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Home My WebLink About32716-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY 110: Z-33180 Date: 07/31/08 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 4000 GREAT (HOUSE NO.) County Tax Map 110. 473889 Section 128 PECONIC BAY BLVD (STREET) Block L- Lot 2 LAUREL (HAMLET) Subdivision Filed Map 110. Lot 110. conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 27, 2007 pursuant to which Building Permit 110. 32716-Z dated FEBRUARY 27, 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 DORMER AND DECK ADDITIONS AND ALTERATIONS TO AN EXISITNG ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to AUGUSTUS D & BARBARA S KELSEY (OWNER) of the aforesaid building. SUFPOLK COu..-L': DEPARTMKIIIT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE 11IO. 3055594 OS/29/08 06/16/08 CUTCHOGUE EAST PLUMBING PLUMBERS CERTIFICATION DATED ~~"-;;- Rev. 1/81 ~'1Y S\J8V Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 nil " 0 d_; , ~ i , }'\'\ .J .,' J APPLICATION FOR CERTIFICATE OF OCCUPANCY \ l- 'T , .' This application must be filled in by typewriter or ink and submitted to the Building Dep~rtmellfr;~y'ith th,,~ foll~vI\'n~: 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 2/10 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: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swinuning 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. ., -''5-~ New Construction: Old or Pre-existing Building: V (check one) Location of Property: ~~ ~~ Ie. ~ t:)i tin , House No. Street I Owner or Owners ofPropertY:~OE~ )::" Q :'i:.e"o( Suffolk County Tax Map No I 000, Section ---3 '2.B Block 0 (g l-~lllUl...- Hamlet Lot 0) Subdivision Filed Map. Applicant~ Underwriters Approval: Lot: Permit No. '32.'1 i (" Date of Pen nit. .--. t'"f:lltrfL Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate SOU Fee Submitted: $ -Z- ~ (0). 0'31 ~a C4 C/ ')~\g ~ '1 Final Certificate: / ~tfYL (check one) 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 Soutbold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE -#0320C ...----Date: June f2. iOOg- --- - THIS CERTIFIES that the construction of a second-floor dormer addition. deck and window reolacements At 4000 Peconic Bav Boulevard. Laurel. New York Suffolk County Tax Map # 128-6-2 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 11/4/06 pursuant to which Trustees Permit # 6481A Dated 11/15/06. Was issued, and conforms to aU ofthe requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for the construction of a second-floor dormer addition. deck and window reolacements The certificate is issued to BARBARA KELSEY owner of the aforesaid property. r~~ Authorized Signature 1 OW~ Hall, 53095 MaII\ Road P O. Box 1179 SouU'lold, New YOrl( 11971 fax (516) 16S.leZ3 Tel9p/101U1 {5161 765.1 S02 OFFICE OF lliE BUILDING INSPECTOR TOWN OF SOUTHOlD C E R ~ I FIe A T ION DA~E: ~ /; ~f Building Permi c No. 752.'" I b Owner: ~~""""( (please print) Plumber: :r.'[')'Vlt>~ .1./ {v -fc.hd1've- E, f.- H xl/e (p.lease print U I certify that the solder used in the water SUpply system contains less than 2/10 of 1\ lead. Sworn to before me this _._./'_7f... ...---':' _ day of ~Illr" Not:.ary PubUc IL \~' u L ~aCl g - -- JANETV. STEWART Count.y NOTARY PUBLIC. Sli,t~ of New York No. 52-4(;633485 Qualified in Suflolk County Cc>mmIlI$\On Expire:! Nev. 30. 20 Ie v '-"'?""<'/"'??"'~",'''''--~~,"",'''''' ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Located at ~ ~ ~ ~ ~ ~ ~ I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~@] ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ii!ffi! BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 Upon the application of CERTIFIES THAT upon premises owned by SJ O'CONNOR ELEC. CONTR. 1195 SHIPS DR. SOUTHOLD, NY 11971 . KELSEY 4000 PECONIC BAY BLVD. LAUREL, NY 11948 4000 PECONIC BAY BLVD. LAUREL, NY 11948 Application Number: 3055594 Section: Block: Certificate Number: 3055594 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Outside, Attic, Lot: Building Permit: 0 BOC: os11 A visual inspection of the premises electrical system, I.imited to electrical .devices and wiringio 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 29tb Day of May, 2008. Name Alarm and emergency eqnipment Sensor Sensor Appliances and Accessories Dish Washer Exhaust Fan Wiring And Devices Fixture Outlet Outlet Paddle Fan Receptacle Receptacle Switch OTY Rate &m.i!lg Circuits Tvpe 2 8 o o o o Carbon Monoxide Smoke 1 4 o o 1.2 KW F.H.P 31 31 78 7 7 58 44 o o o o o o o Incandescent Fixture Gen, Purpose GFCI Gen, Purpose Gen, purpose seal I of This certificate may not be altered in any way and is validated only by the presellCeofa raised seal at the location indicated. 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. 32716 Z Date FEBRUARY 27, 2007 Permission is hereby granted to: BARBARA KELSEY PO BOX 405 MATTITUCK,NY 11952 for : DORMER ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER TRUSTEES APPROVAL at premises located at 4000 GREAT PECONIC BAY BLVD LAUREL County Tax Map No. 473889 Section 128 Block 0006 Lot No. 002 pursuant to application dated FEBRUARY 27, 2007 and approved by the Building Inspector to expire on AUGUST 27, 2008. Fee $ 236.00 ~~ , Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL . .. SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.netlSouthold/ PERMIT NO. :3,;) 7ft ~ 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 Check Septic Form N.Y.S.D.E.C. Trustees Contact: ' , Mailto:~~l.,efL -:to'1- I ~G)e- MC>T\m~ Phone:~8 .. 5'451--' Examined Approved Disapproved alc ~~~~~ Expiration fllI,2oJ2r f' r ICJ~ . Building Inspector FEB l? :APPLICATION FOR BUILDING PERMIT J Date '2/ , 20 crT 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. APPLICATION IS HEREBY MADE to the Building Department for thl! issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, 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 rein described. The applicant agrees to comply with all applicable laws, ordinances, building cod , ing code, and regu ions, and to admit authorized inspectors on premises and in building for necessary inspections. name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~ Name of owner of premises \~C, ~fY).Dv KELSE..L( (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. feNo! N Go " . . I. Location of land on which proposed work will be done: Atc:O 'PeCoN\C- ~ '~,,"-JO House Number Street ~~ Hamlet County Tax Map No. 1000 Section Subdivision l~b Block 0 b Filed Map No. : In; :.J!. m,~J(.l';2.. ,I, " "- ,,,1' 49t ,",i'fiq' v'd('>~ . Lot:.., (Name) -----.. 2. State existing use and occupancy of premises and intended use and occupanc~ofpropo;red construction: a. Existing use and occupancy ~ \ N G LE fPfl11 t... 'r' ~~ ~. b. Intended use and occupancy '5p>-rY1~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration V 4. Estimated Cost 100 07fb (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 existing structures, if any: Front 41' Rear Height :2 5 ' Number of Stories '3- Dimensions of same structure with alterations or additions: Front 3. Depth ~ Height '2J? Number of Stories 8. Dimensions of entire new construction: Front 4-"t Rear 40 Height '2:5 ' Number of Stories "2- +0' Depth +~' r Rear~ 2- Depth -\-B 9. Size oflot: Front Il~ Rear 1011 Depth 54Cf · 10. Date of Purchase Name of Former Owner I I. Zone or use district in which premises are situated ~1b 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 7""- I4.NamesofOwnerofpremises~~&( Address~Ic...~Bwo~No. ~8 . '6~l Name of Architect O. fel~ Address ~ll)a-. Phone No 'Z.cj&. 5-+6 'So 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. 16. Provide survey, to scale, with accura!e foundation plan and distances to property lines. ~ ~ -ON ~ 17. If elevation at any point on property is at lO feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF ) ~ (Name of individual si . g contract) above named, ~l\~ (Contractor, Agent, Corporate Officer, etc.) being duly sworn, deposes and says that (s)he is the applicant (S)He is the 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 {t..vb-- ~4-;;;;:~ Notary Public ......... M~ICHERT ,_,.l!Il/lliC .>I''''''of N8Iv York 'flo. 36-4741154 Quali~ed in Nassau I SuffQlk }JluntiJ!.1. /j CommiSSion t"pl'es _ /0/6/1 eJ.. '7 , ---- 3:J-7/G z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING N FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON REMARKS: ,F~ ~, ~0k, ~~~. DATE (, ~ S - 0 r INSPECTOR ~~ ] "J--7/' z. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION REMARKS: ~-t:a-~~ ~J0- ~ ~ ,- cYL- ~ olL 1E= c.c~. rt- .~ ' (pL ~ ~~ [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION [~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION . DATE S - ;1-/ - 0 f INSPECTOR ~~ )'J-7/':Z- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRucnoN [ ] ROUGH PLBG. P<f INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON REMARKS:~ ~~ La- tJ/\ ~ ~ ~~~ " DATE ~-/s- () ~ INSPECTOR ~ ~ 3l-7/fo:z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONS11lucnoN REMARKS: DATE ;7 ~7,- () t N ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION aJL...<L 0 / INSPECTOR ~, ~ 3 'J-7/ h Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ~M;;.~STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRucnON [ ] FIRE RESISTANT PENETRAnON p V- ""' L-t;:l- " DATE ;2--S -tJ g INSPECTOR ~ ~ II"" );;-71 ~ Z- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] FOUNDATION 2ND D<(!.w.IN~ STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RESISTANT CONSTRUCTION ~ U/'lIC;;a rJ- JuL tJ.A(.o - " , INSPECTOR ~~ DATE 1"'- t.f - () 'I f ...~ 3d-7/~ z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION MFRAMING(STRAPPI~ [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONS'IllUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~ ~oIc, DATE I ;;L ~ ?-o - d 1 INSPECTOR ~ ~ 11""- , ."~ ") ()-7/~ Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION t1><l FRAMING~RAPPI~ [] FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENEmAnON REMARKS: " DATE 1~-17/ () 7 INSPECTOR ~.~ FIELD INSPECTION REPORT FOUNDATION (1ST) ------------------------------------ FOUNDATION (2ND) ROUGH FRAMING & PLUMBING . INSULATION PER N. Y. STATE ENERGY CODE . FINAL . F \ l'\....Q... Tr-l.l d-n ^ ~ II DATE COMMENTS 0.>.." ~~ .- ::l ~"" N t- ~ \i' t~~ ~~~ : . z ? J A ''VI'? d1.#(J' ..\..~ _,..,/V~ .O,,"fA. ~'j7 -l=- rv 0 I ~ -07 Vt..-'. - '-~ ~. f) r-. ~ .~ -J-f-..v -I- Afi,j, "A r r iI~ LA:, ^ h-i":t1,. !J. ""- < ,K}' :;j ~ ~ ~ ~. 17 P..;;t-;,,. v r ('Il- -,.. rI-- rf:' ...L.' Q) "'"i-. \,...' _ .. ~ IJA JJ. " .....I..-LXC. "-""lI~ ,. _ I" ...., It:: "'"\ -'~ /~ , j(~,~cr O.i. 0 ;A. 01~. ././ .~? ~D '1- YOJlL ~ J- 1'). - C'~, dJV ~ K ~;d -c- 7F ~ ,3.-7/iW' il. .U ..n v~ L ~k ./ "" ?/J) 'I "" -.2= ^ , (\ g: ~~/~~'tJ1 &., ~~ JJJK V'.L" AU".. f;; ./;A/J 1"4"t ,;';"":l.J .1.1, (J,..I-.t- AL'J I;.., · 7" r< " /1 S --;-{ , cJ '_ --<U' -c~~"'VF- / -'2.. /-- -;::;;-U '....,/11/, ',J...".. O::......u- ., . --V~....-...""f--~. . -- ' A C'-c:.~. E~~ ~/7./. ~. (' ~.., AJ, />J).', " / t7 ~ ~'-1~7 ~\fl ~V'P' //. (/ "'~ '- b-.Y,~y hC~V ""3-- oR. ,~ f_.n S ;;1-/.-0 a) '- --' ADDITIONAL COMMENTS ...-c Ve..) (-C:6/ p._ 1_ . c/o , u ~ ~ r J....-5-o ~ /!.k'& t. IF cv.t. N: jI iI.. . - ~ ~ ,. <:.... 0 ~ Z ~;B 'i- ~ ~ oO!::1 \ :s OJ ~ .J .., I - 4 0 o z I~ ' :t: ~ ~~ ~~ .." :-l ", DONALD G, FEILER .ARCHITECT 11725 Main Rd' Box 1692' Mattituck, NY 11952' 631.298.5453. Fax 298.1380 February 15, 2007 Mrs. Patricia Conklin Town of Southold Building Department Town Hall, Main Road, Southold, NY Re: Proposed Renovations to the Kelsey Residence 4000 Peconic Bay Boulevard, Laurel, New York Dear Mrs. Conklin: I have investigated the existing sewage disposal system at the above mentioned project, and can verify that its capacity meets the requirements of the Suffolk County Department of Health Services for four bedrooms at the existing single family dwelling. DO'NALD G. FEILER · ARCHITECT 11725 Main Rd' Box 1692' Mattituck., NY 11952' 631.298.5453' Fox 298'1380 January 16, 2008 Mr. George Gillen, Building Inspector Southold Town Building Department Town Hall, Main Road, Southold, NY Re: Proposed Renovations to the Kelsey Residence 4000 Peconic Bay Blvd, Laurel, New York BP# 32716 Z Dear Mr, Gillen: In regard to the above mentioned project, I can certify that the existing window headers conform to the requirements of the Residential Code of New York State, . ~ "New York State Department of Environmental Conservation Division of Environmental Permit., Region One Buikling 40 - SUNY, stony Brook, NewYcrlI11790-2366 Phon." (631) 44~-0>103 . "AX: (631) ~44-O360 Webslte: W'Il'W.dec.stale.ny.us ~ ... ....., Erin M. CroIIy Commissioner .i,/ ,- Letter of Non..Jurlsdlctfon . Tidal Wetlands Act October9,2003 Ms. Barbara Kelsey P.O. Box 405 3790 Peconic Bay Boulevard Matliluck. NY 11952 Re: Kelsey Property 4000 Peconlc Bay Boulevard Mattltuck, NY 11952 DEC# 1-4738-03200/00001 Dear MG. Kelsey. Based on the infomlation you have submitted, the New York State Department of Environmental Conservation has detelTTlined that: . The portion of your propertyWhlCh is located landward of a functional and substantial man-madll structure (a bulkhead) greater than 100' In length, constructed prior to. 8/20n7 as shown on Aerographlcs Photograph #66-1890, Is beyond the Jurisdiction of Article 25 (Tidal Wellands). Therefore. ili aCCbidaneewi!litheCUli'entTldatWetlands land Use Regulations (6NYCRR Part 661 )no permit Is required under the TldalWetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any klnd may take place seaward of the tidal wellands jurtsdictlonal boundary, as indicated above, will10ut 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 adeqUllle work area between the tidal WlllIand jurtsdiclional boundary and your project (i.e. a15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale beml. . Please be further advised that this letter does not relieve you of the responsibility of obtaining any necessary pemlits or approvals from other agencies. ,';-:.;i:,_. Sincerely, . AI ~ ....d. ~~ GeorgE> W. Hamrnerth PelTTIit Administrator cc: BMHP William A. Keley file ,~jL~,,-, Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. 1 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 Permit No.: 6481A Date of Receipt of Application: November 4, 2006 Applicant: Barbara Kelsey SCTM#: 128-6-2 Project Location: 4000 Peconic Bay Blvd., Laurel Date of Resolution/Issuance: November 15, 2006 Date of Expiration: November 15, 2008 Reviewed by: Board of Trustees Project Description: To construct a second-floor dormer addition, deck, and window replacements. r- Findings: The project meets all the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code. The issuance of an Administrative Permit allows for the operations as indicated on the plan prepared by Donald G. Feiler, Architect dated November 3, 2006. Special Conditions: Final inspection. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth in Chapter 275 of the Southold Town Code, a Wetland Permit will be required, This is not a determination from any other agency. James h;pr::6 Board of Trustees Jl?'{~ OWNER )Ji , RES-21,O LAND, SEAS. IMP. ,,- < /' () ~' LJ /,:/ {,'f -./ <.-' :' ;. .E"iIJ,o (/ 700 35"0 AGE NEW FARM NORMAL Acre Tillable 1 Tillable 2 Tillable 3 Woodland Swampland 3rushland House Plot -- fotal --- TOWN OF SOUTHOLD PROPERTY RECORD CARD -.) STREET i ,()';C VILLAGE DIST. SUB. LOT 1'?,'(.. /1 ACR. , ~. $'"U ~' ,N ~ ~ J,.) ,f,',.( I v . ~ v--y",", S ~. i//i. W ?d la, Ie ~h! !" " VL COMM. CB. NU5C. Mid, Value TOTAL DATE REMARKS 't?'<=-. $+ BUILDING CONDITION ND f.Q,; 5 BELOW ABOVE Value Per Acre Value - FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD " j J~ </ a :?y T')' /'- '" V-'. DOCK -- F ..:.~. M. Bldg. Extension Extension Extension Porch Porch Breezeway Garage Patio O. B. Total '1(06 ~,.....~ "',./ - ( -~t~..,:,: ~:i.:~,.._~., ~;-}~;:~<'r .! I. 128.-6-2 9/06 / ~ ~_..,...'--7 3 J' y V'(/ <C- /,j-~-i) ~ ,n-- / . Itls 7 X rl I~'I </9 ~ 6o.8!Y.. ;}, 00 I Lf 7 '0 IA.A-';"j...","".~.v-':.";:'~ f f) ;( '1 ; wfJ1) ..;.r~ 7tl. 1/1/ /.~ '1'00 ~CJ '$. 't,-;)., .:h1J 'X J.(r I~ ~~<? ,F2AJ Foundation Basement Ext. Walls Fire Place Type Roof '/, /1/ I - /1/ / / . \' ,/ /!, / - I /- 410' ~e~Q. I ) ,I Ii- ,.-, . t-e';:;:~." [Ie" Ci c( Ij/- C-1a~ rL,e' Dormer Recreation Room ,. /""1' r' /Tt1""" Driveway 7J<;tq ~'" " ..)73 V <t> ,. ~% .., C<::-" f' 0 ~.;;>.-.. ----;;;;:; / ..;,.{'jI,,.; ... .". 10 Bath U Floors Interior Finish Heat Rooms 1 st Floor Rooms 2nd Floor ;L , . ..ku:, i 7 .- :;/jC/._J .1 /~_,;:-:;, ro ~ P'/ f.) . , Dinette K. 'LR. DR. BR. FIN. B. -'1;j;_< ..,,-- -------------,-.,--.- , , '---"",.."."V, ...- - ~"- , , , - , " " , ,-, ", 1, ,\;- COLOR , " .' d 7 . , , ~ , " ~. 2> t ~" ," , .. ~ r ,'::-: >. " lid-at") A v//~" " , ~ I" , '-', TRIM ,1 , [J~I -Ie' A 1.5 '1 1"- if, / / / .' ,. " II / I .~: . I- 4 10' , ~I 10 I 3 s/ ..,. " ;/ .j-~;'t J .1 , I I M. Bldg. ~I .-,.- Foundation I Bath c - '-'L-- nn L.. :i / - , l\ \ \"" \. \ ~ .~ ~\ ,l ~ ~ ~ ~ ~. ~ . 0/ ~ 'li ~ i: <0 II ~C; l a .,'" (vU ~ VI ~ I" 'i-"- ~ \\ ,. , \ \~!' Q. ,. SURVEY OF PROPERTY A T LAUREL TOWN OF SOUTHOLD SUFFOLK COUNTY, NY. 1000 . 128 - 06 - 02 ScakJ: 1" = 40' Jan. 13,1993 :I; ')> ';Q .~ ~ \11 \ '" " , ;1. AREA = 1091 Acres to tie lines / 1/97/ 1 prepared In acCOrdOfKfJ '11th ",. minimum .JGf/dQl'dI for J/II. '11''1.,. tlf ../~ by 1he L.I.A.L.S. tllJd appro"fJd OfId adopted lor 'UM un by The New Yarlt Slat. Land Till,. Anodal/on. 93-122