HomeMy WebLinkAbout32556-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32871
Date: 02/08/08
THIS CERTIFIES that the building ADDITION & ALTERATION
Location of Property: 1300
(HOUSE NO.)
County Tax Map No. 473889 Section 103
STROHSON RD
(STREET)
Block 10
CUTCHOGUE
(HAMLET)
Lot 27
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
NOVEMBER 15, 2006 pursuant to which
Building Permit No. 32556-Z
dated
DECEMBER 7, 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 ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS
APPLIED FOR.
The certificate is issued to JERRY W & LINDA L MATEJKA
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARnmNT OF HEALTH APPROVAL R10-05-0222
02/07/08
ELECTHICAL CERTIFICATE NO.
115815C
08/17/07
PLUMBERS CERTIFICATION DATED
01/14/08 CUTCHOGUE EAST PLUMBING
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Rev. 1/81
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APPLICATION FOR CERTIFICATE OF OCCUPANCY "71~O
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
Form No.6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, propel1y lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 COlln).
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 2/1 0 of 1 % 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. }<'or 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 10 the applicant.
C. Fees
1. Certificate of Occupancy - New dwelhng $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 Prc-existing Building - $100.00
3. Copy of Ccrtificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date. / - - i) 1
-----------
New Construction: ____ _____ Old or Pre-existing Building: ~ __ (check one)
Location of Property: 1300
I-louse No.
Owner or Owners of Property: ____ f ~ ,z./l..~
I
Sufl{,lk County Tax Map No 1000, Section
5 +rzo( St2LLnPd__
Street
AL'/I"'/J.tt~~ t.4J::-q-
ID~ .__Block I9
CU.+I't'..D.tuL AI. V
amlet
Lot Z. 7
Subdivision
l"llcd ~lap
lot:
Permit No _3~CS-(;.
Date nf Permit.
~ -Lbj( Applicant ~N vrt)::, Co/lf~oj+__ 151Jt.~
___ Underwriters Appnl\;i!- ~___.___________
IIc;dtli Depi. Appro\,,!:
N 1/1=------
/'
Planning Board /\ppro\,';II.
Request ["r:
Tl'Inpnrdry Certificate _
Final Cerlificat,,,
.~ (check one)
Fee Suhlllilled: $ ____-2CL rV
Applicant Signature
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{O Z3J15I/
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.
32556 Z
Date DECEMBER
7, 2006
permission is hereby granted to:
JERRY W & LINDA L MATEJKA
1300 STROHSON RD BOX 41F
CUTCHOGUE,NY 11935
for
ADD & ALT TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER
TRUSTEES; C.O. SUBJECT TO DEMOLITION OF ACCESSORY PRE EXISTING GARAGE
at premises located at
1300 STROHSON RD
CUTCHOGUE
County Tax Map No. 473889 Section 103
Block 0010
Lot No. 027
pursuant to application dated NOVEMBER 15, 2006 and approved by the
Building Inspector to expire on JUNE 7, 2008.
Fee $
522.00
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Authorized Signature
ORIGINAL
Rev. 5/8/02
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Electrical Inspection Certificate
Issue Date
8/17/07
Elecll'lcallnapectlon Service, Inc.
375 Dunton Avenue
ElIllt Patchogue, Hew Vorl< 11772
(831) 28&-4642
Issued To:
Street:
Village:
Section:
Mr. & Mrs. Jerry Matejka
1300 Strohson Road
Cutchogue
Block:
Application
115815C
Zip: 11935
Lot:
Town: Southolcl
Contractor: Brite Star Electric Lie. t# 3398-E
Was examined and found to be in compliance with the National Elsetrical Code.
o Commercial 0 HVDefec:ts 0 Pool 00 1st Floor 00 Indoor 00 Ba88ment 0 HotTub
00 Residential 0 Del Garage 00 Attic IKJ 2nd Floor 00 Outdoor 00 AddItion 0 Survey
Switthes Receptacles Fixtures
30 40 37
Oish_sher Washer/Amps Dryer/Amps
1-20a 1 20 1 30
Furnace 0/1 Gas Clreulatots
Meter Amps
1 200
Phase UGlOH
1 ~/
Jacuzzi
1-20a
Bldg. Permit: 32556
Other Equipment
1-200 amp MIB Panel
-Air Handler
GFI
7
Heaters
AlC
Fans
5
Ovsn Range/Amps
1 40
Smoke Detector
8
Television
MICI"O_1I85
1-20a
Bell Transformer
CO Detactor
2
H!(fj~~~
President
Rough Inspection: 04118/2007
In5peC\or: John Me Mahon III
Anal Inspection: 0811512007
inspectDr: John Me Mahon III
This certifICate must not be _"ered in any manner. Inspectors may be identified by their credentlats.
---.-----
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T OW" Hail, 53095 Matn Road
POBox \179
Southo!d. New Yofl(. , 197'
Fax (5\6) 765-1e2J
TelephOl\ll (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTH OLD
C E R T 1 FIe ^ T ION
DATE' / II" Ib_~__
{~
Building Permit No.
Owner:
(please-'- piIi1t)
Plumber: ~r-_G_15l'Jl6Ji /C~cJ~ VC- c=
(please print) T~ 2<7> 17- f
f-ff (nC-
I certify that the solder used in the water supplY system
contains less than 2/10 of l' lead.
1 If /- .
-~rg Signature)
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'WO;"j!. ::o::??~
Notary Public,
~Ul:lAN J, NAGY
NNotary Public State of New Yvrk
. o. 4896735
QuelMied In Suffolk County
Commission Expires Mav 2U jj
-L H- Ef;iJ!5
county ~/~ fw
James F. King, President .<!If,
Jill M. Doherty, Vice-President
Peggy A. Dickerson
Dave Bergen
Bob Ghosio, Jr.
Town Hall
53095 Route 25
P.O. Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1892
Fax (631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
# 0270C
Date November 14. 2007
THIS CERTIFIES that the second-story addition to the existing dwelling. renovation of first
floor, new cesspool. and installation of a drainage system
At 1300 Strohson Rd.. Cutchogue. NY
Suffolk County Tax Map # 103-10-27
. .;;.'
Conforms to the application for a Trustees Permit heretofor~ filed in this office
Dated 12/19/05 pursuant to which Trustees Permit #6284 Dated 1/18/06
Was issued, and conforms to all ofthe requirements and conditions ofthe applicable
provisions of law. The project for whlcb this certificate is being issued
is for a second-storv addition to the existing dwelling, renovation of first floor, new cesspool.
and installation~f a drainage svstem.
The certificate is issued to JERRY MATEJKA owner of the
aforesaid property.
ror~
Authorized Signature
JAMES J. DEERKOSKI, P.E.
260 Deer Drive
Mattituck, N.Y. I 1952
(631) 298-7116
,)
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JAN25
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Date: January 19,2008
To: Town of South old Building Dept.
Re; Framing! Strapping! Plumbing! Insulation Inspections
Matejka
1300 Strohson Rd.
Cutchogue, NY I 1935
Permit# 32556
To Whom It May Concern:
A Framing, Plumbing, Insulation, and Strapping inspections was preformed on the above
property, and it is deemed that all this work was done as per plan and meet all state and
local building codes. A Pressure test was also performed on the entire Plumbing System.
Any other questions please feel free to call.
\
'\=1,
James-J. Deerkoski
f'
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1,
JAMES J. DEERKOSKl, P.E.
260 Deer Drive
Mattituck, N.Y. 11952
(631) 298-7116
Date: March 26, 2007
"""..~
~u
To: Town of South old Building Dept.
Re: Strapping
Matega
1300 Strohson Rd.
Cutchogue, NY 11935
Permit#32556
To Whom It May Concern:
A Strapping inspection was performed on the above mentioned project, and all strapping
is in place and meets all state and local building codes. Any other questions please call.
"~
. "
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. \ Sincerely
"""
~ames\/~
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."2n
]AMES]. DEERKOSKI, P.E.
260 Dccr Drive
Mattituck, N.Y. 11952
(631) 298-7116
Datc: December29, 2006
To: Town of South old
Re: First & Second Foundation Inspections
Matega
1300 Strohson St.
Cutchogue, NY 11935
Permit# 32556z
To Whom It May Concern:
TIlls lettcr certifies that first & second foundation inspections were preformed on the above
mentioned property and was all done correctly and meet all state and local building codes.
Any qucstions please feel (ree to call.
JAN
'es]. Deerkoski P.E.
4 fYY_7
./ "
3~Ss~ Z-
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
REMARKS:
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[ ] FOUNDATION 1 ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING I STRAPPING C><t FINAL
[ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
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DATE /-IS-o~ INSPECTOR *~
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FIELD INSPECTION REPORT i DATE I
FOUNDATION (1ST)
COMMENTS
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FOUNDATION (2ND)
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INSULATION PER N. Y.
STATE ENERGY CODE
FINAL
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8 . 53095 Mam Road
. :. $ P.O.BQ\ 1179
"~.. ~~A!$' Southold. N\ Jl97:.0957
.~~~y
-05/2: / '2807 :f': 43
531 i' t!~ '30:~,4
Town Annex JFirst Floor. NOr1h For!- B<lJIk
54375 Main Road fat )O'IOg.< ".venue\
SOlltllold. NY 119' J
Imp: r ISQutholdtown. nmthfork. ne.t
BOARD OF APPEi~LS
TOWN OF SOUTHOLD
Tel. 1(31) 765-1809 Fax (631) 765.9064
May J.f , 2007
Mr. and Mrs Jerry Matejka
94 Fulton Blvd.
Commilck. New YOI'k 11725
Re: File No 6018 - Jerry and Linda Matejka
Dear Mr. and Mrs. Matejka:
Enclosed please find a copy of the Zoning Board of Appeals detemlination
rendered at our May 10,2007 Meeting..
Before commencing construction activities, please be sure to follow-up with
the Bl.ilding Departm<:nt for the next step in the zoning review and building permit
;::ppl;cation process. You may want to fumish a supplemel"tal CC1py of the enclosed
when submitting additlon.!!1 doculllentation requested of the Building Department. I
have aiSO today furnished a copy of the enclosed decision to the Building
Department for their records.
Thank you.
Very truly yours,
Enc!.
&71;~ki.u/{lk1-<. .
Linda Kowalski
Copy of Decision to:
Building Department
85;21/2807 89;43
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:BA
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C:;:l';ld P. G..,dll'ingcr
Ruth D (ii:v(i
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L\.~..lit: Kane" \Vcjsn~tin
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SOLthold Town Hall
53095 Mai,. Road. PO. 8e>. 117',
Sourho"!. NY I ) 971-W~9
,Q.f]..L~U9catlon:
TOWf\ Anne:" /FJrst FloCI", Nor')) Perk B;.lnk
).B75 M:'lin RO:ld fat Ynunp AveMl.:~)
>"ut,,,ld, NY 119' I
.\FPE~[S [3tV.RD ME'vtBER5
.ii.lI1C";' r.:i:'li:dc..JI", ChajHl1an
Ilttp:l!.~ ell! holdtown .northfork, t'lC!
ZONING BOARD OF APPEALS
TOWN OF SOUTHOU)
Tel. (63l; i65-1809 . Fax (631) 71i5-9064
FINDINGS, DELIBERATIONS AND DETERMINA'nON
MEETING OF MAY 10, 2007
28 File No601 B - Jeny and UI1da MeteJka
Proper:y lQCilt!OIl. 1300 SJrohson RQad. Cutchogue
CTM 103-10-27
SEQRA DETERMlN.o,TION; The Zoning Board of Appeals (ZBA} has visited the property under
consideration In ,his applicaticn and determines that this review faPs under the Type II category of
t'1€ Stete's list of Act,ons, wltilout further steps under SEQRA.
EXISTiNG PRQPER1Y FACTS/DESCRIPTIOti The i:lpplical1ts 15,587.24 square fool parcel has
106.10 feel along Strohson Road and is improved with a single-fami!y dweliing, accessory shed and
accessory gilrage. as shown on 1/3/2000 survey, The existing lot coverage for the property was
':onlirmed by Joseph A Ingegno, Land Surveyor, in a letter dated February 21, 2007 to the ZBA at
2,782 square feel, or 17.84%
6ASt~OFAPE'lICATIO,". Request for a Variance under Sect,on 280-15, based on the applicants'
reque~t to amend 8uilding Permit No. 32557 -Z, based on the Building inspector's February 2. ;:00/
Notice of Disapprove! concerning lhe existing garage Iceated in a yard other tt:an the COde-required
rear yard The new construction places the eXisting garage in a side yard.
llii.EE9lK_C:OUNTY ADMINISTRATIVE CODE: Thi~ application has beel1 referred as required
UI1:ler lhe Suftoli\ Count; Administ'a:iv9 COde Sections A 14.14 to 23, and the Suffolk Coumy
Department of Pianning reply dated April 12,2007 states that the application IS considered a matter
for 'oe3; dete~mination as there appears :0 be no signifiC<lnt t;Ounty-wide or inter-community impact.
TOWN G9DE. CHA.PTf;R 298 l:W.~P DETERMiNATION: The applicants are requesting an 8 It by
26 ft. cO",lred open floret: on the west side (entirely landward) of their home. The lBA Jurisdiction
s based 010 the location of the eXisting garage, of Which half will be located in a side yard instead of
:ode permitted rear CT front yards !ocation., after the porch is bt..iil This applIcant's appliC<ltion 'or
an are.~ V!lnance is exempt under Chapter 268.
El.t:lQlNGS OF FACT
:he Zoning 80ard of Appeals held a public heanng on th:s application on April 26. 2007. at willen
time wr.!ten and oral evidenC!I were presented. BaSed upon ali testimony, documentation, persO:lal
InspeeTIc,n of the property, and other eVidence. (he Zoning Boord finds the fOllowing facts to be true
end releVant
E'5/21 "22:87 ~1'3: 49
E317b5gCb4
ZBA
F~:GF. 0:::
P'ge ~ .. May 1e. 2007
ZB ~ile No 6016. Jerry al'ld Linda Matejka
CTM NO.1 03.10.27
ARt;A V~~ANCE RELIEF REQUESTEQ: The owner/applicant seeks a varianc@ for the iocation of
an eXisting garage which will D@ partially in a side yard as a result of the proposed construchon of a
porch addition to th!" dwelling.
REASONS FOR BOARD ACTION: On t~'e basis of testimony presented. materials submitted and
perso!"!allnspections. the Board makes the following findings:
1 Grant of (ne area variance will not produce an undesirable change In the character of the
neighborhood or a detriment to nearby properties. The preexisting garage is presently located or
the street side of the home. The fact that part of the garage will be along side the porch. as opposeo
to the yard in front or behind the heuse, wili make little or no difference to the appearance of the
property
2. The benefit sought carm~t be a';hieved ::>y some 1T1ethod, feasible for the applicant to pursuc<,
other than an area variance. Removing part of the porch would net achieve significant gain, ar);!
relocating the garage 1$ precluded by its age and condit'on.
3 The 'eiief granted herein is not substantial, for the same reason staled in #1 above.
~. The difficulty has been self-created, but only in (he sense that It resulted from the construction of
a porch addition on the street side partially adjaeent to a pre-existing garage.
5. No evidence has been submitted to suggest that failure to remove the garage for a ~ew porch will
have an adverse impact on pnysical or environmental conditions ir! the neighborhood In addition,
"he lot coverage 1$ less than 20% as cOJ;firmed in the February 21, 2007 letter to the ZBA by Juseph
A. 109<:gno, LPS
6. Grant of the requested relief is the minimum action necessary and adequate to enable the
apphcanl to enJOY the benefit of a porch addition, while preserving and protecting the character uf
the neighborhoOd and the health. safety and weltare of the COmmtonity
RESOLUTION OF THE: BOAB.Q: In considering all ot the above f;;!ctors and apOll/ing the balancing
test under New YOrk TaWil Law 267-B, motion was offered by Member Simon, seconded by Member
Goehringer, and duly carried, to
GRANT the variarce as applied for. as shown on the 113120% swrvey, (evised November 22,
2005 by Joseph A. Ingegno. Land Surveyor,
Any deViation from the variance given such as extens'ons, or demolitions Which are not shown tn
the applicant's diagrams or survey site maps, are not authorized under this application when
'nvolVlng nonco!"!formltl!!S under tt-,e zoning code. This a~tion does not authorize or condone any
05/2i/2CS7 03:~3
[2:17~,5'3€E,q
:SA
F''::~GE ('14.
Pago j - May ~O. 200'
28 File No. 6016. Jerri arO Unda Matej""
CTM No 103.10-11
current or future use. setback or other feature of the subject property that Jllay '/iolate tM 70n.ng
Code. olher tt.an such uses, setbacks and other features as are expressly addl-essed in this acti:J~1
The Board reserves the right to Substitute a similar design tI1at is de minimiS in nature fOl an
alteration that does not increase tht3 degree of nonconformity
Vote of the Board: Ayes: Members D1l11l:io (Cha.'!rm~ Oliva, Gee
This Resolution was dUly adopted (5-0). /7 .
( t. ~
- -~
J es Dinizio Jr., C
pproved for FIling
finger, Simon. and Weisma~
Board Of Southold Town T rush~es
SOUTHOLO, NEW VORK
0;).~t-f
PERMIT NO, DATE: ".){It.',.]~...2.oo6
ISSUED TO ,"...~:..~.~~^~~~..~.1.~P~..~!{;~.~A... . .....m.". .....".
. i\uthllri1!uttntt
Pursu~nt io the provision, of Ch"pter 6\5 of the laws of
tho Stotc of New York, 1893; and d1~ptcr 404 of the lAws of the
. State of New York 1952; Md thc Southold Town OrdinMeo en-
titled ."REeULATlNG AND THE PLACING of OBSTRUCnONS
IN AND ON tOWN WATERS AND PUBLIC LANOS .'lnd'tho
REMOVAL Or: SAND. GR.AVELOR OTHER MATERIALS.f~OM
LANDS UNDER TOWN WATERS:!.'. .'l1ld in .'lcc~danco wHhihe
Resolution of The Board IIdopted at a mooting held on . .J"l!.,.J~
209(;, IInd in consideration of the sum of $ 25().O(J .. paid by
Jerry l"n<1 Linda Ma
........, ...."",.....
/IIIIi-
of .yutch.o"ue..... N. Y. Md subject to the
Terms end C<>ndilions li.ted on tho rever.e sldo heroof,
'~. of Southold Town Trultoos authorizes Md pormHs the {ollowing: ~
:"lWetland Permit to construct tt ~ccond-$toIY addition to the exlsung dwelling and renovato th~ first floor by adding
226 sq-fl, abandon U'o cesspool a~d put in a MW Otlt1 over 100' from fnhw, pCrVl0U:; driveway or t'l dtywoli
,roq"irM \0 conlnin runoff if 1M drivtl i. p~vOd. gutlers and drywells on IIle hou",'. haybn1e Iino during construction.
and all as deplcteo on the pl~.}ns drawn by Josoph lngeono datod NovomtJOf 22, 2005.
<16 in ac;cofdan~(l with the ddailed sf'MHlccHon, a< presont/;ld in
. the orl9inatltl9 4ppllcaHon. .
IN WITNESS WHEREOF. TI,o said Board of Trustoos here-
by Gdu$es Hs Corporote Scot to bo amxcd, Mdth<l$e prosf>nh to
be $ubs~ribcd by Ii ma;ority of the said Board liS of this dat.e,
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TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southold/ PERMIT NO.
fJ;d-)s1,t:;'
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the ~Wbwing, before appl~ing?
< Board of Health ,~p~ -;'
. < 4 sets of Building Plans ~
. Planning Boarypproval
_ Survey V
'" Check ~
Septic Form ./
NYS.DEC 7
. Trustees /'
Contact:
Examined I;J 7 , 20 OJ,
Approved ~, 20 0 /,
Disapproved ale ~".
Mail to:
Expiration
~ 17 , 20.Q~
,
Phone: ~3r-R-~- ;<roD
...&..
NOV. 6 ZUI"
APPLICATION FOR BUILDING PERMIT
"-,-
,-
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Date
IIi S'
/
,2~
~
INSTRUCTIONS
, a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets or' plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location oflot and of buildings on premises, relationship to adjoining premises or public streets or
arells, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval ofthis 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 part 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 not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting 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 South old, 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 inspe .
7'-1 FLU- /r:> A.I A't-v D
eo!1 "'? ~aili%~res/J~J?t) 7f:HPiPlYy
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
-""
, 1 a corporation)
~
Name of owner of premises -::JE-!42-Y ~ L//I/)).4 1V1?"7'7EJ}::-.4
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location ofland on which proposed work will be done:
/3 tJ7} $T/lIIJI1S61/1/ I2..tJffb
House Number Street
County Tax Map No. 1000 Section
Subdivision
/.03
Block / t/
Filed Map No.
eu.-T4-Jo61.J5 ,() y 1/93 ':>-
Hamlet
A3~M1:~_~..
AlaY ~'ni<<~""""
vtnOlO: .lof!al~~l bltlllsull
_ Of I1E....tt''i.,I1l.! lI<1it.,," 1.oJ
(Name)
I
'I
.
TEST~HOLE DATA
(TEST HOLE DUG BY McDONALD GEOSCIENCE
ON OCTOBER 27, 2005)
EL.2.2'
"10.:3'
:"1 {
~ r /1 U~ s 82'26'50"
I~o
I ";
(0 /_.
~
1/
I
(USES ~t~tTbNG
WATER)
HENRf/O/Ji'
ED/TH AA. BOCZEK
BOCZEK
J.;.< ,,,~5 Ie
~ '~C:-;Ig~
,.,..... ,:~~r_
~
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Il.; /
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J
I
SURVEY OF PROPERTY
SITUA TE
NEAH PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-103-10-27
SCALE 1 "=30'
JANUARY 3, 2000
NOVEMBER 22, 2005 ADDED TOPOGRAPHICAL SURVEY
O'
aROW?<ISILTYSANOSt.I
2.5'
"
.
p,o,u: BROWN FlI<E TO IolEDIUIoI ~ SP
"'.-..
.'
. .
.
AREA = 15,587.24 sq, It.
(TO BULKHEAD) 0.358 ae.
WATER IN PALE: BROWN molE TO
lLDlU"'SHfDSP
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"
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NOTES
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUIr.l
EXISTING ELEVATIONS ARE SHOWN THUS; ~
2. MINIMUt.t SEPTIC TANK CAPACITIES FOR 4 BEDROOM HOUSE IS 1,000 GALLONS.
1 TANK; 8' LONG, 4'-3" WIDE, 6'-7" OEEP
3. ~INIt.4Ulr.t LE....CHING SYSTElil FOR -4 8EDROO~ HOUSE IS 300 sq 11 SIDEWALL AREA.
2 POOLS; 6' DEEP, 8' dio,
@ PROPOSED EXPANSION POOL
@ PROPOSED LEACHING POOl
~ PROPOSED SEPTIC TANK
4. THE LOC....TION OF WELLS ANO CESSPOOLS SHOWN HEREON ARE FRO~ FIELD
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
5. FLOOD ZONE INFOR"'4ATION TAKEN FROM:
FLOOD INSURANCE RATE MAP No. 36103C0164 G
ZONE AE: BASE FLOOD ELEYAflONS DETERMINED
ZONE X*: AREAS OF SOD-YEAR FLOOD; AREAS OF 1 DO-YEAR FLOOD WITH AVr.RAGE
DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN
1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM laO-YEAR FLOOD
ZONE X AREAS DETERMINED TO BE OUTSIDE SOD. Yt.AR FLOODPLAIN
".
~~
.....
.....
BALDWIN
PLACE
..9r
,..
W '~
:>
~
\.
N/O/F
A. MADELENE HAUSER
DWELLING
(USES PUBLIC WATER)
'"
------------- -----
b d . of evistir;[' san:1.2.ry s stern must be. in
A an OIL"11en< : .'''" . ;;'~p~' ,'M" rement Submit
comfonnancc. \'JIm ClCpJ,u"."< """'.C, .'
"""'1M "," :"'O'if.
completed lorm " v. , .-_, - .." .. '
...,vrr~_'_"" "'--
PREPARED IN ACCORDANCE WITH THE' MINIMUM
STANDARDS r-OR TITLE SURVEYS S ESTABLISHED
BY THE UA,l.S. AND APPRO~ AND ADOPTED
FOR SUCH USE. BY THE NEW RK STATE LAND
TITLE ASSOCI
,,,
( 1
't-\
N.Y.S, Lie. No 49668
,\
\:-)
,
~ .-.
SLiFFCLK COU;~TV DEF:.\:~::.1ENT OF HEf.,LTH SEHViCES
PER"Il~7 !-:r'-'~ f'~l~,:,;,~"-,,,\'~j 6"'!,:,:; ~\....~.,;~,.10"'~:"":"'-II~'.V" eCR' A
<ill,I' ...,.\.,"'\., ..1.~)\_I-__",;., j.....-:...n~,...'-' '-'l"~-'
S;:- ;,~i~S r A:\l:j.Y r~~;..:;c ':;'~G[ ;-~l~D
CERTIFIED IQ~
FIRST A~ERICAN TITLE INSURANCE CO. OF NEW YOR,
PECONIC ABSTRACT
JERRY ~ATEJKA
LINDA ~ATEJKA
UNAUTHORIZED AUERATfON OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEIoI YORK STATE
EDUCATION LAW
COPIES or 1 HIS SURVEY MAP NOT BEARING
THE-' LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALID TRUE COPY
CERTIfiCATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TiTLE COMPANY, GOVtRNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDiNG INSTI-
TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE.
Josep A. Ingegno
land Surveyor
___~AJ J ,t\':Jl:l_.__
re..,.,.,.l.. L.,7j(j~H :;~,c= ,.,..~ -<l)..~)..
.....' .... '.'OjJ",
-...- ~." -...--.- -
1,."',',/),,2,) '{.uaA . 12L
-, --~~.__._, . -../"J.;..,-__
~.......,!", .,,, ':' ,l.,<~.t, f' ~ ::.':-';"'~"""r"', ":. i
. .J, ,-"t- h "" \#",.,,-"~j;1 ""10..0""; v~~..., 1. ",-'
- .
tXPIRES THREE YEARS mo:.] D:~..n: OF t:':'7R.OVAL
TiUe Surveys -- Subdivisions - Site Pions - Construction Layout
PHONE (631 )727 -2090
fox (631)72:'-1127
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASE~ENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
OFFICES LOCAffO AT
322 ROANOKE AVENUE
RIVERHEAD, New York 11901
MAILING AODRESS
P.O. Box 1931
Riverhead, New York 11901 -Olj65
99-7778
TEST HOLE DATA
(TEST HOLE DUG 8Y McDONALD GEOSCIENCE
ON OCTOBER 27, 2005)
O'
iIROWN SILTY SlH() SW
2.!f
".
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PALE BROWN f1NE TO
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."
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a 2.2'
.ArrR IN PAl[
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I-
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PLACE
10.S
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EXISTING WA1!RUNf:------";
(AS PE_R 5)WN~)
OVERHEAD W;RES'-
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-:1 j~~:
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1 STORY
FRAMf
HOUSf
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2nd STORy
ADDITION
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--
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9.9'
't
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N/O/F
A. MADELENE HAUSER
DWELLING
(USES PUBlIe WATER)
VJ
UNAUTHORIZED AlTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NEW' YORK STATE
EDUCATION LAW
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VALlO TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TunON. CERTIFICATIONS ARE NOT TRANSFERABLE
CERTIFIED TO:
FIRST At.lERICAN TITLE INSURANCE CO. OF NEW YORK
PECONIC ABSTRACT
JERRY t.lATEJKA
LINDA t.lATEJKA
THE EXISTENCE OF RIGHTS or WAY
AND/OR EASE~ENTS OF RECORD. IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
SURVEY OF PROPERTY
SITUATE
NEAR PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-103-10-27
SCALE 1"=20'
JANUARY 3. 2000
NOVEMBER 22. 2005 ADDED TOPOGRAPHICAl SURVEY
DECEMBER 7. 2006 ADDED PROPOSED GARAGE
AREA = 15.587.24 sq. fl.
(TO BUU(HEAD) 0.358 oe.
NOTES..
1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUW
EXISTING ElEVATIONS ARE SHOWN THUS; .1.!:LC
2. WINIWUW SEPTIC TANK CAPACITIES FOR 04 BEDReow HOUSE IS 1,000 GALLONS.
I TANK; 8' LONG, 4'-3" WIDE. 6'-]" DEEP
3. "'INIMUM LEACHING SYSTEM FOR 4 BEDROOM HOUSE IS 300 sq ft SIDEWALL AREA.
2 POOLS; 6' DEEP, 8' dla.
e PROPOSED EXPANSION POOL
(@ PROPOSED lEACHINC P<l0l
~ PROPOSED SEPTIC TANK
4. THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM nELD
OBSERVATIONS AND/OR DATA OBTAINED FRO'" OTHERS.
5. flOOD ZONE INFORMATION TAKEN FROM:
FLOOD INSURANCE RATE NAP No. 36103C01604 G
ZONE AE: BASE FLOOD ELEVATIONS DETERMINED
ZONE X., AREAS OF ~OO-YEAR FLOOD; AREAS OF 100-Y[AR FLOOD WITH AVERAGE
DEPT1-l OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN
1 SOUARE MILE; AND AREAS PROTECTED BY LEVEES FROM lOO-YEAR FLOOD.
ZONE X: AREAS DETERMINED TO BE OUTSIDE SOO-YEAR FLOODPLAIN.
*
N.Y,S. Lic. No. 49668
l:l 4
:s€))
Jose Ingegno
Land Surveyor
Title Surveys
Subdivisions
Site Pions - Construction Layout
PHONE (631)727-2090
Fox (631)727-1727
OFFICES LOCATED AT
322 ROANOKE AVENUE
RIVERHEAD, New York 11901
MAILING ADDRESS
P.O. Box 1931
Riverhead, New York 11901-0965
88-777C
\
HOLE DATA
~ BY McDONALD GEOSCfrNCf
CTOBER 27. 2005)
o'
BROWN SILTY s..HD SU
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EXISTING WA~NE
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A. MADE ENE HAUSER
DW LLlNG
(USES PU Lie WATER)
511L-L-
1:::/J ~1jI 6
UNAUTHORIZED ALTERATION OR ADDITION
TO THIS SURVEY IS A VIOLATION OF
SECTION 7209 OF THE NE\J YORK STATE
EDUCATION LAW
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR
EMBOSSED SEAL SHALL NOT BE CONSIDERED
TO BE A VAllO TRUE COPY.
CERTIFICATIONS INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED, AND ON HIS BEHALF TO THE
TITLE COMPANY. GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING lNSTl~
TUTtON. CERTIFICATIONS ARE NOT TRANSFERABLE.
5rll.-Lfb
~)111"
CERTIFIED TO:
FIRST AMERICAN TITLE INSURANCE CO. OF NEW YORK
PECONIC ABSTRACT
JERRY MATEJKA
LINDA MATEJKA
SURVEY OF PROPERTY
SITUA TE
NEAR PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-103-10-27
SCALE 1 "=20'
JANUARY 3, 2000
NOVEMBER 22, 2005 AODED TOPOGRAPHICAL SUR"",
DECEMBER 7, 2006 ADDEO PROPOSED GARAGE
AREA = 15,5B7.24 sq. fl.
(TO BULKHrAD) 0.358 ae.
NOTES:
1. ELEVATIONS ARE REFERENCED TO N.G.V.D, 1929 DATUM
EXISTING ELEVATIONS ARE SHOWN THUS; ~Q
2. MINIMUM SEPTIC TANK CAPACITIES FOR 4- BEDROOI.4 HOUSE IS 1,000 GALLONS.
1 TANK; 8' LONG, 4'-3" WIDE. 6'-7" DEEP
3. MINIMUM LEACHING SYSTEM FOR " BEDROOM HOUSE IS 300 sq ft SIDEWAll AREA.
2 POOLS: 6' DEEP, 8' dla.
@ PROPOSED EXPANSION POOL
\@ PROPOSED LEACHING POOL
~ PROPOSED SEPTIC TANK
4. THE lOCATION Of WELLS AND CESSPOOLS SHOWN HEREON ARE FROM fiELD
OBSERVATIONS AND/OR DATA OBTAINED FROM OTHERS.
5. FLOOD ZONE INFORMATION TAKEN FROM:
FLOOD INSURANCE RATE MAP No. 36103C0164 G
ZONE AE: BASE FLOOD ElEVATIONS DETERMINED
ZONE X. AREAS Of 500-YEAR FLOOD: AREAS OF lOO-YEAR FLOOD WITH AVERAGE
DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN
1 SQUARE MILE; N>lD AREAS PROTECTED BY LEVEES FROM lOO-YEAR FLOOD.
ZONE X: AREAS DETERMINEO TO BE OUTSIDE SOD-YEAR FLOODPLAIN
N.Y.S. Lic. No. 49668
------
a 4
:s'~D
Jose Ingegno
Land Surveyor
Title, Surveys - Subdivisions - Site Plans - Construction Layout
PHONE (631)727-2090
Fax (631)727-1727
o
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[3:',:>.:- SlAB 1.0'S
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30.5'
SUFFOLK COUNTY DEPARTNi",';, Of HEAL 1 ~i SERVICC::;
AWROVN_ OF CONSTRUCTED WORKS FOR
FEB A ;INGLE FAMILY HESIDENCE __
o 7 .. OOR H.S. Ref. No. Q' Q:J -6:1.;)2
.)ate
HENRt/O/F
EDITH l. BOCZE/(
. BOCZE.rr
rile __ dllpos;il and wale, H'Poly helMj..... at tills localioo ""ve
Inspected and/or carti'fl6d by thls n~..PC'l.rti\oi1 or vloer aGf;ofK"~ 300 fCtu
b;o aa~sfacloly FOR p, MAXi~' Or: -.1:- BEOf{OOi~S.
t.(.) /. ~__
____ .-'.m~"-r--
Welter J. Hilber , P.E.. Chie! 3
Office of Wa.stewa r r.'811i'.}8m'lntg
__ .... .....__........./' ....,..Ii
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162.45'
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NOTES:
'--:-'~":::-i 1, FLOOD ZONE INFORt.4ATION TAKEN FROM:
1 ;'\; : FLOOD INSURANCE RATE }.lAP No, 36103C016'" G
ZONE AE: BASE FLOOD ELEVATlONS OETERJ.4INED
ZONE X.: AREAS OF 500-YEAR FLOOD: AREAS OF 1OQ-YEAR FLOOD WITH AVERAGE
DEPTH OF LESS THAN 1 FOOT OR Willi DRAINAGE AREAS LESS THAN
7 C~ 1 SQUARE J.4ILE; AND AREAS PROTECTED BY LEVEES FROJ.4 laO-YEAR FLOOD.
ZONE X: AREAS DETERJ.4INED TO BE OUTSIDE 500-YEAR FLOODPLAIN.
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SURVEY OF PROPERTY
SITUA TE
NEAR PECONIC
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
s.c. TAX No. 1000-103-10-27
SCALE 1 "=20'
JANUARY 3, 2000
NOVEMBER 22. 2005 ADDEO TOPOGRAPHICAL SURVEY
DECEMBER 7. 2006 ADDEO PROPOSED GARAGE
JANUARY 5. 2007 FOUNDATION LOCATION
SEPTEMBER 18. 2007 F1NAL SURVEY ON ADOITlON
JANUARY 15. 200B ADDEO SEPTIC SYSTEM & DRYWElLS
JANUARY 24. 2DOB CORRECTED SEPTIC SYSTEM MEASUREMENTS
AREA = 15,587 sq. ft.
(TO BULKHEAD) 0.358 ce.
CERTIFIED TO:
FIRST AMERICAN TITLE INSURANCE CO. OF NEW YORK
PECONIC ABSTRACT
JERRY MATEJKA
L1NOA MATEJKA
UNALJTHORIZED ALTERATION OR ADDmON
TO THIS SURVEY IS A VIOLATION OF
SECTI[JN 7209 or THE NE\..' YORK STATE
EDUCATION LAW.
COPIES OF THIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAl OR
EMBOSSED SEAl SHAU NOT BE CONSIDERED
TO BE A VAlID TRUE COPY.
CERTlFICATlONS INDICATED HEREON SHAlL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY
IS PREPARED. AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AND
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI-
TUTION. CERTlFlCATIONS ARE NOT TRANSFERABLE.
THE EXISTENCE OF RIGHTS OF WAY
AND/OR EASEMENTS OF RECORD, IF
ANY, NOT SHOWN ARE NOT GUARANTEED.
Nathan Taft Corwin III
Land Surveyor
Title Surveys - Subdivisions - Site Plans - Construction Layout
PHONE (631)727-2090
Fax (631)727-1727
OFFICES LOCATED AT
322 Roanoke Avenue
Riverhead, New York 11901
MAIUNG ADDRESS
P.O. Box 1931
Riverhead. New York 11901-0965