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HomeMy WebLinkAbout30367-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-30765 Date: 02/14/05 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 1820 MILL RD PECONIC (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 67 Block 7 Lot 14 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JUNE 1, 2004 pursuant to which Building Permit No. 30367-Z dated JUNE 1, 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 ADDITIONS & ALTERATIONS TO EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to MICHAEL & JEANNE BARTOS (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1085196 09/23/04 PLUMBERS CERTIFICATION DATED 02/12/05 J.ZEES PLUMBING & HEATING Authorized Signature Rev. 1/81 e. o . � 3J3 Form No.6 TOWN OF SOUTHOLD B + O 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. Frees 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 /1 �✓ Date. y J New Construction: Old or Pre-exi ting Building: (check one) Location of Property: /7o10 House No. f�Sttreeett Hamlet Owner or Owners of Property: Z l�/a e/ Y" Veal / Suffolk County Tax Map No 1000, Section ~ Block OQa 7 Lot Subdivision !v Filed Map. Lot: Permit No. �0 2K7'Z Date of Permit. `�� Applicant: 00 CLS 01041 e 0 h e Y Health Dept. Approval: Underwriters Approval:zc-k ��dS�y� 9 09 Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ pZ f (Applicant Signature Lo 30?G 5 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) I (a X1 ,34% 7 PERMIT NO. 27522 Z Date AUGUST 1, 2001 Permission is hereby granted to: JEANNE M BARTOS 209 PARK AVE - 2ND FLOOR LYNDHURST,NJ 07071 for CONSTRUCT ADDITIONS & ALTERATIONS TO AN EXISTING ONE FAMILY DWLG PER ZBA #4658 . THIS PERMIT REPLACES BP#25783 at premises located at 1820 MILL RD PECONIC County Tax Map No. 473889 Section 067 Block 0007 Lot No. 014 pursuant to application dated AUGUST 1, 2001 and approved by the Building Inspector. Fee $ 718 . 80 A Author! ign ure ORIGINAL Rev. 2/19/98 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. 30367 Z Date JUNE 1, 2004 Permission is hereby granted to: JEANNE SWEET BARTOS 209 PARK AVE - 2ND FLOOR LYNDHURST,NJ 07071 for CONSTRUCT ADDITIONS & ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING ZBA#4658 . THIS PERMIT REPLACES BP#27522 . at premises located at 1820 MILL RD PECONIC County Tax Map No. 473889 Section 067 Block 0007 Lot No. 014 pursuant to application dated JUNE 1, 2004 and approved by the Building Inspector to expire on DECEMBER 1, 2005 . Fee $ 718 . 80 Authorized Signature ORIGINAL Rev. 5/8/02 c� 5 BY THIS CERTIFICATE OF COMPLIANCE THE S S NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 5 BUREAU OF ELECTRICITY S 5 40 FULTON STREET — NEW YORK, NY 10038 5 SCERTIFIES THAT S 5 5 5 Upon the application of upon premises owned by 5 5 5 5 rj REP ELECTRIC MIKE BARTOS P.O. BOX 635 1820 MILL ROAD S MATTITUCK, NY 11952, PECONIC, NY 11958 5 Located at 1820 MILL ROAD PECONIC, NY 11958 5 5 Application Number: 1085196 Certificate Number: S 1085196 c5 Section: Block: Lot: Building Permit: 27522 BDC: NS11 S 55 Described as a Residential occupancy, wherein the premises electrical system consisting of Cj 5 electrical devices and wiring, described below, located in/on the premises at: S 5 5 First Floor,Second Floor,Outside,Attic, cS SA visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed 5 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the Day of S 23rd September,2004. 5 Name OTY Rate Ratin¢ ircuit Twe Appliances and Accessories Exhaust Fan 3 0 F.H.P. Cj Oven 2 0 7.2 KW Cooking Deck 1 0 40 Amps 5 Dish Washer 1 0 1.2 KW Furnace 1 0 Oil Air Conditioner 1 0 30.000 BTU 5 Panels 5 1 60 8 Wiring and Devices S Outlet 77 0 Fixture 5 Fixture 74 0 Incandescent 5 Fixture 3 0 Fluorescent 5 SOutlet 87 0 General Purpose Receptacle 50 0 General Purpose, Switch 22 0 General Purpose 5 Paddle Fan 4 0 seal Receptacle 1 0 20 amp Laundry 5 5 Continued on Next Page 1 of 2 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. L 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 S NEW YORK BOARD OF FIRE UNDERWRITERS 5 S 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 c� SCERTIFIES THAT S S S 5 Upon the application of upon premises owned by S 5 SS 5 5 REP ELECTRIC MIKE BARTOS 5 OMATTITUCK5ROAD NY 11952, PECON C' N11958 S 5 5 Located at 1820 MILL ROAD PECONIC, NY 11958 5 c 5 Application Number: 1085196 Certificate Number: 1085196 S 5 5 5 Section: Block: Lot: Building Permit: 27522 BDC: NS11 5 Described as a Residential occupancy, wherein the premises electrical system consisting of Selectrical devices and wiring, described below, located in/on the premises at: S 5 First Floor,Second Floor,Outside,Attic, 5 A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed S 5 herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other 5 authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of September,2004. 5 5 Name OTY Rate Rating Circuit Type C5 Receptacle 1 0 30 amp Dryer CSU [�+ Receptacle 9 0 GFCI 5 5 Dimmers 28 0 S Service 1 Phase 3W Service Rating 200 Amperes S Service Disconnect: 1 200 cb L+ SMeters: I C' 5 5 S 5 5 5 5 5 5 S seal S 5 S 2 of 2 5 5 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. 5 co Go = Town Hall,53095 Main Road Oy �� Fax(631)765-9502 P.O..Box 1179 �O! �a0 Telephone(631)765-1802 Southold,New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: Pe- ;k-" g' Building Permit No. �(/ 7 1-2 z Owner: / 'Ilc a c / 7���— Os (Please print) Plumber--- 1- ��� / Aahk,,70 (Please print) j v I certify that the solder used in the water supply system contains less than 2/10 of I% lead. -S (P mbers Signature) Ems. Sworn to before me this {� day of , , - 20 a Notary Public, 0 U. County JAYNE P.MARTIN Whq bk State of New York W in Suffolk �uali County COMISSIM Ekes Jan.31, d 0 p �7 �O�gUFF01,�co JEAN W. COCHRAN JAMES A. RICHTER, R.A. SUPERVISORO �� ENG NEER TOWN OF SOUTHOLD y T Fax. (516)-765-3136 '� `1►aO Tel.(516)-765-1802 OFFICE OF THE ENGINEER TOWN OF SOUTHOLD January 7, 1999 Mr. Michael Bartos 1820 Mill Road Peconic, New York 11958 Re: Building Permit Application SCTM #: 1000-67-07-14 Dear Mr. Bartos: Please be advised that your residence is located in flood zone AE (Elev. 10'). All proposed construction shall conform to Chapter 46, FLOOD DAMAGE PREVENTION, of the Southold Town Code. Drawings which have been submitted to the Building Dept. will require revisions to indicate compliance with the above referenced Code. The following items are some of the requirements of chapter 46 and need to be addressed. Proposed finish floor elevations shall not be less than Elevation 10' and all foundations shall have a minimum of two openings designed to allow for automatic entry and exit of flood waters. If you have any questions concerning this information, please contact my office. Si rely, �4 James A. Richter, R.A. Page 2—March 4, 1999 Appl. No.4658: 1000-67-7-14(Bartos) Southold Town Board of Appeals T. (3) There are no factors present to suggest that grant of the requested variance will have an adverse effect or impact on physical or environmental conditions. (4) The grant of the requested setback variance is the minimum action necessary and adequate to enable applicant to expand the existing house while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION/ACTION: On motion by Member Collins, seconded by Chairman Goehringer, it was RESOLVED, to GRANT the requested variance authorizing construction of an addition as described, with a minimum setback of 23 feet at the closest point to the bulkhead. VOTE OF THE BOARD: GOEHRINGER, DINIZIO RSA, COLLINS, (MEMBER HORNING of Fishers Island was absent and excused). T ' esoluti was y ado p -0 RARD P. GOEHRINGER CHAIRMAN For Filing 3/10/99 APPEAIS BO?y 2D IE+ j SQFFO(� Southold Town �� in I 0 CSG 53095 Main Road 1 Gerard P. Goehringeop , i �� James Dinizior o P.O. Box 1179 d3tNR 0�SOUTHOLD H Z Lydia A.Tortora Southold,New York 11971 Lora S. Collinsy O�� ZBA Fax(516)765-9064 George Horning j �`� Telephone(516)765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION SPECIAL MEETING OF MARCH 4, 1999 Appl. No. 4658—JEANNE SWEET BARTOS 1000-67-7-14 STREET & LOCALITY: 1820 Mill Road, Peconic DATE OF PUBLIC HEARING: February 23, 1999 FINDINGS OFFACT PROPERTY FACMDESCRIPTION: The subject property contains a total area of 9,357 sq. ft., with 100 ft. frontage along the north side of Mill Road, Peconic. The property is improved with a single-family dwelling and accessory shed storage building as shown on the September 22, 1998 survey prepared by John C. Ehlers, L.S. BASIS OF APPEAL: The Building Inspector's two January 7, 1999 Notices of Disapproval, under Article MII, Section 100-239.48 and Article MV, Section 100-2446 for the reason that total lot coverage limitation and setbacks from bulkhead will not be in conformity with the Zoning Code,for a proposed addition to dwelling and"as built" 10'x 14'deck. AREA VARIANCE RELIEF REQUESTED: Applicant proposes to expand an existing house. Initially, applicant also requested approval of an"as built"deck measuring 10 ft. by 14 ft. At the February 23, 1999 hearing, and in correspondence from the applicant's architect dated February 25th and March 1, 1999, applicant indicated that the deck will be removed and thus should not be counted in the lot coverage calculation. According to the figures submitted by applicant's architect, lot coverage including the proposed house expansion but without the 10x14 deck is 19.8°x6. Consequently, no variance is needed with respect to Code Section 100-244B, and applicant's request is solely for a variance allowing the house addition to be set back 23 feet from the bulkhead at the closest point (the northeast corner). The northeast corner of the existing house is 27.6 feet from the bulkhead. REASONS FOR BOARD ACTION, DESCRIBED BELOW: On the basis of testimony presented and personal inspection,the Board makes the following findings: (1) Because the lot is shallow, applicant requires a setback variance in order to make any meaningful addition to the house. Even after the expansion, the house will be small in size and consistent with nearby dwellings. Grant of the setback variance will not change the appearance of the property in a way that would produce an undesirable change in the character of the neighborhood or detriment to nearby properties. (2) The requested variance is not substantial because the part of the proposed addition that extends beyond the long-established house setback of 27.6 feet Is a triangular segment of only about 30 sq. ft. 1 r TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date: January 7, 1999 To: Mr. Michael Bartos 1820 Mill Road Peconic,New York 11958 PLEASE TAKE NOTICE that your application dated December 30 , 1998 For permit to Construct an addition/alteration to an existing single family dwelling at Location of Property 1820 Mill Road Peconic New York House No. Street Hamlet County Tax Map No. District 1000 - Section 67 - Block 07 - Lot 14 Subdivision: Filed Map No. Lot No. Is returned herewith and disapproved on the following grounds: Under article XXIII. Section 100-239.413, construction within 75' of a bulkhead in not permitted. The proposed building addition is within 23' of an existing bulkhead. The proposed deck addition is within 16' of the existing bulkhead. The as-built non-conforming deck was never issued a building permit and can not be used to establlish the existing encroachment. The existing encroachment is indicated as 27.6'. ZL z L- James Richter, R.A. i Building Department TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date: January 7, 1999 To: Mr. Michael Bartos 1820 Mill Road Peconic,New York 11958 PLEASE TAKE NOTICE that your application dated December 30 , 1998 For permit to Construct an addition/alteration to an existing single family dwelling at Location of Property 1820 Mill Road Peconic New York ..j.2 use o. Street Hamlet County Tax Map No. District 1000 - Section 67 - Block 07 - Lot 14 Subdivision: Filed Map No. Lot No. Is returned herewith and disapproved on the following grounds: Under article XXIV. Section 100-244.13, lot coverage shall not exceed 20%. The proposed construction, including the existing shed and bulkhead deck, constitutes 21.4%. This is 135 square feet over the allowable 20%. Proposed Single Family Dwelling: 1.748 Sq. Ft Lot Size: 9,357 Sq Ft Proposed deck: 140 Sq. Ft. 20%x 9,357 = 1.871 Sq. Ft. Max. Existing Storage Shed: 48 Sq. Ft. Existing Deck &Bulkhead: 70 Sq. Ft. Total Area Proposed: 2,006 Sq. Ft. James A. is ter, R.A. Building Department BUILDING PERMIT REVIEW CHECK LIST �(ql Applicant/ �1�1A�, `11�s-� Date p�� � Owners Name: ( Reviewed: �p /1 `l Architect/ M,,� Date Engineer: PkiDN(,�+59YS Or, 201-Wt. 1131 Submitted: SCTM#: h y District: 1.000 Section: I Block: Lot: 1 Project2Q „n I�� �0�0 Subdivision Location: M Name: Single&separate Requir certtficatton: Y / Zoning District: [Lot size: Actual: #2D3! 351-1j' [Lot coverage O)P6 Proposed: Req. op I J / eq Y1azd Proposed: 4� 1 [Rear d �_) [Front Yard Proposed:_� [Side Pro sed: .1 Rear Yard ro sed. Project Description: Na-r(W F61eyt)rav� S'-5(t 54VM&,y Oluellt) AGENCY PERMITS Permit RE2UIRED FOR REVIEW NO YES Number Suffolk County Health Dept. New York State D. E. C. _ �f �738-C8�� Town Trustees _ (� Town Zoning Board approval: 40 SMACK fi 1 Uew©K-.�C Town Planning Board approval: Flood Plane Elevation ??? L 10 Flood Zone: Notes: I CUtSeO 7�� �� *car 7�7(,zo.D !.�-7 (J� *80 ,DECE A S Per t){A- 2LA - 23 w►tty r'Ram aQi.tiwent) - PN-,g4. to fig,ST fLooC, I (p'?(a 5 7rXMAL fee $ 16 •o s� Sri f� I o 6 o Amrrioym. Aga `� 311, 5`t.90 550 765.1802 BUILDING DEPT. INSPECTION [ FOUNDATION 1ST [ ] ROUGH PLBG. [ FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS• Llc DATE � � INSPECTOR pis-tees BUILDING DEPT. SPECTION UNDATION 1ST [ J ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ l FRAMING ; [ J FINAL KS• owrE iN pro �25---7ff-T7 a65-iso2 u��iNa DEPT. INSPECTION [ FOUNDATION IST [ ] ROUGH PLBG. t/] FOUNDATION 2ND [ ] INSULATION [ 1 FRAMING [ ] FINAL [ ] FIREPLACE 8 CHIMNEY RE RKS: DATE <� � INSP 76 AW2 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ rRAMING [ ] FINAL [ ] FIREPLACES CHIMNEY REMARKS: 1 4z DATE © INSPECTOR suaoINa oar. INSPECTION [ ] FOUNDATION IST [ ] RO PLBG. [ ] FOUNDATION 2ND SULATION [ ] FRAMING [ ] FIRE C 8 CHIMNEY REMARK L DATE 4::T 71,,9' IN8PE 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] F NDATION 2ND [ ] INSULATION [ FRAMING [ ] FINAL [ ] FIREPL�AnCE & CHIMNEY REMARKS: Z. ,DATE 8PECTOR .� Z.,OD�&;��- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. � [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL � [ j FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE 8 INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL/jam _, l [ ] FlREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: /X 61, cor DATE dZZzKzoo_s_-- — INSPECTORv'� 3o367 ,7— 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: l DATE �� 7 � �� INSPECTOR INSPECTION 1 ' COMMENTS i If 7 WNDATION OST) AffKQJGH FRAME &WSULATIL PLUMBING Cc) 1N PER STATE ENERGY CODE IvAe ®', FINAL b �.: � Chi► ADDITIONAL 1 1 I' /4401i Board Of Southold Town Trustees SOUTHOLD, NEW YORK • Y. PERMIT NO. _ DATE: May. 29,..1998 ISSUED TO .................... EAN,NE....B.ARTOS. ... __._....... ..._....................... ..._. •.A � h h Pursuant to the provisions of Chapter 615 of the Laws of ;� the State of New York, 1893; and Chapter 404 of the Laws of the t State of New York 1952; and the Southold Town Ordinance en- ` titled "REGULATING AND THE PLACING OF OBSTRUCTIONS `. y IN AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the M Resolution of The Board adopted at a meeting held on .May„28,,,•,.1998 19.....98., and in consideration of the sum of $...150....0.0_..... paid by 4'9 Jeanne Bartos of ........PecoAk......................................... ........... ... N. Y. and subject to the Terms and Conditions listed on the reverse side hereof, of Southold Town Trustees authorizes and permits the following: Wetland Permit to construct a two story addition on east side o existing structure with a small single story addition on south an ' west side of structure, with condition that no other construction to be dpne seaward a gi r2w QJaybafgs ae placed on tie, seaw side all in accordance wi nn tie etas specs ications as presented in of the originating application. property during construct of the addition th emgG s Ohl ♦♦ I� WHEREOF, The said Board of Trustees here- by causes its Corporate Seal to be.affixed, and these presents to >r be subscribed by a majority of the said Board as of this date. 7 1 O 4 ......... . .'/...... .... ...z .... s. '� Trustees Town Hall Albert J.Krupski,President ��� �y 53095 Main Road James King,Vice-President P.O.Box 1179 cz Henry Smith H Z Southold,New York 11971 Artie Foster Its p Tele hone(516) 765-1892 Ken Poliwoda �'� • ��� Fax(516)765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 29, 1998 Jeanne Bartos 209 Park Ave Lyndhurst N.J. 07071 Re: SCTM #67-7-14 Dear Mr. Bartos, The following action was taken by the Board of Town Trustees during its Regular Meeting held on May 28, 1998, regarding the above matter: WHEREAS, JEANNE BARTOS, applied to the Southold Town Trustees for a permit under the provisions of the Wetland Ordinance of the Town of Southold, application dated May 7, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 28, 1998, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standard set forth in Chapter 97-18 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approves the application of JEANNE BARTOS to construct a two story addition on east side of existing structure with a small single story addition on south and west side of structure, with condition that no other construction to be done seward and a row of hay bales be placed on the seaward side of property during construction of the addition on the east side. BE IT FURTHER RESOLVED that this determination should not be considered a determination made for any other Department or Agency which may also have an application pending for the same or similar project. Permit to construct and complete project will expire two years from the date it is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Two inspections are required and the Trustees are to be notified upon completion of said project. FEES: None Very truly yours, aa-c� �. / - g.? Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. DEC ACE Dept. of State t NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC-PERMIT NUMBER EFFECTIVE DATE -1-4738-01853/00001 ■ March 25 1998 FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(S) Under the Environmental March 31, 2001 Conservation Law TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate I � ❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Duality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: Long Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ❑ Other: PERMIT ISSUED TO TELEPHONE NUMBER Jeannie Sweet Bartos (201) 438-3734 ADDRESS OF PERMITTEE 209 Park Avenue, 2nd Floor Lyndhurst, NJ 07071 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Sea Level Mapping 6 East Main Street Riverhead NY 11901 (516) 727-3757 NAME AND ADDRESS OF PROJECT/FACILITY Bartos Property Mill Road Peconic LOCATION OF PROJECT/FACILITY SCTM #1000-067-07-14 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Goldsmith's Inlet DESCRIPTION OF AUTHORIZED ACTIVITY Construct approximately 600 sq. ft. additions to existing single family dwelling. All work shall be in accordance with attached NYSDEC stamped approved plan. 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) and any Special Conditions included as part of this permit. DEPUTY REGIONAL PERMIT ADMINISTRA- ADDRESS TOR: George W. Hammarth MMR Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 AUTHORIZED SIGNATURE DATE �� March 27, 1998 Page 1 of 5 GENERAL CONDITIONS Inspections 1. The permitted site or facility, including relevant records, is subject to in- spection 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 represen- tative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3) . A copy of this permit, including all referenced maps. drawings and special conditions , must be available for inspection by the Department at all times at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify, suspend or revoke this permit when: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regula- tions is found: b) the permit was obtained by misrepresentation or failure to disclose relevant facts: c) new material information is discovered: or d) environmental conditions, relevant technology, or appTicable law or regulation have materially changed since the permit was issued. 3. 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 , fees or supplemental information the Department requires. Any renewal , modification or transfer granted by the Department must be in writing. 4. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination 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. 5. Unless expressly provided for by the Department, issuance of this permit does not modify. supersede or rescind any order or determination perviously issued by the Department or any of the terms , conditions or requirements contained in such order or determination. Other Legal Obligations of Permittee 6. The permittee has accepted expressly. by the execution of the application, the full legal responsibility . for all damages, direct or indirect, of whatever nature and by whomever sdffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits. actions, damages and costs of every name and description resulting from this project. 7. 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 in a person not a party to the permit. 8. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required for this project. Page 2of 5 :9i•20-ba(7'92)-2.5c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( Tidal Wetland 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized,or project. if, in the opinion of the Department of Environmental Conservation 13. Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of shall be removed evenly,without leaving large refuse piles,ridges across the people of the State, or cause loss or destruction of the natural the bed of a waterway or floodplain or deep holes that may have a resources of the State,the owner may be ordered by the Department to tendency to cause damage to navigable channels or to the bank; of remove or alter the structural work,obstructions,or hazards caused a waterway. thereby without expense to the State, and if, upon the expiration or 14 There shall be no unreasonable interference with navigation by the work revocation of this permit, the structure, till, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be com- 15. If upon the expiration or revocation of this permit,the project hereby pleted, the owners, shall, without expense to the State, and to such authorized has not been completed,the applicant shall,without expense extent and in such time and manner as the Department of Environmental to the State,and to such extent and in such time and manner as the Conservation may require,remove all or any portion of the uncompleted Department of Environmental Conservation may require,remove all or structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse.No claim shall be made against to its former conditidh. No claim shall be made against the State of the State of New York on account of any such removal or alteration. New York on account of any such removal or alteration. 10 That the State of New York shall in'no case be liable for any damage 16. If granted under 6 NYCRR Part 608, the NYS Department of Environ- or injury to the structure or work herein authorized which may be caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or improvement of navigation,or for other purposes,and Sections 301,302. 303,306 and 307 of the Clean Water Act of 1977 no claim or right to compensation shall accrue from any such damage. - (PL 95-217)provided that all of the conditions listed herein are met. 11 Granting of this permit does not relieve the applicant of the responsi- 17. All activities authorized by this permit must be in strict conformance bility of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part the U.S.Army Corps of Engineers,U.S.Coast Guard,New York State of the permit application. Office of General Services or local government which may be required. 12 All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by Tnhn Ehl ers of any wetland or waterway by suspended solids, sediments, fuels, 10/25/97, last revised_ on 2/24/98 solvents,lubricants,epoxy coatings,paints,concrete,leachate or any SPECIAL CONDITIONS 1. Any debris or excess material from construction of this project shall be completely removed from the adjacent area(upland)and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 2. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 3. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration,whichever comes first. The approved methodologies are as follows: a. Stabilization of the entire disturbed area with appropriate vegetation(grasses, etc.). b. Temporarily stabilized with straw or hay mulch or jute matting or other similar natural fiber matting within 1 week of final grading. Temporary stabilization shall be maintained until a mature vegetative cover is established. 4. A row of staked hay bales or approvable erosion control devices shall be placed 30 linear feet from the tidal wetland boundary, at commencement of regulated activities and remain in place until project is cgmpleted and all disturbed areas stabilized with vegetation. DK PERMIT NUMBER 1-4738-01853/00001 PROCRAMIFACILITY NUMBER FPage 3 of 5 SUPPLEMENTARY SPECIAL-CONDITIONS The following conditions apply to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenic, and Recreational Rivers Permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page one or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. D. 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 the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC Permit No. 1-4738-01853/00001 Page 5 of 5 r 95-20-6f(7/87)-25c NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 25 Tidal Wetland For Article ( 1 5. Roof runoff shall be,directed to drywells a migimum of 75 feet landward of the tidal wetland boundary for immediate on-site recharge. 6. No fill is authorized. Supplementary Special Conditions(A)through(F)Attached r DEC PERMIT NUMBER 1-4738-01853/00001 FACILITY ID NUMBER PROGRAM NUMBER Page 4 of 5 , • c,UFrOI{��;�a ,JUDITH T. TERRY Town Hall, 53095 Mum Road I = P.O. Rox 1171) TOWN CLERK '' 1 Southold. New York 11071 .y O� Fax (5161 765.192? r:EcrsrRnR Or V1TAI,srnTlsllcs ., MARRIAGE Of FICERTelephone (516) 765-1801 RDAN RECORDS MANAGEMENT OFFICER �0� FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93)) , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93)) . BL:�3. C-EF-L TOWN OF SOS►+OLD `0h T. Terr Y Southold Town Clerk August 25, 1993 APPLICATION #_ PAGE 1 of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representative to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE, TO THE T OF Y OWLED TRUE AND ACCURATE.Off (APPLICANT'S SIGNATURE) DATE SECTION 2• PROPOSED DEVELOPMENT (To be comRieted by APPLICAN'n NAME ADDRESS TE PHONE APPLICANT BUILDER /n ENGINEER,. O- �`�l�l PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location. Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION PAGE 2OF4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE Cd New Structure dResidential (1-4 Family) Addition ❑ Residential (More than 4 Family) ❑ Alteration ❑ Non-residential (Floodproofmg? ❑ Yes) ❑ Relocation ❑ Combined Use (Residential & Commeraal) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 0 Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECTS ZQ (R) B. OTHER DEVELOPMENT ACTIVITIES: ❑ Fill ❑ Mining ❑ Drilling ❑ Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) ❑ Road, Street or Bridge Construction ❑ Subdivision (New or Expansion) ❑ Individual Water or Sewer System ❑ Other (Please Specify) After completing SECTION 2,APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION fTo be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: ❑ Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). ❑ Is located in a Special Flood Hazard Area. FIRM zone designation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located in a floodway. FBFM Panel No. Dated ❑ See Section 4 for additional instructions. SIGNED DATE APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED (To he completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: ❑ A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale,and specifications,including where applicable:details for anchoring structures,proposed elevation of lowest floor(including basement),types of water resistant materials used below the first floor,details of floodproofmg of utilities located below the first floor and details of enclosures below the fust floor. Also ❑Subdivision or other development plans(If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser,the applicant must provide 100-year flood elevations if they are not otherwise available). ❑ Plans showing the extent of watercourse relocation and/or landform alterations. ❑ Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other: SECTION 5 PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A. ❑ Is B. O Is not in conformance with provisions of Local Law , 19 . The permit is issued subject to the conditions attached to and made part of this permit. SIGNED , DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPLICATION # PAGE 4 OF 4 APPEALS: Appealed to Board of Appeals? ❑ Yes ❑ No Hearing date: Appeals Board Decision --- Approved? O Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued) The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, including basement in Coastal High Hazard bot m of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is JQ FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPP-CTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: i Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: 0 NEW BUILDING O EXISTING BUILDING O VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19AS MODIFIED BY VARIANCE # DATED ' SIGNED: DATED: C/C(93) Mr. Marion Gabrysiak March 15, 1999 186 Valley Road Riveredge,New Jersey, 07661 Re: Bartos Residence SCTM#: 1000-67-07-14 FLOOD ZONE AE (EL lo) Dear Mr. Gabrysiak: As per our recent telephone conversation, enclosed please find a copy of Town Code relating to Flood Damage Prevention. I have also included a copy of the letter that should have been sent out with the original disapproval and a copy of the Zoning Board Variance indicating that no deck will be constructed. To process the permit application it will be necessary for you to submit three revised sets of plans. The following list of required changes should not be considered a complete list and it is offered only as a starting point for you to review Chapter 46 of the Town Code: 1. Plans should indicate finish floor elevations as well as the existing grade at the perimeter of the proposed foundation. The finish floor elevation must be at or above elevation ten(10). 2. Plans should indicate foundation openings as specified in chapter 46 of the Code. (Minimum of two openings with a total combined opening of one square inch for each square foot of floor area.) 3. Mechanical and electrical work will not be allowed below elevation ten (10). 4. When located below the Flood Zone Elevation, Crawl Spaces shall not have a final grade or floor slab below the exterior grade. If you have any questions concerning the necessary modifications required by Chapter 46 please contact my office. Sincerely; James A. Richter, R.A. BOARD OT MA011 ..... . ...:9999. -FORM NO. 1 3 SETS W VLANS'................ TOWN OF SOUTl101.D S'UAVIrY ...... . ... . ...9,9,�;:..•••• . . BUILDING DUAWER NT CIIECK ......... .:'•'• . .: .. . .. . . . . 'GOWN HALL SL??Tic LtOlidd .... ... .. . . . SOU1T11OLD, N.Y. 11971 TEE t 765-1802 NOTIFYt CALL� ....... .. . 9999 . lbmnined....... .. ......... 19.... _ ( ��/' �/ ' NII. TOi..... . . . Approvttil......(P: Z ...... 19Tt remit No. ...... ..................... Wsapprwed arc .......I.............. ....................... ............... . .......................... •.• •.•.�.• w ....ky. << h (7 (lkcilding Ins*tor) APPLICATION FOR WILDING P51lHl'C � December 30..ig98 -------------'� �Da to............. .. . . eO O! ?T. IL T INSTRUCTIONS TOWN �S UTHOLD a. 'tliis application oust be completely Pilled in by typewriter or in ink and aulxaitted to tlw Building Inspector wi 3 sets of plans,, accurate plot plan to scale. free ac cordlog to sds.ule. b. Plot plan al-amlog location of lot and of buildings on premises, valatiocahip to adjo1a1% premises or public streets or areas, anti giving a detailed description og layout of property oust be drama ca the d18WW'Amick is part Of this a�[)lication. ' c. '!he work covered by this application ray not be conmweed before issuance of dliltuft hwdt• d. Upon approval of tits application, the Ikuildtag Inspector gilt issue a bAlding Vemit to dna applicant. SWI permit aliall be•kept on dna premises available for inspection thro4mt the work. e. No building shall be occupied or used in whole or in part for ata► purpose'whatever until a Certificate of Occupancy small lave been granted by dna Building Inspector. 11MICICi'I * IS llcl M MALL' to due 041ding Deparoment for tie issuance of a AdIdiog Pewltpwcaccant to the Tow 15uilding Zone Ordinance of the Toof Southold, Suffolk CocWty, New York, and other applicable>(9ac+81 Ordiccanaes ar lWaulations, for the eonsttuction of buildings, additions or alterations, or !tr•recavel or deanlition, as herein ,described. Tlfe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regular:ions,(a,tid to admlt authorized inspectors on premises and in build for 9999.. 9999 . .. .. .......... ........... (Si• tura of applicant, or Paw a corporation) 1820 Mill Road PeconicSouthold NY 9 9 9 9.....9 9 9•••9 9••J 9 9 9 9 9.9 9.••..,...............o.. (Mailive address of applicant) State %,Awtltier applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulick General Contractor. ................................:....•.....9......................,V 9 9.0 9..••:9•*•.••goes 9•9•...9 ............. Jeannie Sweet Bartos Flame of weer of premises ...:..............9.............................. .......................................... it on the tax roll or latest dead) If &RAicaiit is a corporation, signature of duly outlwizacl officer. ..........II................... ......................... (Nam anti title of corporate officer) Builders License No. ..........99............: PluTbers License No. Llectricians License Nov .v.v...........I..... Other Trade's License No. 1. location of land on wl►idn proposed udrk will be dont;.................,......................................�.... 1820 Mill Road . Ppg4}l�F� P Q $Rut, R11 Clouse 23�nber Street ttacalsC ccxunty Tax map No. 1000 Section0 6 7 0 7 14 (, .....•....•...... 131ock .......••••9.9.• Tat .. •�•S:• Y•..'• WWivision .,Map..of,Bailey. Park ......... Filed Map NO.- ..l0:�7:09.... lot ...••..•:...�.. (Name) 2. State existing use and occupancy of premises and intended use and,ocoAxmcy of proposed eo:nstructiont a. W.atic,g•use and OccupancyPrivate Residence •..•9.9.•••••••.•.••.9..•9.9.9.•99.9..9.9.9..9••99'•..'/.i....9................ Private Residence ' b. Intended use and Occupancy ............................................................................. tblure of work (dw*% ildt aMileabis)t Neu Building .......... Addition ...X....� Alteration ..:X..... Repair ............ iBrwral ........:.... Demolition ,............ Other IJorit ................•. 6666. ....... $70 , 000 (Nacription)• Ent imatetl cost .••�..................... fee. ...i................•.•..•.•....•••.•... 6666 (to be pe'I en filinn this application)• If dwell Ina, twiter of "111 a traits ............ U-mixtr of "Ilion units on each floor ................ 1f garage, number of cars ...0 ..................... if if Imeittees, ectarereial or mimfroccupancy, specify nature and- extent of each type of use...................... olmrnsions of existing structures, If anyt Vront.�.Q,5.......... hear ....... Npcll ..36:.6.'........ � ' Iktlgltt .•..•5.0...............• 1Mmber of Stories .•..1........•6666. . Ulnenal is of s to stasdrm With alterations of'amitionat Mont .,4 4660'6646 Rear .46 .50.' ,. Depth ne p ................. llielgitt ....��:t 7.�......... Mob r of Stories ............... nhtmnalons of entire row eonetructlont 1*rortt ...42.:60..:., Ikar ..46.::5.0..... Depth . 36.:60 ' • Iki�tt .......1................ gaiter of Stories ..•2..•..•.••.6666. Size of too Prom .(.��/.RQS.sQp.CR�......... 11ear ...RQ.•.$.�.....j.... rApt�h ..I IQ.•.Qq....:.... 0. bore of Purdlese ..I.`S L 2W.M....... i'1amQ of ronmr (bitter .HI..O.Y:t.A Ae t....................... I. Zone or use district in witch premises are situated ...A:4 Q,,....,,.•....:6:6........6.......................... 2. Does proposed cottatruction violate any zdxting lase, onlinadtte or reguttationt ... 0.................. 13. Will lot be regraded. t...,Yes 6&66*64a4 Will excess fill be removed from prermiaeat lyn I90 X . Ih. Rtetnea of Otmer of pt�nises Jeannie' Sweet 4 Bartcftreas 1820 .Mill. Road 6...66657 h-7h� 164:4 L'tibcxF leo:-:........... 201-489-1181 Hm+e of Ardtitect ..6.9.q4i......... Phone ............ MichaelBartos k1820 . Road51�67�5�1644 &we of Contractor ... 4i.... .., 15. Is this property wid in 300 feet,of a tidal wetland? * YES .X....... NO .......... art+ W, 190 MI"1Qah17t1Sii M mum HAY.M Imt;)Ulim P1.0T DTAGRAH Locate clearly and distinctly all buililings, shouter existing or proposed, and indicate all set-bath ditnensiona frctn property lines. Give street end block mober Or description according to deed, and show street nd+nee arxi irxlicate t.hether Interior or corner lot. See submitted architect 's plans and survey r Plots by John C. Ehlers„ L. S . #50202 � 8-ml1: (it N-W YtXZK, (11JR11 (lh ....................... Michael J. Bartos .heitq; duly sworn, tleixtses atxi nays that' he is the soplActmt. ......................................................... (tbm of imilvithinl signing contract) nerve turned, Contractor Ile in the ................................................. ........................... . .................. (Cmttttactor, agent;corporate officer, etc.). , of ttaid t> ier or owners. ntxl its duly authorized to perronn or have i> rrbrn+ed the said stork atxi to make aril kilt: thin niq>i lentiat; tint all etatentatts cOntAtned in this nithilcatitm are true to Cite best of his ktxvledge air lx%I lef; text that the wtsrk will in peribtmed in the mmner set forth in Lite application filed therewith. ,Mtrn to bafure me tits .......1;�p.... ...tiny of .. ...19 clotaty lN&H�.. .:. ... yC ... ....... ... . .. 6666.. ........ (SI tature o ppticattt) M,RGATitT A. RNEMANN Michael J. Bartos NOTARY PUBLIC OF NEW JERSEY My Commission Expires May 13,2002 ZONE VE IEL 13) zam vs Town of Southold 360813 OTHERWISE PROTECTED AREA • AN IDENTIFIED 11-16-91 (SEE COASTAL BARRIER LEGEND) •\\ • •\ • �. �� • \ •\ • ZONE AE .\\• \ _..��`\\\ • \ , �/ (EL 101 `�►•.�� •\ .�\ •�\ ZONE X ZONE VE \\`�\ • (EL 13) .\ �\ • ZONE ��.• o AE (EL 11) \ • . • P \ • \\ • �\ ZONE X i ZONE y `\ ZONE AE X O , IL 10) i y \ZONE \ ���,•�rirti�rr X t- ZONE ZONE X X ZONE AE EL 10i ZONE X H P � O J ZONE z X a z 0 MARION J. GABRYSIAK & ASSOCIATES Architects, Planners & Construction Managers 186 Valley Road, River Edge, NJ 07661 (201)489-1181 fax:(201)996-0246 ENERGY CODE REVIEW Non-Electric 7813 (Part 4) Table 4-1 DESIGN CRITERIA: Good Degree Days O.A. 10°F, I.A. 70°F For: BARTOS RESIDENCE PER DWGS: A-1 TO A-9 M. GABRYSIAK & ASSOC. 1820 Mill Road, Peconic Dated: 12126198 Southold, NY ENVELOPE COMPONENT U. VALUE R. VALUE Exterior Wall Uo 0.20 Roof/Ceiling Ao 0.05 Floor 0. 05 Foundation Wall R-5.0 Entrance Doors U.40 R-2 .5 Uo = Uw Aw + Ug Ag + Ud Ad. . . . Ao . 05 x 2502 + . 33 x 1484.98 + . 33 x 90 = . 168 3827 All HVAC Equipment to meet requirements of 7813 . 12 thru 7813 .21 All HVAC Control Systems to meet requirements of 7813 . 134 All Duct Systems to meet requirements of 7813 . 19 All Ventilating System to meet requirements of 7813 . 16 All Piping Insulation to meet requirements of 7813 . 18 All Service Water Heating Systems and Equipment to meet requirements of 7813 . 32 All Electric and Lighting Systems to meet requirements of 7813 .52 thru 7813.54 Air Infiltration of Envelope Systems to meet requirements of 7813 .4 All Fireplaces to meet requirements of 7813 .5 All Building Service Water Heating Systems and Equipment requirements of 7813 .32 thru 7813 . 34 To the best of my knowledge, ,� D ARC belief, and professional �� GAB judgement, these plans are in compliance with the code F 9075 �O'cESTA �� SURVEY OF LOT 31 4 PART OF 6 0 L D S M I TH 1 LOT 36 "MAP OF 8A I LEY PARK" c S FILED SEPT. 261 I q32 AS # 1 OQ'7 INLET SITUATE: PEGON I G TO1NN OF SOUTHOLD SUFFOLK GOUNTY, NY IEp -9'xa. N89 °48 ' 36"E 93 . 88 ' _ 51JRVEYED 10-25-q7 z / - AMENDED 01-2q-q8 T I f;E 6L NEW GERTIFIGATION5 07-14- 18 z T 1E � T� r-. K,y ��� �- - KD TOPOGRAPHY Oq-16-q8 AMENDED: Oq-22-q8 W � I � SUFFOLK GOUNTY TAX MAP 1000 067 07 14 N �St�NL' 6E SH�� GERTIFIED TO: p8G K'�S 6.I, JEANNE SWEET BART05 pG - F I DEL I TY NATIONAL TITLE I NSURANGE l 9� !� 5 0 g"8 W GOMPANY OF NEW YORK THE 5UFFOLK GOUNTY NATIONAL BANK 2.5' ? ) v- Rp,M� d y - F E ►� f CO z U5 Hp �' W p° 3 c00 gs 9 �TQ'' Ne 3, --,A NOTE5: OpRY 0 � ���� REFERENGE DEED: LIBER 11232 PAGE 353 Ri C X49 ■ DENOTE5 MONUMENT FOUND � DENOTES PIPE FOUND W0) ed DENOTE5 TIMBER BULKHEAD r0 05 o p0m� O AREA = q,357 5.F. OR 0.21 AGRES aiti0 ELEVATIONS REFER TO MSL NGVD 2q PROP05ED ADDITION5 FALL WITHIN / \ FLOOD ZONE DESIGNATED A5 "AE" WITH A BASE FLOOD ELEVATION OF 10 A5 SHOWN ON PANEL 161 OF 1026 MAP # 36103G0161 G DATED MAY 4, IggB w 10-0. 00 , ��J0�/ W J16 -unaumarizetl alteration or addition to a 5—ey vin lationn0,sectione]209land subrticvlsionr*ss2aOf l sthe New York State Education Law.' \�� !G of NEIN 'Only copies fro,the original dt in isL L s vey �` \�/ O I earkes with an rig coal of[he lane a rveyor's staapee seal seal Or considered to ne valid tree .7certi+icac.ons indicated Hereon signify tna[this vey was prepared in accdrennce with the e \ sting Cgtle of Practice for Lane Surve Ys aabp[ee by the New York St Association of Professional __ AV �QI -��__ �� * r Land Surveyors. Saftl certcf icait ons shall run poly Ll/ `_� — m me person roc wnos[ne aurver is preparm. #4 `` ' ane On hid behalf to the title coepany, governeen tal agency dna lending nstitu[ion listed nereon, and -- O to the a scgnees of the lentling cosi ifu[ion. Oerfifica- �` tionssare not transferable[o additional institutions 5 .� -_ --- F�LAND g� N.Y.S. LIC. NO. 50202 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET - - -- - - RIVERHEAD, N.Y. 11901 - 369-8288 Fax 369-6287 REFERENCE # 9773tapa SURVEY OF LOT 5-7 4 PART OF 50LDSMI TH 1S I LOT 36 "MAP OF BAILEY PARK" INLET ' FILED SEPT. 26, q52 SITUATE: PEGONIG ,,C TOM OF SOUTHOLD NB9 .4B ' 36"E 93. BB ' - SUFFOLK COUNTY, NY - - _ _ riF•s��d. / _ - r_ .ma TIE LINE— -_ ARVE ED(A-2q-46YED kk 1 I I 7E! 71hd•,1 BI-KD _ \ NEW CaMPIGATION 07-14-98 NSII W I I Sri TOPO6RAPH1 09-16 96 tois \ } r j� Ar>B+vED, 09-72 96 ID ^ AMENDED. 05-11-99 I o al4 - ' Q. m SUFFDuc caa+7h rAx ww jy EI ='.O yHECJa 1000 061 07 14 1 .� Q1> I+lOJG �; 3Q �jkls7D.Q k-1 6'1, g(j-KO 6ERTIFIED TO. I a IAa r 's 7,1 ori 11 FID�ITY NATIONAL�'A"�TITLE INS avAWE v 2�' A.:f%,!. EI= l.a C o r �.• 1 T1£ SUFFOLK aMtYNAnrn L YORK 01 FFzPME p15p_64 �' ; 6112 In 1 a V Vl IbOtAe ,�� °' I` to�-1 �7, tvlti- '. I ytOR ' /,'i;:i m, EI_7.a3' = �o ^'v* 1 : Nmis, I •O' 105' / I r 'ti c� g REFEREWSE DEED, LISW 112'32 PAGE 359 HOUSE ;�;' 69 —i � m NoB ■ DeNOTesrwtul�rtrroam ! I 4I tr T , EI=7S �' r T ° DENOTES PIPE FOUND NN ' '' % ' P2o� PfFfPme } r c q oENDTEs TIMBER BULKHEAD mXddltlon17 EJ'=6`§ 1 . �jc. AREA x 9'x31 B.P. OR 0.71 ACRES m n • r, y.2' E =7.5 �` ELEVATIONS REFER To MSL NSVD'39 n WI r � PROPOSED�/ I ; k OOP ZONE DIDESI�PT ALL WITHIN PLEDD AS "A LLJ MTN A BASE FLOOD ELEVATION OF IO I AS SHOWN ON PANEL 161 OF 1026 O / � � MAP ° 56109601616 DATED MAT 4, 1996 e 1177 ' , l 3 0 pO.W .00 ppi I O W s"HAL r0co ~P� G INTr�Le - ROApw�Y 1,D * - ,.;;•�w�_ '_r�w�r.' LA _.. PLUMING Y.S. LIC. No. w202 PLUMBER CERTIFICATION ALL PLUMBING WASTE - GRAPHIC SCALE I,- 2O 6 EISTJMWT'M4 N STREET V Y ON LEAD CONTENT BEFORE &WATER LINES NEED RIVERMEAD.WY. t79of CERTIFICATE OF OCCUPANCY TESTING BEFORE COVERING 359-8286 Fax 369-8287 REFERENCE ° 9773t000 SOLDER USED IN WATER I SUPPLYSYSTEM CANNOT EXCEED2120 OF 196 LEAD. If Copper tubing is u8ed PROVIDE ANTI SCALD AMD/OR for water distributing STHERMAL SHOCK PREVENTING M6m� plp shall be `PROVIDE '/� HR. FIRE D��I G6T DEVICES AS TO PARE 902.6(K) tvaes K or L on RATED SEPARATION TO 41 STATE WILDING CODE. PART. 717.3 (0 (1) OF N.Y. STATE BUILDING CODE. APPROVED AS NOTEDA? DO NOT PROCEED WITH DATE-�i a 2•qq B.P. p 15 29-3 �- FRAMING UNTIL SURVEY FEE: `�SJ°j4 20 BY: ' • ^`o^I OF FOUNDATION' PROVIDE OPENINGS FOR NOTIFY BUILDING DEPARTMENT AT EMERGENCY ESCAPE AS 765-1902 9 AM TO 4 PM FOR THE HAS BEEN APP REQUIRED BY PART.714 OF FOLLOWING INSPECTIONS: MSOUTP.GLD I FOUNDATION - TWO REQUIRED N.Y. STATE BUILDING CODE. FOR POURED CONCRETE 2- ROUGH - FRAMING & PLUMBING UNDERWRITERS CER ICA3. INSULATION REQUIRED; 4. FINAL - CONSTRUCTION MUST PROVIDE SMOKE-DETECTING BE COMPLETE FOR C.O. ALARM DEVICES ALL CONSTRUCTION SHALL MEET OCCUPANCY Y OR AS TO PART.721.1 THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY USE IS UNLAWFUL N.Y.S BUILDING CODE. CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS WITHOUT CERTIFICATE n AR HT OF OCCUPANCY p�Fp��`•ABR `jQ . ..f.' .A"P,T _-_r_? 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