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HomeMy WebLinkAbout32132-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33080 Date: 06/09/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 300 BIRCH (HOUSE NO.) County Tax Map No. 473889 Section 54 RD (STREET) Block 9 SOUTHOLD (HAMLET) Lot 18.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building permit heretofore filed in this office dated JUNE 15, 2006 pursuant to which Building Permit No. 32132-Z dated JUNE 19, 2006 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY INGROUND SWIMMING POOL WITH FENCE TO CODE AS APPLIED FOR PER ZBA # 5875 DATED 5/11/6. The certificate is issued to CHERYL FELD (OWNER) of the aforesaid building. SUFFOLK COIlNTY DEPAR'l'MEIlT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3248 07/29/06 PLUMBERS CERTIFICATION DATED N/A ~ri~ Rev. 1/81 . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 -, . ;j \ jJl.i~ 1 __J APPLICATION FOR CERTIFICATE OF OCCUPANCY \ --- :--...._~..._-'- This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 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 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory 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. tl'1 /0 9: SI.J.:l \ MM I^-\ ~<XJ....... / / New Construction: \ / Old or'Pre-existing Building: (check one) Location of Property: - 300 \b~c:h ~A-() Sn.~",\~~ House No. Street Hamlet Owner or Owners of Property: C. ~ Y L y(: ( 0 Suffolk County Tax Map No 1000, Section ."5'"1 Block <1 Lot 18. I Subdivision Permit No. 39.1 3d. --=2.. Date of Permit. Filed Map. Lot: Health Dept. Approval: 12. / lo Ie)+- Applicant: (\ ~ -t? 'f l .T ~U) I / Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: / (check one) j~i1t! Fee Submitted: $ .2.5".00 Co -2,?>?:,D~ ~ C 144d-) 3d-I?> ~ SUFFOLK BUREAUOf ELLCTfllCAL INSPECTORS, inc. 40 Nottingham Drive, Middle Island, NY 11953 Telephone: 6314958136. Fax: 631 980 6455 . E-Mail: SBEIGS@gmail.com CERTIFICATE OF ELECTRICAL COMPLIANCE Applicant: Raymond Electric Rough In Inspection Date: 7/29/2006 Application NO: 3248 Suffolk County Tax Map NO: Final Inspection Date: 7/29/2006 Certificate NO: 3248 Building Permit NO: This Certificate of Electrical Compliance is limited to the inspection and compliance of electrical equipment and/or work described below, installed by the applicant named above, located at the premise of and not after the final inspection date above: Owner: MargoliS Address: 300 Birch Road, Southold, NY 11971 Address of Inspection Site: 300 Birch Road, Southold, NY 11971 X Residential Indoors Basement Service Shed Commercial X Outdoors 1st Floor X Pool Other: New Renovation 2nd Floor Hot tub Addition Survey Attic Garage Inventory Service 10 Heat Duplex Recpt Ceiling Fix HID Fix Service 30 1 Time Clock 2 Switches Wall Fix Smoke Det Main Panel Hot Water 1 GFCI Recpt Recessed Fix Co Det 8 Ckt Sub- Panel GFCI Breaker 1 Single Recpt Fluorescent Fix 1 Pump Disconnects Dryer Recpt Range Recpt A/C Blower Emergency Fix Transformers Exhaust Fan Appliance A/CCond Exit Fix Twist Lock lVSS Heat Pump Electric Heat 1 Pool Luminaire Other Equipment: 1-Chlorine Generator The electrical work and/or equipment described above were inspected and appear to be in compliance with local, state and national electrical code requirements-and this office. Applicant: Raymond Electric Inspected by: . ~e;f R. Surdi Signature: ~ License No: 5141-ME Date of Certificate: 8/19/2006 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. 32132 Z Date JUNE 19, 2006 permission is hereby granted to: CHERYL FELD 300 BIRCH RD. SOUTHOLD,NY 11971 for : CONSTRUCTION OF AN INGROUND SWIMMING POOL PER ZBA DECISION & CONDITIONS, FENCED TO CODE at premises located at 300 BIRCH RD SOUTHOLD County Tax Map No. 473889 Section 054 Block 0009 Lot No. 018.001 pursuant to application dated JUNE 15, 2006 and approved by the Building Inspector to expire on DECEMBER 19, 2007. Fee $ 150.00 LA.... C~~ / Authorized Signature ORIGINAL Rev. 5/8/02 APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerard P. Goehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809. Fax (631) 765-9064 -, j\i\ \ \ Mailing Address: Southold Town Hall 53095 Main Road. P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex /First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MAY 11, 2006 \ ~B.fjJe No. 5875 - CHERYL FELD and JON MARGOLIS ~Eirty location: 300 Birch Road, Southold CTM 54-9-18.1 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without an adverse effect on the environment if the project is implemented as planned. PROPERTY FACTS/DESCRIPTION: the applicant's 1.69-acre parcel has direct frontage along four streets: Pine Road, Maple Road, Chestnut Road, and Birch Road. The property is improved with a single-family, one- story frame house and accessory garage, all shown on the 6-20-90 survey prepared by Kulhanek & Plan, land Surveyors, P .C. BASIS OF APPLICATION: Zoning Code Section 100-33, based on the Building Inspector's March 10,2006 Notice of Disapproval concerning a building permit application to construct an accessory in-ground swimming pool. The new construction is proposed in a front yard rather than the code-required rear yard. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on April 27, 2006, at which time written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the property, and other evidence, the Zoning Board finds the following facts to be true and relevant: AREA VARIANCE RELIEF REQUESTED: The applicants wish to locate an 18' x 44' in-ground swimming pool in the yard northwest of their dwelling, 80 feet from the front lot line along Pine Road and at least 20 feet from the lot line along Birch Road. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: The property has four front yards, and while a swimming pool is an accessory structure that is customary and incidental to a residence, the zoning code does not provide for a pool in a front yard without a variance, except when the land has frontage along a waterway. For these reasons, a) grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. b) the benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue, other than an area variance. Page 2 - May 11, 2006 ZB File No. 5875 - C. Feld and J. Margolis CTM No. 54-9-18.1 c) the difficulty has not been self-created d) no evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions it] the neighborhood. e) grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an accessory in-ground pool, while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Dinizio, seconded by Member Goehringer, and duly carried, to DENY the variance as applied for and noted by Skim King Pools on the 6-20-90 survey prepared by Kulhanek & Plan, Land Surveyors, P.C., and to PGRANT alternative relief as noted below and subject to the following conditions: 1. Screening with ~vergreen plantinQs at a minimum heiQht of 5 ~et. 2. The pool shall not be covered with a roof or enclosed. ' 3. The pool sh8lToemoved for a minimum setback of ~et to match the existing setback line of the dwelling. 4. The pool shall be 16 ft. x 44 ft. (or less) instead of 18 feet wi@. Any deviation from the variance given such as extensions, or demolitions which are not shown on the applicant's diagrams or survey site maps, are not authorized under this application when involving nonconfonmities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. Vote of the Board: Ayes: Members Goehringer, Dinizio, Simon, and Weisman. Chairwoman Oliva was absent.) This Resolution was duly adopt~-O). Ui~,7'g- J ~. ~~(L Ruth D. Oliva 6/14/06 Approved for Filing -AtTN g L.J& Ri)'V1: c::kJ JJ '1/2 'l Ii t f, I " '" l,l.,,!;,.'''''' . p ,.., ".,. " In I r>fi .~~8~ " I I ~ ~.....:s~""'ei_r.s; 'rAtNy, ",",07 .; .shlolo.-f'f, N.Or ; ~.' (fiu.....e:.,q......ref.l:l. i I I " I , ..;.... ~., TITLE No. SO' ~D . .P/N~ '1 N~7'4. '-90" ~ 11~.o.y bl " /b f\ ::t (!) 1.30.!!J1' 'i:I f\i o o f\i o (tl' 4-"".tiA.ellSU, Ie. c~~ "/K. ~ ~ COMPL WITH Att.....CefDe-m.J. NEW YOR STATE & TOWN CODE" AS REQUI ED AND CONDITIONS C SOUTHCt.D TOWN ZBA Ct.D TOWN PLANNING BOAR ~TOWNTRUSTEES ~. V.s, DEe l\l o o ~ ). \) I' Il't J " 1.30. ~ ( . N4-7.4~'40"~ ~ 0 &j ~ 0 ~ ~ ro f'l\ .t) .; ,. -,... ,.' '. r ro:::I.'~: f~ , .t) " l., !AI II! &.l ~(h ~Ul " '6\ 1W , .~ 0" "'~' h\P' "I.. \M,! , " ) ~~ , ..,.l\) ':o'N "T''; .,.-'. "\ .......,. t ':i~'': '-=';3 '..:/6':"", .', '--';;;'7".~':::'~;;':;:f')\l.rje-5,~f<o.:~.,", ",'." i .:-" <";~-'~~~~;~~''.:-;''k~~'-'~ ~""'~":_~~:r:1c'~"''':-:)'r:~lt:.:~,,;>~of,,...;_.:.~~)>.-, i, ':::'.','i.,,<~>:.,,~,,;:~o':':~~J~::~~~?:""" '~~"'i" . .,' .:,' .~.-. -, ""-'.-,, ' . S-'::H,(.J,'"!T. so~,~t:::! .:-1 ,;; ( MEASUREMENTS IN U.S. STANDAIlD i ".' ", . . 'r::?irY{~~~,;- .. i f~'"~;~.~;~1 ~:L~~:/ . ., "'-,' , ". TH_\OIMEIlIlIOHSiHOWN H.R_O!I;"ilOia THISTRUCTURES ~o lHE PROPERTY LiN_ .~I FOR .Ii INclFlCPUIlI'OS_ O~L Y.. THEY ARE /'IOTINTEND.u TO .. U~ED FOR TI!_ _R~CTI(lN OI',F~.C.";'.STRUCT1I.R~OR AIn OTH_R IMPROYaI_NT. ". "., ", J. . (" ' . . ~ ".' .." ' - . '"',coP~:~~\~i;~URY!Y"AP~t "~5i.~It"llUlli:= UNAUTI!ORlZED ALTUATlONIORADllI-' '.cWRING TH'; "I.ANll:.;SUIlYEYDI'S "AUll~ANDLENDlNGIN5I1TV11~ . D>l~lIliON. TlDNS TO TI!IS"SURVEY 18.A VIOLATION .., INKED 'EAL- OIt"e...08SED SEAL "INS1lIIIllO,ND TO N,TNE AISI,NEES. Of /J E. L~lil)lIfO OF SECTION 7208, SUI-DIVISION I OFTI!E' - .., , . SMAl:l iiilr'U,!CONSiDERED. TO.BE A NEW YORK alUCATION LAW. VALID TRUE coPY. -'.. _...... 'llt/AIWnEEs ARE NOT TRANSfERABLE TO ADDMOHAL INST1TUTttlJ'lS ll!!.SUBBEjlUE1Il' ~ . KOL~~NEK & PLAN . LAND SURVEYORS. P,C. SECTION DATE .<a - 20 . ..9,0 BLOCK 11/:50' SOUTH HO ~ D GUARANTFEll TO '.i t '" s CJ,r,ro '- "'- COUNTY JOB No. ". ".., ONG isL.(mr 0fFK:r I 'W_miHnrER OFFIC! p.O.aOX487. ,.' P.o.8I>X178:., . LONG B~APH. N.Y. 11561.. I'OUNDRIDGE;N.Y.l0'7~>.' 800-541-512oi . '"/i.' ...~ FAX (5161.43J.9461 FAX'19t41'?64-0306. ~o. .3Soo~ - .....,.... ~--- - .3 ~f J,:f.- Z. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING I STRAPPING ] FIREPLACE & CHIMNEY ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION C>4 FINAL ~ ~ [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: ,y:;~ 4~ 6}<, / ~ ~- c/1kt ~ {----: ~~M- ~/ DATE I 'J-~L(-o 7 INSPECTOR ~ ~ 3;)-1 3> 'J- ~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~ ~ .~ ~'- ~ ~~~.~ a~ ~ L,....- [ ] ROUGH PLBG. [ ] INSULATION v(FINAL C-:;:2.. , .;L~ ~ INSPECTOR ~ ~ DATE s ~;l-J-"7 FIELD INSPECTION REPORT DATE .. ' COMMENTS .- uJ", V'" -~ V"_ 'V'"" 'It (\J ~ ~~ ~ '" t'l ,Z !:l \jJ c 0 '" '"" E:i C)0~ - ~ ~ ~ r;:; '"" FOUNDATION (1ST) FOUNDATION (2ND) . ROUGH FRAMING & PLUMBING INSULATION PER N. Y. STATE ENERGY CODE S -'r-S- 0""1 ,Y '" ~",'.J. - -+:. /"\. 'n j) , f ...,1, ~\ , r 'li'",H . ~ JJA ~A./-r;t. tLr.,.\--/.-' Al11 W.J t 0,_0 "a v. ~.A~A~ ~,~ 1(..... ". /;j.. -'- ,. ~,~ A /.'At70~ FVU h- ,,!,,-t:r 2; v, '.. '0, {j /.Mr A - -p ~ /l//_A -I; ---I:::f~ l V~.:.. _~ ",'P/, ,//('.1. k7:,.L,~ (~~, r.-JI'l ~.... ('~,_ I / ( GJSJ~r,"'7~ J ~ ~Y;~ 1// / ===fii= ,ADDITIONAL COMMENTS \\\.21017 /..p ('f'\'\)~-0\..t- (M, . r.f) _. ~ 11-~If-07 ,,'..V J.( ~ A 1~, Ak . -P 1nZfJf.M"~ J_ ~_ 'f"off ... o".....J/I>. ~ fl- JJ .. ;6, ',i.A.-I d~ 'I' /}']) flNL ^ J) ./ A'O.., # (/ ~ C/ g "--' FINAL ~ I (j) -f: I0\" 5 " fi (t " ~ I"Q t'l ~ " ?< \ ! I~ "'- - , . ~ ..S) . l- e '"" ~ . - 0 -, z = '" L~ .:+>;; '" ." ;l , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL . SOUTHOLD, NY j1971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ BUILDING PERMIT APPLICA nON CHECKLIST R :-.:::-.-__ Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: i ) Mail toSLO I rl\ K, :7 \ -ete 2511- iL\Ll r'6 100 Examined '" PERMIT N?I'~/3 -2. -e:. dt" ' '<" ...P' , . " , /' ',-.,., " ,C/' ,'-' , " , ./ . rOO \s (J} }t"ne:, Approved Disapproved alc \ , ." Expiration ~ APPLICATION FOR BUILDING PERMIT Date Yi\?AYc.h "I ,20D(.. 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 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. . . /1 /:/ / I 1/ OCCUPANCY OR I MMEDIATEL V" USE IS UNLAWF'J'- (Sign ofap lca or name, if a corporation) N~~~~Ed'gMOpL(,1~I~DE) WITHOUT, CERTII=ICATE ~mG\'KtM:\CJ:)/\\0 BEFORE "WATER (Mailing address of applicant) . OF OCCUPANCY cSoLI:\ t\Old) N:{ Ilq-=1J whether applicant is owner, lessee, agent, m;."hit.\<l;.!l,eqgineer,.!:t;neral contractor, electrician, plumber or builder ALL liU'~,. mUCT,ON SHALL MeEl THE REQUIREMENTS OF THE ~b~~~~\~R1~R~'~~I~M' t (As on U or latest deed) If applicant is a corporation, signature of duly authorized officer FEE: I s/). BY: /~ RETAIN S~Or:Hv' WATER RUNO~OTIFY BUILDING DEPARTMENT AT (Name and title of corporate officer) PURSUANT TO SECTION 45-1OC F~i'~6~It'GU.JJ\,1"TO ~!M. F'JR THE OF TU~ TOWN CODE ' ,~P[cr.~"s. . .m;; . 1. r J'JNDATION - TWO REQulhE FOR POURED C:,JCam= Q 2. ROUGH . FR;.:AING & PLJMBllvG 3. INSULATION 4. FINAL. CONSTRJC"ICN MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE .So LL th o~EQUIRE~ENThlY\ THe X'{, r!; ('r: NEW ~K ST..T~ RE8POl~"Il:l~t ~OR I'J.;,IU~ ~":-t3Jh"~i' IGN OR CONSTRUCTION ERRORS. "'BI~ei::~; "1 ,.\C'. Lot \8. I .(f'~fI#'pN :;;:'. , Lot S Name of owner of premises Builders License No. d.. \ 4 I:;;'" H Plumbers License No. Electricians License No. t9- /.p 15 (J Other Trade's License No. I. Location of land on ~ich ProP;?Sfd work will be done: 300 bw'ch (U1I House Number Street County Tax Map No. 1000 Section Subdivision 5t\- (Name) 2. State existing use and occupancy of premises and intend a. Existing use and occupancy ) 11 e use and occupancy of proposed construction: Ii \ c(2.t'!c..(i b. Intended use and occupancy (Jofl l 1\P~t(UJ . \ 1nShl\ tr1'~}"'O~ 3. Nature of work (check which applicable): New Build;1Jl; Poo J 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. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front Rear Depth 10. Date of Purchase Name of Former Owner I I. 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 / 14. NamesofOwnerofpremises~Address/~OO~'~ ed Phone No. 510-.I'K3- 5'5'7Q Name of Architect LwJ .John nO n Address 1\6 U ~1Lt/Av..L Phone No "3~I-J.1 oS 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. 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 disilriCektb propertylU1es. Y.':" . L . '''AI'' , ~ '. . .. ' . , ... ., .. ' ~I 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on'fur;ey': - ...... .:/"', I' STATE OF NEW YORK) '. SS: .~ COUNTY OF ).; ..1, . j.' ~0:-Y -"I ((Oc\e.a-lce.!i~ =. .... > ~~~g duly sw~~~;e~oses and says that (s)he is the applicant (Name of individual signing contract) above named,,'M . (S)Heisthe (0(\ HO.C:\"lIY ~".'" .. . (Contractot,~gen;,. ~prpQrate Officer, :~iit;! "1 of said owner or owners, and is duly authorized to perforrJ or..liave:perfo~d'i~ 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 '7 day of e~ ~ fuWJ~ Signature of Applicant KATHLEEN Q!JlOU!Y NOTARY PUBLIC, _ ofNewYClIlt No.01Q\J81lMi24 Quelilled 1Il__ Caunlr Commilllon Ellpjla AprIl 25, :ao~ J~1 f " rOfL-fCP. flDMfl'fEP. ~f?.OM5'Jfy\C~ '" X-fln:~fH)ruwf' 10 Ylf5~ro "'",,6 i'1JJi'Ii!ElmG SCHE~l1C 44' " o ""..,"- FOI'J'iED COtiC. STEPS -lJ1- ,. 0, ... ':. , -~. . , SlIE<CTIiOJi\! is .0 f " T '" ;rJ '~ ':' " 211 to 4" ~W WffOM SJlECTI!OIi\! IA 'i' 10' --; '" mJQ =0 il ~.~ "E ... cmx ~ SJIECTI!OIi\! IB . WAlfR Uf\f -M- RGl.lfD fON/o,l?f1V,ffN Uf\fRtN.?CONCI(f1f A' LI A d" ^ .q- FORM 111:5 )'700 P5/ POIlW CON'Jflf VlNit. UNrR 2" 10 4" 5AND .. lf~OTIESJ I. Smt:1ill' IS Ol'SlCiffl7 fGR U9.' ffl.(}N up.;m N-D Of!!. Y II'J f?US VM'I!' 111' CPfl~.17 Wf,~ f/'Bl.e 15 A MINIMUM Cf '1'.8" IJtl.OW fit ppm09.'l7fIIJI3f'D CPJa. 2. ~faFll. 'MIH a.eAN e",,"1H. fffe Of ROOfS A'-Ir I7WRIS. DO 'lOf fl.WN 111' f1'1(/jr Cf ~,'afU 10 exaw fit f1'ICHf Cf M WAfeR III frli' poa BY MCfe 1lV'N 8". eft: M WA~ fa exaEO BfaFU BY /NJRj; 1l-WJ 8". 7. W/>l.fS ro ff 5/IOOfH. NON 51JO f'l!'e. 9.OPW AWAY fROMPOO. 'I. WAfeR !?I5l'05/>l. 5W'!.l. ff l.IM1fel71O OIM'I'PS PROPERf'( ro our l.COt. ffW.f,~~,IS ~0 o z tiS o d" ~ a.. ~ ..... -"'- >- Ohi z ~g ~ ":L 00: ~ 0 f- N c>. ~ >- LLI >- :>~~6 ::;" <r 00 VI cl. oL. cL ,;J ~ :r ~ -=r--~ ->/ 0 "<PrY - 05-22-Cl5 "