconfor(n-10.g vyersterly stde;Yard setback of 9 7' d easterly stye orr�,
se ack�txctnc,�rtform3tles arepFee [ Ing �p1'ibr to �ontn�� It: is also! flat -i at,the
. aOb
cnt vert h t �ega�lz, the;' b cit of the,6401114 Ohlb- fioryrff �-rt s d ir-`iits` relent
t(F :lbt'1'.�3 ,3.�„' ' t 'Cb'f1{I t ; Slf im" ly S��d 0 /.IICt 1 fie" E7 Twig' p"t
Iwgst of�k [�.pt`4�#,sr =" tee rr�l�� o EflrT
rory t eft ad, ins'la>`cal-ireas� tidl laape
cedd wt �li =trees
k ar ci'pla�r'M,b, �i�I�.pro�il�e�ri�ttaf�u ���x'rs�l eta�ieert�the two�ra�et�
2 Tlie`�eriefit'soxaght cartno#be achieued 4y some.rnettia'd, feasible'for th applicants to
ptrzs!*, other ti tan art.area V iatir Thi board rei*gnii6s that,tht✓:dwelling has
extete�t in tts: Pfe'aeht� on fore rt}"aj�y years, end together w V..the fact that:the
su'rrotan it g properties°end buildings'ge`also Wejl es fa ltshed and tr >isfttig.'for many
yrs:
f 3 Mth,ough the.variance is the rtlinimurh necessary, the relief granted is. substantial
j &-CA: se tf'e easteAy side-area for the proposed addition is a S: reductidb;of the code
required 1_5 ft mintin`um, end total side-yards at 19.7+- feet. The stct�agie shed is a
WO-dtjoh,of 'i.3 fest froin�the code required minirnum of five feet from th&westerly side
property line
4' 'hhe'difficulty was self-created mainly because of the past placement of the home in
1947, end:the s#orageshed, both of which have e)dsted: for many years, prior to the
current�Cown Code.stde'yafd setback requirements.
1:
5 1"here,is no evidence that the grant of variance relief will have.an adverse effect or
impact on`P, cal or environmental conditions in the neighborhood or district.
l 6: Grant of the relief:requested is the minimum action necessary and adequate to enable
the applicant;to enloiy the benefit of alterations/additions, while preserving and protecting
l the 'character of the neighborhood and the health, safety and welfare of the community.
3:
I '
y ,
Y
y
1
Page� NovernkSer'6;203 .
ZBA 853$3—R.and A.Combs
86-6-24-at'Peconlc
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the
balancing test under, New York Town Law 267-B, motion was offered by Member
000nnger, eecorided by Member Orlando, and ciuiy carried, to
G1kANT.:the variance 0s app{ied,for, as shown on the;survey prepared by Stanley.
1,
Jk Isa 6'n—o Jr..; September, 12, 200$ snowing the dadition airid,
pioposed gara6e„and hand-sketched survey n.otation by Mark.K_SchGvarz, A:I.A
dirt rmirig' showing the drew off proposed alterations, and 1011103 (913b 03)
Onstrur,o diag?an1,g{prepared tay Mark K. Schwartz,A.I;A:
This aciir�n.does:riot authorise or condone. any current or futyre use, setback dr other
feature;oP fhb°suject pti?ip�eity that.rt�ay etiolate the foiling Codd, other than.such uses,.
setbacliss X00 other fee rda as are,eXpres ly addr=essed in this action.
Vote of the Boa Ayes: Members. Ulna (C airwoman) Goehringer, Tortora, and
Oriarid (Vice Cl air:man At�serit w IiYlember Homing; This Resolution was duly
adopteo'(4-0.):
x.
V. .
Ruth ): Olivia, CQnroa'inan 1 11/13103
Approved for f=iliog
i
t
I
Mark K. Schwartz, AIA —Architect, PLLC
Mft P.O.Box 933 Phone:(631)734-4185
•��� Cutchogue,New York 11935 Fax:(631)734-4185
FAX TRANSMITTAL
Date: November 29,2004
To: Southold Building Department
Main Road
Southold, New York 11971
Fax number: 765-9502
Phone number: 765-1802
From: Mark Schwartz
Re: Combs House
6526 Indian Neck Road
Peconic, New York
Pages: 1 (including cover sheet)
Comments:
I have inspected the water side deck for the aforementioned project and certify the
construction meets or exceeds the NYS code when built.
Please call this office if you have questions or require additional information.
Mark
CombslFax.doc
,
I
_ r t I-++ '
M. Bldg. _ `�',� , undation Bath
_[Uj
Extension I ` v ' sement 1,4,d Floors
i' Interior Finish
Extension Ext. Walls0.
Extension .Fire Place Heat
!✓ Porch Roof TypCA J-tlA
e
YP
7 z
i Porch Rooms 1 st Floor f
i
3reezeway Patio Rooms 2nd Floor
Sarage Driveway Dormer
I B.
i" �
f
1
_ Ek� TOWN OF SOUTHOLD ftOPERTY RECORD CARD a .
OWNER STREET 65af GE DISTRICT SUB. LOT
FO " ER OWNER Cruz"ck-shGtnK 1,L E ACREAGE
CQ wl 65 4t4 iio Cgv-,nbs 14 j Ce .,1; P A' owe `s 0.1 so I •
N4 I
S / W TYPE OF BUILDING
RES. ISEAS. VL. FARM COMM. I IND. ( CB. ( MISC. I Est. Mkt. Value
LAND IMP. TOTAL DATE REMARKS01.9 C2
700
i P,
13Do 30 �Oo cE 4ej
� F
log:;ez P214 -6
.,.
L 114 --lao- Co m b- vJ +-o Ivo 0
A E BUILDING CONDITION
.41,, 4QL1 to to Co rn bs-
N&V NORMAL BELOW ABOVE FRONTAGE ON WATER �,�
Farm Acre Value Per Acre Value FRONTAGE ON ROAD
Tillable 1 BULKHEAD
Tillable 2 DOCK
Tillable 3
Woodland
Swampland
Brushland
House Plot
TotoI
Albert J. Krupski,President ��� �� Town Hall
James King,Vice-President ti'Z' Gy 53095 Route 25
Artie Foster C* P.O.Box 1179
Ken Poliwoda Z Southold, New York 11971-0959
Peggy A. Dickerson
y�� a��� Telephone(631) 765-1892
j Fax(631) 765-1366
- BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
December 17, 2003
Mark K. Schwartz, AIA
P.O. Box 933
Cutchogue,NY 11935
RE: AGNES S.COMBS
6525 INDIAN NECK LANE, PECONIC
SCTM#86-6-24
Dear Mr. Schwartz:
The following action was taken by the Southold Town Board of Trustees at their Regular
Meeting held on December 17, 2003:
RESOLVED,that the Southold Town Board of Trustees APPROVE the Amendment to Permit
#5646 for the proposed additions and alterations to the existing single-family dwelling, and as
depicted on the survey prepared by Stanley J. Isaksen, Jr. last revised 1/2/04.
This is not a determination from any other agency.
If you have any questions,please call our office at (631) 765-1892.
Sincerely,
A4Z4 �7. 4.'�• �n e
Albert J. Krupski, Jr.
President,�Board of Trustees
AJK:hns
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC PERMIT NUMBER EFFECTIVE DATE
1-4738-03036/00001 January30,2004
FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S)
Under the Environmental January 30, 2009
Conservation Law
TYPE OF PERMIT■New ❑Renewal ❑Modification❑Permit to Construct ❑Permit to Operate
j ❑ Article 15,Title 5: Protection of Waters ❑ Article 17,Titles 7,8:SPDES ❑ Article 27,Title 9; 6NYCRR 373:
Hazardous Waste Management
/ ❑ Article 15,Title 15:Water Supply ❑ Article 19:Air Pollution Control
l ❑ Article 34:Coastal Erosion
❑ Article 15,Title 15:Water Transport ❑ Article 23,Title 27:Mined Land Management
Reclamation
❑ Article 15,Title 15: Long Island Wells ❑ Article 36: Floodplain Management
❑ Article 24: Freshwater Wetlands
❑ Article 15,Title 27: Wild,Scenic and ❑ Articles 1,3, 17, 19, 27,37;6NYCRR
Recreational Rivers ■ Article 25:Tidal Wetlands 380: Radiation Control
❑ 6NYCRR 608:Water Quality Certifica- ❑ Article 27,Title 7; 6NYCRR 360:
tion Solid Waste Management
PERMIT ISSUED TO TELEPHONE NUMBER
Raymond and Agnes Combs (631) 734-5045
ADDRESS OF PERMITTEE
6525 Indian Neck Lane, Peconic, NY 11958-1726
CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER
Mark Schwartz, AIA, P.O. Box 933, Cutcho ue, NY 11935 631 734-4185
NAME AND ADDRESS OF PROJECT/FACILITY
Combs property, 6525 Indian Neck Lane, Peconic
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold Richmond Creek
DESCRIPTION OF AUTHORIZED ACTIVITY:
Reconstruct single family dwelling and construct an addition and garage. All work must be done in
accordance with the attached plans stamped NYSDEC approved on 1/30/04.
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 ADMINISTRATOR: ADDRESS
George W. Hammarth DMG Region 1 Headquarters, Bldg.#40, SUNY, StonyBrook, NY 11790-2356
AUTHORIZED SIGNATURE DATE
Page 1 of 4
.V January 30, 2004
301yL-
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS:
�.
DATE ��3 d r INSPECTOR
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
�y
------------------------------------
- �
FOUNDATION(2ND) C��
• z
9�
ROUGH FRAMING&
PLUMBING H
R
(�x
INSULATION PER N.Y.
STATE ENERGY CODE
r
S
FINAL �-
a�
ADDITIONAL COMMENTS
'tet Z
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD,NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. 3oltL4 Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 3� ,20__JContact: ,,yy IG J C(�
Approved 3 I lc ,20� Mail to: /"(/ale t7H
Disapproved a/c P.O. 60X 933 V 7-C H&16v�
_ Phone: 7c3 q - �� P 5'
Expiration 20_� (Zia
Building Inspector
'�D ftmo*) 2-ftk.AS
APPLICATION FOR BUILDING PERMIT
Date (�,3�/8�D¢ , 20
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 the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has r,-,,t.^ommenced 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.
19
(Signature of applicinfoVname,if a corporation)
fio doX 913 c..vaGW4;v,_ //,t 3,5-
(Mailing address of applicant)
State whether applicant is owner, lessee, gent, archit , engineer, general contractor, electrician,plumber or builder
Name of owner of premises �igyM o�ud . 146 X J' 6w e-Y
(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:
(0 5Z r ff _r4UV1"Jk)
House Number Street Q Hamlet
County Tax Map No. 1000 Section (I Block O Lot 2�
Subdivision Filed Map No. Lot
(Name)
2. Stat6 existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy 5;/A) IV C y 2E S 10 AX O /GE
t1 ��
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building.. C f G. Addition Alteration
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost tip(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.
SEe- e(,4P.) ,5
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
SE JE S Ulf(/r-
9. Size of lot: Front Rear // Depth
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated 9- 46>
12. Does proposed construction violate any zoning law, ordinance or regulation �YENO
13. Will lot be re-graded? YES NO ✓ Will excess fill be removed from premises? YES NO
r4y,k0vn �Acaej- & SZS SNOMAo NecK LA
14. Names of Owner of premises G0 MB.I Address Pry G OW/ c- Phone No. Z.3 - S-U¢-C'
Name of Architect e4g ic- SCSI w.4X74 Address ,& 6ox 93 3 Phone No 73 V - I/PP
Name of Contractor Address C-4-,rc,#O c 11E Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X 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
* 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
q&z �i being duly sworn, deposes and says that(s)he is the applicant
(Name'of individual signing cont act)above named,
(S)He is the
(Co actor,Agent, rporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this j
Z_0 �. 200 L/
/.a
Votary Public Si a e of Applicant
JOYCE M.WILKINS
► . Notary Public,State of New yak
No.4952246,Suffolk County
Term Expires June,2, 0
SURVEY OF
DESCRIBED PROPERTY
RICHMOND CREEK
Sl TUA TE
PECONI C,
E 15 TOWN OF SOUTHOLD
e (v 2� 5A• 1 57" E SUFFOLK COUNTY, N. Y,
0 6�1, 529'6 N 71 ,39 SURVEYED FOR RA Y COMBS
5�• 24.�g
W000
N�� a )A , -
DECK WOOD STEPS p NOT TO SCALE
TO BEACH
: STEPS TO BEACH
`TOP OF BANK
N/F W y
FV
BA YLIS cm-k WOOD was
001
STEPS ,2' AREA OF
N 3-0, AL TERA TIONS m
44.4'
SWOOD 51 ,p HOUSE CORNER 1 7
0 4 FRAME 14,j_ 0.2' WEST SET SMALL PK
v 7, FS 10.1 p NAIL IN ASPHALT
CONC. C) WALKWAY
CELLA N SET
STEPS 1.7x1.4' PROPOSED STAKE
18'f/ CHIMNEY ADDI TION
44.4
FD E055
CAI CESISPOOLNIF POLE
O
EMMOR LIL 24 N/F
IJA, CHADWICK cm
& L 0WENHEIM
N GUARANTEES INDICATED HERE ON SHALL RUN
ONLY M THE PERSON FOR WHOM THE SURVEY
1 J' PROPOSED IS PREPARED, AND av NS BEHALF m THE
17RE COMPANY, GOVERNMENTAL AGENCY,
HED 5' GARAGE WH°ANNj5 OFYHf EA�a10SnT RON.
.3.S GUARANTEES ARE NOT IRAII RABLE TO
ADDITIONAL INS111U110NS OR SUBSEOI/ENT OWNERS.
UNAUTNORIZED ALTERATION OR ADD/RON IO 7HIS
POLE SURVEY IS A HOCA RON OF SECACN 7209 CF
FD h. 112 THE NEW YORK STALE EDUCATION LAW,
cm
• wets COPIES OF MIS SURVEY MAP NOT BEARING
THE LAND SURVEYORS EMBOSSED SEAL SHALL
A COor BE CONSIDERED TO BE A VALID TRUE
e
EX/STING
WELL AREA OF EXISTING STRUCTURE.• 1,226 S.F.
PERCENTAGE OF TOTAL LOT COVERAGE: J.78X
N/F AREA OF IMPROVEMENTS TO HOUSE - 1,057 S.F.
BA YLIS, I� PERCENTAGE OF LOT COVERAGE a 3.25%
FORMERLY W AREA OF PROPOSED GARAGE 840 S.F.
KNOWLES v PERCENTAGE OF LOT COVERAGE 2.58X
TOTAL AREA OF EXISTING HOUSE PLUS
ALL PROPOSED IMPROVEMENTS -J,12J S.F.
PERCENTAGE OF LOT COVERAGE -9.61X TM 1000-86-06-24
SURVEYED 5 JANUARY, 2000
AIlllPOVI.P ;\; PlAt 'I EItNIS SCALE 1"-50'
I P�;•:i` ('OMITI.I MINS ()1:
I\ 111 1" `'173�-03036AREA - 32,491.899 SF
OR
I� U _ _
I).\ I I� ���jC+'� 0.746 ACRES
Ul
FQ I� GUARANTEED TO
MON RA Y COMBS
2
0,,
W TOWN OF SOUTHOLD
,
5 13• ?9 ROAD
so.22 N
i N D I A EEK
N SURVEYED BY
STANLEY J. ISAKSEN, JR.
P.O. BO 294
NEW S FOLK NY 11956
10 DEC 03 SHOW PERCENTAGE OF LOT COVERAGE 631-7 4— 8J5
OF EXISTING AND PROPOSED STRUCTURES.
0 NOV 03 ADD NOTE "AREA OF AL TERA TIONS'"
SEP 03 SHOW PROPOSED ADDITION & PROP. GARAGE. N S UC. NO Q9273V R
'UNE 2000 SET STAKE & SMALL PK NAIL, SHOW BULKHEAD.
RRF�
i
� Ir ,ffI'
OCCUPANCY OR
LISE IS UNLAWFUL
vvIl HOUT CERTIFICATE I4Ln
I, All CMItrmtlan IS to a.nfor. to N.Y.S. Ned Local BPI ding rade. OFI OCCUPANCY APPROVED AS NOTED I�
2. All pl Unalnq Is to c"farm to local and County Health Requirements. -_-- . .- ( 361f6� _Tjy 1
1. ❑0WIC Is to caafarm to local, N.E.C. and Underurltars Haaulranents. DATE: B.P. H
4.. Ccecrate Is to be 3000 psi min. on 2 ton psf, soil bearing capacity. Verify. _ I ! FEE: By.
. S. Ilaullf, fres alt .,,and opening, and under ",.list p.rticlen, ane bathtubs. VN - NOTF BUILDING DEPA ENT AT
1. Notily the Architect of all changes. Not rasp...title for any change, 765-1802 8A TO 4P FOR THE r
runout metiricatlons. FOLLOWING INSPECTIONS: I
7. Do opt scale the dreuinq.. -- --- --- -- — — 1. FOUNDATION - TWO REQUIRED
I. Taco Canmettla.a r - FOR POURED CONCRETE
aqui red at all (luso structural[ural lead carrying eanditlon., -----.--.- I"
Joists *.d attar.: _ 2. ROUGH - FRAMING 8 PLUMBING�F.No. 4 Apo matter �S
N.eMr, a�na cl scorns 3. INSULATION
4. FINAL - CONSTRUCTION MUST
gaugl as fir L.r., Mo. 2 and Hatt.. >ro
BE COMPLETE FOR C.O.
� `� L -- ALL CONSTRUCTION SHALL MEET THE -
� aE GJI 0pf, — —_ f REQUIREMENTS OF THE CODES OF NEW _ 1,
___ -- -- YORK STATE. NOT RESPONSIBLE FOR
--- DESIGN OR CONSTRUCTION ERRORS. -
CONSTAUCYION NOTES ui d G i�
. -�
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
8t on
AS AND CONDITIONS OF
3 SOUTHOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARD
'
SOUTHOLD TOWN TRUSTEES 1
n. n
I N.Y.S.DEC I
I
i I
2-rT'
FLOOD ZONE N[A '
COMPLY WITH CHAPTER "46"
FLOOD DAMAGE PREVENTION I
/-� SUUTHOLD TOWN CODE. I '
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