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Home My WebLink About32691-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32869 Date: 02/17/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 620 NORTH (HOUSE NO.) County Tax Map No. 473889 Section 106 DR (STREET) Block 6 MATTI TUCK (HAMLET) Lot 27.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building permit heretofore filed in this office dated JANUARY 26, 2007 pursuant to which Building Permit No. 32691-Z dated FEBRUARY 1, 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 "AS BUILT" ADDITION & NEW ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to NORMAN & ADELE GRUDMAN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 116296C 07/03/07 PLUMBERS CERTIFICATION DATED 01/15/08 MAXIMUM ENVIRONMENTAL ~d'~ Rev. 1/81 Form No.6 TO\VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 f'v\0-' t +u ~W'{\-~~ + ~ 3ts'- ~ l~lj I APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted (0 the Building Department with the following: A. }Ior 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 fonn). 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 211 0 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 bnildings and "pre-existing" land uses: I. 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. Celiificate 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 ofCertiticate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Tcmporary Celiificate of Occupancy - Residential $ I 5.00, Commercial $] 5.0() Date_-.1/5/D6-' I New Construction: Old or Pre-existing Building: ~. Location of Property: 0'2.0 ;rJ(JI2.Ttf DtZIU~.. House No. Street ( clieck one) /111rlJ/7IJc./c Hamiel Owner or Owners of Property:_. AldamA,,", vi A/) c( E ;;1'Z<_;z:,/'1-1!."'/_... Suflc,lk County Tax Map No 1000, Section /<76 Block .----.6._____ Lot 2-7. I Subdiv.isioll Filed Map. ________u_ LOI:__. Applicant: c:4r1.'1 .051/-cC/t.' ~o &-fvp~;CA. Permit No. 3d- Co9/ 'z:.- Dale 01 Pennie :( It /07 Healtli Dept. Approval: ~,kI /~}Vo '" . Underwriters Approval: Planning Board Approval: Request klr: Tell1f\(lj'ilryCertificate ,I ". .. Fee Sl\bl~;itted: $ :;;'S ------- 5 Final Certificate:~__ (check one) /ec~~r?, -- . ApI' lcant Signature FEB .,wL .J ~ \ r>'"." . \J..,--t-e..: i?i7 'f:J col.3:lS(Pq ~. - i L-- 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. 32691 Z Date FEBRUARY 1, 2007 permission is hereby granted to: GRUDMAN 7934 VILLA D ESTE WAY DELRAY BEACH,FL 33446 for : AS BUILT ADDITION AND NEW ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER DEC NJ AND TRUSTEES AS APPLIED FOR. at premises located at 620 NORTH DR MATTI TUCK County Tax Map No. 473889 Section 106 Block 0006 Lot No. 027.001 pursuant to application dated JANUARY 26, 2007 and approved by the Building Inspector to expire on AUGUST 1, 2008. Fee $ 586.40 ORIGINAL Rev. 5/8/02 Electrical Inspection Certificate Iesue Date 7/312007 Electrlcallnspectlon Service. Inc. 375 Dunton Avenue East Patchogue. New York 11772 (631)~2 Application Number 116296C Issued To: Street: Village: Section: Mr. Grudman 620 North Drive Mattituck Block: Zip: 11952 Lot: Town: Southold Contractor: Cross Star Electric Lie. # 3793-E Was examined and found to be In compliance with the National Electrical Code. -- Commercial NY Defecta Pool [X, 1st Floor K Indoor Basement Hot Tub X Residential Del Garage Attic 2nd Floor X Outdoor X Addition ... Survey ---..--- ------- Switches Receptacles Fixtures GFI Healets AlC Fans 9 12 15 5 4 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace 011 Gas C/rcu/alors Smoke Detector Bell Transformer 1 Meter Amps PIIase UG/OH Jacuzzi Television CO Detector Bldg. Permit: 32691 Other Equipment cJ.~ IllhiX President Rough Inspection: 0510912007 InspectOr: John Me Mahon III Finallnspectlon: 0612712007 Inspector: John Me Mahon III This certifICate must not be altered in any manner. Inspectors may be tdentified by their credentials. (..j-V lo.......a t'........:-,..J _.....~J --t'-v --a-v ......~.-'-"... ;Ft~,.. .. >. \.' Maximum Environmental Management, Inc. 840 Lincoln Avenue, Suite 18 Bohemia, NY 11716 Phone: (631) 589-1225/Fax (631) 589-1157 Report Prepared For: ProjectlD# 0801101 JBD CONSTRUCTION Date Collected: 1/15/2008 161 LAURELTON DRIVE Time Collected: 12:35 PM MASTIC BEACH, NY 11951 Matrix: Solid (Solder) Permit # 32691Z Collected by: J Hendrickson Location: 620 North Drive Sample Origin: clw feed to new first floor bathroom Mattituck , NY REPORT SUMMARY PAGE Acceptance Parameter Result MRL Limits Meetsl Exceeds Limits Total Lead in Solder 0.06% 0.01 % 0.2 % Meets Date Extracted: 01/17/08 Date Analyzed: 01/17/08 Method: NIOSH Method 7300 Results were completed by Long Island Anatytical NYS ELAP # 11693 Page 2 of 2 , '''-~ F:'i, "'" v. '. ",' Maximum Environmental Management, Inc. 840 Lincoln Avenue, Suite 18 Bohemia, NY 11716 Phone: (631) 589-1225/Fax (631) 589-1157 Report Prepared For: ProjectlD# 0801101 JBD CONSTRUCTION Date Collected.' 1/15/2008 161 LAURELTON DRIVE Time Collected: 12:35 PM MASTIC BEACH, NY 11951 Matrix: Solid (Solder) Permit # 326912 Collected by: J Hendrickson Location: 620 North Drive Sample Origin: clw feed to new first floor bathroom Mattituck , NY Enclosed are the results for the sample listed above. Please note the analysis showed that the sample was within the allowable limits established by the Town of Southold. You must now bring the Original Report to the Town of Southold. Be sure to retain a copy of the report(s) for your records. If you have any questions or concerns please feel free to contact us at (631) 589-1225. Keep us in mind for all your environmental needs. Thank you for your continued business. Sincerely, ~+. Brian Leshinger President Page 1 of 2 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. o 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 # 0289C Date: January 17. 2008 THIS CERTIFIES that the construction of a second stOTY and two one stOTY additions to dwelling, new deck with steDS. new garage addition. and drvwells for dwelling and garage. At 620 North Drive. Mattituck. New York Suffolk County Tax Map # 106-6-27.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 10/24/06 pursuant to which Trustees Permit # 6506 Dated 12/13/06. Was issued, and conforms to all ofthe requirements and conditions ofthe applicable provisions oflaw. The project for which this certificate is being issued is for the construction of a second stOTY and two one stOTY additions to dwelling. new deck with steos. new garage addition. and drvwells for dwelling and garage The certificate is issued to NORMAN & ADELE GRUDMAN owner ofthe aforesaid property. ro<r; Authorized Signature GAO ENTERPRISES ,~ . .... . DES/<' "'p ,~ INC. '$- 6/4/07 Town of South old Building Department Town Hall Southold, N.Y. Rc:~20 North Dr.Mnttituck, New York (SCTM# 1000-106-6-27.1) Permit No. 32691 Dear Building Inspector, At the above referenced property additions & alterations work is being performed under a permit issued by your office. The letter is to certify that the insulation in the rear Master Bedroom extension is installed in conformance with the Residential Code of New York State, and allows for proper air circulation for the cathedral ceiling as installed. If you have any questions or need more information, please feel free to contact me at 631-732-3150. Sincerely, c .---- ~ )'0 ... \ .--J :""'-'--;:',;,,/~"_:,"?i~0'>iJ'"'' ~"7;PAX: (631) 399-5998 P.O. Box 186, MORICHES, N.Y. 11955 GAO ENTERPRISES'! INC. -PROFESSIONAL DESIGN & DRAFTING SERVICES- 4/l1l07 Town of Southold Building Department Town Hall Southold, N.Y. Re:620 North Dr. Mattituck, New York (SCTM# 1000-106-6-27.1) Permit No. 32691 Dear Building Inspector, At the above referenced property additions & alterations work is being performed under a permit issued by your office. The letter is to certify that the piers, framing, and strapping for the Bedroom & Deck was completed as per the approved permit plans and in conformance with the Residential Code of New York State. Sincerely, TELEPHONE/FAX: (63l) 399-5998 P.O. Box 186, MORICHES, N.Y. 11955 JBD CONSTRUCTION INC. 3')69 1 U,.~:rt "-::-.-.:-~,'~":;.'~,:'_:-_I!ru.TItw,:W1~'.;,:'S!'C~:::~te"~:-:::~';~~~,~-_r~~s,;"~':f::r,:_:"'_'t::':tJt<.~,-,,~-7~,,_::': '~:-~']:"~".l:::'~~~~,"~~::;-::";:-:)'((j,e-::;;~.-::":L\?:::.':::~:;I,:R:C:::lt;--,'_:r:~~lt~;.:"\';:),:.o!tJ,:",,'-_-:'_:~:_%Ft~~t~ll~'ll'.'.C~t,~;J'_".'::-'- "---'-'-':~::I!: George Gillen Town of Southold Office of Building Inspector Town Hall Southold, NY 11971 June 26, 2007 Mr. Gillen, I have attached the revised deck stair plans and the letter from the architect concerning the insulation and venting of the ceiling in the back master bedroom for the project at 620 North Drive, Mattituck ( Permit # 32691 Z). From our last discussion of your requirements this brings us up to date with everything you said you needed to get us to the final inspection. I will notify you when we are ready for the final inspection. Si rely wski Jr. res. JBD Construction Inc. f:~" \-r , i\ L \) ..;v\ \ . -..--> -- ~ 3?-b~1 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING 1)d FINAL 4-; [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONS'mucnoN [ ] FIRE RESISTANT PENETRATION REMARKS: J p- , c.. Jt ?-.s- f 0'> 1-- ~ - tJ g INSPECTOR ~ ~ DATE 3~~17 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING J><J FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: f~ ~ ~ ~ 5/~/1 ~ ~t~~~~ ~ __~~M~-~( ~~~, DATE / ~ / t - 0 r INSPECTOR ~~ 3> ?-, 1 / :2- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND }><fiNSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: ~~.f ~ r ~L'--t-~ + _ ,/f/~~l /~ ...f-- ..~ . ,... /} r . ~ C~~?: ~.~) l.-~\ .J- L~c::i ~&r~, DATE S~/7 -- (/7 INSPECTOR ~ ~ 3;)-~11 ~ TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST (>{ ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION JX(!RAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRucnON [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~~ k- ~ ~ ~.~C. ,J , ~ +- ~~"-&-? c~ o f:--~r-r0- ~~. ~ ot-.. ~.;-e. / /J~ ~U. ~ A v l/""Jl IJ' ~. +~ /GL~_j DATE S,-(}-~07 INSPECTOR ~~ 3 ?-hq I :z TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION .~ -b4~ }(i FOUNDATION 1 ST [ ] ROUGH PLBG. !::>><lFOUNDATION 2ND [ ] INSULATION :J>6 FRAMING ',STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: /A +- ~ ~ ~ okr-~~~~IC~ ~ t;/- :;L~~ d.-dL /?~r ""4-.~Dk Ce . J.JlJ- If- ;t4~ ~t-~ tf- dJ + ok ' r;j--~ 0 .:t~. ~ a1f d.e~ DATE INSPECTOR ~~ FJELD INSPECTION REPORT OUNDATION (1ST) -~~~~ FOUNDATIONT) ~ ~ "?'A-- ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL '. . . DATE COMMENTS \}.l ,---:R-1> 7 'J..d;;(' 7:. N. r~1JY:::. ~ ~ . . "- ~ \.I. ~ ~~A... -.~.7 "t/-h~"':;'4. ! (c,~ ,-I-J.\ ~ ~ '(L tlf/ .' r> JI. - vi:..,," /5]. ~ \.. AlPd /?c ,~ - ~ -te-- /'" ~ V 4-- ,,-,1; ...J,,~A it n " A ~f 4. ~ 3~X'-o ,.,7\ , :m: ~ If ok #~ '1/ ~ ~ ~ 17 iJ'Y-7_~ (/~'7A "I." (A .~ 1';:~ \T ~;'.t-l~ '0 ~ VI ~ OJ) A.iJM.. ; d. I~VI ~ ~ -P./~..:. ,'/. .~ 'UP" Ii J~' AM."", Z:.lo: 2~"" T~ 7 AllJp~ .;:F" t;;:... _.rl~ h. ~ - ~ L u 9 ~ ~ -+r:- ' I ~. "'"", v C7 (' }2. 5~-t)-j -1I// J.C{J'f/l I\u'A ;.... ".J".... JP.VJ'. 9cf ~ ~ "j .(1 .A \ FM- . _U~,,[ (7.y. f':--: cv~ .r;; t t>I< ~ 1:;j{ fM.);/ ~q,...A.,v(j .'1....li/ _"...d. '\..L ~ ~ ~ . ~ -~~J..,.~o fl.'.. ~'iJa ~ t I~ ~ ~1, /) 7 Q/'^ ~ oj(' AlIHJ r~ L{}..: - .1 ..... N~..... n "I-j '-,./.- ..ll...oJ" / ~ 71. ~ 'vr\' F /1. ' fl, ~'--iI- .II n - ,,"" /J~ v ~ ( // . ,V ~ ^:-.I'> ,\!( ~A7 ..,~7/7 .., '-v f.T ' /~ --- -<. c-" I-I Or~ f-iA D /1#A #), ;tT~ QDJ ;::., , ~ .~. .rJ ~ 5/<1/' _T~"~\..,.JI...-i--I--},..L1 filL 17 ~ /''00... ahVL.v-Y''lJ- I,~^ ',-;:n;:; V ^ ),'TI\ '" r ':Lv 4~.^O+.......1A.. ..Jl -r>I)N1,~ A :t:ll f J! R: I/r~X- F (IF'UO.1.. ~/J.L..J.. or t/pf) -<..1+- .~IIL I)' _ f'.'::~ .--\ I I ~ " / , C7 v ' ,.~ ~. (jJ --t ~~~ ~/K~ Z- C' :v . 00i"J \ ~ - ('[;1 . o ::l 0<',0 Z :t i"J :z-B .... ~ y~ " James F, King, Pt-esident Jill M, Doherty, Vice-Pt-esident 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 December 13, 2006 Patricia C. Moore, Esq. 51020 Main Road Southold, NY 11971 RE: NORMAN AND ADELE GRUDMAN 620 NORTH DRIVE, MATTITUCK SCTM# 106-6-27.1 Dear Ms. Moore: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, December 13, 2006 regarding the above matter: WHEREAS, Patricia C. Moore, Esq. as agent for NORMAN AND ADELE GRUDMAN applied to the South old Town Trustees for a permit under the provisions of Chapter 275 of the South old Town Code, the Wetland Ordinance of the Town of Southold, application dated October 24, 2006, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the Board of Trustees has furthered Policy 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the installation of drywells to contain the roof run-off and the installation of a hay bale line during construction, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on December 13, 2006 at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, z WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirements imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of NORMAN AND ADELE GRUDMAN to construct an addition over the existing dwelling, a new wood deck with steps to grade, a new garage addition, and (2) one-story additions to the dwelling, with the condition of drywells to contain run off, hay bales during construction, and all as depicted on the plans prepared by Gao Enterprises, Inc. and last revised 10/23/06. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) This is not a determination from any other agency. Fees: $100.00 Very Truly Yours, rDOh'~ ice-President, Board of Trustees JD/hkc James F. King, President 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 YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE.CONSTRUCTlON INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE ~pre-construction, hay bale line _ 151 day of construction Yo constructed / Project complete, compliance inspection. 'i--. TERMS AND CONDITIONS The Permittee, Norman and Adele Grudman, 620 North Drive, Mattituck, as part of the consideration for the issuance ofthe Permit does understand and prescribe to the following: I. That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. 7. That iffuture operations of the Town of South old require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. 8. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. 9. That the said Board will be notified by the Permittee of the completion of the work authorized. 10. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. 'Y,~- <'_ <:,-;e',;;:;,;,.-:C ,-,,--.. , ,,"~J~' ~;~iff-.;c)~-;.';"',;{:<;, " {t',--, :.~~o;':~~q-~s~';;:'t4jiL~~:;; _ .~,~~-C-~~--;. ::>::y;~:~,/~;;;~:>t;:~~_~"-,__ ~ "-;:.:;-,~;<:,,,- .--~:: -.->:,<~")H"'-- -,,' -'''c'_,,'d'''' ,- -.-,:~~- - -, ';-': ~,; ,:-",,,-" ;,~>-'${, . '~"-- .. ,. .:~ i:::~;;:; ;-, ~. . . :"j;;/~/; ,~,""-' '_ : _'~-:-;.',J;_;''':;'! -~,~":::;;~t!~tj . -' ;~;;{>~~-'7:~;;~t~~ " it W"" :','-!"-f~~'t''' ,y: ?<-. -':;,"~'> ;'H~~l~~~~l ',~" - ,"-'-' ---~- . .. -;{---"- -"'" 'C ";;:~,~;;-<c :-,>:- " " 'I. '';~;f;~~:,;:~':~;~ ,,;"',," - ,:,~, -,' ft - . ~ --- "o;-f.Y'_ :"..:c",,,.- ''t---.::, --~'- -;h'~ ~:'::-,'<-if'/ i' ;,':..' i~fY;~:' -,." ~f?'i'~~- - -' - < B,' ;i ~9 .2,_~-::':~;~;~~~ ~ -; . __/::.'~ ~','" -<;-~J~'--~~ _....:c/;_. .-~,:, :-., ,,--.. ,'.. ~:; . .-.,~ -', -,' ,~;y, - ~;'" '.,","--.' .",_",,"0"" :~~~;jF:1 -, ',_ '::';-r:-'- ~f(/ " '-"C' ',~~'d;<::" ';f{j;:;~i::{{ },.> ,;.-;:..<- .,'-::' ",-';;" ;,;' -,-,- "--"""-, -.,~~ :<. .<,.,,' A.~"'" " ...w,,~'.'_~.::,.,,;".--;,'~':':' . ,,- .. ",l<_~l Q'''"'' ' . __",,_~7" , . ;~~~t.~- 1 "" .~ -a . :I .,. tit -, r, -~ . . -" "'.:i~~~ '::~~;.> ~ . ~=~ ~r"'", ~t:.~~.?-:- - '. ~- <i1P J~ _~~~::. - "" u,"c ~ . "';i;:s '1~ .~ .. .""' U tjl .... ~fi~ - -- ,';, ~ __,c, o Z tit - X .... 'i:r' 'tyUV", New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY @ Stony Brook, 50 Circle Road, Stony Brook, NY 11790 - 3409 Phone: (63'1) 444-0365 . FAX: (631) 444-0360 Websittl: .wWw.Clec.state.ny.us ~ .... ....." . Donlso ~t Sneehan' . Commlssklner LETTER OF NON JURISDICTION TIDAL WETLANDS ACT Nonnan & Adell Grudman 620 North Dr. . Mattituck;, N.Y. 11952 January 10, 2007 Re: 1-4738-03546/00002 GrudIllan Property 620 North Drive Mattituck, Town of South old SCI'M # 100-106-6-27.1 Dear Mr. & Mrs. Grudman: Based on the infonnation you have submitted, the Department of Environmental COllSeI\lation has detennined that the portion of the referenced property located landWlUd of the crest of the shoreline bank which exceeds ten feet above mean sea level, as shown on the January 19,2006 survey by John Ehlers, L.S., last revised July 6, 2006 is beyond Tidal Wetlands Act (Article 25) jurisdiction. Therefore, in accordance with tbe current Tidal Wetlands Land Use Regulations (6 NYCRR Part 661), no pennit is required for construction, excavatiOn, grading or .other site development activities located landward of the jurisdictional boundary: . . . However, please be advised that DO coDStnlctio.. sedimeetatioa, or disturbllllee of aay'kiJld may take ptace seaward of the tidal wetlaDds jurisdictional boDadary, as indicated above, without a permit. It . is your responsibility to ensure that all precautions are taken to prevent any sedimentation. or other alteration or disturbance to the ground surface or vegetation within Article 25 jurisdiction which may result from your project. Such precautions may incluck maintaining adequate work Ilrea between the tidal wetland jurisdictional boundary and your project (i.e., a 15' to 20' wide construction area) or erectingll temporary fence, barrier, or hale bay berm. Please note that this letter does not relieve YOll of the responsibility of obtaining any necessary permits or approvals from other all~"llcies or local municipali ties. Sincerely, ~<<~ Deputy Regional Permit Administrator cc; BMHP file .C , !06(J-/4(,- OWNER RES. ~ I () LAND IMP. 00 oGg NEW FARM - ; . }O 260(; Tillable 3 Woodland Swampland B rush land House Plot - Total o OF SOUTHOLD PROPERTY RECORD CARD 20 ./Vo If fh 'Dr n/ N ) ~' '. LOT VILLAGE DIST. SUB. nCfA7t 9 J~a~ ~ J~oo'1tri) ~ _ E W TYPE OF BUILDING, 'J.'r;, "'".' ':";-\.-,' ".1'\.1 VL FARM COMM. CB. Mise Mkt. Value TOTAL DATE :2- tJ 0 c) rf~d y Ci vi) .; 00 .5 o-a-f) ',Z-I_ ~ BELOW .; r-,P# 322) \~.$ bw It" i n-faiof' cut-erlvn00S G0 ~ I~"'\ ?3 ") ~30(;) FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD ~- ., ,,' , "'-0'-(\'"'' '3. . ':'?<tlIC, r ~ t 7b I'(t,} ~ 00 '-C <6'J..i:;; \_j -- - DOCK ""~ , - '- .~1 - 116 .' -' COLOR c 0~ 'C:' !:i- II- v '" ..' , " : .; , ' : " . 1>:>:~ . ,6~ :)::' Ie \ (.. f ".' ..- . 'i~"...~.,...J .- ...... ) ~ '" '. ., .. -" " I'{ () . , - : ' '-. TRIM '9 ! " . - .. - :~ +~" I I 111111 .. . ~. I 111111 I II. I "'-. , 1111 . I.'r I I r C, #- '. V I 0[ i .3 J /x- 70 M. Bldg. J{) XJP ,["76 Foundation G-t-.J Bath XO?~ Dinette - . Extension 74 &n ;;iE ).I.rg ., ~ Full Floors K. '/ /b t.., ~ Basement r!l~ Extension 1)( :\ - .2Y Ext. Walls tV If .t/, I nterior Finish ..]'11 #~J{ LR_ I . - Exter:sisn , Fire Place Nv Heat FHA - DR. 10 j( / l - J)...;;J 3o!) 31..6 Ved: /4' y /9' .~ ), hI.. ..\5~ t1/ Type Roof C),L . U. Rooms J st Floor BR. ;;Z +'P' V ~+ q>:17-/~3 ~~5 Recreation Room Rooms 2nd Floor FIN. B. - Porch Dormer Breezeway Driveway Garage I J i. )..1 : A'" d. A(6/ /- ~^~~I""IIS I-v,o i- '0. B. , -~- Total ~r'lS . . - .'1 ~ 0 0 -" /- ',~ - - ..'~ c f( Eci( I I I I . , . t" r c~ E€:t( .- I H \ I v COLOR ~p.- I' - ,. ~~. - , p~", . ~'P ~ ri , .- ,- ..... ~ /,_, ""l v , , ) ~ " '4;~ j..;, .', '"".' ' ;-',;',' >"-"1,< '~:~, , TRIM 11 , Q , 'Q . - - ., , - ~ , +::" , ,I , I I , A ,t' ~ , V- I (. - - - ~, , --- - <" - .. , 3 ~ M. Bldg. JOXlP- ~76 Foundation ~J Bath Xa(s2 Extension /t> '" J ' 7d (, b ~ ;jl€ ). l.rg " Basement Full Floors r,O Extension ~ \( 3 - .2Y Ext. Walls t"NI JI, Interior Finish .1'11 !~~i - Exte~si3n , Fire Place /lit! Heat FtlA , (0 j. 12- - Jttl 30<1 3 (.6' !)ec ( ;t.!y /(j; J. b I.. ...\S~ t1/ Type Roof -a, d/. Rooms 1 st Floor ."" . f/ n__..^.......i......... Rn,.,..,.., Rooms 2nd Floor ."'-: '.-~ ;~ '" , ~ N '" ~ :0: , ;Ie " ,; , j ; , '~:. > 1 ~ ' ' ,.., i"f~ \ COLOR l'? ,.J, , , " .,. ve;' ./ I " ~"", \ ~ - -- ) " " I'f TRIM 'Q - I , ?'I Ma. ~~ + I I I ,,~ ~. -c, j;v \ ( , , , \ , , I .3 \ i \ j M. Bldg. 30'ilP ~76 Foundation ~~ Bath Xo , Extension Il\ 7fJ b ~ ~ 2~ ).1,f8 " e: Full Floors r/() "', ~ Basement - ,~ '_II_ I, 1,1 J.t, Interior Finish .]'11 ~ - '," .,,,",,~,",,,;;-..._,,...,- - TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlSoutholdl ,20~ ,20_ BUILDING PERMIT APPLICATION CHECKLIST JAN 2 6 2J>6 7 Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey PERMIT NO. Mb9 I ~ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Examined Approved Disapproved ale . 1-/ I ' Expiration q J { I ,20~ Phone: APPLICATION FOR BUILDING PERMIT Date J/l.NvAI u ,2001 INSTRUCTIONS /a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector wit/J]. sets of Dlans, accurate pl~ to scale. Fee according to schedule. vll. Plot plan showing location onot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. 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 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. APPLICA nON 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 inspections. ~ ~ u~, G,-0y U5HC Ie ~40 6~ni~. l,/1/c. (Signature of applicant or name, if a corporation) T C/. i5;-/x /'Ifb Mi//'l/tJlE"', //.1. (Mailing address of applicant) , / ( I c/5' ')/ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~bC/1/;- Name of owner of premises /l;;?Ft:.c &tP..C/P.N14/,) (As on the tax roll or latest deed) is a co 1l!!Jti<y1, signature. of duly authorized officer '_'~~ CEu and title of corporate officer) Builders License No. ~ Z75?,f" If Z Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: hZO N~/"'" /)/p/.-!' House Number .. Street ~I'"r;r vet::. Hamlet County Tax Map No. 1000 Sec,yon /{;0 Subdivision ,:; HO/l~ &/2E<;;' /"1\.T.............""\ Block b Filed Map No. q / Lot 27. / Lot flo un" M a Pic, id1" AI .L 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy s,'/UjU F,4/'/I/ t"-" 1?---t:C/Cbl'V c.c / ' b. Intended use and occupancy <;;jit fII/I'1/tj ;?/~/~r'/'/C..R 3. Nature of work (check which applicable): New Building Addition,/" Alteration Repair Removal Demolition Other Work 4. Estimated Cost ~II~ 0 o-C~ . (Description) Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specifY nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ? '3 '. z" Height / 1$ f Number of Stories I I Rear n.z.. Depth <j' "b I ,...} " Dimensions of same structure with alterations or additions: Front ~~ Z. Depth '02, ' Height It! ~ S ., Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories ~ . I ~~ f 9. Size oflo1: Front /4 (; G b Rear {;6 .? Rear Depth Depth 7' .b Lt. (7'1 / 10. Date of Purchase Name of Former Owner II. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO V 13. Will lot be re-graded? YES_ NO """"--WiII excess fill be removed from premises? YES_ NO;./"" /I - A'- c,,1vtli'14.>oI - ./ -n 1'/!!:/1;iv,): - 7 " 14. Names of Owner ofpremiseSi'.{ccic-,,~;q~.M.f,J Address bZCI /VdaH t/ll Phone No. 5("~' 77'6-77 ;; Name of Architect GA'tJ {71/.~'fPPq/SC51 /,0/,. Address F tJ. ,~/% ~/f.((....,phone No (, ~ /. -m: <9<J1? Name of Contractor -liS-.-) (WN,.j'fwd, '..N 11'''<'. Address (Gi LA V("<.L-"to"J D-7 Phone No. ?'3/- <1": Itflll /v]/1< T 'c MuH /' 15 a. Is this property within 100 feet ofa tidal wetland ora freshwater wetland? *YES~NO_ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED. G--r4-kr" b. Is this property within 300 feet of a tidal wetland? * YES ,;../' NO_ * IF YES, D.E.C. PERMITS MAY BE REQUIRED.- /1/""". )." 1<."", rlc"") 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 OGffitt.l: ) /V'-1 OSrliif: being duly sworn, deposes and says that (s)he is the applicant (Name of dividual signing contract) above named, (S)He is the Ac:;. crfl/"r (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. 204 {~..cYV~ ature of Applicant o Public GINA L CICIO Notary Public, State of N7ew Vorll No. 01 Cl604262 Qualified in Suffolk counl~o 112 Commission Exp"es May 30. SURVEY OF PART OF LOT M ~ PART OF LOT N MAP OF SHORE ACRES FILED JANUARY 5, ICfI4, HAP No. 41 SI11JATE: MATTITUC.K TOHN: SOI.JTHOLD SUFFOLK C.OUNTY, NY SURVEYED 01-lCf-2006 TOPO ADDED 0,-06-2006 SUFFOLK COUNTY TAX # 1000 - 106 - 6 - 2,.1 , ~//~~~ / \.~. ~"\; ~ ,'.<0-"" "'~. $' / ~~ ~. / ~ t , RI' " 5} " 'f: ,/ & , 00' , ..... , ..... ~d! f~. ,. 00 /00 V) I~ . ~ ''000 T;; i~ ..;; .: ~ t' , , ~ N89042' W"W , , , , , , , " ", , , 1------ , , , , " , , , , , ! I ~ ""'~===~""" ,,' Lot H ... Jaayview A vemllUle NOTES, . o A HONUMENT FOUND PIPE FOUND STAKE FOUND ELEVATIONS REFERENCE N6VD '2Cf DATUH AREA = 52,80Cf S.F. or 1.21 AGres GRAPHIC SCALE 1"= 50' S88013'30"E ..".. " , , , , , , , , , , o 0:1-1 380.00' p/o Lot H " " Lot 0 Edge of ....etlands as Flaqqed En'Consultants InG. on OCfrO'1/2005 p/o Lot t-: :;; 564.09' (}' I , , / I (1)1 I / \ I r I -'~'~-~'~~-~~-~~;;-'~-~ \~~-~~ ~ ~~ {\~-~~-~~-~ ~-~ ~ '\ \. , \ '- " \ " " \ " " : (j)OI : ~Ol I ,~N\ I .:::: 0 , ~ o en p/o Lot N r;> 00 o en ~w CBR11FIBDTO: Adell Grudman Norib. "......caD Sa.viDp B8Dk, FSB PidcJil)' NalioDal1ildc IiIaunmcc (''''''PIDY ofNcw Yod: N W-+E S -'.JL ~ ~ L () ~ 88 -'.JL \) J -l-.\ -l-.\ -l-.\ a L ~"",--<<,........"".........., .....,~..i..::'~~"t""'.:. -.,.-~-~. ~ ':":. = ;'t'~..-, ...."....-.........-----""...~ -' ~--'-_.....-- ~..r= ..--...........-- ~_T_~......~-~ ~~,.:;-......~~~~ :~~~~~""'C~ t.olhoo~.".........-.g_.~ _...._......_to..-......._ JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369 8288 Fax 369 8287 REF. \\Compaqserverlpros\04\04-266.pro .~.