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HomeMy WebLinkAbout32748-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector TOWn Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33228 Filed Map No. Lot No. THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location Of Property: 1535 PARK AVE MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 2 Lot 31 Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated FEBRUARY 20, 2007 pursuant to which Building Permit No. 32748-Z dated FEBRUARY 23, 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 ALTERATIONS AND ADDITIONS, INCLUDING COVERED PORCH, SECOND FLOOR BALCONY AND ATTACHED ONE CAR GARAGE AS APPLIED FOR PER ZBA #5958, DATED 11/9/6. The certificate is issued to JEREMY & LAUREN HAMILTON (OWNER) of the aforesaid building. SIIFFOLR CODNTY DEPARTMENT OF HEALTH APPROVAI, R10-06-0103 SLSCTRICAL NO. PLDMBSRS CERTIFICATION DATED Date• 08/18/08 04/04/08 3044280 04/08/08 04/14/08 RUSSELL WILLIAMSON ~~~/ r7~~~ H , Authorized Signature Rev. 1/81 Form No. 6 ° TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY 22 ~1 ~__ This application must be filled in by typewriter or ink and submitted to the Building Department with th~ollowing A. For new building ar new use: "-« `~33--goy 1. Final survey of property with accwate 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. ~. Commercial building, industrial building, multiple residences and sirulaz 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: 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 itt writing to the applicant. C. Fees l . Certificate of Occupancy -New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swirrmiing 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. '~ /t ~/ ~ ~ d o New Construction: _ ~ Old or Pre-existing Building: ~ (check one) Location of Property: House No. Street Hamlet Owner or Owners of Property: /~ Q /Y1 ~, ~y c~ Suffolk County Tax Map No 1000, Section ~ 3 Block ~ Lot 3 / Subdivision Filed Map. Lot: Permit No. ~ ~ 7 ~f ~ Z Dale of Permit. p. ~ 7 Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: !/ (check one) Fee Subnutted: $ ~ 5~~ ~ 2 3 3~G.6 ~~ ~~~ I~ ApplicantSignatwe ~i -;li _ y y~ 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. 32748 Z Date FEBRUARY 23, 2 Permission is hereby granted to: FRANCINE M FIELD MATTITUCK,NY 11952 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER ZBA & SCHD AS APPLIED FOR at premises located at 1535 PARK AVE MATTITUCK County Tax Map No. 473889 Section 123 Block 0002 Lot No. 031 pursuant to application dated FEBRUARY 20, 2007 and approved by the Building Inspector to expire on AUGUST 23, 2008. Fee $ 1,177.60 ORIGINAL Rev. 5/8/02 Town Hall, 53095 Main Road P.O.. Box 1179 Southold, New York 11971-0959 ~OFfO(,~~0 ~' ~~ ~y • ~~ ~ ~yo! * Sao BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATION Fax (631)765-9502 Telephone (631)765-1802 Date: ~{ ~i `/ ~C7 Building Permit No. ~ c~ ~ / ~ `" Owner: h' cl. ~ i !~ I d ~''" (Please print) Plumber: ;~5`;C.~~ (/~i ~ ~ ~ o. /hS~N (Please print) I certify that the solder used in the water supply system contains less than 2/10 of 1 lead. ~~ Sworn to before me this ~ y day of C~~a:.~ 20 G ~ --i %~~--~ Notary Public, ~`~~~~` County (Plumbers Signature) buy Pubk:, State of New Yak No.OtOBS'3~009 OIMNbd h 3utlolrc Coutdy ~ ~~pbn pcpires August ,2009 BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET - NEW YORK, NY 10038 I~ 3, `~ ~ ~/ CERTIFIES THAT Upon the application of upon premises owned by SMITTY'S ELECTRICAL CONTRACTING 24 COTTAGE DR FARMINGVILLE, NY 11738 Located at 1535 PARK AVE MATTITUCK, NY 11952 Application Number: 3044280 Section: Block: Lot: JEREMY & LAUREN HAMILTON 1535 PARK AVE MATTITUCK, NY 11952 ~ a ~y~ Certificate Number: 3044280 Building Permit: BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Garage, Outside, Attic, 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 8th Day of April, 2008. Name QTY Rate Ratine Circuit Tvne Alarm and Emergency Equipment Sensor 1 0 Carbon Monoxide Sensor 8 0 Smoke Transfer Switch I 0 60a Generator Permanent Installati ] 0 6 Appliances and Accessories Exhaust Fan 3 0 F.H.P. Air Conditioner 1 0 36.000 BTU Air Conditioner 1 0 48.000 BTU Wiring and Devices Receptacle 68 0 General Purpose Switch 71 0 General Purpose Dimmers 6 0 Receptacle 9 0 GFCI Receptacle 1 0 20a Appliance Receptacle 1 0 20a Laundry Receptacle 1 0 30a Dryer seal Fixture 52 0 Incandescent Continued on Next Page 1 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. fit! 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 SMITTY'S ELECTRICAL CONTRACTING 24 COTTAGE DR FARMINGVILLE, NY 11738 Located at 1535 PARK AVE MATTITUCK, NY 11952 Application Number: 3044280 Section: Block: Lot: JEREMY & LAUREN HAMILTON 1535 PARK AVE MATTITUCK, NY 11952 Certificate Number: Building Permit: 3044280 BDC: ns11 Described as a occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: Basement, First Floor, Second Floor, Attached Gazage, Outside, Attic, 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 En forcement and Administration, or other authority having jurisdiction, and found to be in compli ance therewith on the 8th Day of April, 2008. Name 2 Rate Ratine Circuit Tvoe Paddle Fan 4 0 Disconnect 2 0 60a Air Conditioner Service 1 Phase 3 W Service Rating 200 Amperes Service Disconnect: 1 200 cb Meters: 1 sea! 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. APPEALS BOARD MEMBERS Ruth D. Oliva, Chairwoman Gerazd P. Gcehringer James Dinizio, Jr. Michael A. Simon Leslie Kanes Weisman ,~;'~OF SOUIyoI 9`** ~ ~O http://southoldtown. northfork.ne[ Mailing Address: Southold Town Hall 53095 Main Road • P.O. Box 1179 Southold, NY 11971-0959 Office Location: Town Annex /Fits[ Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 ZONING BOARD OF APPEALS TOWN OF SOUTHOLD TeI. (631) 765-1809 • Fax (ti31) 765-90ti4 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF NOVEMBER 9, 2006 ZB File No. 5958 -LAUREN and JEREMY HAMILTON Property Location: 1535 Park Avenue, Mattituck CTM 123-2-31 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the properly under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. PROPERTY FACTSIDESCRIPTION The applicants' 25,000 sq. ft. lot is improved with atwo-story, single- family dwelling and accessory garage, as shown on the August 27, 2002 survey prepared by John C. Ehlers. The property is 250 feet deep with 100 feet along Park Avenue. BASIS OF APPLICATION: Zoning Code Section 280-124, based on applicants' request for a building permit and the Building Inspector's July 6, 2006 Notice of Disapproval which states that the setback is required to be a minimum of 40 feet from the front property line on lots measuring between 20,000 and 39,999 square feet. FINDINGS OF FACT The Zoning Board of Appeals held a public hearing on this application on October 26, 2006, at which time written and oral evidence were presented. Based upon alt 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 construct an addition at the front of their home which will encroach by one foot into the 40-ft. restricted front yard setback. REASONS FOR BOARD ACTION• On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Grant of the variance will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The existing line of the house is 39 feet from the front lot line, and the proposed additions will all be within the confines of the dwelling setbacks (conforming and nonconforming 39 ft. front yard) enhancing the dwelling with a new porch and second-floor addition. 2. The benefit sought by the applicant cannot be achieved by some method, feasible for the applicants to pursue, other than an area variance since the home is located at less than 40 feet from the front lot line. 3. The relief granted is not substantial, representing one-foot reduction from the code requirement. 4. The difficulty has not been self-created. Page 2 -November 9, 2006 ZB file No. 5958 - L. and J. Hamilton CTM No. 123-2-31 5. 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 in the neighborhood. 6. Grant of the requested relief is the minimum action necessary and adequate to enable the applicants to enjoy the benefit of an addition, 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 Naw York Town Law 267-B, motion was offered by Member Simon, seconded by Member Goehringer, and duly carried, to GRANT the variance as applied for, as shown on the 7-21-06 Drawings A-SITE, A.1 and A.2 prepared by Architecnologies. 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 nonconformities under the zoning code. This ac8on does not authodze 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. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board: Ayes: Members Oliva (Chairwoman), Goehringer, Dinizio, Simon, and Weisman. This Resolution was duly adopted (5-O). ~lX.(AXO 0~. ~--+LflAl~c~ Ruth D. Oliva 11//4G/06 Approved for Filing That these ZBA conditions be written into the Building Inspector's Certificate of Occupancy, when issued. ~ ~-7~g ,Z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING ~ FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: k~ DATE A -/ 3 INSPECTOR 3~-7~8' z TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 1 NSPECTION l ~~i: s~ ~~ [ ]FOUNDATION 1ST [ ]ROUGH PLBG. No o/~ [ ]FOUNDATION 2ND [ ]/INSULATION °ME [ ]FRAMING /STRAPPING [,Jq FINAL [ ]FIREPLACE 8~ CHIMNEY [, ]`FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION ~ REMARKS: ~ ~i-~-C~ /~~~' ~.- .rev t`" "--~ ~ ` i v s-~. -u ~ ` ~ i ~ A~ 1 ~` 7~~P-ocY DATE INSPECTOR "'~ 3~-7~t ~ ~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: ~~. c~ i'~ DATE ! ~ 7~ ~ 7 INSPECTOR 3~7~~ z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATI01 REMARKS: ~ ~ ~' DATE 1 NSPECTOR _'~ 3~7~~z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [ ]FOUNDATION 1ST [Q~ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKCe ~ ~ ` b~- ~r-Q•l~ ~~ ,%~ /~ DATE ~~ ~~ ~ INSPECTOR ~ '~ ~~~"~~'-~ ~ ~-7 ~ ~" z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ~] FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ] FlRE RESISTANT PENETRATION REMARKS: DATE `S~3 ~ r ~ 7 INSPECTOR ~~7~-~z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION RFU~eR~cc~ DATE S 9 - ~ ~ INSPECTOR ~ ° "~ ~~~ 3~-~~~z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. (FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION ( ]FIRE RESISTANT PENETRATION n~uwe~rc. 3, ~-~ - ©7 ~- ~~- DATE INSPECTOR 3~7`~gz- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [~ FOUNDATION 1ST <[ ~] FOUNDATION 2ND [ ]FRAMING /STRAPPING [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE RESISTANT CONSTRUCT [ ]ROUGH PLBG. [ ]INSULATION [ ]FINAL [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT PENETRATION REMARKS: T ~ w-~-~il.~'`~-~(- ~2~~;vtc~- p~ Jam- d- , o~,,~ o ~ ~ d- 3 ~~~°~ DATE INSPECTOR ~ FIELD INSPECTION REPORT DATE COMMENTS ~ ~ ~ ~ ~ ( (~ ~ a~~ ~ ~ ~ FOiJNDATIO (1ST) T s Vh.- I r ~ ~ ~'"~ C ¢~ FOTJNDATION (2ND) _ \ D, t ~ -~ ~ ~ ~- a~e~. y o -~ ~~ _0 7 ~ © U ROUGH FRAMING & PLUMBING ~ _ _ n `CL•u^~`- a ""~ O ., ~ G ~ r 5 INSULATION PER N. Y. STATE ENERGY CODE i iQ \ ~ FINAL ~ ~'0~6"~ ADDTITON OMMENTS ~, aQ. , ~ .1~-4-. D 5, ~9~~~ Z ~~ -S m ~ ~D~ ~ ~ -~ -U~ ~Q ./~ p ~. ~h ,~ ~9 ,y a~ ~ z o x ~ ~ ~ :~ ~ x ~ d t ~ ~ b l~ y l TOWN QF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BUILDING PERMIT APPLICATION CHECKL' IST Do you have or need the following, before applying? Boazd of Health SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 n p ~ www. northfork.net/Southold/ PERMIT NO. ~Ot 7 Examined , 20 Approved ~ ,20~ Disapproved a/c Expiration , 20 Mail to: f11, ~- - ^` _ ~ ~A~PLICATION FOR BUILDING PERMIT ~',~ Date , 20~~ 2 ~ + INSTRUCTIONS .~ a. This application MUST be co ely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accu"rate plot~lan-to cale. Fee according to schedule. b. Pl plo'~~oCving 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. £ 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 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 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. ~\) (Signature of applicant or name, if a corporation) (Mailing address of applicant) 'r State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nam oe f owner of premises ~~p t= M ~ ~ ) ~ ~E }~ ~(~..{ (~ -r(~~ , ~- (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. 1. Location of land on which proposed work will be done: House Number Street amlet n-, County Tax Map No. 1000 Section ~~?j Block ~ Lot y' Subdivision Filed Map No. Lot (Name) 4 sets of Building Plans_ Planning Boazd approval Survey Check Sep[ic Form N.Y.S.D.E.C. Trustees Contact: 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I ~~~: U °11 ~`Y-,l ~ ~'f~l~l\l-y `d~1= ~1~~ `f'l- b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition~Alteration~ Repair Removal Demolition j0 Other Work _ (Description) 4. Estimated Cost ~~,~ i ~~~ Fee If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of existing structures, if any: Front ~j~l Rear 3~ Height 19~Cn r~' Number of Stories 1 Depth 1(Q ~ ~`~ ~` Dimensions of same structure with alterations or additions: Front ~ 4~? v Rear ~/!~ `. Depth ~9 ~ /f~ ~ Height ~2 ~' ,~ Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /(~(~ Rear /~ ~ Depth o2~ 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ~ ~/l~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES~I ISO 4~2-~,~A-l, I~rTAe~-IC~~ 13. Will lot be re-graded? YES O Will excess fill be removed from premises? YES NOS 14. Names of Owner of premisesS- e t `~/9-~K ~ ~ -i-t~-E-l1 LrD l~Address -r G Phone No. 2 J° Name of Architect ~A-r~ K~ ~~A s?,~ Address hone No 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 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) SS: COUNTY O FDl{L. ~fJlt;~(k`7~r~?~~s~t,~- - being duly sworn, deposes and says that (s)he is the applicant (Name of individual si g contract) above named, (S)He is the 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. to before met i day of (/ tJ 20~ BONNIE J. DOROSIO Notary Public, State Of New York No. O1D06095328, Suffo ounty Term Expires July 7, 20 -~~ Signature opt Applicant K, Permit # Permit Date REScheck Software Version 3.7 Release 1 Compliance Certificate Project Title: HAMILTON RESIDENCE Report Date: 02/19/07 Energy Code: 2000 IECC Location: Mattituck, New York Construction Type: Single Family Glazing Area Percentage: 14.000000000000002% Heating Degree Days: 5331 Construction Site: Owner/Agent: Designer/Contractor: 1535 PARK AVE JEREMY 8 LAUREN HAMILTON FRANK NOTARO R.A. MATTITUCK, NY 11952 1535 PARK AVENUE ARCHITECNOLOGIES MATTITUCK, NY 11952 P.O. BOX 93 631-29&1129 MATTITUCK, NY 11952 631-296-1129 r' Ceiling 1: Flat Ceiling or Scissor Truss: 1748 19.0 38.0 30 Wall 1: Wood Frame, 16" o.c.: 2896 11.0 21.0 122 Door 1: Solid: 16 0.045 1 Door 2: Glass: 37 0.310 11 Basement Wall 1: Solid Concrete or Masonry: 1108 17.0 9.0 82 Window 1: Vinyl F2me:Double Pane with Low-E: 11 0.330 4 Window 2: Vinyl Frame:Double Pane with low-E: 11 0.330 4 Window 3: Vinyl Frame:DOUble Pane with low-E: 11 0.330 4 Window 4: Vinyl Frame:Double Pane with Low-E: 6 0.330 2 Window 5: Vinyl Fmme:Double Pane with Low-E: 30 0.330 10 Window 6: Vinyl Freme:Double Pane with Low-E: 30 0.330 10 Window 7: Vinyl Frame:Double Pane with Low-E: 30 0.330 10 Window 8: Vinyl Frame:Double Pane with Low-E: 38 0.330 13 Window 9: Vinyl Frame:Double Pane with Low-E: 9 0.330 3 Window 10: Vinyl Frame:Double Pane with Low-E: 15 0.330 5 Window 11: Vinyl Frame:DOUble Pane with Low-E: 20 0.330 7 Window 12: Vinyl Frame:Double Pane with Low-E: 20 0.330 7 Window 13: Vinyl Frame:DOUble Pane with Low-E: 20 0.330 7 Window 14: Vinyl Frame:Double Pane with Low-E: 20 0.330 7 Window 15: Vinyl Frame:Double Pane with Low-E: 10 0.330 3 Window 16: Vinyl Frame:Double Pane with Low-E: 7 0.330 2 Window 17: Vinyl Fmme:Double Pane with Low-E: 7 0.330 2 Window 18: Vinyl Frame:Double Pane with Low-E: 7 0.330 2 Window 19: Vinyl Frame:DOUble Pane with Low-E: 22 0.330 7 Window 20: Vinyl Fmme:DOUble Pane with Low-E: 12 0.330 4 Window 21: Vinyl Frame:Double Pane with Low-E: 12 0.330 4 Window 22: Vinyl Frame:Double Pane with Low-E: 15 0.330 5 Window 23: Vinyl Fmme:Double Pane with Low-E: 12 0.330 4 Window 24: Vinyl Frame:Double Pane with Low-E: 12 0.330 4 HAMILTON RESIDENCE Page 1 of 7 Window 25: Vinyl Freme:Double Pane with Low-E: 14 0.330 5 Window 26: Vinyl Freme:DOUble Pane with Low-E: 8 0.330 3 Window 27: Vinyl Freme:Double Pane with Low-E: 8 0.330 3 Window 28: Vinyl Freme:Double Pane with Low-E: 8 0.330 3 Window 29: Vinyl Fmme:Double Pane with Low-E: 9 0.330 3 Window 30: Vinyl Freme:Double Pane with Low-E: 4 0.330 1 Window 31: Vinyl Freme:DOUble Pane with Low-E: 4 0.330 1 Window 32: Vinyl Freme:Double Pane with Low-E: 4 0.330 1 Floor 2: All-Wood Joistlfruss:Over Unconditioned Space: 1748 11.0 21.0 49 Floor 2 copy 1: All-Wood Joist/Truss:Over Unconditioned Space: 1748 11.0 21.0 49 Boiler 1: Other (Except Gas-Fired Steam): 80 AFUE Air Conditioner 1: Electdc Central Air: 13 SEER Compliance Statement: Statement of Compliance: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 IECC requirements in REScheck Version 3.7 Release 1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Builder/Designer Company Name Date Project Notes: ADDITION TO EXISTING 1ST. FLOOR 2ND FLOOR ADDITION WITH ATTACHED 1-CAR GARAGE. HAMILTON RESIDENCE Page 2 of 7 REScheck Software Version 3.7 Release 1 Inspection Checklist Date: 02/19/07 Cellings: ^ Ceiling 1: Flat Ceiling or Scissor Truss, R-19.0 cavity + R-38.0 continuous insulation Comments: Above-Grade Walls: ^ Wall 1: Wood Frame, 16" o.c., R-11.0 cavity + R-21.0 continuous insulation Comments: Basement Walls: ^ Basement Wall 1: Solid Concrete or Masonry, 8.0' hU6.6' bg/2.0' insul, R-17.0 cavity + R-9.0 continuous insulation Comments: Exterior insulation must have a dgid, opaque, weather-resistant protective covering that covers the exposed (aboveyrade) insulation and extends at least 6 in. below grade. Windows: ^ Window 1: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? Yes _ No Comments: ^ Window 2: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 3: Ynyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Yes No Comments: ^ Window 4: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Yes No Comments: ^ Window 5: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? Yes _ No Comments: ^ Window 6: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes No Comments: ^ Window 7: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes No Comments: ^ Window 8: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes No HAMILTON RESIDENCE Page 3 of 7 Comments: ^ Window 9: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ^ Window 10: Vinyl Frame:DOUble Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? Yes _ No Comments: ^ Window 11: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? Yes _ No Comments: ^ Window 12: Vinyl Frame:DOUble Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes -Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 13: Vinyl Frame:DOUble Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Fame Type Thermal Break? _ Yes _ No Comments: ^ Window 14: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes -Frame Type Thermal Break? Yes _ No Comments: ^ Window 15: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows wtthout labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes No Comments: ^ Window 16: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 17: Vinyl Frame:DOUble Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 18: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? Ves No Comments: ^ Window 19: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 20: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 21: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, descdbe features: #Panes _ Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 22: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 HAMILTON RESIDENCE Page 4 of 7 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? Yes No Comments: ^ Window 23: Vinyl Fmme:Double Pane with Low-E, U-factor. 0.330 For windows without labeled U-tailors, describe features: #Panes _ Freme Type Thermal Break? _ Yes _ No Comments: ^ Window 24: Vinyl Freme:Double Pane with Low-E, U-Tailor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 25: Vinyl Fmme:DOUble Pane with Low-E, U-tailor: 0.330 For windows without labeled U-factors, describe features: #Panes _Fmme Type Thermal Break? Yes _ No Comments: ^ Window 26: Vinyl Frame:Double Pane with Low-E, U-tailor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Ves No Comments: ^ Window 27: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes -Frame Type Thermal Break? _ Yes No Comments: ^ Window 28: Vinyl Frame:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? _ Yes _ No Comments: ^ Window 29: Vinyl Fmme:Double Pane with low-E, U-factor: 0.330 For windows whhout labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? Yes No Comments: ^ Window 30: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _Fmme Type Thermal Break? Yes _ No Comments: ^ Window 31: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes _Fmme Type Thermal Break? _ Ves No Comments: ^ Window 32: Vinyl Freme:Double Pane with Low-E, U-factor: 0.330 For windows without labeled U-factors, describe features: #Panes Frame Type Thermal Break? _ Ves No Comments: Doors: ^ Door 1: Solid, U-factor: 0.045 Comments: ^ Door 2: Glass, U-factor: 0.310 Comments: Floors: ^ Floor 2: All-Wood Joist/Truss:Over Unconditioned Space, R-11.0 cavity + R-21.0 continuous insulation Comments: ^ Floor 2 copy 1: All-Wood Jois7fruss:Over Unconditioned Space, R-11.0 cavity + R-21.0 continuous insulation HAMILTON RESIDENCE Page 5 of 7 Comments: Air Leakage: ^ Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. ^ Recessed lights must be 1) Type IC rated, or 2) installed inside an appropriate air-fight assembly with a 0.5' clearence from combustible materials. If non-IC rated, the fixture must be installed with a 3" clearance from insulation. Vapor Retarder. ^ Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. Materials Identification: ^ Materials and equipment must be installed in accordance with the manufacturer's installation instmdions. ^ Materials and equipment must be identlfied so that compliance can be determined. ^ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. ^ Insulation R-values and glazing U-factors must be Gearty marked on the building plans or specifications. Duct Insulation: ^ Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.5. Duct Construction: ^ All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives), masllc-pluscmbedded-fabric, or tapes. Tapes and mastics must be rated UL 181A or UL 1818. Exception: Continuously welded and locking-type longitudinal joints and seams on ducts operating at less than 2 in. w.g. (500 Pa). ^ The HVAC system must provide a means for balancing air and water systems. Temperature Controls: ^ Themwstats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Service Water Heating: ^ Water heaters with vertical pipe risers must have a heat trep on both the inlet and outlet unless the water heater has an integral heat trap or is part of a circulating system. ^ Insulate circulating hot water pipes to the levels in Table 1. Circulating Hot Water Systems: ^ Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: ^ All heated swimming pools must have an onloff heater switch and require a cover unless over 20 % of the heating energy is from non-0epletable sources. Pool pumps require a time Gock. Heating and Cooling Piping Insulation: ^ HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F must be insulated to the levels in Table 2. HAMILTON RESIDENCE Page 6 of 7 Table 1: Mlnlmum /nsu/at/on ThleKness /or C/rculating Hot Water Plpes Insulation Thickness in Inches by Ploe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature (°F) Up to 1" Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140.169 0.5 0.5 1.0 1.5 100.139 0.5 0.5 0.5 1.0 Table 2: Mlnlmum Insulation Thickness for HVAC Plpes Insulation Thickness in Inches by Pipe Sizes Fluid Temp. Piping System Types Range(°F) 2" Runouts 1"and Less 1.25" to 2.0" 2.5' to 4' Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate (for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water, Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD: (Building Department Use Only) HAMILTON RESIDENCE Page 7 of 7 • ITECNOLOGIES ARCHPECIVRH PLANN040 CON31Ri7C[ION SBRVICPS 13405 Mdn Raed, Matfimck, New Yeet 11952 631.296.1129 fax: 631296.1128 February 19, 2007 Town of Southold Building Department Southold, N.Y. 11971 Re: Jeremy & Lauren Hamilton 1535 Park Avenue Southold. N.Y. 11971 To Whom It May Concern: Per requirements by New York State Residential Construction Code we certify that the design criteria is done per prescriptive design. All of the load calculations and structural plans comply with all of New York Construction Code based on (AF&PA) for One-Family Dwelling to the best of our knowledge. If you have any additional questions please feel free to call our office at 631-298-1129. ' ITECNOLOGIES ARQD7ECR)R8 PLANNING CONSIItUCf10N SPRVICBS 13405Mm Road, Llattlokk. New Yadc 11952 631.298.1129 6u: 631.298.1128 August 6, 2007 Southold Town Building Dept. P.O. Box 1179 Southold, N.Y. 11971 Re: Mr. & Mrs. Jeremy Hamilton 1535 Park Avenue Mattituck, N.Y. 11952 T.M. # 1000-123-2-31 To Whom It May Concern: According to our energy calculations using the following insulation values within existing and proposed walls, floor, ceilings and new 2" x 10" roof rafters meets or exceeds the energy requirements of New York state energy code. R15 - Existing 2" x 4" wall R21 - Existing 2" x 6" wall R21 - Garage ceiling R21 - Crawl space ceiling R22 - Plywood 2" x 8" ceiling R30 - 2" x 10" roof slope R30 - open ceiling If you have any additional questions please feel free to call our office at 631-298-1129. ~: FORM NO. 3 NOTICE OF DISAPPROVAL DATE: July 6, 2006 To: Agnieszka Drozdowska for J & L Hamilton POBox93 Mattituck, NY 11952 Please take notice that your application dated May 19, 2006 For a permit for an addition to an existing single family dwelling at Location of property: 1535 Park Ave., Mattituck County Tax Map No. 1000 -Section 123 Block 2 Lot 31 Is returned herewith and disapproved on the following grounds The proposed construction on a property in the R40 District is not permitted pursuant to Article XXIV, Section 100-244B which states: "This section is intended to provide minimum standards for rg antin~ of a building_permit for the principal building of lots which are reco ign zed by the town under 100-24, are nonconforming and have not merged pursuant to 100-25. B. Such lot shall be required to meet the following: Lots measuring between 20,000 and 39,999 require a front yard setback of 40'. The survey of the proposed addition indicates the front yard setback to be approximately 39'. '/a~itr~c.~~ Authorized Signature . r" _~-- e~ ' TOWN OF SOUTHOLD PROPERTY RECD • CARD ~ _ z ~ OWNER STREET ` ~ . - VILLAGE DIST. SUB. LOT e.~~ -~, c~ ~ R v~N~F ;f ~.~' 9 - ' FORMER OWNER N ~iAk A~i~ - Dur~r~= 1 e_' ~,.`, _ ACR. j -~ . 5~ moo ~h0~/d-~ ~e (C~ (' .-' S ~~ ,~ TYP OF BUILDING ~ ~ Zoe ~~ , ,S w SEAS. Vt. FARM 'G COMM. CB. MICS. Mkt. Value ~~~~A LAND IMP. TOTAL DATE REMARKS J-© 2 O o ~"' Q ~ `' _~. D~ of `' - eho Es'~ -~-~ Schv(I ~Q/t,~j -N C boo s~eb y~o~ o; ~ ~ ~ - ( ~ -Sc of Q~a•fv Tel. -~/ v y,~,, ~~330~ z ~~ z 9 ,~S 11 r ~ ~ ~,-~ ~;.~j, c-~ a~r qma y a o '{a2>oo ~ 3 3 0 o 5~mo Vert-~4 a ca ~' 2 Z5 s a ~e nn a.(` - Ll ( - 'C CI Q ~~~Vl '~"Wt•-~o?~r..L~no 9~~ 390o y7oo •~ 6 03 ~ ~ c,Vo ~5~5 $lo_ ~S ~3 L~A•~ + c c, AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Acre Value Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD ~O O ~ g sn ~ 9 u a Meadowland DEPTH House Plot BULKHEAD Total DOCK .~. _ ~ ~ \ COLOR t,J +4N ~ // TRIM r~ _ I i 2 ~2camm ,.. __ _ t-- z 3 = /s r / ` Fxtension r ~ X / _ S' o /d8Z 3, j Ct erasion ~X D - /G ion __ ;, Foundation G ~ Bath r!~ - / _- . Dinette ~' ~ e2osaa~~. (2 K 22 = Basement `cJ L L Floors O ~ rC , K. / 2U_4- '~ ~ ~ Ext. Wo s . } ve Interior Finish ~ LR. ,/ Fire Place Heat DR. ~/ m. ~~ d 9 D ~ ~ o p p g YPe Roof Rooms 1st Floor - BR. ~/ Recreation Room Rooms 2nd Floor FIN. B ~. 3BY r, ormer Driveway ' S to o3 0 .,r four s~-GC S9ar. Q • / "Neese ~wI ri7 ~. Sr_ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 p -~ www. northfork.net/Southold/ PERMIT NO. ~O~ 7 ~ "-G 4 sets of Building Plans_ Planning Board approval Survey Septic Form N.Y.S.D.E.C. 20 20~ Disapproved Expiration , 20 Mail to: /1 ~A~PLICATION FOR BUILDING PERMIT ~,~ L2 Date [.t..J , 20 ,Z ~ INSTRUCTIONS a. This application MUST be co ely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot~rlan to tale. Fee according to schedule. b. Pl pla Wrng 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. £ 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 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 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. ~~59,1't. ~,.~~9,rL.047~1e .c~_ ~ (Signature of applicant or name, if a corporation) ~~. ~x ~~~ M~ ~-;~t~~~ ~ ~~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, genera] contractor, electrician, plumber or builder Name of owner of premises ~~pG'P-I ~ ' (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. 1. Location of land on which proposed work will be done: House Number Trustees Contact: County Tax Map No. ] 000 Section ~t~?j Block Subdivision Filed Map Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy I ~~_~-V °~f<`X~t~ ~'f~M\W ~1=~\~~,D_~C' b. Intended use and occupancy Nature of work (check which applicable): New Building Addition~_Alteration,~0 Repair Removal Demolition o~Other Work 4. Estimated Cost ~ ,`~ ~ dZ~C7 Fee 5. If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~j~jI Rear .JS1 Depth ~/~ ~ ~ ~ ' Height 19~G r~' Number of Stories 1 ~ . ~ v ~~7 ~ . . Dimensions of same structure with alterations or additions: Front ~ r~ Rear Depth ~~l ~ /~ ~ Height~_ 2~rf~ Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front /(~(~ Rear /D(~ ~ Depth o2~ 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated ~ y~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES~1~IO 13. Will lot be re-graded? YES NO' n Will excess fill be removed from premises? YES NOS 14. Names ofOwner of premisesS-et -}{E}MI LTD 1JAddress ~ ~~~ K ~ Phone No. 2 ~ - ~ J Name of Architect~A-~ K~ ~;wr"A-~~7 Address hone No Name of Contractor ~~ Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO,6° * 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 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) SS: coUNTY o FfxlG. ~GfJlt;~~(~ ~~~al.ost~~- _ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signi g contract) above named, (S)He is the 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. to before met ' i day of L ~ 20~ BONNIE 1. DOROSIO Notary Public, State Of Newyork No. O1D06095328, Suffo ounty Term Expires July 7, 20 Signature o~Applicant SURVEY OF PROPERTY SITUATE: MATTITUGK TOWN: 50UTHOLD SUFFOLK COUNTY, NY SURVEYED 08-27-02 AMENDED II-0B-0b, OI-10-200 SUFFOLK COUNTY DEFT. OF HEALTH SERVICES REF ~ RIO - Ob - 0103 SUFFOLK COUNTY TAX ~ 1000-123-2-31 C~tTIFI~ TO: Jeremy Hmilton Icemen Haelellom CemmmaalBtI~dTitleln~aoee0ompmy Land Now or Formerly of: ~ Alfred Barlatti 8 Shirley BariatYi Dwe I I inq Septic 1 0+ el•IB' SE~IG ' " (/~ ' _ W -gip ~~ Ne: ~ v O r fl Q T~Z 0 ~ o Q O 3Q~ ~ ~, o ~ `s s ~ G ~0 0 3 ~~m ~ 9 ~ _~~ ~ v N 0 q' 6 ISTIN6 YELL TO 4BANDONED PER ----- JHS STANDARDS ~ ~~~ cF zz LE. Geck ~' _ _ _ v • 8 _ _____ __ __ A3 -~ ~ -~ _e. __________ Y 2 Story 1 e{ Q ,~ Y 'o O FrQrtIB Lp ~ 'fC7 c G .- - - - " o ~- o }{Qp56 _ ~ ~ ' ~' E4 8 ~T ppOpoSED 1*IONS noD nd __ ~ _ _ ____ 66 _ 6. ~__. __._ 4, ~ e u a _ _ ____ oin U y ~b _ ___ 'I _ ______ , G m~ O $.T. ~ p g EX15tN ~I .I F o ~ OSPFIPF. F]fIVPM L~ I 'Py 6 ~~ I ~~ I sl•tT ~ 3as.oo' ,1°~' 586 7'00"W 1 .00 - ~ - - - _ _ y. '-_-___p~.c of pavement ~6I4LL~ d u v ~+~"ISALI~I el.n' `~~-- I50'T05EPTIG_--'~ TEST HOLE McDONALD GEOSGIENGE DARK BROWN I, OL SANDY LOAM BROWN CLAYEY 4, SG SAND PALE BROWN FINE SAND SP I ~' . , . ~ '~ NOTES: MONUMENT FOUND EXISTING SEPTIC SYSTEM TO BE ABANDONED IN ACCORDANCE WITH SGDHS STANDARDS. ELEVATIONS REFERENCE SUFFOLK COUNTY TOPO MAPS AREA = 25p00 S.F. or 0.5~ ACRE GRAPHIC SCALE I"= 30' N W E S Dwe I I inq Septic 1 0+ D r ~r c 9 nQ mZ ~o ~» ~ Qo ET flo ~' 9 3 A~ 9 } C O A 3 Q J BE ABANDONED PER Drlvev+oy and Walk be removed al•Il' dwelling closest neighboring septic Land Now or Formerly of: Gordon J. Hass Dwelling 100.00' _ vacant 100' + ~..., m....., ~a'..ai.~my • xa"w'. ... re. ~. ~,. ~.• ~~ :qa ~i aw ~~ .,.R.a..d.~du.e.tlmd "'~" ~• °.i',~ tea,'., ~x.. rse.ea. n....ura ry. m uw-r. wr ~ ay m ~ aee..w.... ~..f.ws~•4 ~.,...>.,.,.+9,.,.~.. ~..~ .•. a. R..e.,.d.. m..~,d,...e. JOHN C. EHLERS LAND SURVEYOR ~ 6 EAST MAIN STREET N.Y.S. LIC. NO.50202 Y8L RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\CompagserveilprosW2U12-269 updated 09-28=. SUR1/EY O~ PROPERTY SITUATE: M~TTITUGK TOWN: SOUTNOLD SUFFOLK GOUNTY, NY SURVEYED 08-27-02 FINAL SURVEY FOR GO 02-IS-2008 SEPTIG REVISION 03-19-2008 SUFFOLK GOUNTY TAX # 1000-123-2-31 SUFFOLK GOUNTY DEPT. OF i-IEALTH SERVIGES REF. # RIO - 06 - 0103 ~~ ~: Jeremy Eemil[on I.emen JJamilton Commoiwealtp Land Title Ineiusice ComPmY JISBC Mortgage Caporition SUFFOLK COUNTY DEPARTMENTOF HEALTH SERVICES APPROVAL OF CONSTRUCTED WORKS FOR A SINGLE FAARiII' RESIDENCE Date~PRO4 7flflk H.S. Re.'. No. Q ~~ -fi'~'G~~~ Tire sewage disposal and water suPPN 'xiilties et thk beatlon hide peen Inspected andlor cortifled by mL ~=a%rbneM or other agendas in0 tblilf) b pe satisfactory FOR A MAXI OF ~_ BEDROOMS, ~` W81ter J. h111bert, P.E., omce a waelewa~r ~,t I Land Gordon J~Hassly of: Land Now or Formerly of: Alfred Barlatti 8 Shirley Bariatti N86°57'00"E 100.00' ,J well ~ R 1 1 W V 8 ~ \ 1 ~ I ~ 1 \ W V 1 1 ~\ l \ /. r fl 1 ~ ' 1 a -n~Z I ~ 1 ~ `. ~ ~ ~ ^' `'~ I 3 Q ~ 0 ~ I is 5 ~ ~ ~ ~ I \ I 1J 1 N 1 ~ ~~ Q Q 3 r Q3 ~ l tpe ® N `?~ ~ ' \\ 14 t ~ 1 1 ~ ~ I ~ 1 ~ If ~ (NJ~~ V 1 ~ I ~ I cellar entr AG ~ ^ ^ 1 8 -20`- 46"1' a ICI' .. 2 STORY FRAME s HOUSE & GARAGE o ~., `~; • u Ie 3' 4, 9 ~s ~ P ~ \ _ 16.0' A .'~' ~' / /asphalt WA ~` k~ drlvewa.~ \ \ ~ h\ ' ~ ~ I ~ I \ \ \\ / V v ~~, ~ GP ' ST I II 3es.oo' S86°57'00"W 100.4 edge of pavement ]~~]~ ~M~IDIllA~ 3 7 r ~r ~fl aQ 'o ~. ~ rno Q~ F ~ 9 p l fl 3 A~ 9 ~ -lL O T 9. N (D J e~ .n~~.a ~^~~,~a~. ,~., aye ~i.. rvQ wa.gnoidm `~ grei d w we ...y.'• ~ .em.e mai snit d ~e...e u a .mu w ~M. NOTES: G Rn~... ro a.~s ~' w"~ :... ~-, avyar.. b miy ~ MONUMENT FOUND °d ~ ~.:a Area = 25p00 5. F. Area = 0.5'139 Acres GRAPHIC SCALE I"= 30' JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N W E S N.Y.S. LIC. N0.50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Compagserver\ptoss\02\02-269 fmal.ptn SUR~/EY O~ PROPERTY SITiJ?~TE: MATTITUGK TOWN: SOUTHOLD su~o~K couNrr, NY SURVEYED 08-27-02 AMENDED II-08-06, OI-10-200 SUFFOLK COUNTY DEPT. OF HEALTH SERVICES REF >< RIO - O6 - 0103 SUFFOLK COUNTY TAX p 1000-123-2-31 Cffit1II+ll~ 110: Jamy Hem'IOm I~Ert;~OG Ca~lfhLd191leI>a~maaeeCamPm9 Land Now or Formerly of: ~ Alfred Bariatti 8 Shirley BariatEi Dwelling Septic 150+ el•ID' 9 Q TEST HOLE ~ n Z ~ McDONALD GEOSGIENGE p ~ a DARK BROWN m ~ ~ OL SANDY LOAM - `~ o T I, BROWN CLAYEY o ~ ~ Q 3 m 4, SG SAND '~ ~. o PALE BROWN FINE SAND ExISTING v'ELI. c,.P SGDHS STANDP 11' ® 385.00' NorES: ~`,,~~w J ^ MONUMENT FOUND EXISTING SEPTIC SYSTEM TO BE ABANDONED IN ACCORDANCE WITH SGDHS STANDARDS. ELEVATIONS REFERENCE SUFFOLK COUNTY TOPO MAPS AREA = 25,000 S.F. or O.SI ACRE GRAPHIC SCALE I"= 30' cp N W E S Dwelling Septic 150+ D 3 r ~r ~o Q9 mL ~o ~~ rno a~ E T 00 ~} Q_ 3 A~ 9 - O n m J BE ABANDONED PER ExiStl ~ ~Ne ~~~ y~blk ~~ OSpIIOL d(N0 WP1' el•Il' M•ID' i _ _ _. .. - - ' - I e i le I ~ a. rr~enl¶n1U¶~` el•11' /~ dwelling vacant 100' + 0 n m t./1 O 8 „~,.e~a.,~,~m..` , ..., „a..-~ -~ ~...`~ ~ ~"a.:..p.. .~....d.a d ~.~.... m........ w'~• ..... W.~.~~ m ~~ JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO.50202 RIVERflEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.\\Compagserver\prosW2\02-269 updated 09-28-: GEC z~ G.E. G1eck O ---~-~--~~ _ 8 ----- -- --- ---3~--- b !19 V .1 CJ,ynry, ',R o Fr '~„ J -- - Hone o~ o -- _4 „, u ----___ I50'T05EPT~G_--~" '"TO SEPt~G 01 y X5 " ' Y / Y i I ~~ ia' e 0 closest neighboring septic Land Gordon J~Hassly of: Dwelling 100.00' _ el•19' BE ABANDONED PER