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HomeMy WebLinkAbout33063-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33696 Rte: 05/07/09 I~{IS U~TIFIES that the building NEW DWELLING Location of Property: 735 COREY CREEK LA (HOUSE NO.) County Tax Map No. 473889 Section 78 subdivision SOUTHOLD (STREET) (H~iMLET) Block 4 I~)t 24 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 16, 2007 pursuant to which Building Permit No. 33063-Z dated 5Qky 22, 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 ONE FAMILY DWELLING WITH REAR DECK, COVERED FRONT PORCH AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to DENNIS A & PEGGY A FERLIN (OWNER) of the aforesaid building. S~FOL4K CO~TY DEPART~ OF ~%L~{ APPRO~-AL R10-07-0016 ELECI~IC~k5 U~TIFICA~ NO. PLUMBERS U~u~'rIFICATIONDATED 11/o7/o8 3050656 04/06/09 HENRY SMITH 02/2~/09 Rev. 1/81 TOW OF SOUT OLD II " BUILDING DEPARTMENT ~ll ]]J 765-1802 j 2009 APPLICATION 'FOR CERTIFICATE OF OCCUPANCY BLDG, D£p~. TOW~ OF $0UrH0il) ~ais application must be filled in by typewriter or ink and subnfitted to the Building Depm~ment with the following: A. For new building or new use: 2.Final survey of property with accurate location of all buildings, pr0perty lines, streets, and unusual natural or topographic features. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). ~ Approval of electrical installation from Board of Fire Underwriters. _? Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer, responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements: B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 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 Certiticate of Occupancy is denied, the Building Imspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelllng $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy- $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Oecupancy - Residential $15.00, Commercial $15.00 New ConstructiOn: / Old or Pre-existing Building: LocationofProperty: 7~'~ C~O~"~:J/ ~.~r~ House No. " Street OwnerorOwnersofProperty: De-r~/~l$ *- P~qqi~ Suffolk County Tax Map No 1000, Section 7 ~ Date. check one) Hamlet Block 0 ~ Lot 22 ~ Subdivision C o Permit No. 3 3 Health Dept. Approval: Plmming Board Approval: Request for: Temporary Certificate Fee Submitted: $ Dateof ermit.$p ;}e 0OTnppli t: Dermis Underwriters Approval: Final Certificate: (check one) Applicant Signature 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 JANON GENERAL CONTR. CORP. P.O. BOX 439 FARMINGVILLE, NY 11738, DENIS & PEGGY FERLIN 735 COREY CREEK LANE SOUTHOLD, NY 11971 Located at 735 COREY CREEK LANE SOUTHOLD, NY 11971 Application Number: 3050656 Certificate Number: 3050656 Section: Block: Lot: Building Permit: 0 BDC: ns11 ~escribed as a ~esi~endal oco~pano¥~ wherein the ~remises electrioal system consisting o~ 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 the26th Day of February, 2009. Name QTY Rate Rating Circuits ~ Alarm and emergency equipment Sensor 4 0 0 Sensor 4 0 0 Appliances and Accessories Air Conditioner 1 0 Above 1500 Cooking Deck 1 0 30 Dish Washer I 0 1.2 Exhaust Fan 3 0 Hydro Massage Tub (Therapeutic) I 0 Qven 1 0 40 Pump Motor 1 0 Panels Service Service Disconnect: Service1 Phase3w Service Rating200Amperes Wiring And Devices Fixture 27 Continued on Next Page 50 200 CarMon/Smoke Smoke BTU Amps KW F.H.P Amps FH.P cb 0 Incande~-~t I 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. 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 JANON GENERAL CONTR. CORP. DENIS & PEGGY FERLIN P.O. BOX 439 735 COREY CREEK LANE FARMINGVILLE, NY 11738, SOUTHOLD, NY 11971 Located at 735 COREY CREEK LANE SOUTHOLD, NY 11971 Application Number: 3050656 Certificate Number: 3050656 Section: Block: Lot: Building Permit:0 BDC: ns11 Described as a Residential 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 the26th Day of February, 2009. Name QTY Rate Rating Circuits Type Paddle Fan 7 0 Receptacle 1 0 20a-laundry Appliance Receptacle 1 0 30a Dryer 16 0 GFCI Receptacle Receptacle 47 0 Gen, Purpose Switch 41 0 Gen, Purpose 2 of 2 seal This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (63 I) 765-1802 Fax (63 I) 765-9502 BUILDING DEPARTMENT TOW'N OF SOUTHOLD CERTIFICATION Date: ~[~{°7 Building Permit No. Owner: D~- Bat3 (Please print) Plumber: ~3 ~ ~'3 ff'h ~ (Please print) lead. I certify that the solder used in the water supply system contains less than 2/10 of 1% ~lm:nb ers ~gnature) Sworn to before me this ~7 '~ ¼ dayof~ , 20©cl' Notary Public, ~ County 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. 33063 Z Date MAY 22, 2007 Permission is hereby granted to: DENNIS A & PEGGY A FERLIN 3662 DEMOTT AVE WANTAGH,NY 11793 for : CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 735 COREY CREEK LA SOUTHOLD County Tax Map No. 473889 Section 078 Block 0004 Lot No. 024 pursuant to application dated MAY 16, 2007 and approved by the Building Inspector to expire on NOVEMBER 2~ 9~008. Fee $ 2,244.80 ~~!~at~ ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION { [ ] INSULATION [ ] FINAL ] FIRE SAFETY INSPECTION ] fiRE RESISTANT I~F. NETRATION DATE ~//~ ?/(~) 'Y / / INSPECTOR //~/~'ff TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [/~O~NDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ [ ] ROUGH PLBG. [ ]INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION DATE ~ . INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] F~J~iDATION 2ND [ ] INSULATION ~ [ ~FRAMING ~RAPPING~ [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~v{..~/~ ~ ~.~]2.~_. ~zJ& DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST /~ROUGH PLBG. [ ] FOUNDATION 2ND [ ~~.~ STRAPPING [ [ ] FIREPLACE & CHIMNEY [ ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PE#,-i.ATION REMARKS: DATE //'- I -¢ 7' INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [~,]~IJ~H PLBG. [ ] FOUNDATION 2ND [(,,']'INSULATION [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT C0NSTRUCTi0N [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] I~I~LATION [ ] FRAMING / STRAPPING [ ~'] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESlSTA~__~CONSTRUCTION[ ] FIRE RESISTANT PENETRATION REMARKS: ~~//~ )L~o~_~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [[]]~ORAUN~ND~IsOTNJNPFIDNG [[ ~TION [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [IF IRE RESISTANT CON~ION~ ]/F~..)RESISTANT .ETRAllON REM~ DATE t /? '" INSPECTOR × ' ~////'~ FIELD INSPECTION REPORT I DATf COMMENTS ~.j.~ '' / "-- ~ ~S~ATION PER N.Y. ~ ~ STATE ENERGY CODE ~DITION~ COUNTS /y-_ ~- . TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration _, 20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: APPLICATION FOR BUILDING PERMIT Oate INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. lfno zoning amendments or other regulations affecting the property have been enacted in the interim, the Building h~spector 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) /? 7~;~o~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ' ' Name of owner of premises b ~/L,t ~ ) 5' ff~-/~ t._ !/0 , 6-~ /~o/_. j/L) (As on the tax roll or latest deed) ~ If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~ 7 Plumbers License No. 30 Electricians License No. oQ, Other Trade's License No. Location of land on which proposed work will be done: 735' House Number ~ Street Hamlet County Tax Map No. 1000 Section '7 8 Block O q Lot ~ Subdivision (-~F'~/, C~'~Cff ~-~T-~7'-C-5 Filed Map No. ,~?~R Lot (Nam'e) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /['/0 ,t~ ~ b. lntended use and occupancy O/t/C /~'-/~,v///_ 5,- 3. Nature of work (check which applicable): New Building ~ Addition Repair Removal Demolition Other Work 4. Estimated Cost ~',~zg./)2¢~ Fee 5. If dwelling, number of dwelling units If garage, number of cars Alteration (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 Height. Number of Stories Rear .Depth Dimensions of same structure with alterations or additions: Front Depth. Height 8. Dimensions of entire new construction: Front ~5 Rear ,~ Height x~tg~ O O Number of Stories 9. Sizeoflot: Front /0~. O; Rear /D.~. ~' .Depth q,2 ~3 ,10 lO. DateofPurchase ~-oq-~- Iclqq Name ofFormer Owner T)O~I'~ Number of Stories Rear 11. Zone or use district in which premises are situated fi/,40,/~ ~'~l~l t/.r4 - /~q' / -! 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES__ NO x, Will excess fill be removed from premises? YES NO -- 14. Names of Owner of premises Address Phone No. Name of Architect 5'~O F,,ff ,T. T~ e6'~RZ ~, /_C Address (a3 o 5~ 6£ot(6C ,4 &rPhone No NameofContractor .r'X~II]~ ~--~-/~b/-/~ Address,BO~x j)~oTTl~oneNo. 5-/~?~! .17o( ( )'/d,,, av,q e r' ) /,,vt 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 I}IiiQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY OF~ \S~ ~'~e ',q v'x ,_~ ')C~--~5 '~/, 'dx. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, )He is the ~L~ ) ~('k-~ ~ (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 tree 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/'vq _ ~ day of ~ ]/~ 200~ Notary Public'~ Signature of Applicafit Ho. 4855805 Oualilied In Suffolk Coun~ ~, n Commiss o~ Ex¢~es April 14,~~ ~ Permit Number Checked By/Date REScheck Compliance Certificate New York State Energy Conservation Construction Code REScheckSoffware Version 3.5 Release ld Data fllaname: C:kProgram Files\CheckhREScheck~Ferlin.rck PROJECT TITLE: Ferlin COUNTY: Nassau STATE: New York HDD: 4910 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 01/25/07 DATE OF PLANS: 10/2006 PROJECT DESCRIPTION: 735 Corey Creek Lane Southold, New York 11971 COMPLIANCE: Passes Maximum UA = 526 Your Home UA -- 417 20.7% Better Than Code (UA) Ceiling 1: Fiat Ceiling or Scissor Truss Ceiling 2: Cathedral Ceiling (no attic) Wall 1: Wood Frame, 16" o.c. Window 1: Wood Frame:Double Pane with Low-E Window 2: Wood Frame:Double Pane with Low-E Window 3: Wood Frame:Double Pane with Low-E Window 4: Wood Frame:Double Pane with Low-E Window 5: Wood Frame:Double Pane with Low-E Window 6: Wood Frame:Double Pane with Low-E Window 7: Wood Frame:Double Pane with Low-E Window 8: Wood Frame:Double Pane with Low-E Window 9: Wood Frame:Double Pane with Low-E Window 10: Wood Frame:Double Pane with Low-E Window 11: Wood Frame:Double Pane with Low-E Window 12: Wood Frame:Double Pane with Low-E Window 13: Wood Frame:Double Pane with Low-E Window 14: Wood Frame:Double Pane with Low-E Window 15: Wood Frame:Double Pane with Low-E Window 16: Wood Frame:Double Pane with Low-E Window 17: Wood Frame:Double Pane with Low-E Window 18: Wood Frame:Double Pane with Low-E Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA 1234 19.0 0.0 63 582 30.0 0.0 20 2332 15.0 0.0 153 4 0.330 1 4 0.330 1 7 0.330 2 11 0.330 4 7 0.330 2 7 0.330 2 11 0.330 4 7 0.330 2 7 0.330 2 7 0.330 2 7 0.330 2 11 0.330 4 Il 0.330 4 11 0.330 4 I l 0.330 4 12 0.330 4 4 0.330 1 4 0.330 I Window 19: Wood Frame:Double Pane with Low-E 4 Window 20: Wood Frame:Double Pane with Low-E 4 Window 21: Wood Frame:Double Pane with Low-E 11 Window 22: Wood Frame:Double Pane with Low-E I l Window 23: Wood Frame:Double Pane with Low-E 9 Window 24: Wood Frame:Double Pane with Low-E 5 Window 25: Wood Frame:Double Pane with Low-E 9 Window 26: Wood Frame:Double Pane with Low-E 5 Window 27: Wood Frame:Double Pane with Low-E 9 Window 28: Wood Frame:Double Pane with Low-E 7 Window 29: Wood Frame:Double Pane with Low-E 7 Window 30: Wood Frame:Double Pane with Low-E 11 Window 31: Wood Frame:Double Pane with Low-E I I Window 32: Wood Frame:Double Pane with Low-E 11 Window 33: Wood Frame:Double Pane with Low-E 11 Window 34: Wood Frame:Double Pane with Low-E 11 Window 35: Wood Frame:Double Pane with Low-E 11 Window 36: Wood Frame:Double Pane with Low-E 4 Door 1: Solid 4 Door 2: Solid 4 Door 3: Glass 24 Door 4: Glass 19 Wall 2: Wood Frame, 16" o.c. 624 Basement Wall 1: Solid Concrete or Masonry 165 Wall height: 7.0' Depth below grade: 5.5' Insulation depth: 7.0' Floor 1: All-Wood Joist/Truss:Over Unconditioned Space 440 Crawl l: Solid Concrete or Masonry 19 Wall height: 4.5' Depth below grade: 2.2' Insulation depth: 2.0' Furnace 1: Forced Hot Air, 78 AFUE Boiler 1: Other (Except Gas-Fh'~d Steam), 80 AFUE Air Conditioner 1: Electric Central Air, 10 SEER Air Conditioner 2: Electric Central Air, 10 SEER 19.0 0.0 0.0 10.0 0.330 1 0.330 1 0.330 4 0.330 4 0.330 3 0.330 2 0.330 3 0.330 2 0.330 3 0.330 2 0.330 2 0.330 4 0.330 4 0.330 4 0.330 4 0.330 4 0.330 4 0.330 1 0.330 1 0.330 1 0.330 8 0.330 6 37 11 30.0 0.0 15 10.0 0.0 4 COMPLIANCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications, and other calculations submitted with this permit 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 to the best of his/her knowledge, belief, and professional judgment, such plans or ~Pui~;~rC~ie~Sgner~aminc°mpliane~.e~. Date E rosion, Sedimentation and Storm-water Run-off Control Plan ASSESSMENT FORM .EXEMPTION S: Yes A. Does this project meet the minimum standards for classification as an Agricultural Project. ~ ,Note: If you answered Yes to any of the above, a Storm-water, Grading, Drainage & Erosion Control Plan is not required. ~O .ACTIONS REQUIRING THE SUBMISSION OF A STORM;WATER~ GRADING~ DRAINAGE & EROSION ~CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. .Item Number: (A Check Mark (-/) for each question is required for complete application) Will this project retain all Storm-Water Run-off generated on Site? (This will include all mn-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Will this project require any land filling, grading or excavation where there is a change to the natural existing grade involving more than 200 cubic yards of material within any parcel? Will this application require land disturbing activities encompassing an area of five thousand (5,000) square feet of ground surface or more? Yes No Is there a Natural Water course running through the site or is this project within One hundred (100) feet of wetlands or a beach? Will there be site preparation on slopes svhich exceed fifteen (15) feet of vertical rise to One hundred (100) feet of horizontal distance? Will driveways, parking areas or other impervious surfaces direct Storm-Water Run-off into and/or in the direction of a Town Right-of-Way? Sworn to before me,~ this; Notary Public, State of New York No. 4855805 Qua f ed In Suffolk County.~ Cermiss~on Expires April 14, ~----.' (Signature of Applicant) 7. Will this application require the placement of' material, removal of vegetation and/or the .construction of any item within the Town Right-of-Way or road shoulder area? (This item does not include the installation of driveway aprons.) 8. · Will there be site preparation within the one hundred (100) year floodplain of any watercourse? Note: If any answer to quesbons ~ne through eight is answered with a check mark in the Box, a Storm-water, Grading, Drainage & Erosion Control Plan is required and must be submitted for review prior to issuance of any building permit. STATEOFNEWYORK, ~ __f , ~ ~ That I ....... ~]~i'~ !.',~ ......:'~}~ '~.'5( [.I. ~ C7 being duly sworn, ~eposes and says that he/she is the applicant for Permit, (Name of individual signing Document) l And that He/She is the Q') kt,~.}(X?-5'. (Owner, Coho actor, Agent, Cmporate Officer, crc) Owner and/or representative of the Owner or Owner's, and is duly authorized to perform or have perfmmed the said work and to make and file this application; that all statements contained m this application are true to the best of his knowledge and belier; and that the work sill be performed m the manner set forth m the application filed herewith. N LOT ~1 d)VELLiNG) ,,,.,, az~x~a, ~5;, ~UR V~Y OF PROPERTY ~o~ ~ SCALK' 1 =40 u~c~ ~o, ~ooo JANUARY 12, 2007 (PROPOSED HOUSE) ~ ' ~ r~ SINGLE FAMILY ~E~iDENCE ONLY car I~t ~n~ U~KNO~) ~PI~TH~EE YEAR~ FROM DATE OF APPROVAL ELEVA TION5' REFERENCED TO AN ASSUMED DATUM. Iorn fornilior with the STANDARDS FOR APPROVAL ..... : ~: .... :_~: .... ~ AND CONS?I?UCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ~ " ond will ob~de b.y the conditions set forth therein ond on the to construct. /~/~~?i ~9 The location of wells ond cesspools shown hereon ore ~ from field observotions ond or from doto obtoined from others. ANY AL~RAEON OR ADDISON TO ~lS SURLY IS A ~OLA~ON 618 OF SEC~ON 7209 OF ~g NEW YORK S~A~ EDUCA~ON LA~ * PECONIC $U~~~ I EXCEPT AS PER SEC~ON Z209-SUBOI~SION 2. ALL CERTI~CA~ONS (651) 765-5020~-1797 ~ SAID MAP OR COPIES BEAR ~E IMPRESSED SEAL OF THE SUR~YOR FILED [N T~ S~F~K CO~TY CLE~ 'S Of c[CE ON A~, 12~0 TRAVELER STREET ~ ~ ~OSE SIGNATURE APPEARS HEREON. 15, i967 AS FILE NO. 4923. · ~. SOUTHOLD, N. ~ 11971 ~--lii I I LOT ~l ~ a~la' SURVEY OF PROPERTY ~ A T BA YVIE~ ~ ~ TOP[N OF SOUTHOLD SUFFOLK COUNTE ~ ~ LOT ~ MAR~ 20, 20~ JANUARY tZ 2007 (PR~OSED H~SE) JUL Y 17~ 2007(FNDTN LOC.) ELEVA I7ONS REFERENCED TO AN ASSUMED DA rUM, I om familiar w/th the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and will abide by the cond/tions set forth therein and on the permit to construct. The location of wells and cesspools shown hereon ore from field observations and or from data obtained from others. ANY ALrERATION OR ADDITION TO THIS SURVEY IS A VIOLATiON OF SECTION 7209 OF THE NEW YORK STARE EDUCATION LAW.. EXCEPT AS PER SECTION ,7209-SUBDIVISION ,2. ALL CERTIFICATIONS HEREON ARE VALID FOR TI'#S MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIENA TURE APPEARS HEREON. LOT NUMBERS REFER TO 'HAP OF COREY CREEK ESTATES' FILED IN THE SUFFOLK COUNTY CLERK'S OFFICE ON AUG. 15, 1967 AS FILE NO, 49~3 AREA-21,803 SO. FT. / I~ECONIC .~U~E~ ~- A'797 12JO TRAVELER STREET'T~'~i,-)~.I .i .I SOUTHOLD, N.Y. 11971 j ~,~, ~.i.t S,C.D.H.S. R~ NO. RI0-07-0016 N S T#1 5,.~'6 · 22' ST#2 55' 27' LP#1 2'2' 55' LP#2 67' 62' SEPTIC MEASUREMENTS ~ 56'6 ~9.0' '8' ~ ~ ~ LOT ~1 rc SURVEY OF PROPERTY N ~.~3'~' ~.. .~ A T BA YVIE~ g ,~. ~ EUFFOLK COUNTE N.Y. . 1000- ?8-04-24 ~ m MARCH 20, 2000 ~ ~ JANUARY 12, 2007 (PROPOSED HOUSE) JULY !7, 2007 (FND~. LOC.) OCT. 29, 2008 (SEPTIC St'STEM) LOT BB LOT ~3 ~ ELEVATIONS REFERENCED TO AN ASSUMED DA TUM. I am familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES and w/Ii abide by the conditions set forth therein and on the permit to construct. The location of wefts and cesspools shown hereon are from field observations and or from data obtained fram others. ANY ALTERATION OR ADDItiON TO THIS SURVEY IS A V~OLATION OF SECtiON 7209 OF THE NEW YORK STATE EDUCATION LAW. EXCERT AS PER SECTION 7209-SUBDI~ISION 2. ALL CERTIFICA770NS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. ,lJEt~.a~' J Management LOT NUNBERS REFER TO 'iv,.4P OF CORE¥ CREEK ESTATES' FILED IN THE SUFFOLK COUNTY CLERK ':' OFFICE ON AUG. 15, 1~67 AS FILE NO, 4923, AREA-'21,803 SO. FT. ' ' FAX (651) 765-1797 1230 TRAVELER STREETI soupcons, ~. ~ ~, 1 00-111 TITLE NUMBER: PAC-3815 VARIANCE SEARCH JEANNE ANSTETT, BEING DULY SWORN DEPOSES AND SAYS: THAT SHE RESIDES AT 386 MARCY AVENUE, RIVERHEAD, NEW YORK AND IS OVER THE AGE OF 21 YEARS AND THAT SHE IS THE OFFICE MANAGER OF PECONIC ABSTRACT, INC., AN AUTHORIZED AGENT FOR FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK, AND THAT UNDER HER SUPERVISION AND DIRECTION, TITLE WAS EXAMINED TO THE PARCELS OF LAND DESCRIBED ON THE ANNEXED SCHEDULE THAT SAID EXAMINATION MADE TO INCLUDE 4~2007 AND TO DISCLOSE IF SUBJECT PREMISES IS IN FACT SINGLE AND SEPARATE OWNERSHIP AS APPEARS FROM THE CHAINS OF TITLE ANNEXED HERETO AND THAT THE EFFECTIVE DATE OF THE APPLICABLE ZONING ORDINANCE 1/1957. AND THAT THIS AFFIDAVIT IS MADE TO ASSIST THE BOARD OF ZONING APPEALS OF THE TOWN OF SOUTHOLD TO REACH ANY DETERMINATION WHICH REQUIRES AS A BASIS THERETOFORE THE INFORMATION SET FORTH HEREIN AND KNOWING FULL WELL THAT SAID BOARD WILL RELY UPON THE TRUTH THEREOF. LIABILITY OF THIS COMPANY IS LIMITED TO $25,000.00 FOR ANY REASON. DATED: 5/8/07 SWORN TO BEFORE ME THIS 8th DAY OF MAY, 2007 NOTARY PUBLIC MICHELLE VAIL Notary Public, ~tate of New York No, 01VA4989798-Suflolk County Commissior~ Expires December 16, 20 O PECONIC ABSTRACT, INC. JEANNE N~..~,~T E TT OFFICE MANAGER TITLE NUMBER: PAC-3815 SUBJECT PREMISES: 1000-078.00-04.00-024.000 Harold E. Cordon Dated: 1/19/49 To Recorded: 1/21/49 Mary L. Dayton Liber 2915 page 371 (premises and more) Mary L. Dayton died 11/8/1956 Suffolk Surrogates #978P1956. The New York Trust Company and William C. Mayer, as Executors of Mary L. Bayton To South Parish Realty Company Dated: 6/7/57 Recorded: 6/12/57 Liber 4313 page 196 (premises and more) Lefferts P. Edson, Michael John Fenello, Joe Thomas Luke and Charles Joseph Harlin d/b/a South Parish Realty Company To Kurt Hambsch, George W. Moore, Jr. and Sidney Warner Dated: 5112/66 Recorded: 5/31/66 Liber 5965 page 236 (premises and more) Kurt Hambsch, George W. Moore, Jr. and Sidney Warner To South Fork Development Corp. Dated: 5/21166 Recorded: 6/16/66 Liber 5974 page 552 (premises and more) Map of Corey Creek Estates filed with the Suffolk County Clerk on 8/15/67 Map #4923. South Fork Development Corp. To Sidney F. Warner continued ..... Sworn to before me this 8th day of May, 2007 Notary Public MICHELLE VAIL Notary Public, State of New York No, 01VA~4989798~Suffolk County Commissior, ~xpires December 16, 20 Dated: 3/4/71 Recorded: 3/5/71 Liber 6895 page 194 (subject premises) PECONIC ABSTRACT, INC. ~eY:anne Ans~Manager SUBJECT PREMISES: 1000-078.00.04.00.024.000 continued ..... Sidney F. Warner To Alan Munro and Jennie Munro, his wife Dated: 11/6/71 Recorded: 11/12/71 Liber 7046 page 509 No proof of death for Jennie Munro in Suffolk County. Alan Munro To John Hinkelman and Christine Hinkelman, his wife Dated: 1/17/83 Recorded: 2114183 Liber 9314 page 483 John Hinkelman and Christine Hinkelman, his wife To Donald Alfano and Doris Alfano, his wife - and- Kenneth Alfano Bated: 3/22/85 Recorded: 4/2/85 Liber 9763 page 479 Donald Alfano and Doris Alfano, his wife - and- Kenneth Alfano To Donald Alfano and Doris Alfano, his wife Dated: 9/30/86 Recorded: 10/3/86 Liber 10138 page 210 Donald Alfano and Doris Alfano, his wife To Doris Alfano Dated: 11/15/94 Recorded: 12/13/94 Liber 11706 page 210 Doris Alfano To Dennis A. Ferlin and Peggy A. Ferlin, his wife Dated: 6123199 Recorded: 7121199 Liber 11977 page 472 LAST DEED OF RECORD Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: t~ Jeanne Ans nager MICHELLE VAIL Notary Public, State of New York No 01VA4989798-Suffolk County ~.. Commissior) Lxpires December 16, 20 ., TITLE NUMBER: PAC-3615 NORTH OF SUBJECT PREMISES: 1000-078.00-04.00-025.000 Harold E. Cordon To Mary L. Dayton Dated: 1/19/49 Recorded: 1/21/49 Liber 2915 page 371 (premises and more) Mary L. Dayton died 11/8/1956 Suffolk Surrogates #978P1956. The New York Trust Company and William C. Mayer, as Executors of Mary L. Dayton To South Parish Realty Company Dated: 6~7~57 Recorded: 6/12/57 Liber 4313 page 196 (premises and more) Lefferts P. Edson, Michael John Fenello, Joe Thomas Luke and Charles Joseph Harlin d/b/a South Parish Realty Company To Kurt Hambsch, George W. Moore, Jr. and Sidney Warner Dated: 5/12/66 Recorded: 5/31/66 Liber 5965 page 236 (premises and more) Kurt Hambsch, George W. Moore, Jr. and Sidney Warner To South Fork Development Corp. Dated: 5/21/66 Recorded: 6/16166 Liber 5974 page 552 (premises and more) Map of Corey Creek Estates filed with the Suffolk County Clerk on 8115167 Map #4923. Continued ..... Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: tt~c...----''''''~ Jeanne Anste e Manager MICHELLE VAIL Notary Public, St~,te of New York No. 01VA4989798-Suffolk County Commission Expires December 16, 20 NORTH OF SUBJECT PREMISES: 1000-078.00-04.00-025.000 continued ..... South Fork Development Corp. To Christian C. Wolf and Margaret H. Wolf, his wife Dated: 1112172 Recorded: 1118172 Liber 7089 page 291 (subject premises) Christian C. Wolf and Margaret H. Wolf, his wife To Philomena Nicolicchia Dated: 1131183 Recorded: 211183 Liber 9308 page 391 Philomena Nicolicchia To Frank C. Nicolicchia and Philomena Nicolicchia, his wife Dated: 6/12186 Recorded: 6~27~86 Liber 10068 page 199 Philomena Nicolicchia To Frank C. Nicolicchia and Philomena Nicolicchia Dated: 4127193 Recorded: 6/16/93 Liber 11633 page 195 Frank C. Nicolicchia and Philomena Nicolicchia To Patricia A. Duryee Dated: 2~22~96 Recorded: 2128196 Liber 11764 page 126 Patricia A. Duryee To Thomas W. Carlo and Melissa Carlo Dated: 4/18/05 Recorded: 4/25/05 Liber 12383 page 767 LAST DEED OF RECORD Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC, by: ~ Jeanne AnsJ[~J.~Office Manager MICHELLE VAIL Notary Public, Stste of New York No. 01VA4989798-Suffolk County ¢ommissior~ Expires December 16, 20 TITLE NUMBER: PAC-3815 SOUTH OF SUBJECT PREMISES: 1000-078.00-04.00-023.000 Harold E. Cordon Dated: 1/19/49 To Recorded: 1/21/49 Mary L. Dayton Liber 2915 page 371 (premises and more) Mary L. Bayton died 11/8/1956 Suffolk Surrogates #978P1956. The New York Trust Company and William C. Mayer, as Executors of Mary L. Dayton To South Parish Realty Company Dated: 6/7/57 Recorded: 6/12/57 Liber 4313 page 196 (premises and more) Lefferts P. Edson, Michael John Fenello, Joe Thomas Luke and Charles Joseph Harlin d/b/a South Parish Realty Company To Kurt Hambsch, George W. Moore, Jr. and Sidney Warner Dated: 5/12/66 Recorded: 5/31/66 Liber 5965 page 236 (premises and more) Kurt Hambsch, George W. Moore, Jr. and Sidney Warner To South Fork Development Corp. Dated: 5/21/66 Recorded: 6/16/66 Liber 5974 page 552 (premises and more) Map of Corey Creek Estates filed with the Suffolk County Clerk on 8/15/67 Map #4923. South Fork Development Corp. To Saverio Toscano and Ruth Toscano, his wife Bated: 11/6/71 Recorded: 11/12/71 Liber 7046 page 511 (subject premises) continued ..... Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: ~ Jeanne Anstet ,~ce Manager MICHELLE VAIL Notary Public, St~,te of New York No, 01VA4989798-Suffolk County Commission 2xpires December 16, 20 SOUTH OF SUBJECT PREMISES: 1000-078.00-04.00-023.000 continued ..... Saverio Toscano and Ruth Toscano To Peter Mathews and Joanna Mathews Dated: 11/4/82 Recorded: 11/8/82 Liber 9267 page 141 Peter Mathews and Joanna Mathews, his wife To Peter J. Hughes and Eileen M. Hughes, his wife Dated: 5/3/91 Recorded: 5/14/91 Liber 11262 page 287 Peter J. Hughes and Eileen M. Hughes, his wife To Susan Quarty Bowen Dated: 7/12/99 Recorded: 8/4/99 Liber 11980 page 280 LAST DEED OF RECORD Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: ~ Jeanne Anst ,~ice Manager MJCHELLE VAiL Notary Public, State of New York No. 01VA~4989798-Suffo k County ~-, Commissior ,;xpJres December 16, 20 ~ TITLE NUMBER: PAC-3815 EAST OF SUBJECT PREMISES: 1000-078.00-04.00-034.000 Arthur C. Johnson To Arthur C. Johnson and Charlotte L. Johnson, his wife Dated: 7130153 Recorded: 8~6~53 Liber 3558 page 512 Arthur C. Johnson and Charlotte L. Johnson, his wife To Benedict A. Manasek, Jr. No proof of death for Benedict A. Manasek, Jr. Dated: 1219169 Recorded: 12/11/69 Liber 6673 page 532 in Suffolk County. Mary J. Manasek To Joseph A. Samuolis and Eva Z. Samuolis, his wife Dated: 12/3/76 Recorded: 12/7/76 Liber 8154 page 117 No proof of death for Eva Z. Samuolis in Suffolk County. Joseph A. Samuolis died 12110196. Helen Verity, as Executrix of Joseph A. Samuolis To Tammy McGann and John R. Goodwin Dated: 8~7~97 Recorded: 8114197 Liber 11846 page 475 Tammy McGann To John R. Goodwin Dated: 12/16/99 Recorded: 1212/299 Liber 12009 page 182 LAST DEED OF RECORD Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: ~ Jeanne Anst~tt~, ffice Manager MICHELLE VAfL Notary Public, Stste of New York No. 01VA~4989798-Suffotk Court ¥ Commission ~:xpires December 16, 20 TITLE NUMBER: PAC-3815 PREMISES TO THE WEST: COREY CREEK LANE Sworn to before me this 8th day of May, 2007 Notary Public PECONIC ABSTRACT, INC. by: ~g Jeanne Ans er MICHELLE VAIL Notary Public, Stete of New York No. 01VA~4989798-Suffolk County Commisslor~ .:xpires December 16, 20 ___1 UNOERWRITERS CERTIFIC~j~ APPROVED AS NOTED DATE: '~/JJ / ~ BmP. ~ ~ ~ NOTIFY BUILDING DEPASTMENT AT 765-1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORI~ DESIG ERRORS· IMBING WITH "46". OF OCCUPAN~f gT~R, COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF ~UTHOL~WN ZBA SOUTHOLD TO~N PLANNING BOARD SO UTHOLD ~¢OW~I~J~STEES .L ¢'-~o" N.Y,S, DEC LqI:TAIN STdRM WA~ER RUNOFI~'~ ~SUANT TO SECTION ~-10C ' ', OC ~ANCYOR, ,, us 'm UN~AWFOL~ ~ ~ ~ ~""" WITHOUT-~ERTIFICATE: OF OCCUPANCy. ~ ALL CONSTRUCTION SHALL MEET THE REQU~REUENTS OF THE / / CERTIFICATION. OF NAILING & CONNECTIONS / :? _~, 4__Zr _= '1: 1C'~ II.Sq6'~ -¢ c~i~ ~m ~. I[ ~ c~r ~ils ~ ~[1~ ~ll ~, ~ I~l m~ ~ ~ibil~ for bls ~l ~h tf m ~si~ field prlor ~ ~s ~ h ~n, I/~ d~ ~1~1~, I~hd 8 ~ .~, ~lmum, ] -~" ~ ~.~ ~i~, ?b? ~s ~ all ~ In ~1 ~h. ~ ~lj~ ~, ~ f~, a~ all o~s ~ in~l'; l~m ~ ~ si~ d ~ ifld~,l k~ldim ~fl ~ ~IJd in s~ a ~r ~ p~l ~i~ d imdd~ d pl~ Ji~, ~.~tnim~ l i~ ~ pl~k ~i~ ~11 ~V w~ ~18 ~ [~. Chl~ ~l~i~ I.~. ALL WINDOWS TO BE ANDER,~, 41)0,11 .) 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