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32210-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31686 Date: 07/18/06 THIS CERTIFIES that the building NEW DWELLING Location of Property: OCEANIC AVE FISHERS ISLAND (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 9 Block 4 Lot 23 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 14, 2006 pursuant to which Building Permit No. 32210-Z dated JULY 14, 2006 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 SINGLE FAMILY DWELLING WITH 2 OPEN PORCHES AS APPLIED FOR. The certificate is issued to THOMAS SHILLO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-95-0112 07/06/06 ELECTRICAL CERTIFICATE NO. N-586288 02/13/02 PLUMBERS CERTIFICATION DATED 11/02/04 GLENN GELLO A tho ized 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. 32210 Z Date JULY 14 , 2006 Permission is hereby granted to: THOMAS SHILLO PO BOX 161 FISHERS ISLAND,NY 06390 for CONSTRUCT ONE FAMILY DWELLING WITH 2 OPEN PORCHES AS APPLIED FOR. THIS PERMIT REPLACES BP 24788 . at premises located at OCEANIC AVE FISHERS ISLAND County Tax Map No. 473889 Section 009 Block 0004 Lot No. 023 pursuant to application dated JULY 14, 2006 and approved by the Building Inspector to expire on JANUARY 14 , 2008 . Fee $ 1, 742 . 40 r orize igna ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL :— 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY jw ' A. This application must be filled in by typewriter OR ink and submiYted'�''�ulding inspector with the following: 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 12 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 a 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 Buildine - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 / Date �13�,10�. New Construction. . . . .,,,77. . . . . Old Or Pre-existing Building. . . . . . . . . . . . . . . . . Location of Property.Ro'.&f. IkI. . . . . . . .. . . .clGGcn/G. ./,Y,KG•.. . . . . . . . hs3/ {S, . �f .l�:/.•. `�� House No. ��/'' S//treet Hamlet Onwer or Owners of Property. . . . . , . . . , , . . _ • _ • . • • • . . . _ County Tax Map No 1000, Section. . .IPO . . . . . .Block. . .1. . . . . . . . . . . .Lot. . . . . . . . . . . . . . . . . . Subdivision. . . . . .lV`11. . . . . . . . . . . . . . . . . . . .Filed Map. . . . . . . . . . . .Lot. . . . . . . . . . . . . . Permit No. Date Of Permit. . Applicant. . .�,44 !?r �? IS ;`.""�°`] Health Dept. Approval. . . . ; , , , , , , , ,Underwriters Approval. "q . . . . . . . . . . . . Planning Board Approval. . . .N�`Q• • • • , • • • • ,, , , , . . Request for: Temporary` Certificate. . . . . . . . . . . Final Certicate. ,�. . . . . Fee Submitted: $.. . .44`ck „Gncl�P ( . . .16593 - - - -- - icnNT . . . . . . . . . . . . . . . . co X3168(0 THE NEW YORK BOARD OF FIRE UNDERWRITERS ],:�Gitin56 BUREAU OF ELECTRICITY :;0A1 ;+ 1 A 40 FULTON STREET, NEW YORK, NY 10038 e� 1 Date FEBRUARY 13,2002 Application No. on file 13093996!" THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number is in the premises of 'I-{ORAS J. SHILLO, El END, ��FF-LISHERS Lj��SiLAND. NY in the following location; El Basement LA,I lst FL 414 2nd Fl. ATTIC/OUT Section Block Lot was examined on FEBRUARY 08,2002 and found to be in compliance with the National Electrical Code. FIXTURE RECEPTACLES SWITCHES FIXTURES I RANGES I COOKING DECKS I OVENS I DISH WASHERS EXHAUST FANS OUTLETS I INCANDESCE FLUORESCENT OTHER AMT. K.W. AMT. K.W. I AMT. I K.W. AMT. K.W. AMT. N.P. 85 1.78 69 85 1 2 1 4. 5 2. J, -,' 2 - DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS I SPECIAL RIC-Pr. TIME CLOCKS I BELL UNIT HEATERS I MULTI-OUTLET DIMMERS SYSTEMS AMT. K.W. OIL N.P. GAS H.P. AMT. W.G. AMT. AMP. AMT. AMPS. TRANS. AMT. N.P. NO.Of FEET AMT. WATTS 3 F 2 — SERVICE DISCONNECT NO.OF S E R V I C E METER NO.OF CC CONR. A.W G A.W.G. A.W.G. AMT. AMP. TVPF EQUIP. 1 R RW 1 0 SW S 0 SW S 0<W PFR 0 Of CC.GOND. NO,OF HI-MG OF HI:MG NO.OF NEWRAIF OF NEUTRAL 1 200 CB 1 X 1 2/0 1. 2/0 OTHER APPARATUS: PADDLE FAN-4 BOOSTER PUMP (PUMP) 1-HP-1 PANELBOARDS: 1-20 CTR. 100 G.F.C.I:-12 SMOKE DETECTOR:-3 LL Z & S CONTRS. INC. LSC.#924-E GENERAL MANAGER P.O. BOX 202 FISHERS ISLAND; NY, 06390 Per This certificate must not be altered In any manner;return to the office o1 the Board If Incorrect. Inspector$may be Id tilled by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. TEL. 765-1802 S�FFa�c op OGy TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX'728 TOWN HALL SOUTHOLD, N.Y:. 11971 1jut C E R T I F I C A T I O N ' Date // a d y Building Permit No, c)3 0 qY- z Owner 309S- Owner (please print) Plumber 6 enq Ga//O (please print) h I certify that the solder used in the water supply system contains less than 2/10 of 18 .lead. Ce7J►� �y 0� $U��K . (plumber's signature) Sworn to before me this n( day of IfOVrr�l(� Z .' No , ry Public Notary -Public, SUFfj)LK County MARVBPANKIV.a Notary Public State of New York NO 52-8267950 . 07/17/2006 09:52 FAX 631 788 7798 FIT£::M ONZ R002 ).S FIEIZ T,NSPECTYON RFPJRT DATE COM!ffit rs _ � \a FOUNDATION ( IST) ii u j a I FOUNDATION (2ND? IL n )r p �OD6a FRAME & PLDMSINC \V �II INSULATION PER N. Y. MTE ENERGY ? n R II 7 CODE ;! 0 tl ^ u ii O" n tl FINAL .� . ADDITIONAL COLKENLS: i>.l.t:�.V..i 3ZZ6 fP w `iii,. ✓ /C�� p �I 2 JUL 1 7 2rj' ' G 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. 24788 Z Date MARCH 19 , 1998 Permission is hereby granted to: THOMAS SHILLO PO BOX 161 FISHERS ISLAND,NY 06390 for CONSTRUCT A ONE FAMILY DWELLING WITH 2 OPEN PORCHES AS APPLIED FOR at premises located at OCEANIC AVE FISHERS ISLAND County Tax Map No. 473889 Section 009 Block 0004 Lot No. 023 pursuant to application dated MARCH 19 1998 and approved by the Building Inspector. 0 / Fee $ 1, 436 . 60 3 ,00 rpInspector 7 �O / �✓ 1 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) Date19s, (... Na 23095 Z ��� Permission Is hereb r oto r. �� g i� T.A f?fr.....�. 4' ..Z ........................................... •• ^"y�••••• .. e..................................................................... .................................................................................................................................................................. .................................................................................................................................................................. ....................................................................... ............................... at premises located ....................... ..............................................I-7 ! R ...... .... �a'>Lr ............................................ County Tax Map No. 1000 Section .........7 ........... Block.......... ......�. .. Lot No. .... .............. pursuant to application dated ..... .................................. 19...767..... and approved by the Building Inspector. Fee .t ..... .. ... .. ................ nspector Rev. 6/30/80 James Volney Righter 2719% a r c h i t e c t s n c SHILLO HOUSE • FISHERS ISLAND NY • SPECIFICATIONS 25 OCTOBER 1995 The work covered by the specifications and corresponding drawings shall consist of building a new house for Mr. Thomas J. Shillo at Fishers Island NY. 1 - CONCRETE AND MASONRY 1) Foundation walls to be reinforced poured concrete as shown on drawings . 2) Chimney to be concrete block, faced on the outside above the roof with brick, with three clay-lined flues . Living room & dining room fireplace surrounds and hearths to be bluestone . 3) Do not lay masonry or pour concrete when the temperature of the outside air is below 400 F. Protect work from cold and frost, and insure mortar or concrete will not freeze while hardening. No anti-freeze ingredient shall be used. Masonry work must not be done in full sun at temperatures above 80 degrees Fahrenheit unless shading and water misting are provided to control evaporation. 4) Newly laid masonry work shall be protected from rain until hardened. 5) Discard and do not use mortar which is unused after 1 1/2 hours following the initial mixing. 9) Unless otherwise indicated on the drawings, make the masonry plumb, level, and true to line, with square angles and corners . 10) Use only bricks and blocks that are clean and free from dust and other foreign materials . 11) All masonry to be flashed adequately with lead flashing to prevent penetration by moisture. 2 - CARPENTRY 1) Framing lumber to be kiln-dried. Exterior walls to be 2 x 6 . Interior partitions to be 2 x 6 or 2 x 4 as noted. Pieces with knots affecting structural integrity should not be used. 2) All framing in contact with masonry or in moist areas shall be pressure-treated. 58 Winter Street • Boston Massachusetts • 02108 - telephone - 617 • 451 • 5740 3) Use metal hurricane clips on all roof rafters: Simpson H 2 . 5 . 4) All adhesives used shall be water resistant construction grade. 3 - WINDOWS Marvin wood windows : 1 ) 5/4x4 exterior casings . 2) Double-hung windows to have sash lifts (2 per window) and locks. 3) Install aluminum triple-track storm/screens, (Not by Marvin) white baked-enamel finish, on outside of Marvin double hung windows . Muntin # Type/Size Layout R. O . size (w x h) Qty . Remarks 1) WDH 3230 6/6 31 - 23/8" x 5 - - 99/16" 9 Single-glazed, ADL primed 2) CDH 2422 1/1 21 - 63/8" x 41 - 47/e^ 3 Insulating glass 3) CDH 2828 1/1, 21 - 103/8" x 51 - 47/8" 19 Insulating glass 4) WCM 2836 4-light 21 - 5" x 31 - 09/16" 3 Single-glazed, ADL primed 5) CDH 2816 1/1 21 - 103/8" x 31 - 47/e" 3 Insulating glass 6) CDH 2822 1/1 21 - 103/8" x 41 - 47/8. 7 Insluating glass 7) CDH 3636 1/1 31 - 63/e" x 61 - 87/8.. 1 Insulating glass 8) WCM 2432 4-light 21 - 1" x 21 - 89/16" 4 Single-glazed, ADL primed 9) WCM 2436 4-light 21 - l" x 31 - 09/16" 2 Single-glazed, ADL primed 4 - DOORS Exterior doors : # Mfr . Type Size Remarks 1) Morgan M-100 3 ' -0" x 6 ' -8" Include screen/storm doors 2) M-3984 3 ' -0" x 6' -8" Include screen/storm door Interior doors : Morgan M-1051 pine 6-panel doors . 5 - HARDWARE Schlage Plymouth knobs, brushed chorme finish, except where noted. Brushed chrome hinges, latches, and strikes. 6 - THERMAL AND MOISTURE PROTECTION 1) Shingles for main roofs : GAF Timberline "Weathered Wood" shingles or Bird Architect 90 (30 year) "Weathered Wood" asphalt shingles, 5" to weather. 2) Flash and caulk interior and exterior joints as required to leave the building weather tight, including all exterior joints at windows and heads and jambs of exterior doors . 3) Step-flash all joints between sloping roofs and side walls . 4) All flashing shall be lead-coated copper. 5) Fiberglas insulation: all exterior walls to have 5 1/2" foil-faced Fiberglas batt insulation; roof : 9" batts; first and second floors : 5 1/2" batts. 7 - PLUMBING 1) All water supply piping to be copper. 2) Use cast iron drain pipes from second floor bathrooms . 3) All fixtures and appliances to have shut-offs . 4) Test and prove tight : soil, waste, and vent plumbing with water as required by code. Domestic water lines shall be proven tight at 125 psi . 5) Metal water piping should be electrically grounded. 6) Provide and install 80 gal . oil-fired hot water heater . 7) Provide insulated recirculating hot water loop for domestic hot water. 8) Provide two hose spigots . S - ELECTRICAL 1) Provide 200 amp electrical service underground to house and circuit breaker panel in basement . 2) Provide telephone service underground to house. 3) Include smoke detectors to code. 9 - HVAC 1) Provide and install oil-fired warm-air heating system. 10 - EXTERIOR FINISHES 1) Exterior porch floors to be 5/4 x 4 fir decking, blind- nailed. Apply one coat of Cuprinol . 2) All exterior trim to be cedar or redwood. 3) Use stainless steel nails for all exterior work, including shingles where nails are exposed. 4) Paint trim (corner boards, eave and rake trim, soffits, porch posts) with one coat primer and two coats oil-base paint . Prime back, sides, and ends of all wood trim. 5) Stain wall shingles with two coats Cabot ' s bleaching oil . 6) All primers and paints used for the project shall be manufactured by one of the following manufacturers as approved by the Architect : Pittsburgh Paints, Benjamin Moore, Sherwin Williams, Pratt 6 Lambert, or Cabot ' s . 7) Sealants shall be paintable. All window and door frames shall be caulked after prime coat is dry . Apply caulk in smooth bead to completely fill joints . 8) Furnish and lay suitable drop cloths for exterior painting to protect roof and decks from paint drips . Lay plywood over all finish decking to protect it . 9) Protect all finish hardware at doors, lighting fixtures, or other finished items from paint spatter by removing them, carefully painting around them or using masking tape and tarps to protect them. 10) Sand all surfaces before priming and between coats of paint to assure smooth even finish. All surfaces to receive paint shall be smooth and free of sandpaper scratches, millmarks, and other imperfections . 11) Painting materials shall be applied in strict accordance with manufacturer' s recommendations, including all temperature and weather limitations . Do not apply paint when temperature is below 50 degrees Fahrenheit, or when temperature is expected to drop below 50 degrees Fahrenheit within twelve hours. Do not apply paint on surfaces in direct sun or where dust is being generated. Do not apply exterior paint within 48 hours of rainy weather. 11 - INTERIOR FINISHES 1) Flooring throughout house: oak strip flooring, except where noted. Apply one coat stain and three coats of polyurethane, satin finish. 2) Use building paper between subfloor and finish oak flooring. 3) Use 1/2" gypsum board on walls and ceilings . Provide double layer of gyp. board on staggered stud walls Use wonder board behind wall tile . 4) All edges and corners shall be left square, all surfaces in true plane, smooth, flush, plumb, straight, level, and ready for painting. 5) Joints shall not occur within 12" of door or window frames openings . In no case shall joints on opposite side of partitions be allowed over the same stud or post, unless specifically indicated. 6) Window and door casings to be Brosco 8753A. Aprons under window sills to be Brosco 8753 . Baseboards to be Brosco 8385B . 7) Counterset all finish nails throughout interior and putty holes . 8) Paint walls one prime coat and two finish coats flat latex paint . 9) Paint wood trim one prime coat and two finish coats semi- gloss oil paint . Sofro k County Department of Health Services Oma of Wastewater Manatement Suffolk County Center Rlverhead.New York 11901 (916){53-2100 CERTIFICATION F CARBON MONOXIDE ALARM INSTALLATION FOR A ONE FAN ILY DWELLING BY A LICENSED ELECTRICIAN Health Dtpartntont Rettre ee Number; IV S D112— Tax Map Number;District Section Blo&(s) Lot(s) House Location/Addrsaa: I HEREBY CERTIFY THAT: 1. Carbon Monoxide Alarm 1 bavc been installed on each 1cve1 of the dwelling in which Sleeping quarters are locate(,AND 2. All carbon monoxide almushave been installed in accordance with Articic 10 of the Suffolk County Sanitary Cc Ic and the Carbon Monoxide Alarm Standards,AND 3. All Carbon Monoxide are UL2034 listed(Latest Edifion),AND a. They have a DigitsJ R,cadout,AND b. They have a reset AND a They have a button to indicate the maximum concentration recorded since the last resa. Ar/ M(Signature of Flecltieian) I (Date) 12 a1e«11— y7ZS--ME (Print Name) (License Number) 1 HEREBY CEIRTIF V THAT THIS DWELLING IS EXEMPT FROM THE REQUIREMENT TO I NSTALL CARBON MONOXIDE ALARMS BEC 'SES 1. There are no Nei banning appliances installed,AND 2. The garage is not attache to the dwelling,AND 3, The dwelling uses an el 'c beating System (Signature of Electrician) (Daft) (Print Name) (License Number) THE O AL SIGN)~D COPY OF THIS FORM MUST BE SUBMITTED TO THE FOLK COIJWTY EYARTMENT OF HEALTH SERVICES IN ORDER TO RECEIVE FINAL APPROVAL W WM-075 01/08/2005 10:08 FAX Bal 788 7798 FITELEPHONE 2003 FISHERS ISLAND WATER WORKS CORPORATION FISHERS ISLAND NEW YORK 06390 AREA CODE 631/788-7251 116/05 To: Suffolk County Health Deparnnent This letter is certification of potable water being supplied to the Fishers Island residence of Thomas Slnllo(SC Tax map# 1000-9-4-23). Service consists of a I and%4"copper line from our main distribution system. Sincerely yours, Robert E. Wall President ,`• BOARD OF HEALIH . . . . . . . . . FORM NO. 1 J SETS OF PL.INS . . . . . . . . . TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . 2 7 1995 BUILDING DEPARTMENT CAECA . . . . . . . . . . . . . . . . . . . SEPTIC FORM . . . . . . . . . . . . . o HOLO, N.Y. 11971 TEL.: 765-1802 t:OTI FY ; Examined .��,/. . . . . . . . . ., 19 g� CALLHAILTO : . . . . . . . . . . . . . . . Approved . `/ . . . . . . . . ., 19 Permit No.-? 309 ' . . . . . . . . . . . . . . . . . . . - - . . . . . . . . . . . Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Buz g Inspector) APPLICATION FOR BUILDING PERMIT Date . . . ��'?... . . . . . .. 19/,;�7 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stieets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy 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 the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant, ame, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . .�4,I?@!Z. . . . . . . --��. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . . . ./f2Z?r? . . . ✓, . �hi��o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . ��o?ya?. . . . S . . . . . . . Plumber's License No. . . SSy-/�. . . . . . . . . . . . . Electrician's License No. Other Trade's License No. , a38•- q� . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. House Number Street Hamlet County Tax Map No. 1000 Section . . . :Q.Q�. . . . . . . . . . Block . . . . . . . . . . . . . . . . Lot . . °?3. . . . . . . . . . . . . S Subdivision . . . . . . . ... . . . . . . . . (N.a. . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . me) 2: State existing use and occupancy of premises/and intended use and occupancy of proposed construction: Von a. Existing use and occupancy . . . ..fly??l`. . / . . . . . . . . . . . . . ... . . . . . . . b. Intended use and occupancy . . . . .V{n QMH �QuL�Y . . . . . . . 3. Nature of work (check which applicable): New Building . . .v , . . • . Addition . . . . . . . . . . Alteration Repair . . . . . . . Removal . . . . . . ' ' ' ' ' ' ' . . . . . . . . Demolition . . . . : . . . . . . . . . Otht=c lYoilc . . . . . . . . . . . . . . . 4. Estimated Cost a . . �i� !0 a• (Description) . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) - If garage,number of cars 5. If dwelling,number of dwelling units . . . . . . . . . . . . . ... Number of dwelling units on each floor. . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of* . . . type of use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear each t . Height . . . . . . . . . . . . . . . Number of Stories . . . : . . . • • • • • • • Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front • • � • � � � . . . ' ' ' ' ' ' ' ' . . . . . . . . . . Height . . . . . . . . . i :. . . . . . . . : . . Number of Stories Rear . . . . . . . . . . . . . . . Depth . . . .. ... . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . .Height Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . . . Number of Stories _ . . . . . . . . . . . . . . . . . . . . . . . • , " " " 9. Size of lot: FrontRear • • • • . • • • • .. . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . : . . . . . . . . Depth . . . . . . . . 10. Date of Purchase • . • • • • • • • • . . . . " ' - • • • • • • • • • • • • • • • • • • • • . . . . . Name ofFormer 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 - • • • • • . . . . . . . . Will excess fill be removed from premises: Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . : . . . . . . . Name of Architect Phone No. . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . .. . . . . . . . Phone No. . . . . . . . . . ..:. . . . Name of Contractor . . . . . . . . . . . . . . . . Address Phon No. . . . . . . . . 15. Is this property within 300 feet of a tidal wetland? * . . . . . . � '" " " " " " " ' • Yes. . . . . *If yes, Southold Town Trustees Permit may. be required. . . . . . No . . . .. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. s STATE OF NEW YORK, COUNTY OF . . . . . . . . . . . . . . . . . S./S / ' ' ' . ' ' . ' • • • • • . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent,corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the fork will be performed in the manner th in the application filed therewith. vorn to before rr►@ 0s r �-- . . . . . . . . . . . . . . . . . . . . . . . . ., 19 . . E ry Publi !'. . . . . . . . . . . . . . . . . . . . . . County fN®NNlf F. tAtof No Jit. � . .-�.. . .. N016ry Public Stan of New York • ' No.+606660 (Signature of applicant) 011040In Suffolk Couyty. Tam Explros i2ai/Ym KNOCKOUT INLET AN➢ 5 ' OUTLET OPENINGS RIBS INSID&� ' + ru e y � J F CAST CONCRETE COVER r: PLAN LOCKING CASTING TO GRADE •J 'd, FINISHED GRADE 7 \ H M 4x4E 12.6/12.6 GA. WIRE MESH ix 2' 6 x 6 6/6 GA. WIRE MESH f,� µ�pLOTHIPI-I .a a r4, ✓�. '� OJE. z li INCE a' WENr v OUTLET LIQUID LEV y. CaNTINUOUS HDT ' AFFLE 1 ^ ASPHALT SEAL LINED WITH 'n 4' SCHEDULE H I/V PVC INLET BAFFLE 0- GAS V 1 DEFLECTD 4' CROSS SECTION \ 1000 GALLON 2 COMPARTMENT SEPTIC TANK NOT TO SCALE 1.00ATI ON MAP A L t V TJ � LESEND� 24' FIRST FLOOR 4' DIA. KNOCKOUTS ELEV. ELEVATION X 63.0 EXI9TIN6 SPOT &RADE /i vv >�o �✓ I`{/y/, // i /�� `� , o o a o a „ - - -70 — — EXISTIN6 CONTOURS 4'-{ I- B'-0' DIA — '10 PROPOSED CONTOURS TEST HOLE CESSPOOL 100.0 INVERT ELEVATION CROSS SECTION NUT TO p 5, Cl- 0 v �+-�..�� NOTESs �e, �X I. COORDINATE D15TANCE5 ARE MEASURED FROM U.S. COAST FILTER AND 6EODET4G SURVEY TRIANGULATION STATION "PROS co FABRIC 6z- - - 2-. 517E-151N'THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK, /o�s'¢s"E 4 ANGLE 10' UP SLOPE TAX MAP 1000, SECTION 009, BLOCK 4, LOT 23. FOUIVO I as. �, e,,,�a / es' ' POST FOR STABILITY AND c \ I I AI y l / // Oq 0/11 l 4y'�'i`�3E / - 1 �0 SELF CLEANING 3. SITE 15 TO BE SERVICED BY MUNICIPAL WATER AND ON d�' / / B/96C�. I s� ` I eo6E , ti SITE 5EWA6E D15PO5AL 5Y5TEM IN COMPLIANCE WITH THE 0 -- REOUIREMENTS OF THE SUFFOLK COUNTY HEALTH DEPT. J.' COMPACTED w' I , tam[aEea / I 1 BACKFILL 4. SITE 15 LOCATED IN ZONE DISTRICT R-40 _ II � II � I 4d \ 4 5. TOTAL AREA: 0.60 +/- ACRES. SILT FENCE b. OWNER: THOMAS 5HILLO NOT TO SCALE BOX 202 / I O Ao/ a \ •w / / "°"`Ea a� FISHERS ISLAND, NY 06390 � a ,' ,r� � W w I / 0 0 Cl `m\ / s \ W �� I �Q 3d 1. BASE FOR LEVELS N6VD I 1 I4/I g?e3, I // \X\/. / / h \� 1 w B. "PERCENT OF LOT COVE'K�C�E — 13% TEST HOLE DATA e-,9 �C� AL��-3735"W u m4,4� Iii W EACH BALE STAKES I / w. i�iL 4� � W EACH BALE JUNE 23,1995 BY RICHARD H. STROU5E, P.E. O" _ 18" SANDY FILL 1866" SANDY 5 OIL 28" 5UB501L O 3u Rs \\8 N I v��1 ro 66" - 165" SAND 204" SANDY TILL X92 I NOT TO SCA E OF NEW �1-7 F �� FI.S 9 0 T T4s ao � SITE PLAN u/F :, m PREPARED FOR JoNv 2. ILII gEu4 � DLII C7�soEuu „ yu,clPeiWa se� H (],,J SITE SE PTIG 54S7�IJ-- ` IS OD THOMAS 5H1 LLO 20 10 0 20 OCEANIC AVENUE 4 MIDLOTHIAN AVENUE GRAPHIC SCALE IN FEET FISHERS ISLAND, NEW YORK REVISIONS CFigNDLER, PALMER �. IGZNG am familiar with the standards for approval and DATE DESCRIPTION construction of subsurface sewage disposal systems 04AS/96 FOUNDATION LOCATION Architecture, Engineering and Surveying Por single famlly residence and will oblde by the uD INDOWAY Mama, CT X63611 e113-410s-3397 FM ffi s l= conditions set forth therein and on the permit to construct. APPLICANT DATE: JUNE 27, 1995 SCALE: V = 20' SHEET 1 OF 1 T 3']70 KNOCKOUT INLET AND DUTLET OPENINGS G .� RIHS INSI➢E� F :J P + _ 3 CAST • CONCRETE COVER I ELM p� ��� ,I "i LOCKING CASTING TO GRADE �l FINISHED GRADE q 4HI xM 4E lE�6/�d.6 GA. WINE MESH i 6 K 6 6/6 GA VIRE MESH 4" WL 3' VEN Y• NUTLET LIRU D LEV - fp C➢RTINWUS NOT n ASPHALT SEAL �LY�Lry W1�H - LE I SCHEDULE W V 1NLEY � BAFFLE � YCr O�auw v CROSS SEGSION . \ - 1000 GALLON NTLT LOCoXIIIII'10N HAI s uz Irl 6 � H 4' nm. KNGCELEV. ELixVxk PION, X 63.0 EX157R"I"16 al ORAvM r 'Nx 4'— 8'_0• DIA �"IRl9RG6Em-"*TOURSi , sTHOLE -j �L 100.a, IN r €L yATpN v J �� n -n / / / .vee c./o �U/� . pA . ' ) (;RQ,�$ SECTION. VT r,/ 'fp / C s� �. NUT TO SCALE 000KPINAV RIl ARS f*ASVll 11i w T FILTER A .-.f w I � �oo `b m•"' �6z'si l ' FABRIC NI,?6EADl"'I^1G ;34HlVBY,'f�F'IAN9W.h'RIflFi 3n'F.AFlyl�i � ti ITT ANGLE 10' UP SLOPE AF I ➢' / ce�'�� �' a• e„ POST TAX.MARs I'dOtl ' ?kyN dp+t+ K 4 "`LOT 2 \ 1 I Adj�' •l / >2. \"-'4 a / P _ r FUR STABILITY HND I SELF CLEANING 8. 51' t$ Tb EIE 5ER`u"IGEi3 ttG1lNld.'Ilg1AI.,WrtTSR AFA4 dhlIT'III >•A.VE_uu,4.eu1- 100 51TE QISf'OS/AI. 'i,,'el I3s t=a / sR 1 COMPACTED w „ I / BACKFILL `'B a 4. 51T.ti 15 LOGA"FED IN ZcpftE,OIfiTKIG'1•.Rn40 Pj S. TOTAL AREA, 0.60 +f- AGRE T. o LTDFNS b. OJNERTHOMAS SNILLO O51 :zi72 r FI$FIEIftS'15LAND, NYOd940- J 9LEVELS NSVD . BASE FOR � S 1 Se-je, ` / \ / \ $ n e. Patzc�AaZ oT nor covER:a cue —„ 13� ora Fq - " E�4 �p K ieo.s7' / ueuuu6).rr . 6z i � - E+B 6o@ .U -1T3T35"W / / w. Iq .d9 OJ �f h EAICH,BALE3' STAKES �j " ..uY'�ltit JUNI! d BY RtIGHAfY,GHt�;l'.!"CgRpUfiEr P.E. �' 'I NilSAN[9Y'FIL..� F (.U>.JrAtP2ouEa� n�we 26'1 (ab fiA>IigY 5U�$Q'fL 34; uty .e3o "e Fill - . ` O I 66 ` =z �� 166. - 204" SAai, lr'TIµ. }�[j �T TO SC LALA "E t, I i i 4F m x N A I I L I � 2 �3 oNu G E I Z 7S' 7 tJ _. - — �I � .�ESr'p6L1GC�, .1-111L.1rGIPdC_ L.aJLTHe:A J��CI �1� /�� Qom/ - r•I oL,r.. Ou Srr2' Savnc 54Sr�w.�- J f 4�af m nTHOMAS ? _: 0 i cn i eD IR o ED 0rffA?IG A I! It MI TM A± V 8NU , AN , SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES /� 1.A t V'13N i �i GRAPHICS LE IN FEET rYI.�HFrR,�+. ISLAND, N�V'1 "rft`�RFC 0�p390 FOR APPROVAL OF CONSTRUCTION OF . SINGLE FAMILY RESIDENCE ONLY REVISIONS DATE HS REF. NO. D ` S [I t3a tauN1�l.Eii F+R,t naEtgt; r. APPROVE " I am familiar with the standards for approval and DATE DESCRIPTION 'I construction of subsurface sewage disposal systems noo ArchrEgctUnly E+,iq and SueveyY��gg ',,�;: Por single family rosldeand ii abide by the RY'fpGYpyav MpMgL r>r'." !rtaYD-N11�a1i>rn lyYt� Yu1AwL.7Yiq' ".r EXPIRES THREE YEARS FROM DATE OF PROVAL aondltlons set forth therein and on the permit to ' � I construct. PLIGANT DATE. JUNE"27, 1995' SHEET 1 OF ' 1 _ �4 �yq I 4 NUE W w R O WEST c 1 O HARROR O U °° bu Vl W ST iRE 'i 100 ll' i Fly e ANk AVery N I/ C _ � U OJ rJ11" ,,r U .r 00 0 H y, > C� Q IRON PIPE >H� �Ij'� •�� = pp (FOUND) N/F c syl y RAYMOND A. LAMB +� & AMY A. LAMB F N �I U N/F LOCATION MAP SCALE 1 "=400' RICHARD G. ARMEN % & LILLIE M. ARMEN OF N,Iw y tiryhj CHIMNEY / �O �I. Shu PPO H.gT9g•p�',1 C36 1 1- E� Q MAPLE 1 SO \ 10 N/F NOTES UNffS O JOHN A. CRAVES 1.) THIS SURVEY WAS PREPARED FOR THE PARTIES AND PURPOSE S . / \ j/�° '� : �` '¢ "• � ' �'}� � , MON. INDICATED HEREON. ANY EXTENSION OF THE USE BEYOND THE / •' *>« _ �;; ��:'•< PURPOSED AGREED TO BETWEEN THE CLIENT AND THE SURVEYOR EXCEEDS THE SCOPE OF THE ENGAGEMENT. art \ I , s •ko '+ qDa*� � NDA', IYfNj N� .' ��:_�, / - \ PORCH / 2.) IT IS A VIOLATION OF THE STATE EDUCATION LAW FOR ANY L,.I PERSON, UNLESS ACTING UNDER THE DIRECTION OF A LICENSED LAND SURVEYOR, TO ALTER AN ITEM IN ANY WAY. w As2 , /� > Q IRON PIPE . , Y e U,.=' m \ \ I \ 7p57s• O 3.) ONLY COPIES OF THIS SURVEY MARKED WITH THE LAND Q Y so' / SURVEYOR'S SIGNATURE AND AN ORIGINAL EMBOSSED OR INK SEAL _ j a ARE THE PRODUCT OF THE LAND SURVEYOR. J m Z 19.7' W - - MON. / 4.) COORDINATE DISTANCES ARE MEASURED FROM U.S. COAST AND tL N o z .6GR4v - - (FOUND) GEODETIC SURVEY TRIANGULATION STATION "PROS" o Q of Z U o �� fl DRIWWAY / 5.) SITE IS IN THE TOWN OF SOUTHOLD, COUNTY OF SUFFOLK TAX a < --- -------- -- -- / MAP 1000, SECTION 009, BLOCK 4, LOT 23. D Q U O hLLI O D 0 ZU) .I fi.) TOTAL AREA = 0.60f ACRES. O > N J \ SET \ ~` `. `V cz STAKE SEPC T NK 7.) SITE IS LOCATED IN R-40 ZONE. Q -'-'- ._V a , i •'-".'��!T.:C,�..n^.Y5 � LL --- o / \ LEACHING -\ 137 II MONUMENT h ° / D'... h I 7.57•a y 'N I POOLS I N7 7, \\4- N 1941.96 JUL ( �U -� 91Y� �\ W 1774.49 MAPLE 1 / � FpM1I f STAKE _�`` �(�� GRAVEL i \�) C) / \\\llZ11— U\ �C %�.�OR1 VtlYAY / �\\ PLANTED N F AREA .— — JOHN R. KIMBERLY `.� — ---`= -- j o o POLE _ #92 N W InE0 cr a / Cl.t_ J / j/6 fq N WE �O/ O / 2 % 3 Q, I / Q / O M � Iry 3 m N I I Id / O ~ Z 7 W z w Z W C') O V1 q I1 C- O W R 1 3 a m o 0 DATE: 02/21/2003 QUALITY CONTROL CERTIFICATION SCALE: 1 " = 20' GROUP REVIEWED DATE PROJECT MANAGER 2,0 --SURVEY Q� I FrcrJn ENVIRONMENTAL SHEET CIVIL N/F NOW OR FORMERLY zo to a zo sRAL woomw SF SQUARE FEET GRAPHIC SCALE IN FEET 1 OF 1 ARCHUECTcuRECTURAL FILE J4688 gill , L ,T k i „ PLU , w � AU ftUA MEEo . 2+ ID o S c T L� IMO , - FLUsH FkAMED PLUMBER . - T CERTlFICATlOM ON LEAD CONTENTBEFORE. ? I A ' I W' ' ERT/ _ . C FICATE.Of OCCUPANCY w �° I P U -- x SOLDERUS D N, ATR � l W E j SUPPLY SYSTEM CANNOT EXCEED 2/70 OF 1%LEAD k , I T O C SIO I . , L_— I 4 sTEE� '<.OL (TYI� I UoWertubin in 0 used for �II weNr . I 2 to JOI',�Ts C� I(:o,C. 'j � I • ,. , disVibuting (� ,, I Mtem;Piping shell 6e PLUSH - FK.4MED l OftYPesKOiGonly - r _ L I � I b Go - l I 5 > I t r dolbTS �" IG° o.c. o FLUSH ' FM- C) yy -- f, x n - '•F..I 5fi I _e i 14 O Y ITS p •, V I I { 1 I 4 -1 n I : E I Y Q 1 , LII � I I 1 I- e a e I„ Ul L _ + "E� ti+f ��� r t M.� w°v✓'c�`w CYOR ,: P I s „ I— , , ,�� CCU Al' 0 i III � I I AWFUL. • � L, E S 1J N �� . USE 4 TIFI A E I yG 7 C R � . I I < ' WITHOUT U I I t Y I NC OF OCCUPANCY h„ ' ` ,,,'.•- L ''''- ' .p vJ 'm4' au',�i� y�kSG.k�I Hk�';"F: �+ J` _!S-Rk, ,' T ' _ " +, p -f - - _ ,. o i �� q ( I "J:` �} •! "�" q d,r d•1 x - .tr fi,-'.3:'. _T .,'s ! UNDERWRITE Als � � � + � RS CERTIFICATE :' .; O'IOH.LR000 NMOl - - tI I REQUIRW� - � I � , �9661�L Z x.90 �f � kRPR VED AS Nf1FED ( ' µ3.' fv 'DATE: / t? yr . e 8.R d _ 7 1 _ , FEE RV:'�" Y! NOTIFY BUIL ! G, DET+A T ;i °T !1 , lilll O � - e 4 RM TO n RM FOS THE PROVIDE OPEMIRGS FOR FOLLOWING INSPECTIONS. EMERGENCY MAP(As 1,'FOUNDATION . TWO REnuIRED , - + .' FOR POURED CONCRETE e . • '� ° AEQOIRED BY P11RT 714 GF a, " OUGH - FRAMING.&IPLUMEING • 2`! — U° ZO - O° 2 �k —.Q` NY STATEOILDIND G INSULATION �' ' r RECOMPLETE FORCOy .�k,'J$+ 'FINAL - CONS9RUCTION „ ALC. CONSTRUCTION'S skkAU, MEt=I` r:j� _ THE 'REQUIREMENTS OFTHE,, Ni' . - -y �'� a� ' STATE CONSTRUCTIQN t.! ENERGY / COKES.. NOT HE$R ONt IBLE FQR DESIGN OH CONSTRUCTICfMI� dliS I _ •y-.NSE b y i , i ?'172b D,O NOT,PROCEED WftW s : t _ - F 4 1. � a I nI st��' ,,p�" +FRAMIN . ,. G'UNTLS .. _ � • nw EY rvY x 9pb�� '.e xa k OF FOUNDATION' OC" AS BEEN APPROVE , . r ) s 51 _.. . .NE x } I 1 N r .. r j ,. - 4 r I r - - lil '4f {' ;^ u -t Y .t. y 7,�n" . 7 w ;.a t a'�.' .. I 11-11 rr - _ .�.+ I yah +"uI J �, >r, .wr qc l w .; r ,y r , • "i 'mr1. 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