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32255-Z
FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33257 Filed Map No. Lot No. THIS CERTIFIES that the building DEMO & RECONSTRUCTION Location of Property: 1000 SOUND BEACH DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 99 Block 1 Lot 5 Subdivision conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 17, 2006 pursuant to which Building Permit No. 32255-Z dated AUGUST 1, 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 RECONSTRUCTION OF A PORTION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER TRUSTEES WITH FLOOD PERMIT. The certificate is issued to of the aforesaid building. A WITSCHIEBEN & JANET CAREEN (OWNER) SIIFFOLK COUNTY DEPARTMENT OF HSAI,TH APPROVAL ELECTRICAL NO. PLDMBERS CBRTIFICATION DATBD Date• 09/03/08 07-9172 07/31/08 uthorized Signature Rev. 1/81 • G ~' S i ~~ - 3~~ j{ ~~~ FormNo.6 ,~ yaa I" U ~ U TOWN OF SOUTHOLD ~,.~ y Y ~ ~ BUILDING DEPARTMENT TOWN HALL 765-1802 y~p~. DEPT. f (±~~THOI.D gPPLICATION 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: 1. 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 1% lead. 5. Couunercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer resparsible 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 piaperty showing al(properiy lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect sigied by the applicant If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. lees 1 . Certificate of Occupanc~~ -Ness dwelling $25.00, Additions to cba~elling $25.00, Alterations to dwelling $25.00, S~i~inuning 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 ~. Temporary Certificate of Occupancy -Residential $15.00, Conunercial $15.00 Date. g~~~D ~ New Constn~ytion: _ Location of Property: Old or /00 o Spy ,~. ~ Building: (check one) /~,r. /~9 rri House No. ~ Street Owner or Owners of Property: _ ~../,¢,/Cr Suffolk County Tax Map No 1000, Section ~ Block Subdivision ~i~o r /L; J/ _ _ Filed Map. Permit No. __-~~ Date of Health Dept. Approval Plamiing Board Approval y~~ Request for: Temporary Certificate Fee Submitted: $ D, ~ J7-.~a~J/ /lie Ei~ %'~/ ~~~~ Applicant: 26L !v~'/scl,:e Hamlet Lot Lot: Underwriters A royal: ~~ PP d7- Sr/7o7 ~~.3i-d/ ee ~P- O~ f-~-od 3-iti:l~~'o Final Certificate: ~- (check one) ter, • i , ,,,,<<, A plicant Signature J~ 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. 32255 Z Permission is hereby granted to: Date AUGUST 1, 2006 CAROL A WITSCHIEBEN 376 PLEASANT LANE HAWORTH,NJ 07641 for DEMO & RECONSTRUCTION OF A 404 SO FT PORTION OF AN EXISTING FAMILY DWELLING AS APPLIED FOR PER TRUSTEES MAINTAIN 15' SIDE W at premises located at 1000 SOUND BEACH DR MATTITUCK County Tax Map No. 473889 Section 099 Block 0001 Lot No. 005 pursuant to application dated JULY 17, 2006 and approved by the Building Inspector to expire on FEBRUARY 1, 2008. Fee $ 250.00 Rev. 5/8/02 ORIGINAL PERMI TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.netlSouthold/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Boazd of Health 4 sets of Building Plans Planning Boazd approval PERMIT NO. 3aa~- Septic Fotm _ N.Y.S.D.E.C. Examined , 20 Approved ,20 Disapproved a/c Contact: Mail Expiration , 20 r _.r~ ~~ i !~ T: Y l,`;; 2 ~'^1! Building Inspector !_. Z 21JO6 APPLICATION FOR BUILDING PERMIT Date ~ , 20p~__ --i INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. £ Every building permit shall expire if the work authorized has not commenced within 12 months afrer 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. 0 W (Signature of applicant name, if a corporation ~~ a•ttS loeo Soars ljerak d,¢,•~ ~~ f~ ~ ,y y (Mailing address of applicant) ~ /fS'3 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises Cna / /} . (~1; ~s ~{~t aJ AM.~ S4n~t ~ ~ •><sc (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 N 1. Location of land on which proposed work will be done: iono rrs/ 8,trcN AL:vG House Number Street Hamlet 1/46.2. County Tax Map No. 1000 Section o 99 Block 1 Lot ,y' Subdivision Cai/r:» /lC: DD ~S1r~t Filed Map No. /67Z Lot ys ~ (Name) v~ coq '1S t /i cor y~, 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy eufi mar ~y 1Lv5 '/tee s ~ b. Intended use and occupancy t~{;S~„~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair ~/ Removal Demolition Other Work (Description) 4. EstimatedCost~~ eod Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each floor ~ If garage, number of cars vw 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. sear S:>~ a it>w 7. Dimensions of existing structures, if any: Front_ _ _Rear_ Depth ,~ Height~._/y ~ Number of Stories r 1 sw.K• s.°~ s;lt obu Dimensions of same structure with alterations or additions: Front Rear Depth /~ ' Height ~y ~ Number of Stories f 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories ANtby wii+~ ~t/iroyc 9. Size of lot: Front /oo ~ Reaz /oo ~ Depth ~+ z 7MaT ~'NrcdNrl. / II . ~~urley- ~'uwl; h~ 10. Date of Purchase O~ol+a. I'I~fs Name of Former Owner s*o..llG • ~/~ fsr.~ :.il. w ass °"'''1 ~«%sfsi~¢- tI1UiT 11. Zone or use district in which premises are situated OI•e I ~~: ~y !+s `°~Jn[ Mks c ~ 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 Y c,atofA~w;aac.~;e.~.~ aoi-; y-y79T l4. Names of Owner of premises 1ic..~ b:~:el.g ~~JAddress Ua S°owr~~twc~ h. Phone No. ~c °~~,) Name of Architect Address " "'Y r~4t~' Phone No Name of Contractor Address Phone No. -t 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES r NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMTI'S 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. ~ ~s ,~~ FM:s~: <+'~% A~ ioar~./i•`°! ~~ /t"~;'~ Ilt(rrlo.+d }0 MAkF Ow.ti9.oKC+~ ~` ~ ier"~SJrvuf /t.~-s~iX.~•p'1ar 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. t"ID°"'~"'~"'R 'y' ~~~ +~ 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. r~~ STATE OF NEW YORK) SS: COUNTY OFD e~pL ~- /,{~~ TS~i2~U.u-rr being duly sworn, deposes and says that st~te is the applicant (Name of individual signing contract) above named, (S)he is the (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of _ !~~ 20 0 a. ~ ~ - .._ Notary Public / ~ k . ~-~/ Signature of Applicant „ ... ~+~. ryplgryP~ut~,~~~~Vyork ~. (k~m~~Jan 18,20 /(~ 3 ~~ss 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 [ ] FlRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: off, ~--~e_ . ~~:-~C. d~--~ ~2 ~~ . `~ ~ ~ -~- DATE ~ r ~ ~ ° ~ INSPECTOR ` ~ " ' ~~ ~ 2-a-SS z ~~~ TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION ~, [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION D [ ]INSULATION FRAMING STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION REMARKS: ~~'`^~`''"~'~~, ~~ ~ ~~ DATE INSPECTOR ' ~~~'` 3a-a~~~ 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 REMARKS: ~ " ~"""` ~ ~ ' ~ ~ v ~ a-~~ -6l .~~-~-- DATE INSPECTOR ~ ~~ 3 ~~ssz TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 1 NSPECTION ( ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION FRAMING / ST_ RAPPING [ ]FINAL --~ [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] RRE RESISTANT CONSTRUC110N [ ]FIRE RESISTANT PENETRATION REMARKS: ~ d~ DATE ~a ~~~ ~ p INSPECTOR ` '~"'D - `~~ ~ ~-a~ss z. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [~ FOUNDATION 1ST [ [ ]FOUNDATION 2ND [ [ ]FRAMING /STRAPPING [ [ ]FIREPLACE & CHIMNEY [ REMARKS: l~~ 0 ] ROUGH PLBG. ] INSULATION ] FINAL ]FIRE SAFETY INS~PQE~CT~ION i ~ ~ I®rt7-6~ ~~-~~ DATE INSPECTOR 3 a-a-.s~ z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1 NSPECTION [(~ FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION e~uwnvc•_ D- 0_~j ~ DATE ~ ~ ~ INSPECTOR '/~ FIELD INSPECTION REPORT DATE OMMENTS ~ ~ ~ a ~ ~ 1 ~ FOUNDATION (1ST) Fpi i - ~ ~ ~ r ~ ~ v ~ ~ ~ FOUNDATION (2ND) z a a .~ ~~ L ~ JY~ i i TS ~ i O 8 Q J~ y ~ 77 ~ y ROUGH FRAMING & PLUMBING ~ ~"'c 0- ~~ i INSULATION PER N. Y. STATE ENERGY CODE " 3 L FINAL t ADDITIONAL CONIMENTS O -a -~ 1 ~ ~ ~ -,~~a' ~ ro ' ~ a G ~ o z x ~~ x ~d b W W Q e v1 }~~' r~. Electricallnspectors, Inc. 308 East Meadow Avenue East Meadow, NY 11554 Office: (516) 794-0400 (631}796.7474 Fax: (516)794-5854 Website: www.electricalinspectors.com Email: infoQa electricalinspectors.com Mail To: East County Electric, Inc. William Oster/Bruce Oster PO Box 2620 Aqueboque, NY 11931 License#: 1005E ELECT AREAS LISTED BELOW ARE AND FOUND TO BE IN COMPLIANCE No visual defects were found for the electrical inspection herein below only. Residemial Inspection Basement: Gawl Space 1st Floor: Ba[broom, Bedroom, Foyer, (fall, 30. Duplex Receptacles, 7- GFI Receptacles Fixmres, !1-Incandescent Fixtures, 6- W Blower, 1-Fractional Motor, I-CO AIa IOOAmp Single Phase Sub PaneU/8C Id Rough 12/4/07 Final 7/3//08 ~' ZL~s Richard M. Bivone President Certificate Number: ~7-9/72 Municipality: Southold, Town OF /nspector: 124 Issue Date: 7/31/2008 Property Address: Larsen 1000 Sound B. Mattituck, NY INSPECTION TIONAL ELECTRIC CODE No obv~ unsatisfactory conditions were found in the areas Bathroom, Master Bedroom, Office eptacle, 30-Switches, 8-Recessed Fixrnres, 8-Fluorescent ms, 1 • Exhaust Fan, 1- 30Amp A/C Condenser, !-1 SAmp A/C Not valid unless signed by an (~ /- authori Ell Ag t Philip F.Gcehring Chief Electrical Inspector I:LEC'CRICAL INSPF.C"FORS, INC. is not responsible for the existing conditions at the subject premises 2. ELN:C'pRICAI. INSPECTORS, INC. is not responsible for anrections, upgrading or replacemem of existing electrical violations at the subject premises. Any corrective work shall he solely the responsibility of the property owner. ELECTRICAL INSPECTORS, INC. DOES NOT WARRANTY OR CNDERWRITE THE IiLF,C"pRICAI. CONDITIONS AT'I'HE PREMISES. 3. ELECTRICAL INSPECTORS, INC. only recognizes the National Electric Code, the Building Codes of New York State all volumes ^nd Lucid Municip:d Codes, as Authorized by The Department of S[atc Code. Division, via Villa¢e_ Town or City Board Resolution. 4..4N 1?IJ?C"PRICAI. SURVEY consists of a visual examination of the premises ONLY: FJeetrical Inspecum lac, will comply with the reyuiremenn o(NFPA 73. latest edition Chapter I, Section I-I, I ?. If violations exist. u Notice of Violation (NOV 1 will be issued requiring correction by a licensed electrical contractor. After the violation has been corrected. a re-inspection will be conducted and if approved a aaYificate shall he issued. 5. A SCRVI:Y CER'CIEICA'fE does not examine the actual wiring or devices unless all walls are opened and wires and deices arc c~posed prior to the survey being conducted. G. :1 CIiRT1FK:ATF, is non-transferable. 7. 1N ELI?CCRIC;II. INSPECTION consists ul an caaminatiun of wiring and instullutions during the rough sCi ees n1 comnuctirn~. After comple[inn of the construction a [tool inspection will be conducted at which time a certificate will be issued provided no violation exi,et. In the eccnt no inspection is requested during the rough stages of construction P:I,ECTRICAL INSPECTORS, INC. will pcrfbrm a CLOSED YJALL SliRVEY tha[ consisU of a visual inspection oY the whin; and installa[ions only. Since access is limited, ELF,CTRICAI. WSPECTORS, INC. shall hear no responsihility for any defects or violations at the premises. K. ELECTRICAL INSPECTORS, INC. shall not he responsible w remove any wulLs in order to conduct an electrical inspection. 9. ELECTRICAL INSPECTORS, INC. will only rele;ue inlimnation, certil icwcs and reports to the applicant after p;rymem Ibr services rendered have been paid in full. 10. F:LF.CTRICAI. INSPECTORS, INC. assumes uu liability tier the results of its inspections I ~. I~hc utrcenicnt our; not be chan~,rd orally. Town Hall, 53095 Main Road P.O. Bux 1179 Southold, New York 11971-0959 August 1, 2006 ,~''~OF SO~Tyo~ ~'~,~ 'j. ~ • ~~0,~ ~~y00UNT`I ,~°,rv' BUILDING DEPARTMENT TOWN OF SOUTHOLD Carol Witschieben & Janet Larsen 376 Pleasant Lane Hayworth, NJ 07641 To Whom It May Concern: Pax (631)765-9502 Telephone (631) 765-1802 Please take notice that I have issued your building permit (#32255-Z) for reconstruction of a 404 square foot portion of your dwelling that was demolished during work associated with building permit #31563-Z, which is now null and void. Please be aware that the new plans submitted to this office noted an "existing deck" on the back of your dwelling, We have removed this from the application because upon inspection of your property it was determined that the existing deck, that was removed from the house during construction, did not match the "existing deck" shown on the plans. In addition, the deck was on your house was built without the benefit of a building permit. You are not permitted to re-attach that deck to the house without the proper permits. Please feel free to call this office with any questions you may have. Respectfully Yours, Damon Rall' ,Permit Examiner Southold Town Building Department FORM N0. 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. 31563 Z Date OCTOBER 27, 2005 Permission is hereby granted to: JANET LARSEN 1000 SOUND BEACH DRIVE MATTITUCK,NJ 07641 for ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR VOI at premises located at 1000 SOUND BEACH DR MATTITUCK County Tax Map No. 473889 Section 099 Block 0001 Lot No. 005 pursuant to application dated OCTOBER 18, 2005 and approved by the Building Inspector to expire on APRIL 27, 2007. Fee $ 435.00 Authorized Signature ORIGINAL Rev. 5/8/02 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 ,~`~Of SOpjyo~ ~#~ • ~~o,~ ~~~OOUNiY,~.,~' BUILDING DEPARTMENT TOWN OF SOUTHOLD STOP WORK ORDER CAROL A. WITSCHIEBEN JANET LARSEN 376 PLEASANT LANE HAWORTH, NJ 07641 YOU ARE HEREBY NOTIFIED TO SUSPEND ALL WORK AT: 1000 SOUND BEACH DRIVE, MATTITUCK, N.Y. TAX MAP NUMBER -1000-99: 1-5 Fax (631) 765-9502 Telephone (631) 765-1802 Pursuant to Section 45-13 of the Code of the Town of Southold, New York, you are notified to immediately suspend all work and building activities until this order has been rescinded. BASIS OF STOP WORK ORDER: CONSTRUCTION IS NOT IN CONFORMITY WITH THE APPROVED BUILDING PERMIT #31563-Z ISSUED ON OCTOBER 27, 2005. CONDITIONS UNDER WHICH WORK MAY BE RESUMED: WHEN AMENDED PLANS ARE RECEIVED AND APPROVED BY THE BUILDING DEPARTMENT. Failure to remedy the conditions aforesaid and to comply with the applicable provisions of law may constitute an of eas p nisi 7 imprisonment or both. DATED: July 5, 2006 EXAMINER (CERT. MAIL) ,~ , ' . • , J'1'~1'f'i'H T. TARRY ~:' 'hOWN CLERK t IlECISFRM OF VITN. STAT1511C5 A{MRI~GF. OFFICIiR RECORI)5 MMIACEM ElJ1' OFPICEII FREEDOM OF INFORMATION OFFICER ~~ ~J; "7/ ~~ ; j i (~= Y ~ ~ ~, ~ c~la ~ ,~~ rca 1.;; ;_ _ ._ ,col .~ ybo 3~-a~ r 'I'm~~n 11x11. 3.11141 wi; r.o. n{~t I17 Sualhold. Ncw ~•urk FoA I.S I(~1 )Rt.11 Tclcrbunc 131(.1 7Q; OFFICE OF THE TOWN CLER TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SO UT HOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under tNe Flood Damage Prevent. reg ulations of., the Code of the Town of Southold: "Floodplain Development Permit ~<pplica[ion" (FOP(931), and %"Certificate i of Compliance f¢r Deve~-p menl in Special Flood Hazard Area (L/C(93)). "~ 1 J iFll~---_ .T~.,~.. ~ I /`/~~h T ~~l_~~i'I~y' V Southold Town Clerk August 25, 1993 ,. ~, ,.. TOWN OF SOUTHOI_D APPLICATION N PnGE I of 4 PLOODPLAjN DG1'GLOPM);NT PERMIT APPLTCATTON This form is to be Qlled out in duplicate. $ECT10N I• GENERAL, PROVISIONS (APPLICANT to read and ~i 1' 1. No wock may start tmtil a permit is issued. 2 The permit may be revoked if any false statements are made 6crcin. 3. If revoked, all work must mue unto permit is rc-iuued. 4, Development shall not lx used or occupied until a Certificate of Compliance u issued. S. The permit will exp've if Lio work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant 6ueby grvcs oooseat to the Local Administratoror his/her repruentative to make reasonable inspections required to verify compliance. ' 8. I, THE APPLICANT, t~RTIFY THAT ALL STATEMENTS I-IEREIN AND W ATTACHMEN'T'S TO . THIS APPLICATION ARE, TO THn BEST OF MY IWOeVLEDGE, TRUE AND ACCUR.4TI3. (APPLICANTS SIGNA' ~~ DATE f/y,/iG Gw~G-TwL APPLICAI`fT~ ew wo / W;,~r„{:s/~ca i / - yrI- 3!y X797 f"~ Sawa+'F -ui~srlt rt~n Lwn:t.sN ~/O Say~rf~ ~^ i3j i9& S~or9' BUILDER N,~/d.JvcJt, Wr ngfl PROJECT LOGdT10N: FDP(9J) To ovoid delay io procrssing the appliotion, please provide cnoug6 information to easily identify the project locatioa Provide Ute street addrus, lot number or Icgal duaiption (attach) and, outside urban areas, the datanee to the nearrst intersecting road or well-known Landmark A sketch attached to tLis appGratiou showing the projcU location would be 6clpfvl. i;~~•l ~ -. APPLICATION R PAGE20f< DESCRIPTION OF WORK (Check ill applicable boxes): URAL DEVELOPMENT ACTIVITY ST&UCTURE TYP ^ New Structure PfResidential a-4 Family) D Addition O Ruidential (More than 4 Family) f~Alleration O Noo-residential (Roodproofmg? O Yes) O Relocation O Combined Usc (Residwtial & Commeraal) D Demdfitioo' e ^ Manufactured (Mobile) Homc (lo Manu- ^ Replacement factured Home Park? O Yu) /I-- `J .6t/iyva9 T~ J!AM: /t//M ESTIMATED COST OF PROJECT S iVl~p~ F~err7AAj'/r A/~ k~• ~~ Q~ B. OTHER DEVELOPMENT ACTIVITIES• ~'D !Sr 5./~INC% ~t K®'y'•~ OP' . ~twYr~ O F'dl ^ Mining O Drilling CdOrading Ari/c Inr~ I-r•./q•%5 Aol- :n -1~~~ ^ Excavation (Except for StruUUral Development Checked Above) i~ooD~{'~-RK.b Ai`Q!• SOQi - ^ Watercourse Alteration (Including Drtdging and Channel Modifications) 5i~"/' !~h O Drainage Improvements (Including Culvert Work) I ^ Road, Street or Bridge CovstruUion /~ O SuF~vision (New or Expansion) / j D In dual Water or Sewer System 6 Other (Please Specify) ~ ~ After tom plcting SECTION Z APPLICANT' should submit form to L.o~l Adm inisvator for review. SECTION ]: Fi.00DPL1IN DETERMINATION (To be comoletcd by LOCAL ADAf[Ni TRATORI The proposed development L located on PD2M Panel No. Datr_d The Proposed Development: ^ L MM~T located in a Special Flood Hazard Arw (Notify the appUcant that the application review is complete and NO FLOODPLAIN DEVELOPMENT' PERMIT [S REQUIRED). ^ Is located is a Specal Flood Hazard Arcs. ITRM zone desiso anon is 100-Year Rood elevation at the sift is:' ~ FI. NO VD (MSL) O Unavailable O The proposed development is lor~ted io a Roadway. FBFM Panel No. Dated D Scc .S r,u ion A tpr additional insinrciions. SIGNED DA ~. .r ' :; . APPLICATION # __ PAGE ] OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED fTo he comnlctcd by LOCAL ADMfNIST'RAT___~)( The applicant must submit the documents checked below before the application can be procured: O A.sitc plan showing the location of all czisting stcuctures, water bodies, adjpccnt roads, lot dimeosiotu and proposcd development. O Devclopmcnl plans, drawn to stale, and spccificatyons, including where applicable: dal ails for anchoring structures, proposcd elevation of lowest Ooor (including basement), typos o(waler resistant materials used below the lust floor, details of floodproofmg ofutilities located below the Cost floor and details of codosures below the lust floor. O Subdivision or other development plans (I[ the subdivision or other development exceeds 50 lots or 5 noes, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). O Plans shovring the extent of watercottrse relocation and/or landtorm alterations. O Top of new fill elevation Ft. NCVD (MSL). ^ FloodprooCmg protection level (nou-residential only) t•t: NGVD (MSL). For floodproofed swUUru, uppGcant must attach certifiration from registered engineer or _ architcu. ~ 1/~ ' ^ Ce~ralion from a'iegsstercd engineer that the proposed adigit~in a regulatory [loodway vrill not result in.a~ increase in the height of the 100-year Oood. A copy of all data and ralculalions supporting due fording must also be submitted. O Other. SECTION S• PERMIT DE"r>:' MINATION fTo be co~lctcd by LOt:AL ADMINISTRATOR) I have dclcrmincd that the proposed activity. A. O Is • B. O [s not in conformance with provisions oC Local Law P , 19 The permit is issued subject to the coadillons attached to and made part of lhit permit. STONED DATE If BOX A is cherkrd, 16c Local Administrator may issue a Dcvclopmcol Pcrmil upon payment of dtsignaled fee. If BOX B is checkers, the Local Administrator wJl provide a written summary of deGciencics. Applicant may revise and resubmit an application io the Local Administrmor or may request a bearing from the Board of Appeals. r, i ~ . APPLICATION rY PAGE 4 OF n APPF~41.S: Appealed to board of Appeals? O Ycs O No Hcariog daft: SECTION 6 AS QUILT ELEVATIONS fTo be submiUcd by APPLICANT' bcforc Ccnihcatc of Compliance is issuedl The following information must be provided for project structures. This scUioo must be completed by a registered profeuiooal engineer or a Bcensed land surveyor (or attach a certification to this appGeation). Complete t or 2 below. 1. Actual (As-Built) ElevaGoa of the lop of the lowest floor, indudmg basement fin Coastal High Hazaid ea bottom oC lowut strouural member of the lowut Boor, excluding piling and cohsmns) is: FT. NGVD (MSL). L ~ AUUa1 (As-Built) Elevation oC Boodproofmg protection a ~~ Ff. NGVD (MSL)_ NOT: Any work performed prior to submittal~of the about informatiou is at the ris~pf the App~'icanl. f , SECTION 7 COMPLIANCE ACTION fTo be comolclcd by LOCAL ADMINISTRATOftI The LOCAL ADMINISTRATOR will complete this section as apphwble based oo inspcaioo of the project [o ensure compliance with [hc cnmmunit}~s local law (or Bood damage prevention. INSP~CT70NS: DATE BY DEF[CIHNC[FS? OYES ONO DATE BY DEFICIENCIES? ^ YES ~ NO DATE BY DEFICIENCIES? OYES ^ NO SECTION 8 CERTIFICATE OF COMPLIANGE(To be comnlcted by LOCAL ADhiINISTRATORl Certificate of Compliance issued: DATE BY: ~: „. , .~ e~ 1 ~~ id Attachment e ~' ~ BAMP,~E / CERTID4CATE %~F COMPLIANCE / for Development in a Special Flood Hazard Area ., ~ ,.. . ' ~• , ~. ' ~~ • • ., ~. ~ , TOWN OF SOUTHO~O CCRT'IFICATE Or COMPLIANCt; FOIt DEVELOP~~fENT [N A SPECIAL FLOOD EIA~AItD AREA .,nm~rw+ THIc rGRTIFICATE) - _ rn -'-'i PREMISES LOCATED AT: PERMIT NO SouaO ~~' ~~~~ PERMIT DA' v 1V ~' OWNERS NAME AND ADDRESS~: I CHECK ONE: C Iy'1s~LstL.~W 3 Tww~/ ~~~~'d~-~/x+~ ~ NEVV BUILDING /aoo Saueal 14a•cN Ar•'y~ _ O E7CISTING BU[LDING A~l'a~r.Ja ~ll~/ 119s=' - O VACANT LAND ' 1I ,~ THE LOCAL ADMINISTRATOR [S TO COMPLETE A. OR B. BELOW: A. COMPLIANCE 1S HEREBY CERTIFIED WITH THE REQIIIREMENTS OF - LOCAL LAW #_, 19_ DATED: SIGNED: B. CO"~IPLIANCE IS HEREBY CERTIFIED WITH TI;E REQUIREMENTS OF LOCAL LAW # , 19_, AS MODCFIED BY VARIANCE # DATED ~ SIGNED: DATED: CIC19]) ..(~- -'U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Read the instructions on pages 1-8. SECTION A -PROPERTY INFORMATION OMB'No. 1660-0008 Expires February 28. 2009 For Insurance Company Use: A2. Bullding Slreel Address,(Inq~uding Apt., Unil, Suite, andlor Bldg. No.) or P.O. Route and Box No. City nn~ ~~ I ~ J` ~ Stale /G ~ , // / I ` GIY lode ~ ~G C L A3. Properly Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) ~l / J A4. Building Use (e.g., Residential, Non-Resident I, Addition. Accessory, plc.) jLC3 ltr Cn'NA A5. Latitude/Longitude: Lal. fl I~00 36, ~ Long. 11- ~ Z So~~ l.J Horizontal Datum: ^NAD 1927 NAD 1983 A6. Attach at least 2 photographs o(t"helbuilding if the CertiOcate Is being used to obtain Oeod Insurance. A7. Building Diagram Number~2 _4 ~w1 A8. For a bullding with adrawl space or enclosure(s), prdvide: A9. Far a building with an attached garage, provide: a) Square footage of crawl space or enclosure(s) I~ ~ sq ft a) Square footage of attached garage sq ft b) No. of permanent flood openings in the crawl space or b) No. of permanent flood openings in the attached garage enclosure(s) walls within 1.0 foot above adjacent grade O walls within 1.0 foot above adjacent grade c) Total net area of flood openings In AB.b _~ sq in c) Total net area of good openings In A9.b sq In SECTION B -FLOOD INSURANCE RATE MAP (FIRM) INFORMATION 01. NFIP Community Name & ommunity Number 82. County Name ~ ~~ 83. State J v 84. Map/Panel Number B5. SuMz BB FIRM Index B7. FIRM Panel B8. Flood B9. Base Flood Elevation(s) (Zone 3 ~ ~- Date Effective/Revised Dale Zone(s) AO, use base flood depth) E I X3(,0 3 I 3 B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. ^ FIS Profile FIRM ^ Community Determined ^ Other (Describe) 811. Indicate elevation datum used tar BFE in Item 89: ®NGVD 1929 ^ NAVD 1988 ^ Other (Describe) B72. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ^ Yes 1~ No Designation Dale ^CBRS ^ OPA SECTION C -BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: ^ Constmctlon Drawings' ^Bullding Under Construction' Finished Construction 'Anew Elevation Certificate will be required when construction of the building is complete. C2. Elevations -Zones At-A30, AE, AH, A (with BFE), VE, V1-V30, V (w(tlt BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, AR/AO. Complete Items C2.a-g below according to the bullding diagram specified In Item A7. ~ I Benchmark Utilized (~•5•Le. S. /1'lon. ~'Z~11'IrVer9ral Datum ,J6/j~ 19Ly Conversion/Comments Check the measurement used. a) Top of bottom floor (including basement, crawl space, or enclosure floor) t hi h B f 5 .~© feet ~O ®feel ~~? ^ meters (Puerto Rico only) ^ meters (Puedo Rico only) b) c) the nex g er oor Top o Bottom of the lowest horzontal structural member (V Zones only) , . ~.3_.s252 feel ^ meters (Puerto Rico only) d) Attached garage (lop of slab) feet ~~- ^ meters (Puerto Rlw only) e) lowest elevation of machinery or equipment servicing the building S .~® feet ^ meters (Puerto Rlco only) f) (Desulbe type of equipment in Comments) Lowest adjacent (Onlshed) grade (LAG) ~.1 feet ~ ^ meters (Puerto Rico only) g) Highest adjacent (Flnished) grade (HAG) feet _~.~ ^ meters (Puerto Rico only) SECTION D -SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification Is to be signed and sealed by a land surveyor, engineer, or architect aumorizea ny law to certlry elegy Inforrnalion. I cedily that the inlormalion on this Certificate represents my best efleds fo Interpret the data available. 1 understand that any /else statement maybe punishable byline or imprisonment under 18 U. S. Code, Section 1001. © Check here if comments are provided on back of form. Noma M..,. '~ /~/'.~I.. Address P, o. Signature , /~ _ ,/G _ Date ~/~/ ~ leiepnona 63~-7z.7- ~"p9u -~_ ign`~ `PFT Cpl 'p.~.~ .p ~a~~' F f !~ /.~ 4 ,4 , ~ d ~, r ~.~., ~~ 2 A ~!, FEMA Form 81-31, February 2006 See reverse side for continuation. Replaces all previous editions JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631)298-7116 Date: September 1, 2008 To: Town of Southold Building Dept. Re: Framing/ Insulation Inspection Witscheiben 1000 Sound Beach Dr. Mattituck, NY 11952 Permit # 32255 To Whom It May Concern: A Framing, And Insulation Inspection was Performed on the above mentioned Project, and all of this work was done as per plan and meets all State and Local Codes. Any other questions please call. ~eerkoski JAMES J. DEERKOSKI, P.E. 260 Deer Drive Mattituck, N.Y. 11952 (631) 298-7116 Date: November 21, 2007 To: Town of Southold Re: Strapping Inspection Witscheiben 1000 Sound Beach Dr. Mattituck, NY 11952 Permit#32255 To Whom It May Concern: ' ~ ~p~_f~ ~ ~l ~ , ~ t e~ ~I ~~i M .~Z9Lt: ~V i i _.~ K This letter certifies that all wind strapping on the above mentioned project is in tact, and meets all state and local building codes. Any questions please feel free to call. ~: Sincerely Jam~Deerkoski P.E. Perini[ # Pemut Date REScheck Software Version 3.7.3 Compliance Certificate .1' Report Date: 07/16/06 Data filename: C:\Program Files\Check\REScheckWSOUND BEACH.rck Energy Code: Location: Constuction Type: Heating Type: Glazing Area Percentage: Heating Degree Days: Construction Site: SOUND BEACH DRIVE MATTITUCK, NY New York State Energy Conservation Construdfon Code Suffolk Counly, New York Detached 1 or 2 Family Non-Electric 20% 5750 OwnerlAgent: DesignedContractor. JAMES DEERKOSKI 298-7116 .Compliance: Passes Maximum UA~ 40 Your Home UA: 39 --> 2.5°/ Better Than Code (UA) Ceiling 1: Flat Ceiling or Scissor Truss: 112 30.0 0.0 4 Wall 1: Wood Frame, 16" o.c.: 240 15.0 0.0 15 Window 1: Wood Frame:Double Pane wRh Low-E: 48 0.330 16 Floor 1: AIFWOOd Joist/Tmss:Over Uncondi0oned Space: 112 30.0 0.0 4 The proposed building represented in this dowment is consistent with the building plans, specifications, and other calculations submitted wkh this permd application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Professional has stamped and signed this page, they are attesting that ro the best of hislher~knNwle,,dge, belief, and professional judgment, such plans or specificatons are in compliance with this Code. 5 Ass V l~~tL~' -"1 ~ BuiklerlDesigner Company Name Da e Page 1 of 4 REScheck Software Version 3.7.3 Inspection Checklist Date: 07!16/06 Ceilings: Ceiling 1: Flat Ceiling or Scissor Truss, R-30.0 cavity insulation Comments: Above-Grade Walls: Wall 1: Wood Fmme, 16" o.c., R-15.0 cavity insulation (~gmmente: Windows: Window 1: Wood Fmme:Double Pane wkh Low-E, U-facto: 0.330 For windows without labeled U-factors, describe features: #Panes _ Frame Type Thermal Break? Yes No Comments: Floors: ^ Floor 1: All-Wood JdsUTruss:Over UncendNoned Space, R-30.0 cevity insulation 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-tight assembly with a 0.5" dearance from combustible materials. Ii non-IC rated, the fixture must be installed with a 3' clearance from insulation. Vapor Retarder. Required on the warm-in-winter side of alt non-vented framed ceilings, walls, arxi floors. Materials IdentiRcation: Matedals and equipment must be installed in accordance with the manuradursr's installation instructions. ^ Materials and equipment must be identified so that compliance ran 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 deady marked on the building plans or specDcetions. Duct insulatlon: ^ Supply ducts in unconditioned attics or outside the building must be insulated to R-8. ^ Return duds in unconditioned attics or outside the building must be insulated to R-4. Supply ducts in unconditioned spaces must be insulated to R-8. ^ Return duds in unconditioned spaces (except basements) must be insulated to R- Return ducts in unconditioned spaces (except basements) must be insulated to R-2. . Insulation is not required on return duds in basements. Dud ConsWdlon: All joints, seams, and connections must be securely fastened with welds, gaskets, mastics (adhesives), mastic-plus-embedded-fabric, or tapes. Tapes and mastics must be rated UL 181A or UL 181 B. Exception: Continuously welded and locking-type longitudinal joints and seams on duds operating at less than 2 in. w.g. (500 Pa). The HVAC system must prowrde a means for balancing air and water systems. Temperature Controls: Page 2 of 4 J ^ Each dwelling unit has at lesat one thermostat capable of automatically adjusting the space temperature set point of the largest zone. Electric Systems: Separate electric meters are required for each dwelling unit. Fireplaces: Fireplaces must be installed with tight fitting non-combustible fireplace doors. ^ Fireplaces must be provided with a source of combustion air, as required by the Fireplace constmdion provisions of the Building Code o/New York State, the Residential Code of New York State w the New York CRy Building Coda, as applicable. Service Water Heating: Water heaters with vertical pipe risers must have a heat trap 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 oNoff heater switch and require a cover unless over 20% of the heating energy is from nondepletable sources. Pooi pumps require a time dodo. Heating and Cooling Piping Insulation: HVAC piping conveying Fluids above 105 degrees F w chilled fluids below 55 degrees F must be insulated to the levels in Table 2. __. __ Page 3of4 Table 1: Mfnimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Temperature (°F) UP to 1' Up ro 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: Mfnimum Insulation Thlcknass for HVAC Pipes Fluid Temp. Piping System Types Range(°F) Heating Systems Low Pressure/lempemtun: 201-250 Low Temperature 120-200 Steam Condensate (for feed water) Any Cooling Systems Chilled Water, RetrigeraM and 40.55 Bdne Below 40 NOTES 70 FIELD: (Building Department Use Only) Insulation Thickness In Inches by Pipe Sizes 2" Runouls 1' and Less 1.25" to 2.0' 2.5" ro 4' 1.0 1.5 1.5 2.0 0.5 1.0 1.0 1.5 1.0 1.0 1.5 2.0 0.5 0.5 0.75 1.0 1.0 1.0 1.5 1.5 Page 4 of 4 /Goc - 9~/ ..r~ fiOWN OF "~?fiJTHOLD P~OPERTY CARD ~~-3~ OWNER STREET ~ {''t'. `-`~ VILLAGE DISTRICT SUB. LOT ~ ,/y, o) ~ u~~ h. en ~' FORMER OWNER r 1 N E ACREAGE ' .. . 6 ~d 0~// -~ i ~ ~ ` GrA ~+ S W TYPE OF BUILDING /aao Q RES. SEAS. VL. FARM COMM. IND. I CB. MISC. Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS ~ CAa r: o .5~ d a ~ 3 a -X1)53(0 ~ -1n/ ` ~- W chr n Tres} r ;Sao ~`oa / to a9/7~ - '~ - Pad; ~ ~ ~E~c • ~~3r~:~F- ~.C~ O `' ~. ~.a c' ~ t ~ _©a ~ 0 5 - L- I I lq 1 ! - U~ ~ +~Ch,'tn ru6fi -~z~ ua ben ~~fno. 20 0 0 600 s . 9G ~ - P$k oZc148fo kt e r> - ~ ~ ! .//r~~ ~, ~AG~'/ 4©mp BUILDING C DI ~ omo 3Z = 320© ~, z~~me 200 ~S2 0~ tyr©o " 2 ~r olf FRONTAGE ON WATER- ~ ~" Farm Acre Value Per Acre Value FRONTAGE ON ROAD ~ 7 7.,/$Tp3 QC I ~~h1S t Q)t Tillable 1 BULKHEAD Tillable 2 DOCK Tillable, 3 AJ (]E i !~ ~'O Woodland Swampland Brushiand - House Plot >: Tota I 31tl4 1tl101 ~ ~ SStllO 'dOHd 'Ol9 30 3dA1 SNIitlW3H HOtl lOl 9f1S 1SIO 3~Jtllll~ 1331i1S Oa\10 ad003d Ala3d0lid alOH1f10S ~O NMOl 99-1-5 2/04 M. Bldg. Extension Extension Extension Garage O. B. ~,t~~21 = S8d 2Nri~ 384 -tHy/ ° - --/-' /fslt5' = 3NZ. {/Y = /Y~ /J~} = So s~! ~~ ti t IB I - d - - ~- - i I ,~7 I ,~ ~ ! Izst ~ ~ L i ' Z F '---a i g.~a S~j 'Foundation C~ Both Basement _ Floors Ext. Walls ~N ~ ~nL Interior Finish Fire Pldce ~, ; ~ Heat __ _ Porch Roof Type -- Porch Rooms 1st Floor Patio Rooms 2nd Floor Driveway Dormer J .Z/:Z- 1 ~H ,~+ *~.. ~~ 6 ~a - ~r I/~llt ; -~ e h , ,, C ; :, __ ___ _ _ _ _ ~ f%' o _.. _ - M. Bldg. , - ~- ~'.. ~ i - /; I - ~ 6o J j ~ ' ,~~~,~~ Foundation ~'d r ~ Bath _-- •, _. rExtension l ~ "~ ~r +1 Basement ~ • J ~ ) Floors _- / _ i /i • - ----- - ~ Extension , ~ 2 ~'.~ } Ext. Walls ~ Interior Finish _ ~ ~ -_ -~ ~ ~ ~ _ I ~$' i _._ I - Extension i ~ - ~ ?` - - u ~ ~ <i ., ~ Fire Place Heat _ - ! - - - + Wis. -, v ~ Porch lk ~ p ~~ i Attic ---r - - __ __. _ __ _ - --- -~ ~" ~ ~ l Porch i ~ Rooms Ist Floor - ---- __ - ~'°°«..ey --- y f __ r ,~ z_, "~ ~", Patio Rooms 2nd Floor - .. -- - - --- Ga rage Driveway - -- -- ~ - _ - ---- - - - -- O. B. - ---~ .l - - - - - ~-~z. . ~ f OWNER ""^ ~"' ~ ~c,:fu r„vLD PROPERTY RECORD CARD ~ STREET .~ VILLAGE DISTRICT SUB. ' ' ~ LOT yj ~ FORMER OWNER -/ ~ I ~ % 1 !L U C, !~" ~ ,~, . / ACREAGE ~"~ ~= ,, s: ~ S W l2 TYPE OF BUILDING RES. ~ r ~ SEAS. ,' - VL, FARM COMM LAND IMP. ~~- -----TOTAL DATE I . I IND. I CB. I MISC. ~ Est. Mkt REMARKS OCr od ~ 30 'Sop .5`urs p Zot, AGE BUILDING CONDITION NEW NORl~AAL BELOW ABOVE FRONTAGE ON WATER . / Farm Acre Value Per Acre Value FRONTAGE ON ROAD . - .J~~ Tillable 1 Tillable 2 BULKHEAD Tillable, 3 DOCK Woodland / ~ "" C/'p Swampland Brushland House Plot Total ~ ~ v ~. v ~. Idg. I may ~ ~ , .• - ~ ~ ~ / tsasem~,~~ _ _ ~ /~~ Interior Finish . :~ sion ~ ~ X/ b o ~ - 2 86 r Ext. Walls ~ _ - iY Heat Extension a X r `( ~ . °- Fire Place ~` ~~ ~(o h 2 ti A Extension /+/~ f ` ~~' , ~ i ! 39` Porch c t -- Rooms 1st Floor __ ?;.~ •~a-`~` ~n // .t' / ` ~ p Porch Rooms 2nd Floor ~' , 1 // ~! Z ~- ~ I ~ / Patio _ - ( ~'$ree'~ewey /os/2 _ /LO- o !oo__ Driveway Garage - - _ - O. B. - - ~/~ 3 q ~~ ~~6 _~d a o - ~ ~ ;, : ~ -r-~~ r~r t~l~ ~ ~~7~T~o~D 'O~ER~"Y RECORD C/! OWNER STREET VILLAGE DISTRICT ~ W FORMER OWNER / e ~ / SUUND 1~~ra~ N S , ~~, ,/~'1 p ~ T~-uc, E W ACREAGE !2 TYPE OF BUILI RES. ~ / ~ SEAS. VL. 1 FARM COMM. I IND. I CB. LAND IMP. -TOTAL DATE REMARKS L~~ ~ ~~ 1~• ~ !e ! J i :gip ~ _; 'v3~~ , f v AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATE R .~ / Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 __ BULKHEAD Tilloble 2 _ - --- -- - DOCK Tillable 3 Woodland -- - - , Swampland Brushland House Plot Tota I ._ - ~ t ~ ~c C.... ° ~ al~i- f w~~~~ I . aw - ! a ny e ' 1- ~ rn 7 ~ 3 ~~ ,6 Foundation li ~ rr Bath Basement ~y ~~ C, Floors l ~ ~~ 2 2 86 f Ext. Walls ~ 1 ,, Interior Finish (,2 _°.' /~f,C,~ Fire Place ~io h e Heat ~ecfr-~c J, . ~ 9G Porch Attic ~d Porch Rooms 1st Floor ;o ~ ~ Patio Rooms 2nd Floor Driveway /~r ' _ -- 3 ~7S ~g~ STREET SvuNO ~'k'Ae N IJ H, S FARM 3'~ L DATE VILLAGE eM~/T~ W ~ COMM. I IND. REMARKS S'.d~ e a n_ RECORD CARD DISTRICT SUB. ACREAGE ~ ~z TYPE OF BUILDING CB' I MISC. • / / ~, LOT ~,lj // ~~. ~ `'~*~C. Est• Mkt. Value G ctrd~ COLOR TRIM 1st 2nd vG M. 13t~+ Extensi 2.6k `t= .~ k = ~~` x~$- Foundation ce - Basement Fin. B. FULL COMBO CRAWL PARTIAL sub Bath FIOOfs _- Dinette I(It. - - Extension k 7 _ ~3 Ext. Walls ____ __ Interior Finish -- L.R. -- -- - Extension __ Fire Place Heat D.R. - - --- -- Patio Woodstove --- BR. --- - Porch, Deck xl~j=la7~ X c ~ ___ Dormer Dock - . - Baths Fam. Rm. - --- " __ _-___ A.C. Garage - - _ -- -___ O.B. Pool 31~~3-z James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel ho~~OF SO(/lyo~ ~O l~COU~ ~~~ 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 ' ^l TOWN OF SOUTHOLD TO: ~~ 1 V" 1 ~ S C~ 1 t bLn G•n.( ~Gn e (- ~r Te "~ Please be advised that your application dated `~ ~ 1 ~ ~ d b has been reviewed by this Board at the regular meeting of ~ (I H I a 6 and the following action was taken: ( ~) Application Approved (see below) L_) Application Denied (see below) () Application Tabled (see below) If your application is approved as noted above, a permit fee is now due. Make check or money order payable to the Southold Town Trustees. The fee is computed below according to the schedule of rates as set forth in Chapter 97 of the Southold Town Code. The following fee must be paid within 90 days or re-application fees will be necessary. COMPUTATION OF PERMIT FEES: ~- ~I ~,1 TOTAL FEES DUE: $ 5 ~ ~ BY: James F. King, President Board of Trustees X98-Soot , James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel ~o~~pF SOUryo~ ~O 'rrV Q ~Oly ~ ~ 1 1 ~N~ BOARD OF TOWN TRUSTEES Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631)765-6641 TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR APRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE Pre-construction, hay bale line 15i day of construction '/z constructed t% Project complete, compliance inspection. Southold Board Of Trustees Meeting July 19, 2006 !~' ,llll.!20 ;~~ L___ __ _ ~r~ Application for Administrative Permit for Repairs and Rebuilding to Witschieben-Larsen Residence 1000 Sound Beach Drive Mattituck, NY 11952 Suffolk County Tax Mau Number 1000-99-1-5 Description for the Permit for the Administrative Application to proceed with emergency repairs to Witschieben-Larsen Residence. A "Stop Work Order" was issued on June 28, 2006 due to mistake by contractor during the excavation process for an extension for which the Town issued a Building Permit, by removing the existing den and foundation on the spot when contractor concluded the azea required immediate repair to the foundation and rebuilding of that room. Because of this error, an opening has been left to the main home approximately 3' by 6', a large hole has been left by the excavation of the azea and foundation to the existing family room has been exposed to the elements. Consequently foundation of that room is eroding and in need of immediate repair. As a result of this error, applicants for the Administrative Permit respectfully request the following as discussed during the site visit on July 13: 1. Immediate repair to the foundation ofthe existing family room due to exposure of the site and impact of the rains for safety reasons. 2. Approval to rebuild the pre-existing den "in kind" within the 15 foot set back, in order that the house can be closed and made more livable. 3. Approval to rebuild the pre-existing cement patio "in kind" that was removed by contractor at the same time the den was demolished, within the 15 foot set back. 4. Approval to bury oil tank behind the existing bedroom on the Cyprus side of the house where it was previously located. Additional Pending Permits (in progress): • Amended DEC Permit issued in 2004, expiring in 2009. • Boazd of Health Permit Building Permit to be issued by Town upon receipt of Trustees Administrative Permit to repair existing family room foundation, rebuild foundation of den, den and cement patio (within 15 foot set back) and replacement of oil tank. • New Building Permit to be applied for by July 30`x' 2006 for newly revised smaller extension design. • Trustee's Permit to build newly revised extension -application to be filed by owners prior to July 30, 2006. Sincerely: ~ e ~.~ Carol Anne Witschieben Janet Witschieben Larsen -Owners James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel y~O~~pF SOUr,~o~ T • ~~0~ ~~(iQU~ i~~rlf' BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Permit No.: 6397A Date of Receipt of Application: July 17, 2006 Applicant: Carol Witschieben and Janet Larsen SCTM#: 99-1-5 Project Location: 1000 Sound Beach Dr., Mattituck Date of Resolution/Issuance: July 19, 2006 Date of Expiration:July 19, 2008 Reviewed by: Board of Trustees Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Tetephone(631)765-1892 Fax (631)765-6641 Project Description: Complete emergency repairs to foundation of pre-existing den and repairs to foundation of existing family room. Also to rebuild, inkind, within the 15' setback, the existing den and cement patio, and to bury an oil tank, and all as per plans prepared by James Deerkoski dated July 16, 2006. Findings: The project meets all the requirements for issuance of an Administrative Permit set forth by the Board of Trustees. Special Conditions: No disturbance to beach grass during construction. If the proposed activities do not meet the requirements for issuance of an Administrative Permit set forth by the Board of Trustees, a Wetland Permit will be required. This is not a d~et'e`r`mination from any other agency. v ~ ~I James F. King, President Board of Trustees SOUTHOLD TRUSTEES no. G~391 ~F Issued To ~~~+ ~ars~ N PE ~a.., W-~„sti~,~kN Date ~ ~'~ ~°6 Address ~ aoo ~S'°`X'~ ~c.~`l Dry /'~R~ THIS NOTICE MUST BE DISPLAYED DURING CONSTRUCTION -TOWN TRUSTEES OFFICE,TOWN OF SOUTHOLD SOUTHOLD, N.Y. 11971 TEL.: 765-1892 Peggy A. Dickerson October 15, 2002 Ms. Chris Rivera 250 Sound Beach Dr. Mattituck, NY 11952 o~~~~ ~ji~l ~ Sao BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD RE: 1400 Sound Beach Dr., Mattituck SCTM#106-1-35 Dear Ms. Rivera: Telephone (631)765.1892 Fax (631) 766-1366 The Southold Town Board of Trustees reviewed the survey dated April 17, 1986 and last revised November 12, 1999 and determined the proposed second-story addition to the existing dwelling to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surtace or vegetation within Tidai Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. 1 i f ~ad ~ a ryryQ / ~ n' V V~.]~~hu:l ~ 1.1 (:iVl~~1~.i~ c } t .a •I •' lr ?~.. ~ yv , • I'` :. Y. ' ,. f( 1. ?t. i i 1 ~,~: n'h nll 01„vin n n, nd.lma. to ILI. 1•.r, of n n rivlSlnn .1 uyn.n Je .d r'n 1•... lSr. Sr41r Cdutmq„ lo•: (T,. • 11.•1 r+.,. pn Iwmmq r» Ignd .,4q .,A.d f•rol •r : ' 1... •.1 . .. ~ 11 wr. l • : mn.lr•••d ,.. 1... n'r r ^r•r ..u. ,,.,. . .,. 1lnha0 rl l.e:,, ~,ali e•n .II. ~.,n yhye I. .n ,.,: .,. ,., ~. p. 4or ,;,n••1 c.. Le 1. !..•1 t. ,AV Id4 ~ .... rl v'Inn.y t .1 6...:n n •nei... lu, loin, h: r.~ r; ~ .,1 a1 J'•• '• Lr . ., noun 1 •uu.n•~n. f ..1 , r a~taaaDYu Mew A9pRuDsa y.K• Aw4fAtT.E. 11`ii'1-~ SUi.•Yf:Y fOR •• eErcaENCEI pONALO G, ,~ J~SSJE A. WJTSCNIE•BEN M/4 CAPTAIN KIDO ESPArES .~ r..•vu•r~rr..v ~, ,, •,,.~ rILED~JAN. 14r1p~9-MAP N0. 1875 Other Troae's ucensc 1.~. ••••••••~, . _. 1, l.aation of land on which proposed work wilt be done. Mcp No..:......u..s~-s•••~•••••••••••r.^•• 5eraeti'ond Number ,....,••_~~'nru."f.~,.ai:~tt•~ 2. Store existing use atd occupon:y of pre.nlse: and Intended use and aeulwncy of proposed construct ! t?Fn!.7.'i. h.~:... ................................ o. Exisltinp use and acupontY ~•••• °•° ................................ .~r..~.tf.ap.~.rlt/..J..~t1L ........................ b. Intended use pnd txeuponcy ............. ' r .. J~0 5~ ., ~o ~5~~ /~~ / ~o v~~~ `~ 2yo ~' r" A mo ~ / ~,.~op ~o F ~OOE ~r h ~Q~r"~ /a r' O C r a Z,~ O~ O ,TS ~ CAA ,. i .;' who ~\ ,o~ :. ~/`" " ~O. ~_ 0 ~O A A O ` /~ `~A a \ 0),p~t"~` jr ,~~~ >a~ M ~ ~ 1 t~/ 10 ~~ s,' 4. { r,L ~. /r` ~Z \a a w ~N, ' ``,a~ .~ . , o~ ~ ? , i `Os. ,~ 0'30 / y5 ~OJ~O U ~Fl7n n_I s.~~ ~.i ~7iU~~ , , ~'T~i £~ !: 1 JU :.,L•1lis.Vil ' '.lTIT $iltl,: •c,'i w " lc + 2 ~~ O~ ~rL 6~ ,DO OR~J P~~ 8~ , IlfaUl+., nd Odnnli,~n ur ad<LM1On 10 Ihls survby is a viulolian bf vmnon ~.~p9 u! r:+: h•~ Vwk $IOIe @ducunan Lav. Cc}v o' Ihh srr..y + nM boar mg I^a Innd :brvc~a' a ~~•Lad anal nt •~Fm•od •.. a +' all nrn bn <onaelr,..d b bt .rbd rnrv Gvmrr•~ s o• t :nan ai. ns inb.ob•r{ I,^rr..n :hall mn •~ly w :nr+ pp. sin I •. vh~•a ~ ~. u.:ay r: pmp.r. L, n..q en I+q L b..°. In shn bdu r . a: s.:n.n.o'cl a;7vacy uni I+udi..n v;nmm~n Irsrri fr'I~Kq` rnlJ r. ~ ". rt of ihr rn nra 4WVrr<n Grmm~L•r. .. nng4 1 ::anl:nr~+1. ., u~.,r.wn :n VII Vll.vli r, y .. rs A~sscBATv SHOW II,pD1110fJ t~,rC. A+a~.6P~s,P,E. II~ZZ~7l~ SURVEY FOR REfERENGE+ DONALD G. 81 JE'SSfE A. WITSCHIEBEN M/O GAPTAlN lfIDD ESTATES I _z__.._.. ~~~+El?~~.JAN.19,~1999~{NAPNO.1672 ^ • A\ V ~r . 1 'iia ~Q • • J. '~• p^ f .'~ : op i ,y •. i• ~ y • ~ ~..it~ •. ~ ~ w 1. i~ I~ ~, 1 f i 3. Nature of work (check which applicable): New Building .................. Addition .,Y-XyiX....... Alteration ................., Repair .................... Removal .................... Demolition.................... Other Work (Describe) ...................................... 4. Estimated Cost ......~,~OQp..)'~.17 ................................Fee ....... ... 5 QS? ......................................................................... (to be paid on filing this opplicotion) ........... 5. If dwelling, number of dwelling units ........... ~??? Number of dwelling units on each floor ............................ If garage, number of cars ..................................... ...................................................................................................... 6. If business, commercial or mixed occupanry, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front .......................... Rear .......................... Depth ............................ Height ............................ Number of $torles ............................................................................................ ................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Fleight ............................C..Number of Stories ........................................ 8. Dimensions of entire new construction: Front .......~U ................ Rear 1tt............ Depth ~9 Height ............................ Number of Stories .....17X18................ 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Dote of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..............."A"...d1.°.L........................................ ....................... 12. Does proposed construction violate anyy yzoynying law, ordinance or regulation? .............HP..................................... 13. Name of Owner of premises .x~[?tx~~~.•,sy :~~ ohn FeaII ..............Address ......:..................................... Phone No..................... Nome of Architect ........ll.r...~!:.L.~.~.Y...:;....5............Address ...........................:................ Phone No..................... Name of Contractor .................. °.........................,......Address ........F.1?tti_tUCk.............. Phone No..................... .............. . PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or comer lot. So,~N~ ~ Dom`'` ) BEAG~ R f) STATE OF NE~~ YORK jj 5.5. COUNTY OF .+`.~A.~.I> :.............f ~••••~•~•••~•• ~ ~Y•t"'•P~F•~••`••••~~,••••• ••••••••••••••••• .........being duly sworn, deposes and says 1 the is the applicant (Name of individual signing applica on) ,•S ` ~ ^ ~ ~ _ ~_ above named. He is the ......G.QAl.^2.C.tAS .............. (~ (/(2~~(~i .L l~.onrracmr, agent; corporate officer, etc.) - ~~~~ ~~~~~ of said owner or owners and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in~the application filed therewith. Sworn to before me this ....................$.... d of ....................R42.x h............, )9.b4.. ///1 Notary Public, .. .. /~ ...~~~7••t'd'••:•..3~r..u... ... .... .......................... .. ~r~T'S:~M.a~o/ arty ~ .... ... ... ~!~~onrr~ees .. (/j~.~. (Signature of applica ) NMery Pu".I~q Slek of New Yort T e~ ~ d; v3, Suflol% Coun1Y q..:. ... r.~Lymy A4arcb 30. 19~i~" 3. )Mlature f work (check which applicable): New Building ....................Addition ..7L9t][..........Alteration .................... Repair .. .. .................... t ! ...............Removal Demolition,...............,...Other Work (Describe) ,,,,.,,...........,. 4. Estimated ost.. .... Fee ......... S 250• ~~ ..................................... g .~....................................................................... ~to he paid on filing this application) If dwellings umber of dwelling units...D~ ......................Number of dwelling units on each floor............................ `•;If garage, n tuber of cars ........................................................................................................:................................... 6. ~Y business, ommercial or mixed occupancy, specify nature and extent of each type of use .............................. 7. Dimensions of existing structures, if any: Front ..................)k2.... Rear............ -F2....,..... Depth ........2Q............... Height ...........................Number of Stories ......OIIf..................................................;...,........................................, i. Dimensions of Same structure with alterations or additions: Front ..............................r. Rear ................................ Depth .............................. Height ............,.................Number of Stories ...................,..'~.......... 8. Dimensions of entire new constfrction: Frant.........20 ............... Rear ..........5.0. ..... Depth ..........2}•............. r Height ............................ Number of Stories .,....~................ .......' . 9. Size of lot: Front ....... Rear ............. ..... Depth .....x.50•• , 200 ............. lOp... ~.... { 10. Dote of Purchase ........................................................Name of Former Owner .............:........................................... 11. Zone or use district in which Premises are situated..........ataN .....................................::..:.................................... 12. Does proposed construction violate any zoning law, ordinance ar regulation? ............i00•~ ................................. 13. Nome of Owner of premises.......~~~..$g.~y...........Address ............................................Phone N0.............,....... Name of Architect .................................n.....................Address ........,..................................,Phone N0.............,....... Name of Conlractor ................................~..................Address ........,..,................................Phbne NO..................... ~' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set•b~pck,dimensions from property lines. Give street and block numbers or description according to deed, and show street, names and indicate whether interior or corner lot. tSTfiJbDw~G ^1 ~~ Q4~ Ily: ~i I STATE OF NEW YORK, > S S. COUNTY OF ....5.~~.~.......) ,,,,,,,,, , , ,,,,J@}~„gr~ .................................................being duly sworn, deposes and says that he Is the ~pplicant (Name o m rv uo signing application) ~ :~ i above Homed. He is the........p~ep.. ~1k1.2fPe~T...(Contro~ ................................................:..: ...........................'............. W" ctor, agent, corporate offlcer,,:e tJ of sold 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 ore true to the best of his knowledge and belief; and that the work will be performed in the manner setl~~q~hTirkoj~p application filed ther@with. Sworn to before me this tt®lAry Pe61m, Stxm of New Yurk yp. 52~0344'J43, Sulbik County I ..................~3, da/Y~[gf ..................... g~..... 8~~ es~ tint, Moak 3a, ts63 (Signatu of~?p can Notary Public, ...,~^'.,.~.ka~0~!~,,.-i••••~A~F~~~ L/~~f1~7`Tit~! .,.