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HomeMy WebLinkAbout27806-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29833 Date: 11/13/03 THIS CERTIFIES that the building ACCESSORY Location of Property: 1775 INDIAN NECK LA PECONIC (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 86 Block 5 Lot 9.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 8, 2001 pursuant to which Building Permit No. 27806-Z dated OCTOBER 18, 2001 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 ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR. The certificate is issued to ROLAND M & KAREN L GRANT (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 1153076 09/02/03 PLUMBERS CERTIFICATION DATED N/A C thq ize 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. 27806 Z Date OCTOBER 18 , 2001 Permission is hereby granted to : ROLAND M & KAREN L GRANT PO BOX 126 PECONIC,NY 11958 for CONSTRUCTION OF AN INGROUND SWIMMING POOL AS APPLIED FOR at premises located at 1775 INDIAN NECK LA PECONIC County Tax Map No. 473889 Section 086 Block 0005 Lot No. 009 . 001 pursuant to application dated AUGUST 8 , 2001 and approved by the Building Inspector. Fee $ 150 . 00 —IUuthorized Signature COPY Rev. 2/19/98 Form No.6 - - - -- - TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL .j 7 2003 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 I%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-$25.00 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00, Commercial$15.00 Date. tc)h(D �03 New Construction: V/ Old or Pre-existing Building: (check one), Location of Property: 1-1 7 GJ 1 No 1 N-) N ECk LR \k C House No. Street Hamlet Owner or Owners of Property: Y O"QCQ &Qf1tyV Suffolk County Tax Map No 1000, Section Block C CC, 15�_ Lot < C'c i C C 1 Subdivision Filed Map. Lot: Permit No. ty I S Qy Z Date ofPermit. I C I26 1 O'3 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approvals Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ S0 6 2 Applicant Signature co ,298 3 OQ.PE: JrJlJ�rJ�rJ�rJ'r:1111::1 :IrJtJtill:tJ�rJrJ�rJrJ�rJrill:rJ�rJcPrJrI :M11:11 PrJrJrJ1:11 : 1rJrJrJrJ 21:0 rJ�rJr11::�P�Pr1�fcP�PrSrJ�rJr�rJ r�rJrJ o 5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 c5 40 FULTON STREET — NEW YORK, NY 10038 55 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 POLLARI ELECTRIC INC. ROLAND GRANT 5 484 SUNRISE HIGHWAY 1725 INDIAN NECK RD 5 �7C7C7Cj W. BABYLON, NY 11704, PECONIC, NY 11958 5 Located at 1775 INDIAN NECK RD PECONIC, NY 11958 Application Number: 1153076 Certificate Number: 1153076 5 c� Section: Block: Lot: Building Permit: BDC: NS11 �5 Described as a Residential occupancy, wherein the premises electrical system consisting of C, 5 electrical devices and wiring, described below, located in/on the premises at: 5 First Floor,pol&cabana,Outside, PooL+Spa, 5 was inspected in accordance with the National Electrical Code and the detail of the installation, as set forth below,was CSU rj found to be in compliance therewith on the 2nd Day of September, 2003. rj 5 Name QTY Rate Rating Circuit Type Miscellaneous pool cover motor 5 5 Appliances and Accessories Water Heater 1 0 45 KW �+ 5 Pool Bonding 1 0 5 5 Time Clock,Switch 1 0 5 5 Panels 5 1 100 11 5 5 Wiring and Devices 5 Receptacle 2 0 General Purpose 5 5 Switch 4 0 General Purpose 5 Fixture 3 0 Incandescent 5 Fixture l 0 Fluorescent 5 Dimmers 2 0 5 5 Paddle Fan l 0 5 Receptacle 2 0 GFCI rrr+++ Fixture 2 0 PooVSpa seal Receptacle 3 0 20 amp Pool/Spa 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. 75 o rJ�rJ�rJ�rJ�tJ�rJ�r�rJ�c,Wl!II�tJ'OE:11�rJ�rJ�rJ�rJ�rJ�rJ�r�rJ�rJ�rJ::: :; :Pr Jt Jr�tJ�rJ�rJZIEllJ IrJ�r�t�r�rJ�rJ@Pr�rJ�r�rJ�rJ ::1 ZrJ� rPrJ� C3rL3rJ�rJL 50 O rJ�rJrJ�rJrJE�PrJ�rJ�rJrJ�rJ�rJrJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ�rJ@PrJ�rJrJ@PrJ�rJ�r frJ�rJll�rJr�rJL3PL PLLPdL3L3pL JLrL3 rJQ�CWrj prrJ'r pLprr prr.frJpr 0 5 5 BY THIS CERTIFICATE OF COMPLIANCE THE 5 5 5 NEW YORK BOARD OF FIRE UNDERWRITERS 5 5 BUREAU OF ELECTRICITY 5 5 40 FULTON STREET — NEW YORK, NY 10038 �5 5 CERTIFIES THAT 5 Upon the application of upon premises owned by 5 5 5 POLLARI ELECTRIC INC. ROLAND GRANT 5 5 484 SUNRISE HIGHWAY 1725 INDIAN NECK RD e5 5 W. BABYLON, NY 11704, PECONIC, NY 11958 Located at 1775 INDIAN NECK RD PECONIC, NY 11958 e5 c7 Application Number: 1153076 Certificate Number: 1153076 �C5 e5 Section: Block: Lot: Building Permit: BDC: NS11 5 Described as a Residential occupancy, wherein the premises electrical system consisting of 5 electrical devices and wiring, described below, located in/on the premises at: �5 First Floor,pol&cabana, Outside, 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 found to be in compliance therewith on the 2nd Day of September,2003. 5 5 Name OTY Rate Rating Circuit Tune 5 5 GFCI Circuit Breaker 3 0 20 amp Pool/Spa 5 5 (Swimming Pool):This certificate covers compliance at the date of inspection only. Because of unusual em tronments it is advisable to have 5 frequent test and'or repairs made by a qualified person. 5L+ 5 5 5 5 5 5 5 5 5 seal 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 5 NI �L�UPRIUMPI New York State Department of Environmental Conservation AmBuildi%g�Rffl, Stngy-Brop�c4Ngv611�prk 11790-2356 Facsimile l(�5161) 444-0373 Imbow /G1l a((n��d' ani Koren rant' _ 977 yJ� a� �d w'h �d4�1 Cd ra.>+ , IVY /I7°t7 Thomas C. Jorling � Commissioner Re: 7 00661-0 G:Y6 l nd;ah �eck L.cne, DearMr +'1`irsl? Y°h( Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The ? rd )) e1 / / gnd WQrt1 ° h �ti /° ��F 2 /e ✓4 / e E.o h Cd n u r S � Q Sh ° W17 on �/, e S4r ✓e4req� h� .�ohy I1M e72�tr Armed Mgrcy iG /4yi 4nd 3ev,-Sea 4L? r, 6 / 54RS— d ✓1d c e J 4 V." S C7�•'c �: J,� 1-&e.C/ I Ce 41 C/g. Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 151 to 201 wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, lv Deputy Regional Permit Administrator cc:j M �� TOWN OF SOUTHOLD PROPERTY RECORD CARD �►J—i� - s- JNER STREET 7 5 VILLAGE DIST. SUB. LOT A4 tf la ,t Nt Karen --7 A ra vil / ✓ops ,RMER OWNER N ACR. pn;ea g Y � a� g I�� S W TYPE OF BUILDING SEAS. VL. 7y7 FARM COMM. CB. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS O0 ROOD �-44S�fl.(L13coa. F . e.,,z ;.; � ��.r,•, d.4T - S 'Zaa /S �iTz. ` P.z / ire a .. � '''axCT14p-/Qys-s si—T ray; qp 14 ✓3Qd 1-111-,?2- 3/L L �, .3A <r6' .w' G ./HnR errs Gran doln, /—/,/,p 7 S- L 11�3 a35'~ �e 6ztrd,&7-5 1,1 - v Grcn-f *"W 130 c c, Sova �r zoo 3 d3 C� 8a3aa - o e_�Q�, ; � AGE BUILDING CONDITION Gc, �a EW NORMAL BELOW ABOVE i ARM Acre Value Per Value Acre aft"6te� I•. �%0 0 73 � Ilable 2 Mable 3 oodland rampland FRONTAGE ON WATER /Sa ushland FRONTAGE ON ROAD cruse Plot DEPTH Z SD BULKHEAD )tal DOCK I COLOR I TRIM � 17 I .. Ju, Foundation Bath 3 Dinette M BI g � y x _ •Z � 9 �8 5n i �' 3 5o rJ 3 Basement Floors K. Eateon X Ext. Walls Interior Finish LR. Extension I Extension Fire Place tCs Heat DR. Type Roof Rooms 1st Floor Porch Recreation Roo Rooms 2nd Floor Porch Dormer - Breezeway Driveway - -- Gar et Zz x LSI = 3 Z 2 Patio O. B. Total New York State Department of Environmental Conservation _ Buildi%J%TRgyX, F oltproc4N&v���prk 11790-2356 Facsimile (516) 4444-0373 "PO/4,Md 0 .7 .1 /wren _ 4q7 01d 7-6W;' Thomas C. Joding N+/ // lot Commissioner Date: /� �r.'I ��, 41q1 Re: l- (1-73b� - 6 / t/ 7/ocdd;-o Gr4 -t ��a�7e. (/ J nd;eti fleck Lone Dear Mr ,+,11rr Gram ' So 1-t 4o/q, N / r 97/ Based on the information you have submitted, the New York State Department of Environmental conservation has determined that: 4nd W'Z ,1 O h Cir �V- F e /e ✓4 yr 4r S/�aW 7 ori �-Ae S4r ✓ e / ? r 4i('d detect MQ ,-ch /G /4ji o , d } ev, sea 14j, i, l be?rdnd t`b � j 4 v. s d. c �; a d� /� rtZ,-c/e � s TLy L,L)f- cy Therefore, in accordance with the current Tidal Wetlands Land Ude Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act . Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly yours, . lJ. I' Deputy Regional Permit Administrator cc:1 M ��Mimeo an recv k psoe. Albert J. Krupaki, President J'"SUFTown Hall James King,Vice-President 0�0 CQ 53095 Route 25 Henry Smith tiZ' D� P.O.Box 1179 Artie Foster o Southold, New York 11971-0959 Go Ken Poliwoda Dy • Telephone(631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 26, 2001 Mr. &Mrs. Roland Grant P.O. Box 126 Peconic,NY 11948 RE: 1775 Indian Neck Lane, Peconic SCTM#86-5-9.1 Dear Mr. &Mrs. Grant: The Southold Town Board of Trustees reviewed the survey dated March 16, 1995 and last revised June 7, 2001 and determined the proposed pool, pool cabana, and the addition to the dwelling, to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code. However, any activity within 100' of the Wetland line would require permits from this office. This determination is not a determination from any other agency. If you have any further questions,please do not hesitate to call. Sincerely, ^ Q• Albert J. Krupski, Jr. President, Board of Trustees AJK:lms 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSU ON [ ] FRAMING [ FINAL [ ] FIREPLAFE A CHIMNEY / RE-MAARKS: 9.a4 Jo -°—r c� 4' A i' DATE /© INSPECTOR �v M-11182 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [FIN [ ] FIREPLACE & CHIMNEY REMARKS: ZL DATE �� �� 03 INSPECTOR FIELD INSPECTION $EPQ DATE ...a. ; _ COMMENTS =<1� -__ ------a==aaassaxaaaaeaaa---=ceavx I_ C FOUNDATION ( IST)[MM G � 6TI_ON OND) p 6 r 6 ROUGH FRAME PLUMBING C ENSULATION PER N. Y. : f_< STATE ENERGY Z CODE e T r f rill44 -t n VIXAL co s - P :AnnITIONAL s �- /� F } m L s�. C W BOAVD 'Of HEALTH . . . . . . FORM NO. 1 --" 43 SETS OF 'PLANS . . . . . . TOWN OF SOU7HOLD ~ SURVEY . . . . . . . . BUILDING DEPARTMENT �' CIIECE •� «s�- SOUTHOVLD, N.Y. 11971 .11971 \ b`-C- 2-DO TEL.: 765-1802 t:OTI FY ; r, CALL Examined . . ci./. . �Q . , , ]9� . . MAIL TO : Approved 10. .. ✓. . . . .,�O ermit No. . . . . . . . . . . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) n PPLICATION FOR BUILDING PERMIT Date . /�4 . . . . .. 19 . INSTRUCTIONS a. This applica I „bompl tely filled in by typewriter or in ink and submitted to the Building Inspector, wit. sets of plans,accurate plot plan to sca Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app cation. 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 issued a Building Permit to the applicant. Such perr 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 whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Re tions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe TN pplicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, or name, if a corporation) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde `` 1 a�lLl - 0073 Name of owner of premisesR�0.^.0 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number c Street Hamlet �J County Tax Map No. 1000 Section . . . : . f� .tP. . . . . . . . . Block . .J�. . . . . . . . . . . . . Lot . . .! : ./• • Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) '_: State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy �� k *AS.\ rti Ck . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . .Ju?. 1M N!" " "1• ... . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition!. . . . . . +_Iter: nr Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . : . . . . . . . . . Other ticrl. . ;:St on' 4. Estimated Cost . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . (to be paid on tilin; ':hi; Ipu :. hon 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with g1terations or additions: Front Rea- . . . . . . . . Depth . . . . . ... . .. . . . . . . .I.- ..eight . . . . . . . . . . . . . . . . I . . . . . Number of Stories _ . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be regraded . . . . . '. .`. . . . A . . . Will excess fill be removed frgq,rr�� premises: Yes 1` 14. Name of Owner of premises TOW ?. . �:rDw?-3.. . Address )1 ?J !4C! . !Phone No. . . .. . . _3 Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . Name of Contractor7.44Pa : .Ur v.wV . . . . . . . Address Phone No.40A:o??3. . . 15. Is this property within 300 feet of a tidal wetland? *Yes. . . . . . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frot property lines. Give street and block number or description according to deed, and show street names and indicate whetht interior or corner lot. STATE OF NEW YO,,RR��KK S.S COUNTY \OF . 5- . . . . .. • .. �lpwj?�- , , Q��Ka�- . . . . . . . . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . ... . . . . CCA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) if 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 mork will be performed in the manner set fort in the application filed therewith. iworn to before me this . . . . . . . .da o . . . . ���. . . \`otary Public. . . . . . . . . . . . . . �. . ounty X . ... . ..! .• .. .. I . . . . . . . . . JOHN C SWEDNOR4 ` MAUSam ofNOW%* (Signature of applicsr ) ft=460.3N&6"County AAM E'rgrinsMarch 8D.f S_ BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: ey ,(oC�%01 .DATE SUBMITTED, - ' /01 C-1 APPLICANT NAME (&Lew SCTM# DISTRICT: 1.000 SECTION: BLOCK: LOT: ?, l STREET: cet. tA- CITY�NIc SUBDIV.'NAME: t� PROJECT DESCRIPTION: . S ARCHITECT/ENGINEEFE��.� FAST TRACK? SINGLE& SEPARATE CERTIFICATION-REQUIRED? kp, NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83) ZONING DISTRICT: CONFORMING? REQ.LOT SIZEo 0 o ACT. LOT SIZE: Cog'g REQ. LOT COV. �' �' ACT. LOT COV. REQ.FRONT PROP. FRONT REQ SIDE CT. SIDE REQ.REAR PROP. REAR WATER FRONT? yS DESCRIPTION: C �- PANEL #: FLOOD ZONE: , /s P ,e na-rL AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS REQUIRED: SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED#): DTE:—/—/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEc 9i1/7s YES O _1 e hV,,2 oF'N.J. SOUTHOLD TOWN TRUSTEES: YES or C.�- rr�, 6 N J _ TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES o TOWN HISTORICAL PRE (SPLIA): YES o NYS ENERGY: YES OR NO EGRESS (18 H min.?4 sq total) VENT(SQ.FT. x 4%) LIGHT(SQ.FT. x 8%) . BUILDING PERMITS OPEN/EXPIRED: B -Z/C/0 Z N HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND FLR : SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE ,OT _ o o _ -sr X _ ! nLl H 11 - rENEIZAi NOTES* F'`'"` 1) The dssign is based on a draiwgc Boll w ith<10%slit. Gr°uncAvaterohall not exist within the limits of the excavation. �uLe r ' '••��,d�r',�.:� i •• :� �4"` IuuT Ifcarms-dwater isfound tomdet within 6•belowgrade,special j° �r Ewtin.L t T� 111-f fALJ Wan,, . tic day cu.•r•'E l� ; \ ; . aterig facilities will be required Water disposal s limited to %T f n r \ the owner"property. F (2) No surcharge re allowed within 4'-O"of the shallow end and 6 A'-O" � from the deep end. 1 .• .• (3) The pneumatically applied concrete(gunite)shall be a minimum:5.5 !ort paQD ern A ,+A.pLc mix with a mmcirnurm of 3 1/2 gallons of KN 4 svLTi u,.. A" "M1°""'O w S: •"'cTM NYg7 -TA lC water per lOO lbs of cement. c'' ,nes •.i' o� -: .Iwr sw 21 YAI�IC HKp ' CC (4) P.eilforcig steel shall be intermediate grade Millet steel with a ¢l,% G;ZAr ci _ f I -_'� S•• _ minimum lap of 30 bar d diameters. I 3ED 20 .. Tu (5) Pool water supply is to be by fill spout or autoatic water (7 xP j 6' i1 s nAu_o p. controller,Pool is to be kept full duri q freezingm V WAIL L ��-'�. ' ...• (6) Pump capac ty is to be sufficient to empty the pool in 24 hours. S C C T (7) Outdoor pools should be protected by a fence,wall or building in V ` accordance with the N.Y.5.fence enclosure code. n FALL ';N- T C AiRCAP A Irrtallatiom is to be done in accordance with all Federal,State and �S`` ``' �^111Pe �_ _ j o LTA•. _ �I PQf cAS- ;,oe•4� nA LINf L Local Building Codes as well as NSPI suggested standards. _ r i.E " / �J 3ST[� �ADDEL ••:".MER ,T [LTia I •Df L.k'r 114 AT PUFP IIAI At LI4r uYDtA�AT[ L (DI TIOUK) TR'.O Sa•M-cot l.Y•1T 8 l 1 SwAtiL .rTO ,..: L NAIL ` � I m,w OLwn.r �.MAr4 OthW c I l %>, Zo — l2 SECTIO_N _—-5_ SCHEMATIC PIPING ARRANGEMENT fEwar��F„•. [ GUNITE SWIMMING POOL DETAILS FOR: �� ` Nor ' S•�� '\,�1 �j T.te�♦ Ai�4ro 0.ccD IMPERIAL GUNITE CORP 1� vf••„ 74 0, AI . �olanrdr gran/ 3 2 WOOd[AWN AVENU wD ” I ° ` Z °` 1775 gnffian xec oa 'A.. -�+ V f AT r i' o c �"x econic x y. dei �o OAkdA[E, NY. 11769 '<< w 1+�+ / Fn,ow r,Cfn c.•mrA 11.rr -)CDHS. Rel. # RIO-95-0068 6 ,�, el15.S el a c , �� S- 9ei°59 fes'` e/13 � ` ro, gioxe t1 2/'1 ax �.P.. \ IG t)T IE 110 IE-1Z V ✓- - �,� 3� �O J 59' 10,'5 I cE , \ , _ r g'r io.1 6 i NNN CROSSECTION O,` ad SEPTIC SYS NE 0C NO SCALE� 1N n U 9 �� !9 PRP vjsi w\ 3.5 % N wello o.' PIP.v1P° Z w 9. E q w \ . f � A'00• � nt00 2 0 ' I .o `-" �-1 i9 SeV� P WETLANDS FLAG BY ROBERT E. �RRMAN N 6 r Pr f bq{I W�. �r�yst� T I EN - CONSIR T4NTS, Ar- 1 ON MAY 7, 1999 . � lO A . STK FOR OOQI 4 5 e - 045i J 0 p 21.2 j' r z 4 / aG6 Z m o ✓/ 5� SURVEY FOR CERTFIED TO, ROLAND & KAREN GRANT ROLAND KAREN GRANTT Se j N SOUTH BAY AB w. A T PECONIC PAULING BANK STRACT /NL: e� 0 69•Z4'00Test Boringa1fost TOWN OF SOUTHOLD P.M. 2 P.AL SUFFOLK COUNTY, N. Y. 0 95 20 6 o SAAOYTOPSOI< o SAA i 1000 - 86 - 05 - 9.1 2 ' { 2. � Scale: 1" = 60r r LOA LOAMY 6.5 2' Mar. 16, 1995 �Z COARSEa SAND APRIL 4, 1995 (revisions m WITH April 6,/995 (revisions) I0, SA A X SAAp May 1, 1995 (revisions) HEAVY MA Y 4, 1995 (revisions) OT N0.£ ARE REFERENCED TO ' AMOR SUBDIVISION FOR 6RAVM GR. WATER JAN. /F, 1.")9F . Fth hse 8 bans 3ECONM BAY GARDENS, 01K."FILED /N THE OFFICE OF 11.5 THE SOUTHOLD rowN aERIt wrarE Mor. ll, 1996 lloundotlon location! 1EVAT/ONS ARE REFERENCED TO N.G.V Datum. I2' SAND STH April 3, 1996 ( Additions) 16.5 PALE _ GR. WATER GRAVEL Dec. 20,1996 (final) .REA = 2.6069 Acres to tie lines f ORANGE MAY 14, 1999 ( s7KFOR DOCK) BOE NSW y0y SAND Jdne 23 1999&ev4',0n) � ?t•METrQe �' am familiar with the STANDARDS FOR APPROVAL J n• ? 2ool(pro/ a`+ tyo^a `' �o� AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions set forth therein and on the ANY ALTERATION OR ADDITION TO ThYB SURVEY /S A VIOLATION L� permit to construct. OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW to b N.Y.S. LIC. NO. 496/8 EXCEPT AS PER SECTION 7209-SUSOP45M 2. ALL CERTFlCATIONS A9 AOMAVALID F�RT � RE� ESAPORCOPIESRTHE �wREs9EAL THEREOF THE�VYOR q MORS, P.C. WHOSE MU rue£ APPEARS AEREOM (516T 020 The locations of wells and cesspools ADDITIONALLY To COAFLY WITH SAD LAW THE TERM 'ALTERED BY' P. 0. BOX 909 0 TRAVELER STREET MUST BE USED BY ANY AAV ALL SURVEYORS UTILIZING A COPY shown hereon are from field observations IO SIARVEYOR's ..ijP, TERMS SUCH As mrSPECTED• AND SOUTHOLD, N.Y. 11971 . .. ^ # Twc 1 -w -DHS. Ret. # R10-95-00GF' # RIO-01-0/59r,^ j, elrs.s Vel g ?� 9eii f, y"`! o B • R. RIO - OI - 0159 m,^ P` �, \ S/ OO SANITARY SYSTEMS- 2m"' L.P . o �Fi`�3' " Y L� .e 6133. 5" DOOL HSE. 0000 gal. SEPTIC TANKII I _ °p a "� vin. 4 deep 8'0 leaching pool/ — — — ,—water ei rf �N 0 �Mr , l- N al. SEPTIC TANK $ min. p Y 1 '. = NT ARN (1000 gal. CROSSECTION 1 z 2' deep 8'0 teaching pool) SEPTIC SYSTEM NO SCALE' xe' �Ls r 0 1; m PRSI�5 js o PAVERS 135lT " m P 00 L ot h. t - N- 2 P° v. C y ZG4.1 �OO/ a �Maad�1°n `1I b3 �_ WETLANDS FLAG BY ROBERT E. HERRMAN 5_ --�� 6130 v/ 'la `� - ,y w` a0• • •i' O / £N - CONSUL TANTS, INC. I ON MAY 7, x999 N• 0� , _ t d _ r - - 'a P R V - A '�+-� _- SM Fp4 DOIX —'or• i b«e Zm z*� N SURVEY FOR P X39 CERTIFIED TO, T ROLAND & KAREN GRANT ROLAND KAREN GRANT 4 vi• AT PECONIC SOUTH BAY AB:' . TRACT IN... P o QA OO' Test Boring al test Boiing ": TOWN OF SOUTHOLD WASHINGTON MUTUAL BANK, F.A. O S 69� 3/19/95 412/915 Zo3 a 4 P.M. a 2 SUFFOLK COUNTY, N. Y. SANDY SANDY 1000 - 86 - 05 - 9.1 TOPSOIL [-TOPSOIL \1 2 I LOAMY LOAMY Scale: 1"' = 601 6.5 SAND 2. - SAID Mar. 16, 1995 � COARSE SAND APRIL 4, 1995 (revisions ) SAAV It zm GRAVEL GRAVEL April 6,1995 (revisions) May 1, 1995 (revisions) SAAV HEAVY` MA Y 4, '995 (revisions) T NOS. ARE REFERENCED TO ' MINOR SUBDIVISION FOR GRAVEL GR. WATER ,IAhl rr;, 1,4,9F `(ce A horn .ONIC BAY GARDENS, INC.-FILED IN THE OFFICE OF 11.5 /1.5�=-_ _ F SOUTHOLD TOWN CLERK. WHIT£ MOr. ll, 1996 (foundation location) SAAND VATIONS ARE REFERENCED TO NO v Datum. 12' ND SWITH April 3, 1996 ( Additions) 16.5 PALE GRAVEL -- -- -- GR. WATER ' Dec. 20,1996 (tinol) 'EA = 2.6069 Acres to tie lines I ORANGE I MAY 14, 1999 1.six FOR Doan I ,/ SAND �P���f PlFyiv�O dqe 23 /939(reris,o^1 am familiar with the STANDARDS FOR APPROVAL JUNE 7, 2001 I prop. addlt/onsl MEr7a July 24, 2001 (addlNons) 4>7. Bq AND CONSTRUCTION OF SUBSURFACE SEWAGE ?. w, Nov. 4, 2002 / Final I DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the conditions set forth therein and On the ANY ALTERATION OR ADDITION TO TMS SURVEY 6S A VIOLATION J1 "._'I�'ilg permit to construct. OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW �r .• ^`•- •Y• lC. NO. 49618 EXCEPT AS PER SECTION 7209-SUBD/VAS/ON 2. ALL CERTIFICATIONS HEREON ARE VALID FOR TNS MAP AAE] COPES rAWWOF OAEY F PECONI C. SAV MAP OR COPIES BEAR THE AIPRESSED SEAL OF THE SURVEYOR 163/J 765 5�A 63/1 765 - 1797 SOD ZONE ifJE S FIRM 36lG3CUl62 WHOSE SIGNATURE APPEARS HEREON 7 ACTUAL FIELD INORMATIOfJ The locations Of Wells and cesspools ADDITIONALLY TO COAPLY WITH SAID LAW THE TERM 'ALTERED BY' P. O. BOX p MUST BE USED BY ANY AND ALL SUIPVEYORS UTILIZING A COPY 1230 TRAVELER STREET shown hereon are from field observations OF ANOTHER SURVEYOR'S "4P. TEM"•^ SUCH AS_7INSPECTED' AND SOUTHOLD, N.Y. 11971