The URL can be used to link to this page

Home My WebLink About33496-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32915 Date: 03/07/08 THIS CERTIFIES that the building ADDITIONS Location of Property: 64230 CR 48 (HOUSE NO.) County Tax Map No. 473889 Section 40 (STREET) Block 3 GREENPORT (HAMLET) Lot 3.2 Subdivision FHed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 25, 2007 pursuant to which Building Permit No. 33496-Z dated OCTOBER 25, 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 REAR COVERED PORCH & OPEN DECK ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to BRIAN & LUCY O'LEARY (OWNER) of the aforesaid building. SUFI'OLK COU1IITY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE 110. 3056819 02/19/08 N/A PLUMBERS CERTIFICATION DATED Rev. 1/81 ~r 'i05-(pod7 i7~ 1 .. c iJ)i-~U i ~ I U~LFB325 " TQ~~__, -l-~ I ~'J__ A.PPLICATION FOR CERTIFICATE OF OCCUPANCY Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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 2/1 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 buildings 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 I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Celiificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Celiificate of Occupancy - Residential $15.00, Commercial $15.00 Date. X -20-2008 New Construction: Old or Pre-existing Building: V ( check one) &c(,'--'a/,rf amlet Location of Property: c; Y23 n House No. cr<. I...Jf) Street Owner or Owners of Property: Br,'Qr) n<"o.d OY 0 LucCf Block (5llenr~ (')(')(')3 ot Suffolk County Tax Map No 1000, Section m1i')O(' r Subdivision _-TtJY" A. L R . Fro ,..,0' 5 co Permit No. 3 3L) 9 G Filed Map. 063.062 __ Lot: ftu'c el =If 2 C Mn,...,n 8cmC"/l-t, )Y)C. Date of Permit. I 0 - 2 c:::, - 0 7 Applicant. T I Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: V (check one) Fee Submitted: $ ~OiCiJ n (l Q/r)tr./>?'J~) Q~ vp Applicant Signatur ~k,l'lA\'? ( 0 t. :?d-~ 1.5 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. 33496 Z Date OCTOBER 25, 2007 permission is hereby granted to: BRIAN & LUCY O'LEARY 64230 CR 48 MANHASSET,NY 11030 for : REAR COVERED PORCH AND OPEN DECK ADDITION AS AS APPLIED FOR. at premises located at 64230 CR 48 GREEN PORT County Tax Map No. 473889 Section 040 pursuant to application dated OCTOBER Block 0003 Lot No. 003.002 25, 2007 and approved by the Building Inspector to expire on APRIL Fee $ 200.00 25, 20 -----.'" v Signature ORIGINAL Rev. 5/8/02 ~1r.I~~~ BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by LUCY O'LEARY 642 PARK AVE. MANHASSET, NY 11030 LUCY O'LEARY 642 PARK AVE. MANHASSET, NY 11030 I I Located at i ~ I 64230 SOUND AVE GREENPORT, NY 11944 3056819 Certificate Number: 3056819 Application Number: Building Permit: BDC: NS11 Section: Block: Lot: Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, rear porch, Outside, PorchlDeck, A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed herein, was conducted in accordance with the requirements of the applicable code and/or standard promulgated by the State of New York, Department of State Code Enforcement and Administration, or other authority having jurisdiction, and found to be in compliance therewith on the 19th Day of February, 2008. Name OTY Rate Ratin. Circuit ~ Wiring and Devices Outlet 2 0 Fixture Fixture 2 0 Incandescent Outlet 6 0 General Purpose Receptacle S 0 General Purpose Switch I 0 Receptacle I 0 GFCI Paddle Fan 2 0 seal I of I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location Indicated. ~~ rmr;! I!I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~1iI ,t~C1U~L) '\8:3.20 , (OEEO) '\84.08 , FOR FRANCISCO PARCEL II' M\N~~ ~~6~~~~~:L'( OF COR'tIIN LAND N S.C. TAX MAP NO. DIST. 1000 SECT. 40 BLOCK 3 LOT 3.2 N w E s ~~ ~O ~'\~ ~(j '" ~ Q {'" i;!l J>: 6~ "7--;' <ioz. ~ ~Ul ""'~ 91<2, ;~ ~- iJ.~ "'" Q,o ?J \16~ ~J>: ....oz. yO ~ o S80"'\8'20.V4 NOlES: -SlEPS, SEPllC & WAlER lOCAllONS AS PER BUilDER. -REVISED JANUARY 23, 2007 ADDED SEPllCS & WA lER. -02/09/2007 REVISED SEPllCS AND STAIRS -02/13/2007 REVISED SEPllC OFFSETS -02/04/2008 REAR DECK & BASEMENT ENTRANCE ADDED -ElEVAllONS IlLUSTRAlED FROM llME OF FINAL SURVlEY. @ H.W.J. ALL RIGHTS RESERVED. Unauthorized clteration or addition to this document Is 0 violation of Section 7209 of the New York State EducotJoo low. Certifications indicated hereon sholl run only to the person for whom It Is prepared and on his behalf to the TItle Company, Governmental Agency and Lending institution listed hereon, and to the Dssignees of the lending institution. Certifications are not transferable to additional institutions or subsequent owners. Copies of this document not bearing the professional's Inked seal or embossed seal sholl not be considered a valid true copy. The offsets (or dimensions) shown hereon from structures to the property lines are for 0 specific purpose and use ond therefore ore not intended to guide the erection of fences, retaining walls, pools, patios, planting areas, addition to buildings or any other construction. CERTIFIED ONLY TO: By MA TlHEW D. CRANE N. Y.S. UC. NO. 050065 LS. DESIGNED DRAWNJ.J.M./CJ/DB FILE NO. PROJECT NO. 04-0590 F: PROJ/2004/04-0590/DWG/04-0590-FINALDWG / / / / c,~ ~~~\C;,'\t-~ I,\t-;" ~~ . " !;) 4)~c,~ ,.../~ - <?' FE CORN. ....<0<0. 1.5'[ J -;oc " ?~ 'eZ 'MU) 'Z 1/1, ~:P WlZ Om ~ ~ ~. S. 1"\ r ~ o "7- ~ ~ "'" o ~ ~ '::( S? \!l ~ ~ ~ " 'i\ " ~ ~ ~ p, " ~ NOlE: SANITARY SYSlEM TO BE COMPRISED OF TWO CESSPOOLS 8' IN DIAMElER WITH AN EmCllVIE DEPTH OF 8' EACH AND A SEPllC TANK OF 1000 GALLONS 82.5' ~~C! 9>~'i li~0 ~ 89.3' ~ (.JI 01 Ul. FE 0.3'E r ~ o z ~ ~ "'" o ~ ~I") o 19- Ol Co( ~ 0 "'" :I: ; ~% '" z ~ ~ "'\1\ .!!!,~ .... VI z r> ~ ,.L- :fJ 6340 NORTH RD. PROJECT: PARCEL #2 ON THE MINOR SUBDIVISION FOR A.L.R. FRANCISCO SITUATE AT: SOUTHOLD, NEW YORK DATE: FEBRUARY 2008 SCALE: 1"=50' SURVEY DATE: 1 /4/2005 AREA 1.71 ACRES FILED MAP NO. DATE FILED FIELD BOOKS bk 478 p.56 DATA DISC 04-0590 FND. 6/08/05 UND. CONST. FINAL 1 /11 /2007 [I HAWKINS WEBB JAEGER PLiC ENGNERs-IRaInEcrs-9lRVE'tIm-PLNtDS J2J9 ROUTE 112, IlJIUlINC II - SUITE I, WEDFORD, NEW YORK 11783 PHONE (831) 732-7m,fACSIWILE(831) 732-n60 ESTAB. 1172 33>V'lt TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ [ ] FOUNDATION 2ND [ [ ] FRAMING I STRAPPING [ [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRAnON REMARKS: DATE INSPECTO~ 3 f V7~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~ATION [ ] FRAMING I STRAPPING [~NAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTIO~ [ ] FIRE RESISTANT PENETRAnON REMARKS: ~ f4.J jb J;~ C0~ r-J~~L O~~77 ~LoJ'->"" -----'-_~ _ ~ SIf-4/(l( /l.S ~~_S_ tt:J- ~t: ;:;~~O; ~~l~ ' . DATE )- b <0 INSPECTOR ..,.....".,..- .,.....- '33f?' :?- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION C>(!RAMIN~RAPPI~ [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONS1RUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: ;V~~~ (,"Xc,'~ -te:- .~~ ~~r-' tfY'fI/,~ S 'f " -to- 1-VL-~1 O~ T X J ~ ~ NG ~ tf- ~ cV\-Q.. () 1\, P 5 ~ ~JL.fM- A b b ~~ DATE I --10 - 0 K INSPECTOR ~ ~ 33/-r!r;, t;- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 SPECTION [ OUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: p~ -r I~~ ..tic" DATE !1[O/O I ! ( . - FIELD INSPECTION REPORT DATE I . COMMENTS . l;J ." / b]~~~ 'l--L: ./ )'-, ~. ~ .f~y lY~ I I I' , , \ , /) /g ..L~ FOUNDATION (1ST) v ...5'.., (\'It tV ------------------------------------ ~rr= . FOUNDATION (2ND) J./ILt ; ~~ , ( , . ~-o " ".2 f-,fo-o J/1M _~A -' j~ l. /IV l. " ..nH ~ ~p ~ 'M ~ ~ ~I\ J)y\ U Ah . 1.-,' If- ')< t.f.lj . ."'- ~ LVL JI.. J.,,' I 11 -; L ~A Q' {) --C~ , - _ J- .-k. , aM. IJ k', ;D/I yE:; .. ROUGH FRAMING & iuU JJI ~.z-h. d.Jrlrl. vJ~ PLUMBING . ./) V ~~"jd CJ /" --- -- ~ -"---~----_._-- _._----~-~--- -C::J: ------- ~~ INSULATION PERN. Y. -- to; .., STATE ENERGY CODE . (j) .H't/tI /t~W/J PM.-J In A..."1 W,Al,'.' "" :r:;.;SF"L ( -.., ( C~L - E../Uore,S r:JJA-CL . r. ~. r ~ 'P&. R~.o(,/.(UJ. . h~:r# M...:,,\.....) w;, r1# H.<.. -1;) . bJnl5:.~ f.lr,L,. &e/6.L A.tf." ~ - Ii<< .1 C) FINAL 1I.;z/)-)-ll '8 <' L../I /'.n A. v, , ~ f'4. / A .y-. . ". ~'/ ../ y// f/ / / { ~ /' / / . ADDITIONAL COMMENTS () - . J~ z m r . ~ + to; , ~ cy' ~~ , .., 3~ ~ :zj~ ~ l' ~ ~ .e . ( , - --.- TOWN OF SOUTHOLD PROPERTY RECORD CARD ~. - ~/~ ~ES. Zto SEAS, LAND IMP. VILLAGE DIST. SUB. LOT lie, . . ~s9t) ~D 'iIIable louse Plot 110(50 FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD to/d7~(~; ,],1 G.~ ~611ft?? V'oadland ~eadowlond .'7\2- ll\-c ~ 11000 ~ $ea 'otol \'\'00 r , e~, .;,,~ ! - I 1, I j <\~ ""-'~ ,- TRIM . 4- ll' ~ " lA, ~ ,I. ''''' I.z. I- f^ It I... "- lJ: .~ ~3 f "1 , z.- . \ :ac t iI.' r-' - "'" h 'k- ~ ~ , ! I , \ W I 5~ I l.ot 40.-3-3.2 10/06 I 'ill'!' L ,,,,- CJ j) ~ '5 ..~I \ c ~ ,,", I ICJ ( l , ~' ;u ^ I.., .. , I '" cl) , Extension .. , - ,-.~ , - - n. .~.. < I' (h;Extension }::>",- , '~ :j;E1ct ~i~ """""" \6,1 ..~ ~ 164 \ SD.: 3~-o 5~q 40- l:K'/ ~ j;-' , " 2..... ''''U\. l2:>'(" \J 20!' 2,472 Foundation D,e. Both ~Y2-- Dinette ./ h Basement , Floors btw e&: K. ./ - ~\X, - ch .?".t7eo.' ~ \24- Ext. Walls V'''''tL o..l>R, Interior Finish LR, ./ - <;J Fire Place 16 Heat 'I~.::::. , DR. / away 6l~\ - \7~ Type Roof Rooms 1st Floor ( - BR. 't lOst.. - <.J Recreation Room Rooms 2nd Floor " , Dormer Driveway C K>... ./ - " Ae <;.~ ~' ",<1. ~ Yz-/ 2; q~<1( ~ '1 IiW Ip ,,\\1 v v ~4/ - '3aco _ t::lut. -Ie ()61()(p 'S.c. ~'~LClu-'- ._-A...... ..... t_ _ _ . Examined Approved Disapproved ale ,20r ,20~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health -- 4 sets of Building Plans Planning Board approval ~ Survey PERMIT NO. 33'1 '1'~ Check.#=- Jnnd Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoIdI ~;)5 Expiration ,20~ Phoue: 9 os -{, () ::<7 .. I ~ \s'rr', T!~\s , r ~ ~ "q. -"'---II '\J " \ ' . , \ ,-.,,-r \. ' \I\r: GC"T t 5,2Li \~ 1\ LL --" G~ j GEP~. I 1 ;::r~t{N QL3~QL1) III ector APPLICATION FOR BUILDING PERMIT ~:'!; ,20_ Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of 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 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 shallte 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 dem~t n as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, iJ,ousing co\l6, an regulations, and to admit authorized inspectors on premises and in building for necessary inspections. / \;' t I-T ; .!. ~ ("'''''''/''" . i . i" i If ~fn.dh<'! ((.1. I).ill 7dt. fl/'). 1/ 117 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder [?v;//(.f.. , OL4/2..i; ( s on the tax roll or latest deed) oration, signature of duly authorized officer .4 ~,. corporate offic r) uilders License No. 02- - () S '3 '37 J.- I Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: 6'(J..}O Cf<" 13 House Number Street 6-'(2.f(.f/ for ;.. Hamlet 'II) Block :1 Filed Map No. MIllO rJjj,?...~ L- tItt/t........." . 'lM1UII _,lMro ... ...I#~ County Tax Map No. 1000 Section 4 7 3 8 <t~ Subdivision (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy f2(']ldr'1,f.''' L ~..?:,/~ :c.-?II?-'I; c!'-<"c: f/:'~ b. Intended use and occupancy '54 M( <.(/ :/ ~ (:;> V (N C f?O! l ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition /" Addition Other Work Alteration (Description) 4. Estimated Cost 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. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. I': Rear . .' '76 I" Depth 3 2. I 7. Dimensions of existing structjlres, if any: Front 7 ( Height filiP' '../ 2- ~ . Number of Stories , .. '1- Dimensions of same structure with alterations or additions: Front 76' Ie? " Depth vlf ' Height f~'<<<- Number of Stories " Rear 76 /0 ~ 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: FrontjOll Rear i..--J /J. i, Depth 1'i1_Z-.:l' 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 / Will excess fill be removed from premises? YES_ NO / 14. Names of Owner ofpremisesLv~i ()' /....'r?1"1 Address 61'-/..:7 !?J,'/4.1""lPhone No. S 9' - 2-6'11 Name of ArchitectJtrf Hvi/it<. AddressP' 6-~ bVI ~~ott~"1Jhone No 'Z".:--1- ~'iS Q NameofContractor'J'l.( 1?-41...j<.....~T ,'1( Addressll w,~n..1 129. Phone No. ~U'7-<,)'/7) 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO V--.. * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES_NO_ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. i' 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. 18. Are there any covenants and restrictions with respect to this property? * YES_NO ~ * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF~Jf-?t..... ) ..J(,) \.. "" G "~ ci ,J:. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the )3" i t /,,/.. (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of O<~ b-e....- ( ) ..... 20 0" . ....Ot~ I~~--. S.C. TAX MAP NO. DIST. 1000 SECT. 40 N w s BLOCK 3 LOT 3.2 FILE NO. E ~ o ~ ~ m ~ ~\ \~ ~~1 I:) ~ ~ t ~~ ~ ~; ~\\'t - 't ~ C' ~ \ ~~ ~ ~ ~ ~~1i: I-'f. "~ ~ ~~"l ~ FE \ \ :a :t\J,b.\J 0.3'E \ :t, I O.~ \~.201(~) \ ~O\f12 \eA.of1 ~Isc.o 5U601"15\0~ f~ c,OI<l^l\~ \l1t'llwR ~-(O NOTI:5, f'~e.. ~y.\ OR fO, \..IC. y\A,-e<.) -STEPS, SEPTIC. . HATER LOVATIONS AS PER BUILDER. \..NlO (Oye..\..\~l f'\)6 -REVISED ...JANJARY 25, 2001 ADDED SEPTIC,S . HATER. -02/00./2001 REVISED SEPTIC,S AND STAIRS -02/15/2001 REVISED SEPTIC, OFFSETS @ H.W.J. ALL RIGHTS RESERVED. ~ '" Unauthorized alteretlon or addition to this document is a violation of Section 7209 of the New York State Education Low. Certifications indicated hereon sholl run only to the person for whom it is prepared and on his behalf to the Title Company, Governmental Agency and Lending institution listed hereon, and to the assignees of the lending Institution. Certifications ore not transferable to additional institutions or subsequent owners. Copies of this document not bearing the professional's inked seal or embossed seal sholl not be considered a valid true copy. The offsets (or dimensions) shawn hereon from structures to the property lines are far 0 specific purpose and us. and therefore are not intended to guide the erection of fences, retaining walls, pools, patios, planting areas, addition to buildings or any other construction. PROJECT: PROJECT NO. 04-0590 ~ <;:}c. 'T\ ~\\\ \~ \ ~~ \!ffi ~ Q, \ t ~ r ~ QG ~~ ~ ~ -~ \ C\~ "5 ~ i~ \ NOTE, SANITARY SYSTEM TO BE COMPRISED OF TWO C,E55f'OOLS e,' IN DIAMETER I<-lllll AN EFFEC,TIVE DEPTH OF e,' EAc.H AND A SEPTIC, TANK OF 1000 lSALLONS ~ \ii ~ r ~ ~ ~ ~ ~ ~~ - '-<. \iI o ~ '11 ~~ ~I:) ~~ ~\ '-\ \II ~ PARGEL #2 ON THE MINOR SUBDIVISION FOR ALR. FRANC,ISGO SITUATE AT: SOUTHOLD, NEW YORK DATE: JANUARY 2005 SCALE: 1"=50' SURVEYDATE:l/4/2005 AREA 1.71 ACRES FILED MAP NO. DATE FILED FIELD BOOKS bk.478 P 56 DATA DISC 04-0590 FND.6/0S/05 UND. CON ST. FINAL 1 /11 /2007 CERTIFIED ONLY TO: i\DVANIAGE TITLE CHASE BANK, ITS SUCCESSORS AND/OR ASSIGNS BRIAN O'LEARY & LUCY O'LEARY By . MATTHEW D. CRANE N. Y.S. UC. NO. 050065 LS. DESIGNED DRAWNJ.J.M.lCWJ CKD. M.C. n:T&R. t"," HAWKINS WEBB JAEGER PLLC fNGINEERS-JfiafJECTS-~P~ERS J239 ROJ'IE 112, llUILDING" - SUITE 1, MEDFORD, NEW 'tORI< 117U PHONE (I3U 732-7m. FACSIWILE (131) 732-mo Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: ".C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A l.oJtiJ ..p "> ~. '- STORM-WATER,GRADING,DRAINAGEANDEROSIONCONTROLPLAN iiiSiiiOl s;cli; Block ---;:;;t CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. ---------------------------------------------------- ~e:1~:b~~ ~~~~ ~::~;~~ ~~~~~~:~:.~~:~:~~~y~C~~::~?~=,~on~:?- _ _ _ _ _ _);, (This Item will Include all run-off created by site clearing andlor construction activities as well as all Site - ,l.=.J Improvements and the permanent creation of Impervious surfaces.) / Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? n This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Waterflowl . - l.=.J [Jv' nJ t:ll [J- [J/ [JJ [JJ 2 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? 5 Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Horizontal Distance? 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Stann-Water Run-Off Into andlor in the direction of a Town right-Qf-way? 8 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Roed Shoulder Area? (This Ilem will NOT Include lhelnstallatlon of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark In the Box, a Storm-Water. Grading, Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Pennltl ---------------------------------------------------- EXEMPTION: Ve. No Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan Is NOT Requlredl ---------------------------------------------------- STATE OF ~~~N~~~ ..S.lff/J.L............... 5S That I, ..........~.~.~...~.~~R.~................................. being duly sworn, de;"'ses and says that he/she is the applicant for Pennit, (Name of individual signing Document) And that he/she is the ...I).~..;Jh..~....................................................................................................................................... (OWner, Contractor, Agent. Corporate Officer, etc.) Owner and/or representative of the Owner of Owner's, 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 herewith. Sworn to before me this; I~ ~~~~.;~~Jl~..........~ 0 ~.r.::......................... 20D7 .. .....L..g!~......c~......... (Signature of ApplicantV......... FORM - 06/07 -