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HomeMy WebLinkAbout28296-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29841 Date: 11/17/03 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2810 WESTPHALIA RD MATTITUCK (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 114 Block 7 Lot 5 .2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 16, 2002 pursuant to which Building Permit No. 28296-Z dated APRIL 18, 2002 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 ONE FAMILY DWELLING WITH COVERED FRONT ENTRY, REAR DECK AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to DANA FOX (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-01-0198 11/06/03 ELECTRICAL CERTIFICATE NO. 1070589 09/02/03 PLUMBERS CERTIFICATION DATED 09/08/03 DANA FOX -4 � � hor ed 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. 28296 Z Date APRIL 18 , 2002 Permission is hereby granted to: MARY E HAWKINS WESTPHALIA ROAD MATTITUCK,NY 11952 for CONSTRUCTION OF A SINGLE FAMILY DWELLING WITH ATTATCHED GARAGE AS APPLIED FOR WITH ZBA CONDITIONS at premises located at 2810 WESTPHALIA RD MATTITUCK County Tax Map No. 473889 Section 114 Block 0007 Lot No. 005 . 002 pursuant to application dated APRIL 16 , 2002 and approved by the Building Inspector. Fee $ 915 . 30 CL2L Authorized Signature COPY Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 3 �nnz 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%o 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: L 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, Swinuning 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. 6 3 New Construction: V Old or Pre-existing Building: (check one) Location of Property: p s R.I V are ebLG T_�S D M 6 T-n TV CK House No. s r^ Stre Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section ( Block Lot_ Subdivision Filed Map._ Lot: Permit No. Date of Permit._ Applicant: Health Dept. Approval: ✓ Underwriters Approval: Planning Board Approval: — — Request for: Temporary Certificate _Final Certificate: (check one) Fee Submitted: $ 4J'. r___ L Q-e L . 1p 5 o a —p i nt Signatut o N�rr�r�rsrn���nrs��r�rrss��l�n�s rs�n�rr�r n�s�s��r�rnrn�ss�nnsrs�n��r���nr�s�rrrr��nsrr�rs o 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 15j 40 FULTON STREET — NEW YORK, NY 10038 rj 5 CERTIFIES THAT Upon the application of upon premises owned by 5 DANA P. FOX DANA FOX 5 CSU 305 PRIVATE RD. 305 PRIVATE ROAD rj MATTITUCK, N.Y. 11952, MATTITUCK, NY 11952 S Located at 305 PRIVATE ROAD MATTITUCK. NY 11952 c7 Application Number: 1070589 Certificate Number: 1070589 C5 Section: 114 Block: 0007 Lot: 005.002 Building Permit:28296Z BDC: NS11 r� Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: �5 Basement,First Floor, Second Floor,house& pool,Attached Garage, Outside, Attic, Pool/Spa, 5 5 5 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 rj found to be in compliance therewith on the 2nd Day of September, 2003. rj 5 Name (OTY Rate Ratin Circuit Type 5 5 Alarm and Emergency Equipment 5 5 Sensor l 0 Carbon Monoxide 5 5 5 Sensor 9 0 Smoke 5 Appliances and Accessories 5 Exhaust Fan 4 0 F.H.P. ,CS r57 Dish Washer l 0 1.2 Kai' 5 5 Hydro Massage Tub,Residential 1 0 5 5 Furnace 1 0 Gas 5 S' Pump'Motor I 0 l H.P. 5 Air Conditioner 1 0 48.000 BTU rj Pool/Spa Bonding 1 0 5 5 Time Clock/Switch 2 0 5 Panels 5 5 1 100 18 5 5 5 Wiring and Devices 5 Receptacle 62 0 General Purpose Switch 55 0 General Purpose seal rrr+++ 5 Fixture 37 0 Incandescent 5 Continued on Next Page 1 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 5 5 D rJrJr�rJ arrrJrJrJuornrJ�rJ�rJ�r�cnrJr�cnrJ�nrJrJ�rJrJrJrrr�rJ�rJrJ�nrrrJcn @ Ii 11C IrJPL0 o �sss���nsL3r�l�s��ls��ns�rn��l�r �rrFlr�nLs`. rL3rL3L3] X15 ��n 151 1rsrr�rs cns�nn�rr� co 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 rj 40 FULTON STREET — NEW YORK, NY 10038 5 CERTIFIES THAT G5� Upon the application of upon premises owned by 5 5 5 5 5 DANA P. FOX DANA FOX C5 305 PRIVATE RD. 305 PRIVATE ROAD �5 5 MATTITUCK, N.Y. 11952, MATTITUCK, NY 11952 Located at 305 PRIVATE ROAD MATTITUCK, NY 11952 7C c7 Application Number: 1070589 Certificate Number: 1070589 �c�7� Section: 114 Block: 0007 Lot: 005.002 Building Permit:28296Z BDC: NS11 S Described as a Residential occupancy, wherein the premises electrical system consisting of �c1 5 electrical devices and wiring, described below, located in/on the premises at: 5 Basement, First Floor, Second Floor, house&pool,Attached Garage,Outside,Attic, PooVSpa, 5 5 5 r5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below, was 5 found to be in compliance therewith on the 2nd Day of September,2003. �5 5 Name OTY Rate Ratine Circuit Type 5 5 Dimmers 3 0 5 5 Paddle Fan 5 0 5 5 Receptacle I 0 20 amp Laundry 5 L55 Receptacle 8 0 GFCI 'J Fixture 1 0 PooVSpa 5 5 Switch I 0 General Purpose r, Receptacle 1 0 GFCI 5 5 Receptacle 2 0 20 amp PooVSpa 5 55 5 GFCI Circuit Breaker 3 0 20 amp Pool/Spa f5'D Service 5 Cj l Phase 3W Service Rating 200 Amperes Service Disconnect: 1 200 cb 5 5 Meters: I 5 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual environmews it is advisable to have 5 frequent test and,or repairs made b) a qualified person. seal 7 5 5 5 5 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 5 O rra tPLPLPr�rJrJrJrPrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�cPcPrJ�rJ�rJ�rJ�rJ rJ�rJ�rJ�rJ�r�rJ�rJ�rJ�rJ�cPrJ�rJ�rJ�r�rJ�rJ� rJ�rJ�rsrs rJ� rJrJ�MEO o�osUFFOIKc 15 Till Town Hall,53095 Main Ro d 01 Fax(631) '65-1823 P.O. Box 1179 �j, Obi' Telephone (631)765-H Southold, New York 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Date: ®� Building Pen-nit No. Owner: � FO X (please print) Plumber: �AFO X (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. && (Plum ers Si atlire) Swom to before me this 0 day of _ 20D-3 AV, � rI Notary Public, S V��p�V—Count} MELANIE V.BROWN Navy Ptbla,SM of Nwv Yak No.4906712 OWN M 8ulbltCM* Coe MbdM a*"00L 19. �2AV'q S FROM MarkSchwartz,RIR—Architect PHONE NO. : 6317344185 Sep. 04 2002 07:57PM P1 Mark K Schwartz, ATA—Architect, PLLC _ P.O.F.rvx 933 Phone:(d91)734-4185 Cubawgue,New York 11935 Fax:(631)734-4185 FAX TRAN.! MITTAL ate September 04,2002 To: Southold Building Department Main Road Southold,New York 13971 Attu:Damon Rallis Fax number. 765-9502 Phone number: 765-1802 From: Mark Schwartz Re. Dana Fox House Private Road Mattituck,New York Pages: 1 (including cover sheet) Comments: The opening for the garage door shall be for an 8'x 16'wide overhead door. The header will be 2-1 a/4" x 18"microlam beams with 3-2"x 4" posts on each side_ The deck size will be 14'x 24' (in Bea of 14'x 22')and will have the same footings as shown on plan. Please call with any questions you may ha,,a. Thank you. 0 Ag lo o c _ �� TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET Z VILLAGE DIST. SUB. LOT MatLc *ty / I)-e:.; c. t FORME OWNER N Sc(-Ae- I I r-+ E ACR. R O.V�'. haw Stir-�s r 3 � S W TYPE OF BUILDING RES.3 /,/ SEAS. VL. '—' FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 0 _ U U S 3 ' ' . 20 1 l CDGvcc<<E•4- I Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD 2 a' rE Meadowland DEPTH 177, House Plot BULKHEAD Total BUILDING PERMIT EXAMINER CHECK LIST DATE- ISSUED: 02 DATEREVIE\VED: x ;02 APPLICANT: Rac� DATI=-SUBMITTED: ! '02 SCTb4# DISTRICT: 1,M, SECTION: 114 BLOCK: q LOT: S•Z STREET ADDRESS:2ia Cc CITY: SUBDR`ISION��r- . PROJECT DESCRIPTION: ESTIMATED PROJECT COST: CHIT T / ENGINEER: FAST TRACK? 0-j M O SINGLE d, SEPARATE CERTIFICATION-REQUIRED? LIES NOTES: sa,� �p� LOTS 40,000SF-1,10-24 Lot izcc,�uuon ii'RE\TED before June 30. 1983%1-NDERSIZED LUT./FROLI JAN.1997 0i Alza€er iA nonconl:rm ne at any ume atter'. 1:8 ZONING DISTRICT: R-((p CONFORMING? n(D REQ. LOT SIZE: qp'�ACT. LOT SIZE:0+1a REQ. LOT COV. ACT. LOT COV. %9% REQ. FRONT c36 PROP. FRON` >551 REQ SIDE ACT. SIDE REQ. REAR aJ� PROP. REAR WATER FRONT? /\( 0 DESCRIPTION: PANEL #: �I L FLOOD ZONE:, APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: 'ES r NO, (BED #):4 DTE: 10/ 1 / 1 PERMIT #:RIO- -O 198 TOWN SEPTIC RECEIPTCbr N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES orO 3 SOUTHOLD TOWN TRUSTEES: YES or 01 TOWN ZONING BOARD APPROVALCrU--�r NO _ _-S63g TOWN PLAN. BOARD APPROVAL: YES or® TOWN HISTORICAL PRE (SPLIA): YES or ISO' NYS ENERGY:EEYOR NO / EGRESS (18 H mm.? 4 sq total) ✓VENT (SQ. FT. x 4%) 1/ LIGHT (SQ. FT. x 8%) ✓ BUILDING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- HAVE PRE CO'S : Y OR N BP -Z/ C/o Z- NOTES: 7�I1eelN A)Ak QAS" CLQ n AL �Cf 7G 1f7Y�A IE V"k Q�ll zl FEE STRUCTURE: FOUNDATION: Q>3+f SF FIRST FLOOR: (,a 1 SF SECOND FLOOR: eq6 SF OTHER: SF INIIT OTHER TOTAL TOTAL: N o 1 SF FEE FEE FEE I. ( 3,qo 1 SF)- ( V0 SF)-2, 551 SF X S . 30=0600 +$ = s gm-30 2. ( SF)- ( SF)= SF X $ _$ +$ +$ _ $ FROM : MarkSchwartz,AIA—Architect PHONE NO. : 6317344185 Apr. 18 2002 08:34AM P2 SUMMARY OF TOTAL THERMAL RATING It the Total 1heimal Reting Is zero (0) or greater, the proposed design for the building envelope complies with the F_nergy Code. THERMAL TABLE AREA U-VALUE RATING USED A. ROOF/CEILING 187- P) . 04 3 B. NET WALLS 7,096 • 07& 1402 b _ 1 C. GLAZINGWindows 3 6 3 Windows (1st Fir) _�_ _� �= Windows (2nd Fir) Skylights D. FLOORS/WALLS/SLABS 1. FLOORS i 6 Z$ 2 BASEMENTICELLAR WALLS Wall Perimeter Feet Exposure Above Grade Feet Wall U-Value Depth of Well U-Value Inches Below Grade 3. SLAB INSULATION Slab Perimeter Feet Insulation R-Value E. INFILTRATION CONTROL Conditioned Floor Area Sq. Fl. TOTAL THERMAL RATININ Fox" ss �a�- v Y I vT��- IE?►� AF PEALS BOARD MEMBERS �gUfFO(,�c Southold Town Hall Gerard P. Goehringer, Chairman 53095 Main Road James Dinizio, Jr. ~ � P.O. Box 1179 Lydia A. Tortora Z Southold, New York 11971-0959 Lora S. Collins � !� ZBA Fax (631) 765-9064 George Horning '�0� �.a� Telephone (631) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD December 31, 2001 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 Re: ZBA Appl. No. 5038 - Fox Lot Waiver �'r,-e- Dear Yrs�Mcrore: i Enclosed please find a copy of the Lot Waiver determination rendered by the Board of Appeals on December 13, 2001. Please be sure to follow-up with the Building Department for the next step in the zoning reviewlapplication process. Before commencing any construction activities, a building permit and other agency approvals are necessary. A copy of this determination has been furnished to the Building Department for their update regarding their October 17, 2001 Notice of Disapproval and permanent records. Very truly yours, Af GERARD P. GOEHRINGER CHAIRMAN Enclosure Copy of Decision to: Building Department SAN - 3 LCC. y53095 Dain Road y� l;erar.j P..3<,e}irj,,8er. Chairman BQx 1179 James Dinizio. Jr Z Southold,New York 11971-0959 LN-dia A. Tortora Lora S. Coffins �,y • !� ZBA Fax (631) "65-9064 George Horning telephone (031)'7/65-1809 BOARD OF APPEALS TOWN OF SOUTHOLD FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF DECEMBER 13, 2001 Appl. No. 5038 — DANA FOX 1000-114-7-5.2, 5.1 STREET & LOCATION: 230 Lesters Road and 2810 Westphalia Road, Mattituck DATE OF PUBLIC HEARING: December 13, 2001 PROPERTY FACTS: The subject property is located on Westphalia Road in Mattituck. It Is an unimproved lot, identified as Lot 5.2 on the Suffolk County Tax Map, and contains 18,731 sq. ft, according to the survey prepared by Stanley J. Isaksen, Jr. dated August 17, 2001. Lot No. 5.1 is the property owners' house and adjoins part of Lot No. 5.2 at a right angle. CTM Lot No. 5.1 is located on a private road and contains 20,608 sq. ft. BASIS OF APPLICATION:, Building Department's October 17, 2001 Notice of Disapproval for the reason that, under Article II, Section 100-25, Lot No. 5.2 has merged with Lot No. 5.1. APPLICANT'S REQUEST: applicant requests a Waiver of Merger, pursuant to Article 11, Section 100-26 to unmerge Lot No. 5.2 from Lot No. 5.1. Findings of Fact The Zoning Board of Appeals held a public hearing on this matter on December 13, 2001, at which time written and oral evidence were presented. REASONS FOR BOARD ACTION: Based on all testimony, documentation, personal observations by members of the board, and other evidence, the Zoning Board finds the following facts to be true and relevant. 1. The title search, prepared by Fidelity National Title Insurance Co. indicates that Robert Hawkins and Emma Hawkins, his wife, purchased Lot 5.2 and Lot 5.1 or. October 19, 1963. A separate deed was recorded for each lot. 2. On August 20, 1969, the Southold Town Planning Board approved a "lot division," commonly known as a lot line change, according to the letter submitted with this application. The change, approved in accordance with a map prepared by VanTuyl & Son dated July 28, 1969, added a strip of land from Lot 5.2, approximately 20 ft. by 96 ft. to Lot 5.1. All of the other property lines remain intact from their creation. 3. in 1984, Mr. Hawkins died leaving Mrs. Hawkins as sole owner of both lots. Testimony was presented that Mrs. Hawkins believed that both lots were separate until she attempted to sell Lot 5.2 to her neighbor, Dana Fox, who is also the applicant. Page 2—December 13, 2001 7BA Appl. No.5038—D. Fox Parcel,1600-114-07-5.2, 5.2 at Mattituck 4. In considering this application, the Board believes that by action in 1969, the Southold Town Planning Board established the 'original lot lines" of these two lots by its approval of the division. 5. Grant of a Waiver of Merger would recognize a lot that is consistent with the size of lots in the neighborhood. Many lots in the neighborhood are developed with single-family residences on lots similar in size to Lots 5.2 and 5.1. RESOLUTION/ACTION OF THE BOARD: Now, therefore, on motion by Member Tortora, seconded by Member Collins, it was RESOLVED, to GRANT the Waiver of Merger as applied for. 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 Goehringer (Chairman), Din' ' Tortora, Collins, and Horning. This Resolution was duly adopted ,//Z,,32e�-rard P. Goehringer; Chairman Southold Town Planning g Board p • � SOUTHOLD. L. I., N. Y. 11971 PLANNING BOARD •.4•..,. MEMBERS John Wickham, Chairman .C . Henry Molaa Allred Grebe William Unksibaoh August 20, 1969 ... Frank Coyle -' Mr. Gary F. Olsen, Attorney Main Road Mattituck, L. I. , New York 11952 Dear Sir; At a special meeting of the Planning Board on August 19th your letter Refs property of Robert Hawkins EIS Westphalia Road, Mattituck was read; and map reviewed. Upon a unanimous vote the proposed lot division as shown on the map by Van Tuyl dated July 28, 1969 was approved. Yours truly, gpu� � � � J hn Wickham, Chairman Southold Town Planning Board Town Of Southold P.O Box 1179 Southold, NY 11971 * * * RECEIPT * * * Date: 04/17/02 Receipt#: 652 Transaction(s): Subtotal 1 Septic Permit-Construct- Resid. $10.00 Check#: 652 Total Paid: $10.00 Name: Fox, Dana 305 Private Road Mattituck, NY 11952 Clerk ID: BONNIED Interna ID:52965 765-1802 BUILDING DEPT. 114SPECTION [ ] FOU ATION IST [ ) ROUGH PLBG. [ OUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE A CHIMNEY REMARKS: i - DATEC� INSPECTOR 7-7 / W21 -i?,- M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN TION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: a4l� 9 DATE L 0� INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ �RAMING [ ] FINAL [ FIREPLACE & CHIMNEY REMARKS: Y , y� • u C c DATE �� ! t �� INSPECTOR M-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ROUGH PLBG. [ ] FO DATION 2ND [ ] INSULATION [ FRAMING6- [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: �C tL DATEW/ INSPECTOR 765_1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] RO PLBG. [ ] FOUNDATION 2ND [ NSULATION [ ] FRAMING [ ] FINAL ( ] FIREPLACE & CHIMNEY REMARKS:V. �v DATE L INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: S4 DATE INSPECTOR �--� FIELD INSPECTION REPORT ATF1 I 1 4 COMMENTS � � m a FOUNDATION (1 6' az ------------------------------------ FOUNDATION (2ND) rs` Z UZI _ O . z ROUGH FRAMING& �m PLUMBING rz INSULATION PER N.Y. I-ri STATE ENERGI CODE O FINAL R ADDTITON_AL COMMENTS n oz O O z y X62 �wp � m o _ x c _ z c v A TORN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKii- BUILDING DEP aRTNIEN Do you have or need the following,before applyar_ TOWN IIALL Board of Health SOUTHOLD. NY 11971 3 sets of Building Plans _ TEL: (631) '65-1802 Planning Board approval FAX: (6311 765-9:02 Survey — PERMIT NO. Check _ Septic Form N.Y.S.D.E.C. _ Trustees _ Examin-d , 20 Contact: .-_ppr"� , '0_ Mail to: Disapproved ,, Phone: _ Expiration___, 20_ Ir. _ Building Inspector s — - l I qp� 17 2002 �'� APPLICATION FOR BUILDING PERMIT Date d u INSTRUCTIONS a. Tl i, application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with sets of plans, accur.-tl- plot plan to scale.Fee according to schedule. b. Plot plan ,hog=ung location of lot and of buildings on premises,relationship to adjoining premises or public streets �•r areas. and w atenca%, c. The % ork o,.ered by this application may not be commenced before issuance of Building Permit. d. Upon appr_•.al of this application, the Building Inspector will issue a Building Permit to the applicant. Such a peruut hall be kept on the prcir ises available for inspection throughout the work. c. No haildine shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector i-,sucs a Certiflcate of Occupancy. i. E-.er. building permit shall expire if the work authorized has not commenced 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 th- property ha%e 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. APPLIC.ITION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tovm 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 arees to compl,,with all applicable laws, ordinances,building code,housing code,and regulations, and to admit authorized inspectors ;in premises and in building for necessary inspections. (Signature of applicant or name,if a corporation) ic/ '30 5 42 Of rr 'l o D 14M Tu 6 (Mailing address of applicant) Mate «"heater applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name ufoonneiofpremises _&ARV !-dt"xX (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (N-ame and title of corporate officer) Builders License No. Plumbers License Nu. Electricians Licensc iti`cl. Other Trade'; Licen,c No. 1. ation of hand on ;hich proposed work will be done: C�n37�i�S RD `6 oo!'lArriryCh- House Number 9treet Hamlet Count,. Tax Nlap No. 1000 Section BlockN fi 7 2 pQgof '7 SubdiCislon Filed Map No. ' I)DVA (Name) �i .^y'-r r L%" State existing use and occupancy of premises and intended use and occupancy of proposed constructiop: . a. Existing use and occupancy b. Intended use and occupancy ' K'fimi�- / WC-Z'—, -- —_— Nature of work(check which applicable): New Building W6 Addition -Alteration_ Repair __ Removal Demolition Other Work / i Descriotionl EstirnatedCost C500U Fee ' (To be paid on filing this application) If dwelling, number of dwelling units ___/_Number of dwelling units on each floor If garage, number of cars a if business, commercial or mixed occupancy, specify nature and extent of each type of use. 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 3 33 Dimensions of entire new construction: Front S 7 Rear 5- Depth _ Height Number of Stories Size of lot: Front / a g Rear / 72 8S Depth /O / Q V 11i. Date of Purchase Name of Former Owner i 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO 13. Will lot be re-graded? YES I/ NO Will excess fill be removed from premises? YES_NO 3p$ P+er VprE �� 14. Names of Owner of premises 2#Aa 9x Address Phone No. a9g 53 9 Name of.-architect 14? Q/k Address Phone No Name of ContractorHrlg x Address . 3o c��liimrr Phone No. ,*10r777ZJc0(r_ 1 5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO _✓_ * IF IBS, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUd D. 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. 1,. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey,. ,TATE OF NFIV YORK) S. 'OL'NT1 O - LJi4�lli� �Je being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above natned, S)He is the OWAJe—�� C'2 ( ¢� (Contraetor, Agent. Corporate Officer, etc.) F said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this apphcati.ni; 1 iat all statements contained in this application are true to the best of his knowledge and belief; and that the work vill be i•"rfr�trned in the manner set forth in the application filed therewith. S:com to be ore me thi� [] day of-7-75 _0 — ( 1 L'-CYi !nq - otan,Public ' Signature of licant LyN NOTARY PUBLIC,State of Now Ywlt OuelNo- if ed n Suffolk Coou Term Expires March 8,20� TEST HOLE [)A 7 A PERFORMED BY WDONALD GEUSCIENCE � 15 AJCU S T, 2000 �— EXISTING GRADE SURVEY OF BROP✓N LOAMY SAND SM DESCRIBED PROPERTY SI TUA TE i PALE BROWN FINE .SAND SP MA TTI TUCK, TOWN OF SOUTHOLD RESIDENCE SUFFOLK COUNTY, N. Y. RESIDENCE U/C 7' VACANT SURVEYED FOR DANA FOX FOR S.C.D.H.S. USE ONL Y cCl 0 o CESSPOOL 0 N/F SCHELI!V ul� o CESSPOOL SURVEYED 17 AUGUST, 2001 O C) TO E BLEND `j RO CESSPOOL o� IF FOX SCALE 1"--,30' �SP� RESIDENCE SURF- U Q a O 150 +TO CESSPOOL FD I iP / 010„ E '4��` �0 AREA= 18,731.256 SF f w 12 D c� Q `P / / / 82 150 + TO WELL 0.4300 ACRES Z 0 < 179' 70 WELL N / o --s O w LL ~ / OPOSEJ - / 1 0 w O DRIVEWAY' v, PROPOSED -� ZONED R40 m � /'PROPOS 2 ate.. LA �\a F- U a U77L. s —/ SEP TIC - � O FUTURE EXP. POOL p Z W ` 0 W POLE35' o TANK CESSPO L / 1 --- - V O Q f" - —�- // / / / ONGUARANTEESLY THEI HERE ON THE SUR VE N F HA WKINS Li. tj O , ti W "� PROP ED HOUSE S'�' \ / TEST- RESIDENCE IS PREPARED, AND ON HIS BEHALF TO THE f. LL. Q / MOLE TITLE COMPANY, GOVERNMENTAL AGENCY, Q J W to N O B R OM) / \ cr LENDING INSTITLYRON, IF LISTED HEREON, AND a > ,� O Q W ^ 35' \ ( \� / / Q TO THE ASSIGNEES OF THE LENDING INSTITUTION. W Q I U� / GUARANTEES ARE NOT TRANSFERABLE TO Q N \ W O �� G / ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. o (D a. W = W �' �F' // W CESSPOO M O a lV N �/ �O / // \ UNAUTHORIZED ALTERATION OR ADDITION TO THIS C) = Gj O \ SURVEY IS A VIOLATION OF SECTION 7209 OF VLL (n .� h THE NEW YORK STATE EDUCATION LAW. g A W w Iv' J' �P73 ------------- 10 CESSP9SLo Io \\ - O C, 9 a, �V WELL 1 ij0 �� � COPIES OF THIS SURVL--r.v1t P If&BEARING / THE LAND SURVEYORS £M- SS�J,.SEAL t3HALL 0. `� �� NOT BE CONSIDERED TU-B€9 A VALID TY UE a r � n- / COPY t! D Q w 7 0'+ TO CESSP O? �i ` \ // coo •- T0.CESSPOOL S 39" 42' 00" W , C/)w ��)o++ �� i 179.85 O 1k6)-<I' ro N/F BAK TIDY / W RESIDENCE � SURVEYED Y ~ Ln \ STANLEY ISAKSEN, JR. TM 1000-114-07-5.2 �� J. I cESSPO° P.D. BOX 294 RESIDENCE NEW11SUFFOLK, NY 119 63*EA. .5 GUARANTEED TO DANA FOX CR 48 NORTH ROAD ICD su VEYOR FIDELITY NATIONAL TITLE INS. CO. OF NY NY492 3 01C1048 - ez9 r SURVEY OF GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURbEY DESCRIBED PROPER TY IS PREPARED, AND HIS BEHALF THE TITLE COMPANY, GOVERNMENTAL AGENCY, l wvG. LENDING INSTITUTION, IF LISTED HEREON, AND SITUATE TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO r n n MA TT/TUCK, TOWN OF SOUTHOLD ADDITIONAL INSTITUTIONS OR SUBSEQUENT ORINERs f I;OLD �/ SUFFOLK COUNTY, N. 1. UNAUTHORIZED ALTERATION OR ADD1770N TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAIN COPIES OF THIS SURVEY MAP NOT BEARING SURVEYED FOR DANA FOX THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COP Y. SURVEYED 17 AUGUST, 2001 SCALE 1"=30' CONTOUR LINES IN 1929 NGVD BENCH USED k355 1950, EL=16.40 AREA= 18,731.256 SF OR 0.430 ACRES ZONED R40 Q) N 35 07'30"E 100.0' N 52 N/F SCHELIN 10, NE BLEND ROAD °� 30' R/WSTO FD 8 45' 1� E SURFgcE IP /P O 82. N EL 21.5 OLo 0.7 n PROPOSED — �.�. JLr III. ' PJYOr(�SLD uric. CESSPO L POL r 40.0' 20.6 covuMruaN 1 4, ,,, O TANK _ 6.0 16.7 Q ..4 POURED 2.0' 0 0.7' 5 J {' CONCRETE Qz FOUNDA TION ry . �' Fr�TI�Rc ��c pCC� t� 4 7' W-_j2.0' N 39.0' 4 2.0 Q (J� Lo N Q L4J d' L h Z FD cm S 39 42 00„ W EL 25.4 179.85' 0 n W r; CR 48 NORTH ROAD TM 1000-114-07-5.2 GUARANTEED TO SURVEYED BY DANA FOX STANLEY J. ISAKSEN, JR. FIDELITY NATIONAL TITLE INS. CO. OF NY P.O. BOX 294 NEW, SUFFOLK, NY 11956 v 1 73 5835 O ICEN �' LAND SUR OR NYS L C. NO. 492.7 3. 19 JUNE 2002 L OCA TE POURED CONCRETE FOUNDATION 2. 23 APRIL 2002 SHOW R/W DA TA ON MAP TO MA TTI TUCK CREEK 01 C 1048 1. 09 APRIL 2002 SQUARE OFF HOUSE, ADD CONTOUR LINES IN DATUM, COR EC TEST HOLE DATE. GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE SURVEY OF TITLE COMPANY, GOVERNMENTAL AGENCY, LENDING INSTITUTION, IF LISTED HEREON, AND DESCRIBED PROPER T Y TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO SI TUA TE ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. MA T Tl TUCK, TOWN OF SOU THOL D UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF SUFFOLK COUNTY N. Y. THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYORS EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COP Y SURVEYED FOR DANA FOX FC� SURVEYED 17 AUGUST, 2001 r�rG SCALE I"=30' 003 �,i,,� beam AREA— 18,731.256 SF i nd X13 OR {v` wts 0.430 ACRES �yncnt ZONED R40 CONTOUR LINES IN 1929 NGVD BENCH USED k355 1950, EL=16.40 b N 35'07'30"E 100.0' Al N/F SCHELIN s23j3O"F 0 30'R/W BLEND N 35. 07' 30"s�oNE 100.0' Roq� o � 8' 4,5' J��, S'URFq cE lP MELc IP E c s 82 cvYl � BLUESTONE � ORIYEwAY (y n N b 74.0' U RL. in POLE 40. 20.6' 14.4SEP77C $�O CESSPOOLS(2) O CO6.0 KRED ENTRY cN GARAGE 16.6 2.p' 2—STORY j RESIDENCE 0.7' h1k N Ps C4� O 2. ' 7' LQ 6.0— WOW ' LQ 0 39. 13.4' 2. s.o CPs woDECK 36.7 Wi1MUN ��� a, O KELL M Z FD 12.3' 10.1 CMf�N ME FRASHEO S39. 42' 00" W 3.5' 179.85'.16, O O co W CR 48 NORTH ROAD TM 1000-114-07-5.2 GUARANTEED TO SURVEYED BY DANA FOX FIDELITY NATIONAL TITLE INS. CO. of NY STANLEY J. ISAKSEN, JR. P.O. BOX 294 . I"� � # �' t NEW JUFFOLK, NY 11956 631- 34 83 72 LICENS L ND EYO.R g 4. 15 SEP 2003 FINAL SURVEY. � ���- NYS Ll NO. 4V7,3 o €6 J. 19 JUNE 2002 L OCA TE POURED CONCRETE FOUNDATION 2. 23 APRIL 2002 SHOW R/W DATA ON MAP TO MA TTI TUCK CREEK O 1 C 1048 1. 09 APRIL 2002 SQUARE OFF HOUSE, ADD CONTOUR LINES IN DATUM, CORRECT TEST HOLE DATE. i C0T(IFD)j wd�h dzk4 IJYSF3C, -tbWn c,,�Lg, om ev-Q&;sns 6 / UNDERWRITERS CERTIFICATE OCCUPANCY OR D� "I'" "'ID WITH REQUIRED USE IS UNLAVIVFUL FW_' '! `URVEY JFPR VEDASNOTED WITHOUT CERTIFICATE OF FLI ,"-, ' ,'A TION - - --- DA 2 B.RI =, ' OF OCCUPANCY HAS bLFi: N-1"it,,, LJ. NOTIFY BUILDING DEPARTMENT AT _ IFOLL WI 9 NS TO ! PM FOR THE PROVIDE �/� HR. FIRE — � �OLLOWING INSPECTIONS: 1. FOUNDATION • TWO REQUIRED RATED SEPARATION TO PROVIDE SMOKE-DETECTING FOR POURED CONCRETE PART. 717.3 (f) (1) OF ALARM DEVICE$ $ ROUGH . FRAMING & PLUMBING 7 INSULATION N.Y. STATE BUILDING CODE. AS TO PART. 721.1 T Ig IL FINAL - CONSTRUCTION MUST N.Y.S BUILDING CODE. j� BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ATE-CONSTRUCTIGN-&-ENERGH--------- . II ODES. NOT RESPONSIBLE FOR PLU/I/I ER CF/7 )(�. ,,olv 12 � -- i' - * DESIGN OR CONSTRUCT] N gJ)_ ONLEA o C C17 , ,, `ORE CERT/F/C 7 C� X1, - - - i SOLDE 1NCY J _ SUPPLNISYL ;;T — I EXCEED 2110 u,` r �; LAD. PLUMBING G i _yy� ALL PI UMBING WASH Wg'�, & WATER LINES NEED '`'' T --- --_ --_-� — _ II / TESTING BEFORE COVERIN13 LL -rar cy� SEco�ID �r� L--- - --------- ----------------- ------------ IF copper tubing is used _ rn - ---- - - - - - -- -'- - for water distributing —� system;piping iK o9 shall L only� _ - UNDERWRITERS CERTIFICATE REQUIRED PRO VIDE AAITI-. CALD A { ND/OR THERMALS NnrrK PREVENTING -- - _ -- - -Tor OF H,12FAQ — _ - DEVICES TATE BUILDINGT. OCODE. ) _ 1 �_--___ _ PROVIDE OPENINGS FOR EMERGENCY ESCAPE AS {1 T Q "- 1, N.Y.REQUIRED ATE BUILDING 7NGC0 E. 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