HomeMy WebLinkAbout32476-Z
FORM NO.4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32346
Date: 05/10/07
THIS CERTIFIES that the building ADDITIONS/ALTERATIONS
Location of Property: 1600 JOCKEY
(HOUSE NO.)
County Tax Map No. 473889 Section 70
CREEK DR
(STREET)
Block 5
SOUTHOLD
(HAMLET)
Lot 18
SUbdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 6, 2006 pursuant to which
Building Permit No. 32476-Z
dated
NOVEMBER 6, 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to MAMIE A CHIANG
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-03-0075
10/09/03
ELECTRICAL CERTIFICATE NO.
2063367
04/10/07
PLUMBERS CERTIFICATION DATED
08/01/06 RESCOMM
~ize:!!:!!4-
Rev. 1/81
.
.
d- '1~ 11~1
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifYing that the solder used in system contains less than 2/10 of1% 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. 1..1
6. Submit Planning Board Approval of completed site plan requirements. Jr 1m;' 0 2r
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
I. 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.~~;~, }.OO(
( check one)
New Construction: ~
Old or Pre-existing Building:
Location of Property:
l !;-;;(.:;O
House No.
:Yx' '(.F'j
.~ [\~ 11,>:)(..,
()7()
(i_RF;F';){~ ,':DR IIJF;
Street
,"';0, )TH <>1 ::\)
Hamlet
Owner or Owners of Property: ~ A-\--\ \f"
Suffolk County Tax Map No 1 000, Section
Block
O(YJ5
Lot () I 1<
Permit No. iv 1;7;;
Health Dept. Approval:
Planning Board Approval:
Request for:
Date of Permit.
Filed Map.
III ~/(;y, Applicant:_~.hH-IIr-:;
Underwriters Approval:-lO'::'
Lot:
Subdivision
(.). f1--I-I/lt1..Y...,
?,:?,~ 7.
Fee Submitted: $
Temporary Certificate
-2-00
,"/-
Final Certificate: r
(check one)
0--Q ,l"},. . ,_,\-t-. ~ C' A\..J , 'rA."
Applicant Signature "-.)
fJ-.J.Z .1 )505
Co'tJd3lf&
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.
32476 Z
Date NOVEMBER
6, 2006
permission is hereby granted to:
MAMIE A CHIANG
PO BOX 1789
SOUTHOLD,NY 11971
for :
ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP 30712.
at premises located at
1600 JOCKEY CREEK DR
SOUTHOLD
County Tax Map No. 473889 Section 070
Block 0005
Lot No. 018
pursuant to application dated NOVEMBER
6, 2006 and approved by the
Building Inspector to expire on MAY
6, 2008.
..-..'-....,
.......--- oriz
Fee $
150.00
./
ORIGINAL
Rev. 5/8/02
..@]
~ BY THIS CERTIFICATE OF COMPLIANCE THE ~
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ G & S ELECTRICAL CONTR. GORDON LAU ~
~ P.O. BOX 215 1600 JOCKEY CREEK DRIVE ~
~ SOUTHOLD, NY 11971, SOUTHOLD, NY 11971 I
~ Located at 1600 JOCKEY CREEK DRIVE SOUTH OLD, NY 11971 ~
~ ~
~ Application Number: 2063367 Certificate Number: 2063367 ~
I Section: Block: Lot: Building Permit: BDC: ns11 I
~ Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, renovation, Attached Garage, Outside, ~
I ~e~~~~~1 ~:~ec~~onnd~~t~~e j~em~~~~r~~enC~~ica~i~~stet~~ li~i~~~r:~ee~~~tri~:1 ~~:iC~sp;I~~a~~in~o~e th~n~~;~nt s~=~~i~~~ I
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 10th Day of April, 2007, ~
ml Name OTY Rate Ratine Circuit ~ mJ
~ Alarm and Emergency Equipment ~
~ Sensor 2 0 Carbon Monoxide ~
~~~~~ ~
@! Exhaust Fan 3 0 f,H,P. @!
~ Dish Washer 2 0 1.2 KW ~
~ Oven ; 0 4.3 Kw ~
~WiringandD"iCeS ~
~ Outlet 106 0 Fixture ~
ml Fixture 106 0 Incandescent ml
~ Outlet 131 0 General Purpose ~
~ Receptacle 72 0 General Purpose ~
~ Switch 83 0 General Purpose ~
~ Receptacle 10 0 GfCI @!
~ Receptacle I 0 20a Laundry ~
~ ~
I seal I
~ ~
~ 1 of 1 ~
I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I
@]~.@]
; /;e; i",i
'''II
/u
- :5 ...
";r
Ii,;
l!I~~l!I
I BY THIS CERTIFICATE OF COMPLIANCE THE I
~ NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ G & S ELECTRICAL CONTR GORDON LAU ~
~ P.O. BOX 215 1600 JOCKEY CREEK DRIVE ~
I SOUTHOLD, NY 11971, SOUTHOLD, NY 11971 I
~ Located at 1600 JOCKEY CREEK DRIVE SOUTH OLD, NY 11971 ~
I Application Number: 2063367 Certificate Number: 2063367 I
~ Section: Block: Lot: Building Permit: " ; BDC: n511 ~
~ /~ I y,. ~
~ Described as a Residential 3000-4000 square ft. occupancy, wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, renovation, Attached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority haVing Jurisdiction, and found to be in compliance therewith on the tOth Day of April, 2007. ~
~ Name OTY Rate Rating Circuit I.Yl2l< ~
~ Alarm and Emergency Equipment ~
~ Sensor 2 0 Carbon Monoxide ~
~ Appliances and Accessories ~
f.!I Exhaust Fan 3 0 F.H.P. f.!I
~ Dish Washer 2 0 1.2 KW ~
~ Oven 1 0 4.3 KW ~
~ Wiring and Devices ~
f.!I Outlet 106 0 Fixture f.!I
~ Fixture 106 0 Incandescent ~
~ Outlet 131 0 General Purpose ~
~ Receptacle 72 0 General Purpose ~
~~ ~O ~~ ~
~ Receptacle 10 0 GFCI ~
~ Receptacle 1 0 20a Laundry ~
~ ~
~ seal ~
~ ~
~ I ~ I ~
~ ~
I This certificate may not be altered In any way and is validated only by the presence of a raised seal at the location indicated, I
l!I.l!I
AUG 01 '06 02: 15PM SOUTHOLD BUILDING 631 765 9502
P.l
T'lWn Hall, 53095 Main Road
P.O. Bo" 1179
S()\\\nolu, Now York 1197 J -0959
Fox (631) 765-9502
Telephone (63 J) 765-1802
BUIt,DlNG DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATION
Date:_~ ~L-O~
Building PCffiljt No. _ --'?O 7 12___.
Owner: G-O~;W19_k\'\_\l \_(\::\&NtJ:: c..t-\ 18DG!AGI.)\tc.SZ-kA 'DW7--~l:5Wsl';A
(Ple.He j,rinl) L i\-Gt::: L"')
Plumber _~_~ ~:~'::::......__ _____~izf.:, II" (> .
(Please print)
lead.
I c.ertify that th~ solder used in the water supply system contains less than 2/1 0 of 1%
Swam to before me this
/4-
--. ~~ers Siglla,l'ure)
_.
day oHdnu C{ i-(., 20 9.7,
~.1Yl C'-LJJC1c~f(!.~1
Notary Public, . [;)~ I ~County
DEBORAH DAi~Sf'.ER f<OSSI
Notary PC.l':)!iC, Stt!k u{ New York
No 01 D/l..50.3GC62
Qualified in ScHoH\ County II
My Commission Expires Jan, 13 20.=.
ARCH
-
ITECNOLOGIES
ARCHITECrIJRlI PLANNING CONS11!.tJCnON SBRVICBS
134O.lMoiDRood._ Newy.... 11952
631.298.1129 fox: 631.298.1128
FEe 6 2.,
February 5, 2007
Southold Town Building Dept.
Southold, NY. 11971
Re: B.P. # 32476 Z Previous B.P. # 30712 Z (original existing basement plan)
Mamie A Chiang
1600 Jockey Creek Drive
Southold, N.Y.
To Whom It May Concern:
The request has been made by Mr. George Gillen to add the finished basement
storage area to the existing building permit. (final inspection walk-thru 12/11/07) The
existing basement area was not a part of the construction process of the
alterations/additions to an existing single family dwelling applied for and permitted under
building permit # 30712 Z.
Enclosed please find the following for your review and record:
1. 4 copies of the existing basement plan indicating new construction areas.
2. Existing finished basement storage area.
3. New railing location as per final inspection dated 12/11/07.
Please call our office if you have any questions at 631-298-1129.
Ce.: Gordon Lau
ARCH
ITECNOLOGIES
ARCHITECI1JRIl PLANNING CONS1RUCl'ION SERVICES
1340SMoinRood.__ NowYodt 11952
631.298.1129 fax: 631.298.1128
September 1 , 2005
Town of Southold
Building Department
Southold, N.Y. 11952
(r): 1 i;'2 1 n.? Ie r~
.' r . I 1\
0, i ---..,;...; n
'i I,' ,
, ,
, ~J
J 2005
it
Re: Inspection dated August 31, 2005
Mr. & Mrs. Gordon Lau & Mamie A. Chiang
1600 Jockey Creek Drive
Southold, N.Y.
Bldg. Permit # 30712 Z
LL ..
" ""
,.
--...-
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,
,
J
'0 '. '.:~D
To Whom It May Concern:
Mr. Frank Notaro (Architect) inspected and certifies the following:
1. A strapping inspection of the new construction was made on July 22,
2005 prior to exterior sheathing and siding application. All strapping was
applied as per specifications on the construction documents prepared by
Architecnologies. All strapping meets or exceed the requirements of New
York State Building Code.
2. A framing inspection was made on August 29 ,2005. All framing has been
done as per specifications on the framing plans prepared by
Architecnologies. The following has been inspected and noted:
a. Double Ivl beams were used under all parallel partitions as specified.
b. Proper post support has been installed under all point loads of new beams
within the 1S'. and 2nd floor decks.
c. A continuous microllam Ivl rim joist was used around the perimeter of the
new 2nd floor deck construction as specified.
d. All new floor joists have been cross braced as per specifications and code
requirements. Joist hangers have been installed at all flush beam
locations as specified and required.
e. All nailing meets or exceeds the specified nailing schedule noted on
construction documents prepared by Architecnologies.
f. Headers have been installed above all windows and doors.
.
g. All roof rafters have been installed properly and braced to the ridge beam
and the double top plate of the exterior walls. Rafters have been notched
at these locations so that sufficient bearing load has been maintained.
All framing meets or exceeds the requirements of the Residential Building
Code of N.Y.S.
3. All framing plans have been updated per field changes and submitted to
the building department and are a part of this submittal.
if you have any questions please contact our office at (631) 298-1129.
Thank you for your time and consideration,
ARCH
-
ITECNOLOGIES
ARCID11!CTIlllI! PLANNING aJNSTRUCTION SBRVlCBS
1340SMaiD-'_ NcwYad< 11952
631.298.1129 ,.., 631.298.1128
April 6. 2007
Southold Town Building Dept.
Southold, N.Y. 11971
Re: B.P. # 32476 Z Previous B.P. # 30712 Z
Mamie A Chiang
1600 Jockey Creek Drive
Southold, N.Y.
Attn: George Giller,
Mr. Frank Notaro has inspected and certifies the compliance of insulation
installation done by Delfino Insulation, the following was noted upon inspection:
1. New R-21 insulation has been installed within new construction area of the
2nd floor addition.
2. New R-38 insulation has been installed within 2nd floor ceiling area.
3. Fire caulking has been applied per New York State code.
Please call our office if you have any questions at 631-298-1129.
:...-c>
Ce.: Gordon Lau
^
~}
..
/0....
;"{' -
ARCH
-
ITECNOLOGIES
ARCHm!CTUllII PLANNINO OONS'l1UJCI'ION SERVICES
13405 MIiIl-' -. New Yod: 11952
1131.2!lll.1129 fD: 1131.298.1128
October 4,2004
Southold Town
Building Department
Southold, N.Y.
Re: Mrs. Mamie A. Chiang
1600 Jockey Creek Drive, P.O. Box 1789
Southold, N.Y. 11971
To Whom It May Concern:
Per requirements by New York State Residential Construction Code we certify that
the design criteria is done per prescriptive design. All of the load calculations and
structural plans comply with all of New York Construction Code based on (AF&PA) for
One-Family Dwelling to the best of our knowledge.
If you have any additional questions please feel free to call our office at 631-298-1129.
Cc:Lau
3i-if 7 b z.
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST
[ ] FOUNDATION 2ND
[ ] FRAMING I STRAPPING
[ ] FIREPLACE & CHIMNEY
[ ] FIRE RESISTANT CONSTRUCTION
REMARKS:
[ ] ROUGH PLBG.
[ ] INSULATION
M.FINAL ~i
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRATION
F~z ~/ .~Ok,.
ch~~/~<-,;;/-- .~~~~
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C:::ltJ~lc-vC/ /?~ C2~r.
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Jf,..-S-~01 INSPECTOR~' ~
DATE
3 'J--if-76 ?-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING pQ'FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
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DATE I;}.. - / I .- 0 t, INSPECTOR ~ ~
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t2e-/l 3~L\llo
307/J- Z-
TOWN OF SOUTHOlD BUilDING DEPT.
765.1802 ~ ~
INSPECTION ~(
[ ] FOUNDATION 1 ST p\! ROUGH PlBG.
[ ] FOUNDATION 2ND [] INSULATION
[ ] FRAMING I STRAPPING [ ] FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: fI/~~ ~~
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DATE f- ?I--~~ INSPECTOR ~ ~
.
FIELD INSPECTION REPORT
DATE
COMMENTS
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FOUNDATION (1ST)
.
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FOUNDATION (2ND)
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ROUGH FRAMING &
PLUMBING
INSULATION PER N. Y.
STATE ENERGY CODE
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ADDITIONAL COMMENTS v ~
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TOWN OF SOUTHOLD PROPERTY RECORD CARD
)A-i-2. "
VILLAGE
DIST,I
SUB,
LOT
I
FORMER OW ER
Louu;e a el
I? /J iN. Lit I)!? M It NN
EO?V, S rE'/, 1,/ eu e/I}. c "e
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ACR.
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TYPE OF BUILDING
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{;!'1_j..,~':_,,-I:: '
a,. tp~""'{J~
COMM. CB. MICS.
Mkt. Value
FARM
IMP.
TOTAL
DATE
REMARKS
:(l; cD 0
.
7,700
co
/ 0.000
/
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J'/~/C;;rp
cA-::;:y-2:
s;qLli: ::>'7/.3
-J !!;"'~'II $.~ L 1'1)., E }:.::: _',.
/7 7',~ ~.-",."" 70 cN#/1/3rL L~ 7?',?,;" -{-"/.<3.
(/3 -L 1/(..0 8" f).74- <~hY}Ot.b.<> L.izl Ch lan;j i L.a. f4 $ 3i5",Dt);
AGE
BUILDING CONDITION
NEW
NORMAL
BELOW
ABOVE
FARM , Acre i Value Per Value
,
I Acre
r ,
T: liable i FRONTAGE ON WATER , t? .47. ro ;::.
---- / S'7J -< S-SO
,
Woodland , FRONTAGE ON ROAD /,)'1> .
,
I
Meadowl.and I DEPTH
[ ..?&o '
House Plot i BULKHEAD
I
Total "-'"' '-" ! I I --' -
i DOCK
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--------~ -..- -_.._,,---~-~"'-._------- ----------- r I jo /<-. I . I i
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M. Bldg. <<9 x;'/f" : /f?..n;' I I I i I
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Extem;;jon , , , , I
t .~ 1:( c:! /9f?) 350.; , ?.J7 I I i
,2..-" , , '" i ,
Extension , I I
,
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, ,
Extension
Foundation "" .6'. Bath ... . . Dinette
.~ L_
Porch " X;)..-;j . Basement I;:::: U/ Floors -rf/...e.J...:J !K.
/,3 ::; "'0 G p. ~
Porch he Xii 12$' f'A iExt. Walls 4" Interior Finish 1~'kILR I
:: cJ. '" ~I.',d~ V"i .<..t(:.;L .
, ,
Breezeway - I Fire Place /.4;' .) Heat d~ DR.
. ..
/ . (7 / .
Garage .? .j-X ;? ? 7-'-,,"""-<-/( '%' ilS'" f"l"r' Type Roof f, Rooms 1st Floor BR.
c; 'I :J-- -~.- //(vi,
. , .
Patio I Recreation Room Rooms 2nd Floor FIN. B
O. B. Ipormer ,
Driveway i
Total , , 7CJ 9 L.. I
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FROM :C MESIRNO INC.
FAX NO. :631-878-8951
Ma~. 132002 08: 19RM PI
New York State Department of Environmental Conservation
Building 40 - SUNY, Stony Brook, New York 11790-2366
Telephonelii16) 444-0365
Facsimile (518) 444-0360
~
W
EriI1l\L Crotty
COIDDliJlilJner
LETTER OF NONJURlSDICTION -TIDAL WETLANDS
Date: May 3, 2002
Mamie A. Chiang
1600 Jockey Creek Drive
Southold, New York 11971
RE: 1-4738-03018/00001
Cbiaug Property
1600 Joa.ey Creek Drive, Soutbold
SCTM No.J9.!>0~Jo-?-18 _..___,_.
Dear Ms. Chiang:
Based on the infonnation you have submitted, the New York State Department of Environmental
Conserva'ion has determined that the property hmdward of the lOft. el<:vation contour, as shown on
the survey prepared by Anthony W. Lewandowski 01l8/21/00, is beyond Article 25 jurisdiction.
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 oTthe tidal wetlands
jurisdictional boundary, as indicated above, without a permit. It is your responsibility to ensure that
all nccessary precautions are taken to prevent any sedimentation or other alteration or disturbance to
the gr<.mnd surface or vegetation within Tidal Wetlands jurisdiction whieh may result from your
project. Such precautions may include maintaining adequate work area between the tidal wetland
jurisdictional b01ll1dary and your project (i.e. a IS' to 20' wide construction area) or erecting a
temporary fence, barrier, or hay bale berm.
Please be further advised that this letter docs not relieve you of the responsibility of obtaining any
necessary penn its or approvals from other agencies.
Very truly yow., '" .A'/
~i/~'
George W. liammarth
Permit Administrator
ec: Catherine Mesiano, Inc., 12 Mill Pond Lane, East Moriehes. NY 11940
Bureau of Murine Habitat Protection, NYSDEC .
File
DMG
Albert J. Krupski, President
James King, Vice-President
Henry Smith
Artie Foster
Ken Poliwoda
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-095
Telephone (631) 765-1892
Fax (631) 765-1366
. . BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
September 6,2001
Ms. Catherine Mesiano
Catherine Mesiano, Inc.
12 Mill Pond Lane
East Moriches, NY 11940
RE: GORDON LAO
1600 Jockey Creek Dr., Southold
SCTM#70-5-18
Dear Ms. Mesiano:
The Southold Town Board of Trustees reviewed the survey dated August 21,2000 and
determined the construction of a second-story addition to the existing single-family dwelling, to
be out ofthe Wetland jurisdiction under Chapter 97 of the Town Wetland Code.
However, any activity within 100' of the Wetland line or seaward of the Coastal Erosion Hazard
Area 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,
~ (J 0-.~~' Q,
/' 1< I "
Albert J. Krupski, Jr.
President, Board of Trustees
AJK:lms
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/
/~ {
/J
/0 / It
,
'~::;"L\:/~
PERMIT NO. ~
,
BUILDING PERMIT APPLICATION;:HECKLlST
Do you have or need the follo~ before applying?
Board of Health '
4 sets of Building Plans ~
Planning Board approval
Survey /'
Check Jt.- t nr
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Examined
,20L
,20L
Approved
Mail to:
Expiration
,20_
Phone :2rlJ' - 1/ &r
Disapproved a! c
~.
,
,
8 2004
APPLICATION FOR B
DING PERMIT
Date Oc:\D~'i- 4
, 20-.illi-
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this applica,ion may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in par' for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has n,,: 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 the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
]'~,v,ie:'2 j.w~ ~,ydD7VD~
(Signature of applicant or name, If a corporatIOn)
\~4()~ tcJl1.1'tt 'Rd, ~I Kl YIB5J
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plwnber or builder
1~&e:DT
Name of owner of premises -1-IJlf.1I!'. (!..1-lIItl0&
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
~f':('H ITE'(!001 .rv:,IE<'\ .
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
I hQn 30C'hE't C- r<.G# !<hf'-\ I) e
House Number Street
~()T1-1nLD
Hamlet
County Tax Map No. 1000 Section
Subdivision
1()
Block 5
Filed Map No.
Lot )9, -
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy b\\.X"lx I='PrUII_~ \ ~I.{ R.pS\))E~ )('k'
b. Intendeduseandoccupancy '='\\",&11". rl'\-N\L'-l, ,').. ':::>"i l1..t'i'-,\DE"I:lCB'
3. Nature of work (check which applicable): New Building
Repair Removal Demolition ><
Addition X .
Other Work
Alteration 'x.
4. Estimated Cost
\ 9,() . nr:xJ -
,
(Description)
Fee
5. If dwelling, number of dwelling units
If garage. number of cars \ {\ It-e..
(To be paid on filing this application)
Number of dwelling units on each floor
-pxlSTlnS .
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front '1{j' R ~,
Height ,.;20' -0'\ Number of Stories \
Dimensions of same structure with alterations or additions: Front 16' 8l\
Depth ri-O'-O" Height ,15'':7'\' Number of Stories
Rear 6 !J' a. \A ,
16' 0 (.\,
Depth .c
Rear 1h' 'X 1.(.
cJ-.
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
9. Size oflol: Front
Rear
Depth
10. Date of Purchase
Name of Former Owner
II. Zone or use district in which premises are situated
~- Lto
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO ~
13. Will lot be re-graded? YES_ NO~ Will excess fill be removed from premises? YES_ NO~
14. Names of Owner of premises N~MIE'" CA.! lll-DG. Address PO.1'JJ><' \'1\1<; oo,mtoLtfhone No. eLIB-.. iJ?J\ - oq I O.
Name of Architect IC"Rl\-\..:\\( \..:\orl\-'e-O Address 1'0 .fu\("l'~ Nfl.,nn.('iJ'hone No f,''f7 \ -,9.9~" \ \~
Name of Contractor Address Phone No.
IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO _
* IF YES, SOUTHOLD TOWN TRUSTEES & DEC. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES_NO_
* IF YES, DEC. PERMITS MAY BE REQUIRED.
vRtVIOS,L'\. \"-\e\:p.- -.J). t _ r;.. ... VOe.nX\-0DS.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SSe
COUNTY OF f'x>l'rouLJ
Ik~K> \E~A nQ...o '2A'J:sIn0'L\\- . being iuly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the _jf~ P IlJ T
(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 work will be
performed in the manner set forth in the application filed therewith.
20~
~nII~LO.. Uf't'J 'Zd.{)({V,Gn
-+P;j""" Signature of Applicant
JOYCE M. WILKINS
Notary Public, State of New York
No /W52248, Suffolk County
Tem, Elcplr81 June 12, -;l 00")
Permit Number
REScheck Compliance Certificate Checked By/Date
New York State Energy Conservation Construction Code
RES check Software Version 3.6 Release I
Data filename: C:\PROGRA-I \Check\REScheck\LAU RESIDENCE.rck
PROJECT TITLE: CHIANG / LAU RESIDENCE
COUNTY: Suffolk
STATE: New York
HDD: 5750
CONSTRUCTION TYPE: Detached I or 2 Family
HEATING TYPE: Non-Electric
WINDOW / WALL RATIO: 0.17
DATE: 10106/04
DATE OF PLANS: OCTOBER 4,2004
PROJECT DESCRIPTION:
CONSTRUCTION OF A NEW 2-STY
DWELLING.
DESIGNER/CONTRACTOR:
FRANK NOTARO R.A.
ARCHITECNOLOGlES
13405 MAIN RD. P.O. BOX 93
MATTI TUCK, N.Y. 11952
* GROUND SNOW LOAD - 45 PSF
* EXPOSURE CATEGORY B
* 120 MPH WIND SPEED
* SEISMIC DESIGN CATEGORY - B
* WEATHERING - SEVERE
* WINTER DESIGN TEMP. - ZONE 11 B - 11 DEGREES
* ICE SHIELD UNDERLA YMENT REQUIRED
PROJECT NOTES:
-R-3 SINGLE FAMILY RESIDENCE
-HEIGHT - 25'-3" FROM GRADE TO RIDGE
-AMERICAN FOREST AND PAPER ASSOCIATION
(AF&PA) WOOD FRAME CONSTRUCTION
-SITE PLAN
-FOUNDATION PLAN
-FIRST FLOOR PLAN
-SECOND FLOOR PLAN
-FIRST & SECOND FLOOR FRAMING
-CEIILING & ROOF FRAMING PLAN
-BUILDING SECTION - PANEL SCHEDULE
-BUILDING ELEVATIONS
-ENERGY CALCULATIONS
-NAILING SCHEDULE & PLUMBING RISER DIAGRAM
-CONSTRUCTION DETAILS
COMPLIANCE: Passes
Maximum UA ~] ]39
Your Home UA ~ 786
31.0% Better Than Code (UA)
Gross G]azing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value Ii-Factor !lA
Ceiling ]: F]at Ceiling or Scissor Truss 3548 19.0 21.0 89
Wall I : Wood Frame, 16" o.C. 3780 21.0 ]9.0 104
Window] copy]: Vinyl Frame:Double Pane with Low-E 22 0.320 7
Window] copy 2: Vinyl Frame:Double Pane with Low-E 22 0.320 7
Window I copy 3: Vinyl Frame:Double Pane with Low-E 12 0.320 4
Window] copy 4: ARCH TOP 7 0.320 2
Window] copy 5: ARCH TOP 7 0.320 2
Window] copy 6: Vinyl Frame:Double Pane with Low-E 30 0.320 10
Window] copy 7: Vinyl Frame:Doub]e Pane with Low-E 24 0.320 8
Window] copy 8: Vinyl Frame:Double Pane with Low-E 22 0.320 7
Window I copy 43: Vinyl Frame:Doub]e Pane with Low-E 10 0.320 3
Window 10: EXISTING 16 0.3]0 5
Window 10 copy I: EX]STlNG 16 0.3 ]0 5
Window] 0 copy 2: EXISTING 30 0.310 9
Window 10 copy 3: EXISTING 16 0.310 5
Window 10 copy 4: EXISTING 16 0.310 5
Window 10 copy 5: EXISTING 16 0.310 5
Window 10 copy 6: EXISTING ]6 0.310 5
Window ]0 copy 7: EXISTING 16 0.310 5
Window] 0 copy 8: EXIST]NG ]6 0.310 5
Window 10 copy 9: EXISTING 7 0.3 ]0 2
Window 10 copy 10: EX]STlNG ]6 0.310 5
Window] 0 copy] 1: EX]STING ]6 0.3]0 5
Window 10 copy ]2: EXISTING 26 0.3 ]0 8
Window 10 copy 13: EXISTING 30 0.3]0 9
Window]O copy 14: EXISTING 7 0.310 2
Window]O copy ]5: EXIST]NG 32 0.3]0 10
Window]O copy ]6: EXISTING ]6 0.310 5
Window 10 copy 17: EXISTING 32 0.3]0 ]0
Window 10 copy ]8: EXISTING 32 0.3 ]0 ]0
Window 10 copy] 9: EXISTING 28 0.310 9
Door]: Glass 30 0.320 10
Door 1 copy I: Glass 38 0.320 ]2
Basement Wall]: Solid Concrete or Masonry 2]4 ]0.0 ]0.0 26
Wall height: ]0.0'
Depth below grade: 4.0'
Insulation depth: 6.0'
F]oor I: All-Wood Joist/Truss:Over Unconditioned Space 2630 21.0 21.0 60
Floor 2: Slab-On-Grade:Unheated
Insulation depth: 2.0'
Boiler I: Other (Except Gas-Fired Steam), 85 AFUE
406
10.0
311
COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building
plans, specifications, and other calculations submitted with this permit application. The proposed systems have been
designed to meet the New Y ork Stat~. En,~rg,Y C""M!:"ation Construction Code requirements. When a Registered Design
Professional has stamped and S?~~~~~~~:m, .attesting. that to the best of his/her knowledge, belief, and
professIOnal Judgment, such pll'nfa ~&;I~lIte m comphance WIth thIS Code.
~,(."'. X" 'IJ"_"I'J"" < ("
Builder/Designer ~ ~ ,'i)ij\0; Date I e? ~ . t1--t
"0
REScheck Inspection Checklist
New York State Energy Conservation Construction Code
REScheckSoftware Version 3.6 Release I
OA TE: 10/06/04
PROJECT TITLE: CHIANG / LAU RESIDENCE
Bldg.
Oep!.
Use
Ceilings:
[] I. Ceiling I: Flat Ceiling or Scissor Truss,
R-19.0 cavity + R-21.0 continuous insulation
Comments:
Above-Grade Walls:
[] I. Wall I: Wood Frame, 16" O.c., R-21.0 cavity + R-19.0 continuous insulation
Comments:
Basement Walls:
[] I. Basement Wall I: Solid Concrete or Masonry, 10.0' ht/4.0'bg/6.0' insul,
R-IO.O cavity + R-I 0.0 continuous insulation
Comments:
Exterior insulation must have a rigid, opaque, weather-resistant protective covering that
covers the exposed (above-grade) insulation and extends at least 6 in. below grade.
Windows:
[] I. Window 1 copy I: Vinyl Frame:Oouble Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[] 2. Window I copy 2: Vinyl Frame:Oouble Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[] 3. Window I copy 3: Vinyl Frame:Oouble Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[] 4. Window I copy 4: ARCH TOP, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[] 5. Window I copy 5: ARCH TOP, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[] 6. Window I copy 6: Vinyl Frame:Oouble Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 7. Window] copy 7: Vinyl Frame:Double Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 8. Window I copy 8: Vinyl Frame:Double Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 9. Window I copy 43: Vinyl Frame:Double Pane with Low-E, U-factor: 0.320
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 10. Window 10: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[ ] II. Window 10 copy I: EXISTING, V-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 12. Window 10 copy 2: EXISTING, U-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes_Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 13. Window 10 copy 3: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes_ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 14. Window 10 copy 4: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes _ Frame Type_ Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 15. Window 10 copy 5: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 16. Window 10 copy 6: EXISTING, V-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 17. Window 10 copy 7: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 18. Window 10 copy 8: EXISTING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes _ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[ ] 19. Window 10 copy 9: EXISTING, U-factor: 0.310
For windows without labeled U-factors, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 20. Window 10 copy 10: EXISTING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 21. Window 10 copy II: EXISTING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 22. Window 10 copy] 2: EXISTING, V-factor: 0.3] 0
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 23. Window 10 copy ]3: EXISTING, V-factor: 0.3]0
For windows without ]abeled V-factors, describe features:
# Panes~ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[ ] 24. Window 10 copy 14: EXISTING, V-factor: 0.3]0
For windows without labeled V-factors, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 25. Window 10 copy ]5: EX]ST]NG, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes~ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[ ] 26. Window 10 copy 16: EXISTING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 27. Window] 0 copy 17: EX]STING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ]No
Comments:
[ ] 28. Window]O copy ]8: EX]ST]NG, V-factor: 0.3]0
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
[ ] 29. Window 10 copy] 9: EXISTING, V-factor: 0.310
For windows without labeled V-factors, describe features:
# Panes ~ Frame Type Thermal Break? [ ] Yes [ ] No
Comments:
Doors:
I. Door]: Glass, V-factor: 0.320
Comments:
2. Door 1 copy I: Glass, V-factor: 0.320
Comments:
Floors:
[ ] I. Floor ]: All-Wood Joist/Truss:Over Vnconditioned Space,
R-21.0 cavity + R-21.0 continuous insulation
Comments:
2. Floor 2: Slab-an-Grade: Unheated, 2.0' insulation depth,
R-lO.O continuous insulation
Comments:
Slab insulation to extend down from the top of the slab to at least 2.0 ft. OR down to at
least the bottom of the slab then horizontally for a total distance of2.0 ft.
Exterior insulation must have a rigid, opaque, weather-resistant protective covering that
covers the exposed (above-grade) insulation and extends at least 6 in. below grade.
Heating and Cooling Equipment:
I. Boiler I: Other (Except Gas-Fired Stearn), 85 AFUE or higher
Make and Model Number
Air Leakage:
Joints, penetrations, and all other such openings in the building envelope that are sources of air
leakage must be sealed.
Recessed lights must be ]) Type IC rated, or 2) installed inside an appropriate air-tight assembly
with a OS' clearance from combustible materials. Ifnon-IC rated, the fixture must be installed with a
3 n clearance from insulation.
Vapor Retarder:
Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors.
Materials Identification:
Materials and equipment must be installed in accordance with the manufacturer's installation instructions.
Materials and equipment must be identified so that compliance can be determined.
Manufacturer manuals for all installed heating and cooling equipment and service water heating
equipment must be provided.
Insulation R-values, glazing U-factors, and heating equipment efficiency must be clearly marked on
the building plans or specifications.
Duct Insulation:
Supply ducts in unconditioned attics or outside the building must be insulated to R-8.
Return ducts in unconditioned attics or outside the building must be insulated to R-4.
Supply ducts in unconditioned spaces must be insulated to R-8.
Return ducts in unconditioned spaces (except basements) must be insulated to R-
Return ducts in unconditioned spaces (except basements) must be insulated to R-2..
Insulation is not required on return ducts in basements.
Duct Construction:
All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives),
mastic-plus-em bedded-fabric, or tapes. Tapes and mastics must be rated UL 181 A or UL ] 81 B.
Exception: Continuously welded and locking-type longitudinal joints and seams on ducts
operating at less than 2 in. w.g. (500 Pal.
The HV AC system must provide a means for balancing air and water systems.
Temperature Controls:
Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space
temperature set point of the largest zone.
Electric Systems:
Separate electric meters are required for each dwelling unit.
. .
Fireplaces:
Fireplaces must be installed with tight fitting non-combustible fireplace doors.
Fireplaces must be provided with a source of combustion air, as required by the Fireplace construction
provisions ofthe Building Code a/New York State, the Residential Code a/New York State or
the New York City Building Code, as applicable.
Service Water Heating:
Water heaters with vertical pipe risers must have a heat trap on both the inlet and outlet unless the
water heater has an integral heat trap or is part of a circulating system.
Insulate circulating hot water pipes to the levels in Table I.
Circulating Hot Water Systems:
[] Insulate circulating hot water pipes to the levels in Table 1.
Swimming Pools:
[] All heated swimming pools must have an on/off heater switch and require a cover unless over 20%
ofthe heating energy is from non-depletable sources. Pool pumps require a time clock.
Heating and Cooling Piping Insulation:
[] HV AC piping conveying fluids above 105 "F or chilled fluids below 55 "F must be insulated to the
levels in Table 2.
. .
Heated Water
T emnerature ( F)
170-180
140-160
100-130
Table I: Minimum Insulation Thickness/or Circulating Hot Water Pipes.
Insulation Thickness in Inches bv Pine Sizes
Non-CirculatinQ Runouts CirculatinQ Mains and Runouts
Un to 1" Un to 1 25" I 5" to 2 0" Over 2"
0.5 1.0 1.5 2.0
0.5 0.5 1.0 1.5
0.5 0.5 0.5 1.0
Table 2: Minimum Insulation Thickness/or HVAC Pipes.
Fluid Temp. Insulation Thickness in Inches bv Pine Sizes
Piping System Tvpes RamIe ( F) 2" Runouts ]" and Less 1 25" to 2" 2 511 to 4"
Heating Systems
Low Pressure/Temperature
Low Temperature
Steam Condensate (for feed water)
Cooling Systems
Chilled Water, Refrigerant.
and Brine
201-250 1.0 1.5 1.5 2.0
120-200 0.5 1.0 1.0 1.5
Any 1.0 1.0 1.5 2.0
40-55 0.5 0.5 0.75 1.0
Below 40 1.0 1.0 1.5 1.5
NOTES TO FIELD (Building Department Use Only)
The.Jocntions of wells and cesspools
sho wn he,.'~on ]"e (rom iield observations
and r:;T Irom dat~ obtained from others.
ANY AL TERA TlON OR ADDITION TO THIS SURVEY IS A VIOLA TlON R
~~c~~~Tlff ll~~f[TI;ZE7~~; '!~'/;~g,~fs~ EJ:Uft/lg~R'rtr'icA TlONS SUF~oltL' eEl v 'f)'
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF /" C
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYO~C/j"'f) I G : '-
WHOSE SIGNA TURE APPEARS HEREON. J rr " / I"
I '~I
ADDlTlONALL Y TO COMPL Y WITH SAID LAW TERM' AL TERED BY Ji,' 4/1 .
MUST BE USED BY ANY AND AL SuRvEYORS UTILIZING A COpy Fi(' , . S I
OF ANOTHER SURVEYOR'S MAP. TERMS SUCH' INSPECTED' AND (; II"~/' "
. BROUGHT' TO - DA TE . ARE NOT IN COMPLIANCE WITH T~AW. Lli'/j/<
SCDHS. Ref.# RIO-03-007S " kif Ghl
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or 10518 Be. to tie line
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S. 89'45'/0' W.
/53.62'
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JOCKEY
CREEK
/
SURVEY OF PROPERTY
AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N Y
1000 - 70 - 05 - 18
SCALE: 1" = 40'
JUL Y 28, 2003
Sept. 26, 2003 (Septic System)
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P CONIC 5 'RVEYORS, P.C.
(63/) 765 - 5020 FAX (63/1 765 - /797
P. O. BOX 909
/230 TRA VELER STREET
SOU THOL D, N. Y. 119'1/
03 - 201