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Home My WebLink About32605-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32453 Date: 07/09/07 THIS CERTIFIES that the building NEW DWELLING Location of Property: 2965 (HOUSE NO.) County Tax Map No. 473889 Section 123 MARRATOOKA RD (STREET) Block 2 MATTITUCK (HAMLET) Lot 27 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 2, 2007 pursuant to which Building Permit NO. 32605~Z dated JANUARY 2, 2007 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 ATTACHED GARAGE & COVERED PORCH AS APPLIED FOR. The certificate is issued to PEGGY ANN WHELAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL RIO~94~0039 07/05/07 ELECTRICAL CERTIFICATE NO. N~352763 05/19/95 PLUMBERS CERTIFICATION DATED 04/06/07 HI~TECH PLUMBING&HEATING ~i:!::::::- Rev. 1/81 [- uJ \fu .'(i3-G trs- 77LjLj WI r<: ill\ Form No.6 ~ U 'IJ IS n \ TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT 11 ~. 20~7 ~ TOWN HALL - 765-1802 TQW~~8is~~~o' ;)APP ICATION 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: I. 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 huilding $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy ofCeliificate of Occupancy - $.25 4. Updated Celiificate of Occupancy - $50.00 5. Temporary Celiificatc of Occupancy - Residential $15.00, Commercial $15.00 Date. -3~ j 'lCJ65 House No. New Construction: Old or Pre-existing Building: ___ (check one) Location of Property: rJ~(('f<.AIQoKf1 Street a,o~ '" _!.:L..U-______ ____~_ Hamlet Owner or Owners of Property: _PE: C"I;)! G.JNc.LAfIj Suffolk County Tax Map No 1000, Section _J1.~_ Block __1. ____ Lot _2- L Subdivision - Filed Map --:_______ Lol ':'~__ DatcofPermit.~APPlicant:PE_G:G'i ANN UHELAtJ _ Underwriters Approval: OJ~LflL.&._____________ Pennit No. 32 {;o 5 Health Dept. Approval: Planning Board Approval: __~~____ Request for: Temporary Certificate Final Celiificate: .j ~4~4b~ kb'h- (check one) Pee Submitted: $ ---.-z,S. 00 ~.73SS..2. Co~3;< If 52 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. 32605 Z Date JANUARY 2, 2007 permission is hereby granted to: PEGGY ANN WHELAN 2965 MARRATOOKA RD MATTITUCK,NY 11952 for : CONSTRUCT ONE FAMILY DWELLING WITH ATTATCHED GARAGE & COVERED PORCH AS APPLIED FOR THIS PERMIT REPLACES BP # 22216 at premises located at 2965 MARRATOOKA RD MATTI TUCK County Tax Map No. 473889 Section 123 Block 0002 Lot No. 027 pursuant to application dated JANUARY 2, 2007 and approved by the Building Inspector to expire on JULY 2, 2008. Fee $ 776.40 .)1 /l /J A lV'~ {~ , Authorized Signature ORIGINAL Rev. 5/8/02 -)", ,', FlXTUIES NCANDESCENT flUOlESCENT RANGES AMT. ~W. , OVENS AMT. I.W."~ Dl5Il WASHEIS EXHAUST..fANS 'NAT: ~ w. AMT. H. P. OTHER '..,. I'_l~':' 42',' . ~.-.:J.:~': 52..' 42 {, 63 DIMMERS . lEU. UNIT HlATEIS MULn.ouTLIT TUNS. AMT. H.P" '~~~~ AMY. WArn DRYERS . fUlNACI MOTORS PUTUII APPLIANCE FEIDIIS SPECIAL IK'PT nME CLOCICS AMT. NO:" A... w. 0. AMT. NAP. AMT. AMPS. AMY. It.W. OIL HoP. GAS H.Il. ~_.....,-,-~." 1 F .~ 2 "..--.~':.y 2 6 1 SEIVla DISCONNECT NO,Of MlTtR EQUIP, IAZW 1.7W 3'3W 3,,14W S E j NO. Of ce. COND. .... v C!-... ....--....e.. !~~ - -. r::':~ ,NO. Of NflmAlS ,,"W.o. Of_ I A.W.G. Of ce. COND. NO. Of HI-LEG ...... AHO. TYPE ! 1 2/0 1 200 CB x 1 2/0 1 y \ . '"to, ....f."";.r .....;.. .-- o ""AIATUS: ; !' TIMER 20 AMP-l MOTORS.2-1 H.P. G.F.C.I.-6 SMOKE DETECTOR.-l . :-." .~..,... .~""';'..j'. ....r.)."'.' . .....n~., . ,:#.r~ ...._~ .', '.-, ..~.;,;,i:- L RECEIVED HAY 2 6 - " Ii n~:. !,p': Ii; ,'; r I I 1 $~l. 15 ......' '.' AMOUNT . ~_ _ IT CIlICIl OR _.. OIIDIIYO _ 0IIIllIl Of _.... TOIl( lOAm Of" UND_/.1.'1IS AS CASH SINT IT MAIL WIlL . AT _Of_DIL . "'---. ':.'~T:.' ''': ';'--'.,.;.; ~. ~,;:..~. ". '" '7" LIC.#3681-E ALL STAR ELEC. 1570 ROCKY POINT RD. "MIDDIJ)'ISLANo; ~; 11953 ,'...... !J/~ 11 Per. - -----.-..- THIS IS YOUR BILL FOR SERVICE UNDEIED AND IS..~ A CllTlFlCATI Of c:oMPI;IANCL THIS IIU. PAYAILI AT THE NEW YOlK OFACE. .5 JOHN STIEET, N~ YORK. N. Y. 10031 - - ~,- -- - - - - - --- --------------~- -- : 'l,;'-:'::.:?:-,t~~~':,"':';",.;_ ,&~.IiijI~"9C'" . ,:$~~T'~ft'. ...':;"'." ~ :~. ,.. , ~ :~1 11 ,il , t\ :.1'. <I 't. . ,.~. . ~. .\ J .;j " .1 I I .1: tI !1 .1 , ,. 'i i I : 1 1: FROM 50UTHOLD TOWN PLANNING BOARD FAX NO. : 631 765 3136 Ma~. 182001 02:19PM Pi Tt>WT1 HaI~ 530gS Main Road P. O. Box 1179 Southold, New York 11971 Fax (516) 765-1623 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSpeCTOR TOWN OF SOU11iOLD C E R T I FIe A T ION DATE: Building Permit No. OWner I ~l~~st ~~~~cr Plumber: (please print) .....reCH PWMBING & HEATING ENT INC. 700 MAIN RD. AlVERHEAO. NY 11901 L 631-722-9618 I certify, that the solder used in the water supply system contains less than 2/10 of l' lead. i~~ (PlUmbers Signatu el Sworn to betore (p<fl-o- day ot me this I/tJn ( , '}:.9:Loo7 ;~ ~') \ K ..founty Notary Public, @S2. L/L S~"~ Notarf Public, State alllM_ No. 4777162 Qualified in SuffilIk~ .10 ComIr".,... fIIilII April 30; iIII".U: -- ARCH - ITECNOLOGIES ARCHJ11'.CfIJRE PLANNING CONSlRUCI'ION SBRVICES 13405 Main Rood, Mattituck, NowYod: 11952 631.298.1129 fax: 631.298.1128 FEB 5 20~7 February 2, 2007 Southold Town Building Department Southold, N.Y. Re: B.P # 32605 Z Ms. Peggy Ann Whelan Mattituck, N.Y. 11952 To Whom It May Concern: As per our inspection of the site the following items were noted: The construction of the as-built front porch is as follows: 1. 4 copies of as-built 2nd floor loft area and window sizes. 2:-. ,^,pplioalisn for rnfO ownpr In ~\,Jpply Ehecl< far the ~pplk,dliu". If yo additional questions please feel free to call our office at 631-298-1129. o~\~~~-~.'~.~~~.\.. . 1.(1 ~ \\ ( .: " ,- ,,' ',. ., . t. \ rfl(~~~O~.~ J . '/ -"--. ../ ':;";'e, '.,/.. ? " y , I ,J '. "'3(~/ .~ '.---- /~."., , U 0 <' L. I " I I. -- r' "2-2-2.1.11~ ~ ~ \- .~ TOWN OF SOUTHOLD PROPERTY RECORD CARD fl 0, ./0 0 0 - /' :;' - ,:; - oJ 7 ,', OWNER STREET I (Y1~ VILLAGE DIST. SUB. LOT Cl '" ~, ., t? tv ~fla.-.J flJ~f( I1I1ENt:J~ ~/) . / 9 DES': RJ J3E /) I ,.. ChORMER OWNER N ' , E . ACR'!j../. . ,~S- 'A.. .s f/ A #110 II /9, MISe/HC/A S W TYPE OF BUILDING A k ffM, 11 T; i f:J.. /?->k i "'II".~ ' . . . . . RES. 3 /1 SEAS, (191 FARM COMM. CB. MICS. Mkt. Value LAND IMP, TOTAL DATE REMARKS .3 0 ,., 300 . '7~6 ~~ 0 ,/ /0 //,J, IV AGE BUILDING CONDITION ~NEW NORMAL BELOW ABOVE ' , FARM Acre Value Per Value >;., Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD I '10 ~ tR...(J = 7,l-a Meadowland DEPTH . House Plot BULKHEAD . ,Total , DOCK t H'-).s L - ;2\ J/ fUl-<- cR- -~ b . /0 ~ .f' ~~ ~. 3 ~~ o.~ 7. - TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION REMARKS: .:r~ ~. ~ Ok, HA~.~~~, /1/# 1;{j-- ~ <2(;--0 \J "'-,00 ~ ~ ~~,~) DATE ;lJ J-{., ""0 7 INSPECTOR ~.~ [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION 3rb oSZ- TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING r){ FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: ~.'trr-~~ ~ ~ <Lf~'r-7~~ Yd- ~~ a.:tL<- ~ ~w-r-~ i.-r- ~~~ to--~ ~~, ~~.~ .r~ ~ ~ 0)-- "'" DATE I ~ 3 - 0 7 INSPECTOR ~~ I ~~, t ~ . ~ L Z ... ClJ c :::::>> z ~ - I~ ... - II. ~ ~ '-' '-' ... ClJ U '-' ~ .Z LII I;; Z ! ~ A. ... N Z Z ilcn 0 0 - l Z - ~ ClJ ~ Z ~ ~ - - Z Z ! :::::>> :::::>> ~ f f II. ~ --. '-' '-' ~ 1 ..:::I -- ~ ~ ~ z &2 I Q I- ... ell U . Z III ! ~ A- icn Z - . ell !I ~ L i= = :5 ... :) .1:) C o .,. Z I: Z ;: ~ ,....., '--' '-' '--' Q Ii; Z ... N Z Z o 0 - = = ell Q Q ! Z Z Ii ~ :) ~ f f I:: ,......., ..... ,......., \o"....J ........, '--' .. , .,. . \ .:' I:~ i~ II: ~ J , k ~ ') \) ~ .... .1 ~ L .,. Z - -... ~ Q J d Z ~ z 0 \ - ~2 z 5 .t c:J :J :J "" 2 tI) ~ I I a I- z - - II. ... c:J U ,-., .z ,-., .-, 19 III '-' '-' '-' Ii; a -A. tI) z z icn ... N - Z Z Z 0 0 = - = - c:J a a z z z - :J :J I 2 2 .-, ~ ..-, .-, '-' '-' '-' = ~ a . I z Z ~ L 0 52 z 5 \ c:I ~ ~ ~ i tI) c I I~ ... z z - - Ii. .1 U ~ ~ ,......., 19 LII ~ ......... ......... = Q -A. z z icn ... N - Z Z Z 0 0 = - = - c:I ~ ~ z z z - .. N IE tI) ~ e I i J ....... - ......... ......... A ......... II = A r\ a t d Z ~ Z A. 0 - t2 z 5 c:f ...~ ~ ~ HZ l- i .,. I z - - ... .. c:f U ~ ,......, ,......, i! III ~ '--' '--' A. ~ ~ A- t; D .,. Z z lien .. N - Z Z Z 0 0 = - = - c:f ~ D D Z ~ Z Z - .. ~ ~ IE .,. 2 2 i ~ ~ ~ = ~ ,......, ,......, I ~ ~ ,......, '--' '--' = """"" ~ ~ D . C5 Z ~ z 0 - &2 z 5 C5 ... ::) ::) I ~ tI) ~ R: ~ z - - II. ,....., ,......, ,......, i! 1&1 ~ ....... ....... tI) ... ~ A. Ii; c:a z z - icn ... N Z Z Z 0 0 - - = = C5 - c:a c:a z z z - .::) ::) . 11 ~ 2 ! 0 ..... ,......, ....... ....... '-- '-' i :-'12LD I~;S~:-2C71(j:J I!lJATE COMMENTS 1. FOUNDATION (1st) ------- FOUNDATION (2nd) 2. ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE 4 . ~ ADDITIONAL COMMENTS: J..-tg- ~~Ut;.Af} 7 ~ .~ .." '" '" :;: - H >-'l "" c::~ en' ",0 z 0- .c -<:> \to .~ ~ F :I: "" :;: .~ ~ zt ~l . , 1'1, >< - ." .......' H :"'1 ",-:s,.. ""~, o-J _-......:. H ~, o '\ Z " ., :I: " '" I ~\N >-'l ~ :I: \ i::::I~ .';l~ o-J "" 1 '.' \ ," "i ',.J \\C' COUNlY OF SUFFOLK ,. , G) f ~ 1)- ,.r:lJ ., ow ROBERT J. GAFFNEY SIlFfOLK COVN1Y EXECUI1VE L~--~ DEPARlMEHT OF HEALnt SERvIcES UHDA MERMEL..SmN. M.D.. M.P.H. AcnNG Cell -~ER CHIEF BUILDING INSPECTOR TOWN OF SOUTHOLD 53095 MAIN ROAD SOUTHOLD, NEW YORK 11971 Date:. ;j]o!o~ I ~:d-qb1 ;'t1.t,rrCi!oOk cl JM.7tiTilCk T/1I1.::if 1000-1 (}-) - d - 'J.. 7 Dear Sir: that a recent inspection/investigation of the above referenced site on or about 01 by a representative of this Department revealed that construction of a resi nf dweJling has been completed and is now occupied witbout benefit of final approval from this Office and presumably a certificate of occupancy. In this regard we are forwarding the location of the occupied bome for you to take the appropriate action. If you have any questions regarding this matter, please contact me at 852-2100. Very truly y~urs, ^ O. ~~~ Jodi Cerasuoia, R.S. Senior Public Health Sanitarian Office of Wastewater Management +OlVlSION Of ENVIRONMENTAL OUALRY . OFFICE OF" WASlEWAlER MANAGEMENT. RfVERHEAD COUNTY CENTER. RIVERHEAD NY I I QO 1-33"7 · PHONE: 1831> 8152-2100 FAX (831) 852-2OQ2 " "')~; .. I 1015'052 , THE NEW YORK BOARD OF EIRE UNDERWRITERS PAGE 1 BUREAU (sF EtEC;T~i::lTY ~ ~ B5 JOHN STREET. NEW YORK. NEW,YOftK 100S8 86047594/94 Doh> MAY 23,1995 Application No.onJil~ N 352763 THIS CER'1'1'FIESTHAT only i:heei<<irimil:~t.dprne...t..dncri'bed ,belOW and introdUced bY tlw ajiplioantnanMd.n,t~.fKIve"P~icotiOft number;n the premiMs oj ' ..'..... .'.: ," ...... .' ..,. ... :. ,,_. ," . .... ".., .... '.. '" ".. .. ,.GOVEIlNALE, CORNER OF PARK & MARRA'l'OKA RD., MA'l'TITI:lcK, Ii. Yo. I!l B....men' I!l 10, Fl. ~ 2nd Fl. GAR/A'l!'rle/OUT' Section Block 19,199:5 and found to be in compliance wilhthe Nati,onalElectrical Code. Lo, .iii ilu}oUowiiig:l()C~tion; MAY was' e~;,mined em RX,TUU OUTl!tS 42 ICIPrAClIS SWITCHES . JURES lNC::"'NO~CE",T ",fluQRescENT RA GES' AM( K.W. CClOKINGlIECKS :AM'l: K..W: OVENS AM!. IC.W. DISHWASHERS EXHAUST s OTHER AMY, !C.w. AMY, H.P. 63 52 42 1 1. 5 1 F DRYERS RlRNACE MOTORS FUTURE APPUANCE FEEDERS SPECIAllU!C'PT TIME aOcKS UNIT HEATERS MULTI-OUTLET SYSTEMS AMI. H. P NO. OF FEET DIMMERS BEll TRANS. AMT. ItW. OIl H. P. GAS H.P. AMY, NO, A.. W. G. AMT. AMP. AMT. AMPS. AMT. WAlTS 1 F 2 1 2 600 SERVICE DISCONNECT NQ,OF S E R V METER EQUIP. 'A'lW 1,163W3Ji13W 3,164W NO.O~E~:e.COND. Of~C':CgND. .NO.OfHI_tEG C E O~. ~;\rG NO. Of NEUTRALS AM!, AMP, TYPE A.W.G. OF- NEUTRAL 1 200 CB 1 x 1 2/0 1 2/0 OTHER, APPARATUS: 'rIMER 20 AMP-1 MO'rORS:2-1 H.P. G.F.C.I:-6 SMOKE DE'rEC'rOR:-1 ALL S'rAR ELEC. 1570 ROCKYPOIN'r RD. MIDDLE ISLAND ,NY, 11953 . ......, .. .~., . .. .~'....;,' ....~.. -: -.,'" ~ 4.:-. ::,~::- 0 ~~4' "'. ....k .... ..,', ~:~:~.;..:~:~ ;~:~: ..\. ~ .. -....,.. .. _..~' ~~~.. LIC.#3681-E ~AGIR 11 Y Pe-r. , ~ I This certificate ml)$t not be altered ,in any mann,er; return to .heoffic'e of the 8oar'~ if incorred. Inspectors may'be identified 'by their credentials,' "~ ~------~~------------------,---~--~----- FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT mwr/ODGF S' ODEPT, TOWN HALL SOUTH OLD, N.Y. 11971 / TEL.: 765-1802 Examined7~1.?r......, 19... Approved .~~V...., 19... Permit No.f?:?-:?/.~.~ Disapproved alc ..................................... BOARO OF HEALTH ......... J SETS OF PLdNS .......... SURVEy.................. . CHECK .................... SEPTIC FORM .............. NOnFY://~_ ~~~ CIILL ~.~I(~ .s:-. . . . .~ Mil IL TO :/0 /,2. 'A~""'C// ~ ......~~:(........ . $1Y1-/~./:{X.I!7fh .. ...........................~.:.-::~~~~ APPLICATION FOR BUILDING PER~,I!IT Date . . . . . . . . . . . . . . . . . ., 19 . . . 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 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, b:=g code, housing code, and regulations, and to admit authorized inspectors on premises and in building for neces~~~. i~.~on~. .~.................. - - (SignaWtPPlicant, or name, if a corporation) . .PO/30A ~5.S. ~d;Y........ (Mailing address of applicant) State whether applicant is0"'wne0Iessee, agent, architect, engineer, general contractor, electrician, plumber or builder. , ~~~~.~; ~~~~: ~~~'r~~~~e~; 96:: : ~i~;;';;;;;: : d~~: :::: : 4'~: e: !J~::: , (as on the tax roll or(fiest deed) If applicant is a corporation, signature of duly authorized officer. . .......... -.......... "-"" ..... ,............. (Name and title of corporate officer) Builder's License NOG.7J9C:T.''#~77/J/d.. /7; 9f7-flr Plumber's License No. ........................ Electrician's License No. ...................... Other Trade's License No. ..................... , I. Location of land on which proposed work will be done. .. .11l11.J::t'lf:l!?~.I:::.ft-. . . C . .A~. . . . . . . . . . . . . ..../Q.9S..................Paa.k.~..............m~........ House Number Street' Hamlet County Tax Map No. 1000 Section.... .!a~........ Block..... .c?:.......... Lot..... r?!.!.......... Subdivision. . . . . . . . . . . . . ' , , . . . . . . . . . ' . . . . . . . . . . . Filed Map No. ......,....... Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy. . . . . . . . . . . . . . . . . . ',' " . . '&,' ......... ~ .. .. . ; . ; ... . .. .. . . . . . . . . . . . . . . . . ~ :2 .f / !/. ~;^~. ' :1; b. tended use and occupancy.. ./'Ju</6.. .. .v.~.V<:t:. Q.~~C?CC:....... ...................... /' TtIJD:f 3. Nature of work (check which applicable): New Building . .~. . Addition..... . . ... Alteration .......... Repair .............. Removal . . . . . . . . . . . . .. Demolition .............. Other Work. . . . . . . . . . . . . . . . . ~DPtion) . /,.".., ,.-"'"' "',,,".i\',a 4. EstImated Cost. . . . ~'-/Vfv.VV. . .. . . . . .. . . . . . . .. . . .. . Fee. . .. . .. . . . . .. . . . . . . . .. .. . . ,""r.,.. . . .. . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units. . . . . . . . . . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . . . . If garage, 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 alterations or additions: Front ................. Rear . . . . . . . . . . . . . . . . . . Depth. . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . 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. distrir:t in whk::!1 rrp~ises ?::-e sit'Jateo . . . . . . . . . o. . . . . . . . . . . . < . . . . . . . . . ,. . . . . . . . . . . . . . . . . . . . . 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. . . . . . . . . . . . . . . . . . . Phone No. ... . . . . . . . . . . . . Name of Architect ........................... Address . . . . . . . . . . . . . . . . . . . Phone No. ............... Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. .. . . . . . . . . . . . . . 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~~~T;fE 0 NEW YO~u ,\,; 8.S wut l' F. .~'":"'.,:..ffi ~\ I~ ..' . ~~~1i1::... . . . . . . . . . . . . . . . . . . .. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) . above named. . He is the. . . . . . . . . . . . . . . . . . . . . . . . .C~\(\..k~. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 me 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 med therewith. Sworn to before me this ..........~...... R08ER1' L scon JR. . 1ICI\'MlY PUBLIC, staf8&.. '.' . . t:=,::t19 Iii Notary Public, (Signature of applicant) \ \ - - -<> --~ f-'P I I i I i I I -/ I , I \ , \ , \ \ \ \ \ \ \ , \ \ \ "- <:. ~ () 1> 1.- -\ ,-" .lk4t//Vl ~._- ~" '99<1 I, S.C /) rft4li 'CPr If St~~ OF ~Cts 8f \ 5 ::r \ _/-- \ 2 \ ':"C '" I VI \ ,6 _......oost NI'329 SURVEYED For? .- ._-, -.------- ESTATE -...-.>-. -----...- E'-lf:Zf-:\SETI-\ $ J/-\t-/ltS ;\T - MA.T T : TUCi( --- r::;\N~'! 8F SCtJTHOLD, NY. --...- ---\~.-._.._------- HO. v. _':$<'- .:>(:POOL1 SHANKIoN /J/ , L..,.__ t'J\ '? / / / \ /-----. .' y PRO,pl \ 0141VE l" " o H) N 8(; ":':'-1' E' . .:;.; _..I , \00.;15 .---.---, " O. ;0, \ I \ 3'5' ! I !/l \ ,i ~!; ~~=-~__-lL! I 1'0 1'-/oc' ': " I t '" ~c/ ':-r-\{ - ; .--',.- "): r-, , - , .- . ------- j "fJ " s', ~..: -- \ '--~I '~ ' ,'71' '. pROP. I >--15') --.~ ~ "'\~ss' '--~', \1z.~' HO ~_I I ~ ~ ,,'--_ ..l. I .rc', \' , r \-, 'L ~I ~ ,> \ \, ,I I \ ---' I I \, i I! ~, 1 i '~I I ",- SlJI",[:'! f..lG " I ENVELOPE i I ': i \' l" l_~__ '< IE , , , - .t>O f.~' ~ m -1---' / ~ " _Y' G :.i> \.r. v' T~5T HOLE 4-- , 35' 5.86'57' v../ +" \". DAR:..c. I I I i I I i HO, / / ~ U1 () o (j) il )> 3 MAP OF ",0 , ./ .---' p~) CONe. COVEt2 A' C'pOOL) / ~. PQOPEQTY Of:" . . "'I'~' .-.---....~.-.............. SutFOU< co. HEALTH DEPT, APPROVAL H,S. NO, N I ~. CO N) \vJriELAN "'-, I : "'-.j N I i i I i i f! i ' I ; f-L , STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE I SUFFOLK CO. DEPT. OF HEALTH SERVICES. (51 APPLICANT , SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL FOR CONSTRUCTION ONL Y ? "" DATE: - X./ -'1 H, S, REF. NO.: APPROVED: SUFFOLK CO, TAX MAP E IGNATION: DIST, SECT. BL K PCL. 1000 IZ' '2. Z7 OWNERS ADDRESS: e.Jo eu~.fRI~NhI ~ . .. - . Ue-,-~,Y,~I93S TEL, '1a{:.~J! DEltD:L,Z""f3B P,314 TES HOL S A I 1\ S<:ALE'30 -I -- AQEA: le,~ S,F. O<t'lONUM.ENT A~l:? F'ge, ~1 I~" APR. ~~,I994; .Jl...lN.EL 2;).1 199.1_ PLEASlf'NPTE ::>Pi?E DAI2Ic: W-JDY LOA.M " to thla SlJ:vay i3 a vio:;;-..tlon of Sect:ol'l 7208 01 the New York sw. EGuca1iorl Law. Caplet of this curvey ~ not bearlno the land eurveyor'Ilnked .... ot ombouedllOl_lIIIIlII_ 101>"_"'_ a"""-'-'E on~101I1o~1ar _"I Ispr_lIlIIlIIllII 10 the IiIle company, ~ agency and lending Institution listed hereon and !o the a~slgr:ees of the lending In:,\I- tutOb. G~2.r8.n!s~~ ..ra net tru;;:.:'.:.- ;.:";:, lO ::t:'::,:jc,~;..j ;iJ";:.~.,-"... "I .......c;'.. ~ ',' " , 1"1'<0 p, .",eu... 8S':t \i \1\\"1 ~\ i '&'YE~.JUE ~Il\_ 33' -\', . '6 o ._d...___..__-.:..~ _ _.1._ ~\ \"l to, '1:\ NOTE: . i ,~ -, CONTOUR. f ELE'..,IA',ON :lEFEQ. TO 5:.)F';: r..D i..-, p. ......i -, AE;..;,<:':' 5\jr2.vEY'D^T\JM-' r"-,EM..SEA U::VE.!.- It : Is the appllcant'~respoll$lbllltv to 'm:'lntaln adequate..anltarv distance :dl.tween",.1I water ~pplV and sewage .spo.. . acilltles. . . ',' .. AS$JtNEYED JAN, 211 ,,"iwbEWICK VAN T~~ ,Z,v_ LICENSED LAND SURVEYORS GREENPORT NEW YORK BROWN LO....My 5ANC 3' OWII",'-", PALE FINE TO i CCn\lISE ~D! I(oJ w.o.TE~lN ~ ~""LE III<OW"l I FINE 10 ~ 17 ,;- "o;i~ --.'~JT.,.;....'-~-7;;1i~ ;~~ -)(d.~~~:"-:'__~_~_..' .~ & ~ I~- ::z :~ /IJ) ,0 TlUDYNl f051' NlIJ19 \ -~ r-~~ ~ <. ,. " Y' 7 ~ . \ i \ \ \ \ 'I, \ i \ \ ._.---.1 \ \ HO - L_, - ~ ~ , \ N.Ek '57 E. f. o. ~- f 15 '}, o :.D '" t)l ~EET HOLe Y. S.8f,' ".:>7' vI +'" ,,,. PA.l<K , \ \ \ I i \ \ \ /' / '.// {//',- "",'POOL! ], /j' . , / SHAtJNON M/\P 'JF' rrz:>PEJl;' (' ~ / / ~Oo,.j5 rd . -, ~ \.- / / .......<, ~.. __ __ ; L_.l -l~' L... III fn 'J,I o , ' '.' U.'1. m -l ~ ~ H~. \ 'IB~ I .. .1 '/ // , , ~ <1': ('. ,~ o l,"l :] )> . / -.J..' o '< (; " " \ \ P~OP. weu_'. , == : ' j k. 'v =- 'yO ~.-~/ ,-- . r- ...) i ,- 0"'., 1- i\ .y C.':; \ r", 1 t:, .".J r ..._~ .~ ~''--''.\ '~, -- ..-~V " ;,,0 / _/ f)-, '::O"lC. GOVF:12 .{ ':,'POOL) / .J; - / \ j ,f? \ / I~---o ,11\ !, I po.oP. ' O~\ \ ~)'/ ~'nG/_-:: IC ",/. ~_:'- \~ .,. ,', I( , --- .-\ " T C.ONCa. . \ (\ '" '- l \) '\ " , FOWNOA. D ~\ ~. \ '\ \ 8S'~ , \II\~ \)I' .0 .' fr:'N' 'I~ \III".~" r_V__~ '..i_ .. '. -\ ~. () '1_____'________ ~;\\lJ .- NOTE: . , ,~ CONr:.qulZl EU:\I,ATiOl" :2EFEI<. TO '5ljH' ':0. ()?'''''' AE:Q\A.L SUQVE:'TC:~N:UM~MEA;. "e,4. U:;VE;_ -. . f '_, ~ ....... ~ ..," l~ __ ,. " ..... ',\ ", \, 1-_ ~~...) ; \, '> \ , , " I i__ ___r-\ "'.1 '1.T ;-v1A ~' ~' , . 1 : I ,/ ~ - ~ /.~..-,: ~ 1.Hr' -.-'" ",...~~~-t'.' .... -~ '>1# ' i ,'....; :_ \,... . _. ~ "".. ','1 , ---, i I:' . I , SCAl>:: - -::,(,', i . ..- -'-' 1--.-'- _ A,r;:L:~ : ;,6, :R?~.. ..:~__: fJ' t.,>;t,ejt'<"!c' '.-; =. ?:~c t-MENOED FE6.8, !994, AFI;26, 1m: ,JUNE 20, !994i;,EV'lJ.'19:t u. /lM.v.,,/ ,-tL 1/!:;/9f /J.}~ AS ?LJ.12YE'<f:D .J~~ ZliS..,\m RODERICK VAN TUYL. P.C. ./z. v_ -:r:-_j ~ LICENSED LAND SURVEYORS GREENPORT NEW YORK ....~ SUFFOLK CO. HEALTH DEPT. APPROV AL H.S. NO. N I ~ r0 rfl STATEMENT OF INTENT THE WATER SUPPL Y AND SEWAGE DISPOSAL i SYSTEMS FOR THIS RESIDENCE WILL , CONFORM TO THE STANDARDS OF THE I SUFFOLK CO DEPT OF HEALTH SERVICES. IS} APPLICANT SUFFOLK COUNTY SERVICES - FOR CONSTRUCTION ONL Y DATE: H. S. REF. NO.. APPROVED DEPT OF HEALTH APPROVAL FOR SUFFOLK CO. TAX DIST. SECT. ,ooe 123 OWNERS ADDRESS: c.fc EL,~ FR.I cMANN . p.a, eOi9i8 -. _.- (.i)TCHC'GUe N.Y 1:935 _-1.____ . __.__ \cL.,J~A:691~ ! DEED L.2'738 I TEST HOLE I MAP DESIGNATION: BLOCK peL ~. 27 P.314 STAMP i';;.;~~':<?~;!;::;~~ ~'~'. ,~.; ~:i~ L";...I..'.~_.; ~,,:.~: I..... '~;';',iI '{Qik5:a D" ,('<: BR'lWNt ,SI\.NDY LO^~ I' i SQ0"N~~ : ~OAM'( SANe' I, -- ---j 3 r '." L:- I'- .l: ~~ ~'.J G;.~' .', ~t ..'i (;.:;...~;. CC:~~,>~1 to t\ll ~ "~,'J J~ C'>>P-y, C' c/". fl., < fr;; i. t: ~"S,,,;:!,,"l -..,.;' ,.:' ;;,r. ~;:~. ...~' . ",,:4 I I ':'1-; E e~''Y......~l Fi'.:E -C ' (j"QSe 3At~C:.i I ' , I I t. ll;[.- it) ..__._....._..iv..JJ.;iJ1r. SEAL " I ,i __..H.~I.. '1 "''''TEI? iN! I P^LE BI<O''''''I j F!NE"lD COARSE ';#,N i7 ., . . .." . \.<\~' , , J }e" '\' , '10.'__'. . I ~"-,,-,, -"w. \.~ ;!:#.(; '-Ii': '~,~,,"~', . ,J' ~ SCDHS Ref. # RIO-94-0039 N . \ \ \ N/O/F ANNE M, SHANNON 10B,9S' \. 0.5'< . NB6"5TOO.E RCBA1l SCT 1S"IN. T 'i ~ :u U1lUT'f ~ Pot.E WAT[Jl j/(TEIl ~ HJ " -.-, , , - co - ., u. '" ~ '" " , ~. ..,.; . ,~ (--.1 AREA=18,398 SO. FT. RCBAR SCT ~ I"C\ 26.3 lI) ~ <1/ o o '.,f p .. - x..... <l?.p..... ~~ 0,' W. 'V "l ~-< ~ ~l Co w,... 15.3' \ '8.2' \ 'f. ~\ \\ \~ well' t ~ Fe 0.4'< \'" ~ ~ \~ 1lUT'f l;'f.ot.E B4 72' (ACTUAL) 85' (DECO) PAVDIOIT PARK A VENUE " SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N. 1': 1000-128-02-27 SCALE: 1'-30' JANUARY 77, 2007 :z ~ ~ i lIP ~ 5! ~ 5! ~ > :z :z SUFFOLK COU,\!TY ')'C<o' .,"";~--,____ APPRO~:67,CJ_:, -_.",>'~.~,,", ~" ,:,', -=-;- ,;r::: -, D;)'eM.J! 5 'l(JOf. .:~",,:_v<:S':L'c-._:, "'" _.,~ I~.,:,< ~:'l~_~' M 1? T;"Cf~var'(;6i~_""~f - "'..... o'-_!!L~_"'.J_~9' jn<:, .... ~.\I':'C:I a;l(j \''a' ~ ~~ ~;J<}c!i:d C'ne/or carro' . .e, St:~p!~' {acr.:~. _,'..... - be"",,, t.....i . IJr,eQh'i');..n,... '- ~;':'I~.'~t-",;,;;),~:.", '~.-. -"USJ,ClOru F'00 '" l,j', : . ... - S!.Idr..~ o. 'L ~ - ,"'. , ". i[' " .', ':\n 'I ~,.... fiJ,,,,,.IML'M,z_,3' .;C':.;/,;"" 2-,:, :c,,;'~;; e;,i. ._ -----,~~-- ...,-. ., .'''''i'.-;(). --'~~--,~~- "'......,.. ,,~..V:/gher ~;. ;;jjC~e-;:;:.,-::::.-'_->-:-._ C,.ltf'eo..;':-," .' "-'f' !;I-.". _~~~.~~_~~,.S~S,. ;\,:2n~~:':~.~(~;f ---. - -~~ --- -- ..... CO P o o. 'RCBAR SET 618 ANY AL TERA nON OR ADDmON TO THIS SURVEY IS A I-IOLA nON OF SEcnON 72090F THE NEW YORK STATE EDUCAnON LAW, EXCEPT AS PER SEcnON 7209-SUBDMSION 2. ALL CERnFlCA nONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNA TURE APPEARS HEREON. 07-101