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Home My WebLink About32941-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-32958 Date: 04/01/08 THIS CERTIFIES that the building ADDITIONS AND ALTERATION Location of Property: 560 OAK ST (HOUSE NO.) County Tax Map No. 473889 Section 136 (STREET) Block 1 CUTCHOGUE (HAMLET) Lot 44 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 19, 2007 pursuant to which Building Permit No. 32941-Z dated APRIL 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR & AS PER CONDITIONS OF ZBA #3738 DATED 8/18/1988. The certificate is issued to GEORGE W & ANGELINA BORNSCHEIN (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A 02/28/08 ELECTRICAL CERTIFICATE NO. 119694C PLUMBERS CERTIFICATION DATED 01/17/08 MAXIMUM ENV.MANAGEMENT 4zriZ~~ Rev. 1/81 _.._'--_...._-~-- . I' "I. ~ i ~} }l--- I' r'\ : I uUL '.fIR,' i' I -, L_'~" APPLICATION 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 bnilding or new nse: 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 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, For existing buildings (prior to April 9, 1957) non-conforming nses, 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 . I. 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 of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 3/r../<?r Ncw Construction: Old or Pre-existing Building: v (check one) Location of Property: 5W Dale. S+\~c1... CV+-G-\o.OSL"~ House No. I Street Owner or Owners of Property: G-CO~&e: "B.:,retJSCI-I r /A! Hamlet Suf1(,lk County Tax Map No 1000, Section /3{, Block 60<2./ Lot 0</'( Suhdi\/ision .. Filed Map. Lol: Permit No. ? d-q'f I t::. Date of Permit. '1/zt;/ZOO; Applicant: G-ea0i 3rl7~'v. Underwriters Approval: _. Hcalth Dept. Approval: Planning Board Approval: Rcquest for: Temporary Certificate "J,E d~_J Fee Submitted: $ 6"'~ Final Cctiificate: (check one) --'-- ~ ---------- Applicant Signature 6ltz.- 7t(oLfr C.O-'t 3..2~5<j' Electrical Inspection Certificate Issue Date 2/28/2008 Electrical Inspection Service, Inc. 375 Dunton Avenue East Patchogue, New York 11772 (631) 286-6642 Application Number 119694C Issued To: Street: Village: Mr. George Bornshein 560 Oak Street Cutchogue Section: 136 Block: 0001 Zip: 11935 Lot: 044 Town: Southold Contractor: Kenny Knapp Lie. # 33353-ME Was examined and found to be in compliance with the National Electrical Code. Commercial 1.1 NV Defects II Pool Ixl 1st Floor IXI Indoor 1)(1 Basement Cl HotTub IKI Residential [] Del Garage IKI Attic IKI 2nd Floor i<J Outdoor [] Addition Survey Switches Receptacles Fixtures GFI Heaters AlC Fans 33 27 30 7 2 5 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves 1/20a 1 20 1 30 1 Gas 1/20a Furnace Oil Gas Circulators Smoke Detector Bell Transformer 1 X 1 Meter Amps Phase UGlOH Jacuzzi Television CO Detector 1 200 1 /[3<] Bldg. Permit: 32941 Z Other Equipment 11-200 amp MIB Pane1/2-15 amp Air Handler Disc'! 2-30 amp AlC Disc. I ci~l:lML President Rough Inspection: 10/31/2007 Inspector: John Me Mahon III Final Inspection: 01/30/2008 Inspector: John Me Mahon III This certificate must not be altered in any manner. Inspectors may be identified by their credentials. .. \. Maximum Environmental Management, Inc. 840 Lincoln Avenue, Suite 18 Bohemia, NY 11716 Phone: (631) 589-1225/Fax (631) 589-1157 Report Prepared For: Project 10 # 0801102- Revised 2/5/08 JBD CONSTRUCTION Date Collected: 1/15/2008 161 LAUREL TON DRIVE Time Collected: 12:03 PM MASTIC BEACH, NY 11951 Matrix: Solid (Solder) Permit # 32941Z Collected by: J Hendrickson Location: 560 Oak Street Sample Origin: Expansion Tank c1w pipe feed Cutchogue, 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 Southo/d. 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 .~ Maximum Environmental Management, Inc. 840 Lincoln Avenue, Suite 18 Bohemia, NY 11716 Phone: (631) 589-1225/Fax (631) 589-1157 Report Prepared For: Project 10 # 0801102- Revised 2/5/08 JBD CONSTRUCTION Date Collected: 1/15/2008 161 LAUREL TON DRIVE Time Collected: 12:03 PM MASTIC BEACH, NY 11951 Matrix: Solid (Solder) Permit # 32941Z Collected by: J Hendrickson Location: 560 Oak Street Sample Origin: Expansion Tank c/w pipe feed Cutchogue, NY REPORT SUMMARY PAGE Acceptance Parameter Result MRL Limits Meetsl Exceeds Limits Total Lead in Solder 0.04% 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 Analytical NYS ELAP # 11693 Page 2 of 2 FROM I FAX NO. Apr. 01 '. 2008 09: 11AM Pl '~fZNS~Ht/N .. Jame. F. King, President .Till M n....ho'"", V;Nl."p,.,...t1~...nt. ~' ~"",\\ \If O)UII~;'\.. ffd~~~ ~!..!~ \~ ~.~~,OY ''\: rl' I'n.......; ~ .# ~ r.v.DUA.L.Lf'lf e<>uthold, New YOrk 11971-0959 Telephone (681) 765.1892 F~(631)765.6641 Town Hall 53095 Route 25 PellllY A. D1ck-.r$On ~____ T"JI_______ ........... ---0-- r \ I \ BObOhO~' .;~ " \"\ '., ',,_ r, \ " ' \ eel 3 '1\:;)) '\ /.\ .~,' , ,.. -.. ,. , BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ", \ ._--- CERTIFICATE OF COMPLIANCE .-(.. - .-.... ..-' #~ vate: Marcn ..:~. ..:uu~ TIDS CERTIFIES that the existim! deck. SQuare off real' of dwellinl!..' add a second floor to dwelling. extend rear of existil1l;! garage to meet'the dwellin2 At ~60 Oak Street. Cutchol!ue. New York Suffolk County TaxMap # 136.1.44 ' Conforl118 to the application. for a Trustees Permit heretofore filed In this, office Dated Q7,/~1I06 pUl"Suant to which Trustees Permit # 6441 Dated 09/20/06. Was issued, and conforms to all of the requirements and conditions oUbe applicable provisiOnS of law:The project for which this certificate is being issued .Is for thl:, exis~ll deck. sauare off rear of dwel1in", add a second floor to dwe!1in". extend rear ,. ._ . ~ ...... ,. _ _ _ n_ .. _ ..._ .~_ _ _.. 1.'-... ...1.........11:...:..- . I. u.i. v.......~"'.L.U..... ................... ....... ...........~ ......... ....... .....--.......~ I """". _ _ __,....~__ _.... ~. ~~_~'__...1 ""_ "'-;r-^~...'-"~ 't"t'T n"TI""-T~I"'~'I'''''Y _u._^"" ^'.L^ &&a'-' '"'.......~a"'..." ago 1.0...M~_ ,........~-_.....~- .,. _.'1"'....................................., .....-~-- -- -~ I :lUl~A.lU VIVIJt;,I,"'~. I y.,-6<'~ I V ~ I Authorized Signature I I I I \ ...;....,...-.l._ 04-01-2008 08:30 SOUTHOLD BUILDING DEPT 16317659502 PAGEl 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. 32941 Z Date APRIL 25, 2007 permission is hereby granted to: GEORGE W & WF BORNSCHEIN 1750 STEVENS AVE N MERRICK,NY 11566 for : ADDITIONS AND ALTERATIONS TO AN EXISTING DWELLING AS APPLIED FOR PER ZBA, TRUSTEES AND DEC AS APPLIED FOR at premises located at 560 OAK ST CUTCHOGUE County Tax Map No. 473889 Section 136 Block 0001 Lot No. 044 pursuant to application dated APRIL 19, 2007 and approved by the Building Inspector to (" Fee $ 306.80 ORIGINAL Rev. 5/8/02 Southold Town Board of Appeals MAIN ROAD. STATE ROAD 2S SOUTHOLD. L.J" N.Y. 11971 TELEPHONE (516) 765.1809 APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS, JR. SERGE DOYEN, JR. ACTION OF THE BOARD OF APPEALS ReBeRT J. 98l:J8U.!:S JOSEPH H. SAWICKI Application of GEORGE BORNSCHEIN for Variances to the Zoning Ordinance, Article III, Section 100-31 for permission to extend garage located in the front yard area and attach same to existing dwelling, and to construct additions to square off rear of dwelling in excess of maximum-permitted lot coverage requirement, at premises known as 560 Oak Street, Cutchogue, NY; Lot #24 and one-half of #25, Map of Eugene Heights; County Tax Map Parcel No. 1000-136-1-44. public hea . in the Ma of under o. 3737; and as held and luded 0 _ lication 0 AND JOAN WHEREAS, at said hearing all those who desired to be heard were heard and their testimony recorded; and WHEREAS, the Board has carefully considered all testimony and documentation submitted concerning this application; and WHEREAS, the Board Members have personally viewed and are familiar with the premises in question, its present zoning, and the surrounding areas; and WHEREAS, the Board made the following-findings of fact: 1. By this application, appellant requests Variances from Article III, Section 100-31 of the Zoning .Code for permission to (a) extend garage and attach same to existing dwelling, which by becoming part of the principal structure will not meet the required front yard setback, lot coverage and sideyards for a principal structure in this zone district; (b) construct additions to square off rear of dwelling, which will not meet.the limited 20% lot-coverage requirement for all construction. 2. The subject premises contains a total area of approxi- mately .10 of an acre, with 37.5 ft. frontage along the east side of Oak Street, lot depth of 98.6 feet, and frontage along the ordinary highwater mark of Eugene's Creek. l/ / /2- - Appl. No. 3738 ,Iter of GEORGE BORNSCHEIN ;icision Rendered August 18, 1988 // Ii 3. This property is identified on the Suffolk County Tax Maps as District 1000, Section 136, Block 1, Lot 44, is referred to as Lot 1I24 and part of 1I25 on the Map of Eugene Heights, Cutchogue, and is improved with a single-family, one-story dwelling structure and accessory garage, all as shown on the survey prepared July 6, 1979, by Roderick VanTuyl, P.C. 4. The following information has been furnished by the property owner for the record: (a) square footage of lot: 3638 sq. ft; (b) square footage of existing buildings and deck 1423 sq. ft. ; (c) percentage of lot coverage proposed 39.1 percent; (d) square footage of proposed additions, garage 42 sq. ft., house 93 feet; total 135 feet; (e) percentage of proposed and existing lot coverage 42.8%. 5. Town records also show the following dimensions of existing construction: (a) main building 528 sq. ft.; 7 xIS' extension 105 sq. ft.; garage 16 x 14' - 224 sq. ft. {see assessors property record card). 6. The accessory garage structure is presently located in - -- the front yard area with a setback of 1.5 feet from its nearest point with the front property line. The main dwelling structure is set back 22 feet from its closest corner to the front property line, 3 feet from the south side property line, 9 feet to the northerly side property line, and approximately 15 feet to the concrete wall (and 39.5+- feet from the ordinaryhighwater line as shown on the July 6, 1979 survey map). 7. Article III, Section 100-31, Bulk Schedule, of the Zoning Code requires a maximum lot coverage of all buildings to be 20 percent, requires a minimum front yard setback at 35 feet or the average of the established within 300 feet on the same block and same side of the street, and minimum sideyards at 10 and 15 feet. 8. It is the opinion of the Board that the premises is substantially nonconforming in these respects as exists today; however the variances requested in relation thereto are not substantial. The Board agrees that the applicant's requests are the minimal necessary to afford relief under the circumstances. 9. In considering this appeal, the Board also finds and determines: (a) the practical difficulties are sufficient; ".,- / / / 3 - Appl. No. 3738 tter of GEORGE BORNSCHEIN Decision Rendered August 18, 1988 - (b) -theproperty is unique as to its substandard size and limited front and rear yard areas; (c) there is no alternative available for appellants to pursue; . (d) . the' relief will not: in turn be adverse to the safety, health, welfare, comfort, convenience or order of the town; (e) in considering all the above justice-will be served by granting the further noted below. factors, the interests of relief, as applied and ";', .,- A7corc;ling~y., on motion bY.Mr .Goehringer~ seconded by "' . Mr. Gr~gon~s, ~t was...c._.... ',.C.'- ."..C. RESOLVED, to GRANT the relief requested under Appeal No. 3738 in the Matter of the ApplicatioIlof GEORGE BORNSCHEIN-for the attachment and. extension .-of the accessory garage .tothe.. .';' .. principal dwelling, and squaring off' of the corners of the' dwelling; as submitted to this Board, SUBJECT TO THE FOLLOWING' CONDITIONS: . ."..:. L'. Two.doors,. of a. size three ft. wide each; or placed within the -. easterlywall.of. the garage; - . . '. ,.' '. ". . ~-~:~:!-:,;,'?_~.::"""" :_':::~--:-:-' .:',' ".,:"-~,,,,,,,,,-::--~.:,,.:...,.. '. . .~.- ,.--...-.'.....,;.... . -.. larger, -be ......,..,........cc, ...-'---...... .:" 2. No further additional construction or saturation;-_ ~, " ..... '. ... '---3.. Any further additions shall be permitted if they.areat an upper story and not extending past the building; 4. No further.frontyard encroachment for any additional construction-in"any manner~. . .... - - " _O" Vote of the Board: . Ayes: Messrs. Goehringer , Grigonis; .:'''. Douglass and SawiCki.',:(Member .Doyen of Fishers Island was'_.' absent.) This resolution was dUly adopted. lk * * * . /I~d/e;fJ~~ ... GERARD P. GOEHRINGER c:/.. ..:.._ CHAIRMAN .. . H' h_.,.:~.._..... ...". ," Office Location: Mailing Address: .- Town Annex /First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 August 10,2006 Mr. George W. Bornschein 560 Oak Street Cutchogue, NY 1 1935 Re: ZBA File # 3838 - G. Bornschein (1988) Dear Mr. Bornschein: Our department is in receipt of your letter and your inquiry as to whether or not the variances granted with conditions under Appeal No. 3838 are currently in effect for the purpose of applying for a building permit. You state that the construction was delayed, and are planning to apply soon for a building permit to build the same additions. You have also confirmed that the height of the second floor addition is proposed at a maximum of 26 feet to the top of the ridge, that the same two corners will be squared off at the rear of the house the match the new second-floor, that the rear of the existing garage will be extended by a maximum of 3'10" to meet the front of the house, and that the conditions are being complied with. In reliance on the above, and conformity to the conditions of the August 18, 1988 Variance, this will confirm that there is no time limitation to apply for a building permit, and variances go with the land. The conditional approval is therefore still in effect for the purpose of submitting architectural and other certifications required by the Building Department in the building permit review ~- Page 2 - August 10, 2006 Mr. George W. 80mschein Re: ZBA # 3838 (1988 Determination) process. . A copy of this reply will be furnished to the Building Department for their records. Sincerely yours, ~&.c0(L . Ruth D. Oliva ~ Chairwoman New York State Department of Environmental Conservation Division of Environmental Permits SUNY@Stony Brook; 50 Circle Road; Stony Brook NY 11790-3409 Telephone (631) 444-0365 Facsimile (631) 444-0360 To Be Announced Commissioner LETTER OF NON-JURISDICTION Mr. George W. Bomschein 3358 Columbrina Circle Port St. Lucie FL 34952 February 1, 2007 NYSDEC # 1-4738-03623/00001 560 Oak Street Cutchogue NY SCTM # 1000-136-1-44 Dear Mr. Bomschein: Based on a field inspection of your property performed by Charles T. Hamilton of the New York State Department of Environmental Conservation (NYSDEC), the NYSDEC has made the following determination. Your proposed project to construct one story additions and a partial second story addition onto the single family dwelling, and construct an addition to the garage, as shown on the plan prepared by George W. Bomschein on 11/28/06, is landward of the topographic crest of a bank in excess of 10 feet in elevation. Therefore, your project is beyond the jurisdiction of Article 25 Tidal Wetlands. In accordance with the current Tidal Wetlands Land Use Regulations (6 NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional . boundary, as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, bau;cr, or hay bale berm. Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. .-------- v ry truly YO//// CC: Marine Habitat Protection File . James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 SOUTH OLD September 20,2006 Mr. George Bornschein 560 Oak St. Cutchogue, NY 11935 RE: GEORGE W. BORNSCHEIN 560 OAK ST., CUTCHOGUE SCTM#136-1-44 Dear Mr. Bornschein: The Board of Town Trustees took the following action during its regular meeting held on Wed., September 20, 2006 regarding the above matter: WHEREAS, GEORGE BORNSCHEIN applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated July 21, 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, in accordance with Chapter 268, said application was found to be Exempt from the Local Waterfront Revitalization Program policy standards, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on September 20, 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, ~ 2 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, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that the Board of Trustees approve the application of GEORGE W. BORNSCHEIN to square off the rear of the dwelling, add a second floor addition and extend rear of existing garage 3'-10" to meet the dwelling, and for the existing deck, and as depicted on the survey originally prepared by R. Van Tuyl received on July 21,2006. 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.) Fees: $50.00 Very truly yours, Jam~g 0< 17 President, Board of Trustees JFKllms );-1'1-1 z.. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: ~ F~. [ ] ROUGH PLBG. [ ] INSULATION D4' FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON ~ Df(, E~cJ~ c>>it,~\l, j?!~-~d' 'rii ,Au!)l:) DATE ,)....rC)... S - 0 ? INSPECTOR ~~ 39-1/f1 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ~~' [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. t><{ INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION DATE II-r-o 1 INSPECTOR ~~ .3 /?-? if I Z- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION D<J ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON REMARKS: ~h _1 ~ ~"fJL- r;f- ~~ ~ t)K: DATE /lJ.-/S'- 0 7 INSPECTOR ~#-- 3~? 1ft :2- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~MI~TRAPPI~ [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~~. rr~ ' &/(# . DATE 9--U-01 INSPECTOR ~~ 3;)-1 '1/ z. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION 1)4 FOUNDATION 1 ST [ ] ROUGH PLBG. )<LFOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONS1RUCTION [ ] FIRE RESISTANT PENETRATION REM.RKS: . /~ ~~ ~.ok_ U-~~/ 7-30-07 DATE INSPECTOR ~ ~ - - :3 ;;-1 If I z- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING ~ FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: if ~ ~ ~ ~.G l~ ~ fJdi. DATE ~-'-f--()r INSPECTOR ~~ == ~'-1 :t~~ -1 ~ fi ~ 11-Lf- 0< 4-- II ./111 (), .. ^ nIl U II , ./ u..JI 'A ,0 < i=" "J..l-Q;\AJ\.v . DA,A., ./> j. 01>1.... 1. . t ~I? ., ~ ~ =-- " ~p 1!.. -H /' ...LC7 It.. f l 11~ ~?t\ ~ _, J ,J"A .110. a~P f'-::O .~-;.,. c..h. - '( ,'f. / /J~ (//11 <-~I p, y -vr, J CZ It- _, /_p ~,~'~'i\. .~'pJ7 \1' " ')--~5-( 1 L.. -.V \!.. ~k. e::. /J~--tV.,,," rf-- I'---" nY" P., ~ ~,1ItJA> '7. /4. / '.-lfI A- I" Ai 'V7' ~)k; ..- _ // g;~' ADDITIONAL COMMENTS ~ ~ ,,~~~ u'A_-t Ot CfN\\f '-11-aM Iru ~J ~ =~.. ~ 0 ~. , ~~ ('\\iii ~ ::Ole ~ rrr (); ~ l'> .. FIELD INSPECTION REPORT FOUNDATION (1ST) FOUNDATION (2ND) ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL . DATE I - UJ 'i->;;J .~~ ~~ .v"bP j !J(2 Oil 2~ 1:) (/(/V ~\t~ COMMENTS JJ ~ '^ ' 1/'30,'07 I J '~..1 , .~ oK, //10 ~ 1/~ I)' (7 "1 j :.... Uo.j) ~ {)t ~ y ~ l"t. "" 1)"T [;/\ 11 I 2 J\9 () 0", "" O~ :::p"" r:::. if' -\ ~ J, J-. - ^. '_ t1 ~ /11 I DJ / f (/ ....o-R, /~ '(}..I' , n n . I--J-9--JSJ 1 FA. ~A ~ II. 11. ~ .~ -.1,....\ ,,~. . NAP tJA! /rI/..'~ . U+ e--~'- f--- I JI~~ ?-L~ 1'f-$L~ ~7J1? .I.. . ~~JJ ---.- --, -i'j o ~ 'Y "l:l Vi ~ "" o (5 VI"' 2 ~ L-~ ~ /)I::l i'j "l:l ~ I /- i I , I , I I ! ot:' 1- ~ " ~ ,'I ~ L.o-f' Ii.... ,",,"' ; ';' ":." " "~~l ~':.~"C~ ~,Jt!~0<'Y! .,>;",:: ..........',. - ',. N. 82. '01 '/0..'/1''',,;;.'',;., -,'J.,.,., .', " - '-, . ,., , " . ",'~ IY+" ...f!) " .1 -~- -~---. J... 1IJ llJ ~ ~, 11)' .. "2;'::~"';#: .;. -;-"b' La..,.. Z6 '5.'0. .' 'u '1 "c:f5 -" :~ ' _ ."'i . "1: .f'I tA :1 ;~~\" -~\:'}1 'l'~'l~ ' .__ ,~l V "",.-...\ . " ~.; . I\} , ~::'\ . . ',; ~ :' j 0 f..J <14""1. . 1 "~ .~ ~. -0 ..' \il.. '!",:tr .f.... ~..J.: .'....,: ,.., . ~ ~. " ~'i Q .' I '$j.~; t .' ',' .' I fl'/r1""~ I/".~- 'well'O ~,. cOl1c.:~nel.-~It~ , ." '-- r . '. :So s,a.O/'IOHHI. I' - IflOM. c.of pipe; . " ",cow",.. .,.~ S. 98.6 ""'.!$. [ I I j , 1_._- r I L 0.,. 23 . MAP OF FkOPEIZTY SUeVEYEO Foe Gr=OQGE $ :"'\"IGE:::L I N/:4 t30ta,/:~~'Ct11[:"lt\1 n_.'_ _,___ ___ ___.. __..____. . . N ~ l\J . ~.I,' :1' ~l : -. i .. ., . ,. \ " :'\\, --'-j .. , i --.., II . ~ I 1 l\ .... "'1 \. r-- "-~\ i-It'- 11 \ co ~ . IU .;-----: \ \ h'~ t; .p " \' ~ r--'~ l I ~ -t " I ',i . ~\.. t 1 . " ,. V) ~f _._~--._-_._, ~, " \:. " , "">\ \.' Q \ '... \ .", .... . -l: AT CUTCHOGUE TOWN OF SOUTHOLD ,N. 'Yo 5cC'l/~, z.o'-r Q = /YO'" ,lFt.? Not-e: Lof HlJnt_I"S ~/.,ovV'" "''''fe,., -fo ';'.14 of CVj""'''' Hei~lds ", f;/~d ;.., /-h" :5'1fo'k; Co,,..,fy Clerk.'~ . J/,ee ,,, Mal- NQ 85'6. ~ ~ !!J ~ \) ,-::Oc,-.- J . .,". . .9_ :__'==-....~ _~ _0 ", I -I i I I I ! I i i IN J I , , j: rl.') !!) .. <. l!J \j .. " lu I I ! ! -j I; , I I ! JL__~ . '''/1 'Hts MYEY fS A VIOlATION Of '.'L~~ 7209 Of THi NEW YOIIC STA.n ~. r-"'''ON L4W. 1 ... to".. 0' THIS SUJ!V(y MAP NOT i '.lH'1Af'.iD SU:lV(YOI'S INKa> SfAl ~RARIN(J ! T~''l,,5SfD SfAl SHAll NOl llf CONSIDEIlED ! j i A VAliD rRUE COPY, I ; ~~~ANTEES _'N~'CAno H~RmN SHAll RUN i: .' IS 'RE:~[~H';:~"SOr>l fOil VNlOM THE SUfi.Vn ';Tfm CCMF~,,~I;D_ 00". H,S kl-lALf TO 'HE I' ':, lENo . . u iRiU...,NTAl AGt"NCr AND . \.. 'ING ''''':Sl,TUiJON L1SHO H~I<tON AND . I . 'lQ nu ASS:G."mS OF THt tlNDIJ...'G ;NSTI.. I I f ~ GUAuNras AU: NOT TIAHSF'~";'.'. f..fO..AOrOtnn........or.- _ ..,....Nf1lS.. ~ _Inur~ 01. CI'.U_~ - , , : I Gwo""CJI/~d fo +he S:x.d-y,oId :'''lvitl'J'; BaliI-. an:i io fife Gi--;;.f ~me,).i(:at1 7i~f-J~ htSVtTlf/C'.1 C,:,:;;t~.'j:xr/f;j l~;j ;. UI"'~'~(f,~.:i './<-14':; ~.; J 107'::i l.(.JL.::"i ~,'" /... l "-..t. -, :"'I'J"~/.., {.-? :.~. ,-> ,/ ~ n ~-_., "'- .._~~ t -t..-'(f- '" L"c~rlse:J' LaNd SUYV~Y'O"'$ G,.e"'....,tv~- f - N~w yQ......k r-. ,- "r ",~-f' r - . i' .:..)1);; . '._'J. ~f.."JI. ,.,. Hi,..' ......':;:,:.- i ,~','I( (' I. ~..I . . l)i:./:'OCO:['"~j,;.I?;;>,b/k~. i.I;, .#1'.1. TOWN OF SOUTHOLD . BUILDING DEPAR'fMENT TOWN HALL SOUTH OLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ PERMIT NO. 3 ~Cf til-=6 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the followinll before applying? Board of Health ~./-A 4 sets of Building Plans ./ Planning Board approval ./ Survey V Check V Septic Form N.Y.S.D.E.C. .......... Trustees \..0"""" Contact: Examined 1/2 _,20~ 5 ,20~ Mail to: Approved Disapproved alc Phone: '-11 ~ -&d-\"). Expiration ,20_ q:]l) :JR 192 APPLICATION FOR BUILDING PERMIT Date ,20_ 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 of lot 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. 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 inspections. ~ (Signa e of applicant or name, if a corporation) \\ oUJ Cc~M~::ld~~~c~1 N'-(_ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder A-cof-N 1 Name of owner of premises GE:Ol?Gt 4: ,ANl3?f;:L INA. ~<S:C~N (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer c:' (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location ofland on which proposed work will be done: s/oO Op.K:.. c2;,-t"f2E:\:::T-' House Number Street ~+o~e Hamlet County Tax Map No.1 000 Section Subdivision \-00 Block I Filed Map No. Lot 4-4- Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed cORstruction: a. Existing use and occupancy \ - rf(M II>( ?~ 51 'Cl\CN ~ b. Intended use and occupancy '?f'qY)e... Addition Other Work ,f Alteration I 3. Nature of work (check which applicable): New Building Repair Removal Demolition .4- 4. Estimated Cost Q.. 0 c.=>~ D.o.o (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. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existirg structures, if any: Front t D4~ Rear Height ~ '2..~ Number of Stories ---1- 2G> ' Depth S~ ,~\ 2(,1 9. Size oflot: Front '?l.? I Depth I 1: CfC,. ~ 10. Date of Purchase JIJ~ \ c\:'r'l 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_ 13. Will lot be re-graded? YES_NO -{ Will excess fill be removed from premises? YES -/ NO_ \1<:;0 C,;T~v~,", PAJ. 14. Names ofOwnerofpremisesGe;o~ ~NAddressl'l."'~a..~'}t-'G4Phone No. 51C,-&;,e. -4-1~"b Name of Architect ~~ e.. 5el-tuUv\Plt..:l Address :{.~~,q~"';;1 \\1C.~ Phone No (,01-410 -Z~2 ' Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ~ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMIT~A Y BE REQUIRED. - b. Is this property within 300 feet of a tidal wetland? * YES ~ NO_ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 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~ COUNTY o~l.rr~) )c '\1~ 6fttA'! -Jo~f'It-,) being duly sworn, deposes and says that (s)he is the applicant (Name ofindividua Si,;g contract) above named, (S)He is the ~ (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. t~ore me thi - day of ~~ Sign re of Applicant SUSANNA ROWE Nota'\! Pub;,.. State of New Vt'" Qualified In Suffolk County R".~~~17~ _....., 9- ) () MYCOrMt__~() - Erosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM Yes L EXEMPTIONS: A. Does this project meet the minimum standards for classification as an Agricultural Project. _ Note: If you answered Yes to any of the above, a Storm.water, Grading, Drainage & Erosion Control. Plan Is not required. ------------------------------------------------------------------- ACTIONS REOUlRlNG THE SUBMISSION OF A STORM-WATER. GRADING. DRAINAGE. & EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE. OF. NEW YORK. 8. Item Number: (A Check Mark (J) for each question is required for complete application) 1. Will tbis project retain all Storm-Water Run-off generated on Site? (This will include. all run"off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 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? Yes No X'g (;]~ B'K ~ bJ~ BK [;]K (;]6' \ Note: If any answer to questions one through eight 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 permit. 2. 3. Will this application require land disturbing activities encompassing an area of five thousand (5,000) square feet of ground surface or more? , ------------------------------------------------------------------- 4. , (,- Is there. a Natural Water course running through the site or is this project within) One hundred (100) feet of wetlands or a beach? J. 'y' 5. Will there be site preparation on slopes which exceed fifteen (15) feet of vertical rise to One hundred (100) feet of horizontal distance? 6. Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of-Way? 7. Will this application require the placement of material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? (This item does not include the installation of driveway aprons.) Will there be site preparation within the one hundred (l00) year floodplain of any watercourse? STATEOF~~~~FHH~ That 1, 'H'H~'" H.hpi'l.N.H.....H.H.....H.H........ (Name of individual signing Document) S8 ..... being duly sworn, deposes and says that he/.....s the applicant for Pem:rit, And that Helsa. is theHHHAY#N.fT,?'Q",,J.e.~. (Owner, Contractor, Agent, Corporate Officer, etc.) Owner and/or representative of the Owner or Owner's, and is duly anthorized 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 belier; and that the work sill be perfonned in the manner set forth in the application filed herewith. Sworn to before me this; ...ZJrlHHdaY^Of~ .................2007 Notary Public: .~~...;-: Notary Public. S_of New Yorl< Qualified in SuI~1oIkCounty Reg. No. 01CU61 6 <:) MV 9~tlIffil~~I@" I!IIjllI (Si ature of Applicant) Ji~~ "Jord~1? ,<~;);", :<"'->-. ;;"I'~*'" \~., , . ,'-' 1"_ \~~I~:~ ';," " I ,~~} ....~ ",',1','" - .,.)~". ~:~~~?l~j::~,'~;}- Builder Name: Builder Address: Building Address: Project Description Submitted By: Residential Trade-Off Worksheet Envelope 2002 New York State Energy Conservation Construction Code Date: \ Z / ZCl / c>v, '0<00 =1<=- cz:..iT<~E&t-, Gu~G::>Ug.. ~y. \ 'M- It 2ND ~~\'-h0l-l . Zone # GI~I4\ v.::>l;:SIU>t-\ Phone#: G.?\-4,o-~z. Sheet 1 PROPOSED REQUIRED U-factors and F-Iaclors can be found in Tables 1-10 Ceilings, Skylights, and Floors Over Outside Air Description Insulation U-factor x Area R-value =UA Required U.factor x Area =UA Ceiling ~-\g .OS\ ,ZC li2 '3G, .r I . c:>Zf> I,z Floor Over Outside Air li2 Skylight ft' li2 li2 Ceilings: Total Area l2..P ft' . "" li21 '20,2 Walls, Windows, and Doors Description Insulation U-factor x Area R.value = UA Required U- x Area factor = UA Wall 12.-17;> .0132 '1'7\ ;7ft2 ,1'>'-7 I , I?:> 110 a.2ft' I '''''I.T I Window - , 'J;,?J S'b.4- ft2 1-r,G, Door li2 Sliding Glass Door li2 . ft' li2 li2 Walls: Tolal !>tea lolo.2li2 Floors and Foundations Description Insul- Insulation U.factor x Area = UA DeDth R-value Floor Over Unconditioned Ie'-I9 .04T ,Go,~fl2 e.?J Basement Wall It' Unheated in Slab fl2 Heated Slab in fl2 Crawl Wall in It' Required U- x Area = UA factor ,0'0 I i1Go.?j It' l;.~ It' li2 fl2 li2 , ing design represented in these documents is consistent with the building plans, speoifications, and other oa:loulations submitted with the n designed to meet the requirements of the 2002 New York State Energy Conservation Construotion Code. e> G\~\ Company Name ~SI("PN \ 2./Z'1/ o(p Dale "~~'':'~- .-.~ ':-,.-'~' L=~~~ '-"-~-- ( .'" ,;,~ ' "7 I ..~ 'j ,.,1; ;'4;'i "'":. .......t..... _ ~ ..~. ... oS .~.;.. .--.. .':1/ j ~ "'t" ~ /,t,;~l . . ~,.. 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