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HomeMy WebLinkAbout34652-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~TMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34000 Date: 10/09/09 THIS CERTIFIES that the building ACCESSORY GA=RAGE Location of Property: 3175 NASSAU POINT RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 104 Block 13 Lot 12 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 1, 2008 pursuant to which Building Permit No. 34652-Z dated MAY 4, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY NON-HABITANLE GARAGE WITH STORAGE AS APPLIED FOR PER ZBA #6240 DATED 3/5/08. The certificate is issued to PHYLLIS KAUFER of the aforesaid building. ( OWNER ) So~OLKC~)I~q~-fDEPART)~N~TOFHF~khTHAPPRO%5%5 N/A EI~t-r~ICJ%L C]~RTIFICAT]~NO. 129786C 09/18/09 PLUI~ERS CERTIFICATION DA'r~u N/A ~ized Signature Rev. 1/81 Oct 05 09 03:12p p,1 JForm No. 6 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN I~LL APPLICATION'FOR CIgRKU' ICATE OF OCCU'PAI~CY This al:gticaiien mu~t bc filial in by' typ~wfi~:r oc ~k ~ ~bmh~ ~ ~c ~ildMg ~a~ wi~ She 'A. For new ~fld~g or new ~: topo~p~.ie f~m~. ~- Su~t P]~ Bo~ Ap~o~l ofcomp}et~ si~ p~ r~ts, ~. , . . . . C- F~ 4. Up~t~C~o~Oc~pancy_ N~ Cons~cfiom ' Old or ~ist~g BuUdin~ (ch~ o~) Temporary Cc~ifi~t~ Map. Applicant: Undctwrh~ Approval: Lot: (check ' ~plica"! $ignalu~ / Issue Date 9/18/2009 Electrical Inspection Certificate Electrical Inspection Service, Inc. Application Number 375 Dunton Avenue 129786C East Patchogue, New York 11772 (631) 286-6642 Issued To: Phyllis Kaufer Street: 3175 Nassau Point Road Village: Cutchogue Zip: Section: Block: Lot: 11935 Town: Southold Contractor: ESCO Electrical Was examined and found to be in compliance with the National Electrical Code. Lic.# 43646- ME [] Commercial [] NVDefects [] Pool [] tstFIoor [] Indoor [] Basement [] HotTub [] Residential [] Der. Garage [] Attic [] 2nd Floor [] Outdoor [] Addition [] Survey Switches Receptacles Fixtures GFI Heaters A/C Fans 7 10 12 2 Dishwasher Washer/Amps Dryer/Amps Oven Range/Amps Microwaves Furnace Oil Gas Circulators Smoke Detector Bell Transformer Meter Amps Phase UG/OH Jacuzzi Television CO Detector / Bldg. Permit: 34652 Other Equipment 1-Subpanel Hugo S. Surdi President Rough Ir)~ection: 08/19./2009 ' _ . _ Ins~or: / Jo~ McMahon This certificate must not be altered in any manner. Inspectors may be identified by their credentials. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUIDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34652 Z Date MAY 4, 2009 Permission is hereby granted to: PHYLLIS KAUFER 21 BEDFORD AVENGE ROCKVILLE CENTER,NY 11570 for : CONSTRUCTION .OF ACCY DETACHED 4 CAR GARAGE PER APPROVED PLANS AND PER ZBA, TRUSTEES & DEC AS APPLIED FOR. STORAGE ONLY. at premises located at County Tax Map No. 473889 Section 104 pursuant to application dated OCTOBER Building Inspector to expire on NOVEMBER 3175 NASSAU POINT RD CUTCHOGUE Block 0013 Lot No. 012 1, 2008 and approved by the 4, 2010. Fee $ 341.60 Authorized Signature ORIGINAL Rev. 5/8/02 FORM NO. 3 · TOWN OF SOUTHOLD BUILDING DEPARTMENT NOTICE OF DISAPPROVAL DATE: October 6, 2008 TO: Phyllis Kaufer 21 Bedford Avenue Rockville Center, NY 11570 Please take notice that your application dated October 1, 2008 For a permit for an accessory garage; Location of property: 3175 Nassau Point Rd., Cutchogue County Tax Map No. 1000 - Section 104 Block 13 Lot 12 Is returned herewith and disapproved on the following grounds: The proposed construction of this accessory detached garage indicates a total square footage of 1,440. Pursuant to Article XXIII, Section 280-15(c), the maximum square footage allowed on lots 20,000 to 60,000 square feet shall not exceed 750 square feet. Authorized Signature Office LOCation: Town Annex/First Floor, North Fork Bank 54375 Main Road (at Youngs Avenue) Southold, NY 11971 BLDG. DEPt'. TOWN OF SOUTHOLD http://southoldtown.northfork.net BOARD OF APPEALS TOWN OF SOUTHOLD Tel. (631) 765-1809 Fax (631) 765-9064 Mailing Address: 53095 Main Road P.O. Box 1179 Southold, NY 11971-0959 FINDINGS, DELIBERATIONS AND DETERMINATION MEETING OF MARCH 5, 2008 ZBA # 6240 - Phyllis Kaufer Location of Property: 3175 Nassau Point Road, Cutchogue CTM 104-13-12 SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. SUFFOLK COUNTY ADMINISTRATIVE CODE: This application was referred as required under the Suffolk County Administrative Code Sections A 14-14 to 23, and the Suffolk County Department of Planning issued its reply dated December 5, 2008 stating that this apphcation is considered a matter for local determination as there appears to be no significant county-wide or inter-community impact. PROPERTY FACTS: The property is approximately 100 feet width with frontage along Nassau Point Road, and approximately 412 feet deep to rear lot line adjacent to Little Peconic Bay. The property is improved with a single-family, one-story frame house and detached one-story garage, as shown on the November 15, 1996 survey prepared by Roderick VanTuyl, P.C. BASIS OF APPLICATION: This application is based on the Building Inspector's October 6, 2008 Notice of Disapproval concerning a proposed two- stow accessory garage which will exceed the code limitation of 750 square feet under Section 280-15C, as proposed with 1,440 square feet. Findings of Fact The Zoning Board of Appeals held a public hearing on this application on February 19, 2009, at which time Written and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the Page 2 -March 5. 2009 ZBA # 6240 - Phyllis Kaufer CTM 104-13-12 property, and other evidence, the Zoning Board finds the follo~n~if~ctsit(~ be true and relevant: ' ~ Area Relief Requested: Proposed construction of detached 24' ~.~0~' 'garage, totaling 1,440 square feet, instead of the maximum code-permitted size of 750 square feet. The height of the building will be as per code. Amended Relief: During~ the February 19, 2009 hearing, the -~li~an~- indicated that if the application ~s not granted as applied, an alternative 1,104 square foot for a 23' by 48' garage building would be accepted (with height per code) in the same location with a minimum 15' side yard setback, as shown oh Ronald Pascal Constantine, R.A. Map A date-stamped by ZBA March 3, 2009, showing the owner's hand-drawn changes for same. Reasons for Board Action: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Town Law q267-b(3)(b)(3)(1). The grant of the variance as originally requested would produce an undesirable change ~n the character of the ne{ghborhood. Improved properties in the immediate area can be affected by the size of the proposed detached garage, although the applicant's property m unique as to topography of the lot creating a limited building area. The property consists of a limited building area, based on the large kettle hole (depression) to the south of the driveway leading from Nassau Point Road to the area of the proposed site of construction. As discussed at the hearing, the only structures of similar s~ze in the area were built prior to zoning code requirements (pre 1957). During the hearing, the applicant agreed to accept an alternative plan for a four-car 23 ft. by 48 ft., 1,104 square foot garage if the application were not approved as applied. 2. Town Law §267-b(3)(b)(3)(2). The benefit sought by the applicant can be achieved by some other method for the applicant to pursue. The applicant could build two separate buildings with 750 square feet each. Since he has an existing garage, he would rather build one new four-car garage, creating two accessory structures on this parcel instead of three or more. 3. Town Law .q267-b(3)(b)(3)(3). The amount of relief as requested ~s substantiali with a 67% ~ncrease in square footage. The alternative relief granted is also substantial, being a 47% increase in size of the' code required square footage on this +/- 43.000 square foot lot. 2 Page 3 -March 5, 2009 ZBA # 6240 - Phyllis Kanfer CTM 104-13-12 4. Town Law §267-b(3)(b)(3)(5). The difficulty is self-created, as the applicant wishes to build a garage larger than the code allows. 5. Town Law ~267-b(3)(b)(4). No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. This determination is based upon the limited building area caused by the unique topography of this lot. 6. Town Law §267-b. Grant of alternative relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of his property, While preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Chairman Goehringer, seconded by. Member Oliva, and duly carried, to DENY the original plan, and to GRANT Alternative Relief for a maximum 23 ft. by 48 ft. garage building (without the need to reapply with new plans), subject to the following Conditions: 1) Maximum height of structure as per code (indicated at 22 feet), 2) Structure shall contain only the utility of electricity, -- 3) Structure shall be utilized only for storage purposes. That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued. Any deviation from the variance given such as extensions, or demolitions which are not shown on the applicant's diagrams or survey site maps, are not authorized under this application when involving nonconformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code. other than such uses, setbacks and other features Page 4 -March 5, 2009 ZBA # 6240 - Phyllis Kaufer CTM 104-13-12 as are expressly addressed in this action. The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board: Ayes~Goe}l~~irman), Oliva, Simon, and Weisman. (Meml~r~chneider~t~(ine~.) ~'~lution was duly 4 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ~FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ REMARKS: ROUGH PLBG. INSULATION FINAL FIRE SAFETY INSPECTION FIRE RESISTANT PENETRATION DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG.  [ ]INSULATION [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: /~ ~ ~ ~ ~~ DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [~F~MING ~~ [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] RRE RESISTANT PENETRATION REMARKS: TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ ] ROUGH PLBG. [ ] INSULATION ~"FINAL ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ]FOUNDATION 2ND [ ]FRAMING / STRAPPING [ ]FIREPLACE & CHIMNEY [ ]FIRE RESISTANT CONSTRUCTION [ [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION REMARKS: DATE FrlE, LD INSPECTION R~PORT I DATE I CO~IM~NTS ROUGH ~G & ~S~ATION PER N. Y. STATE E~RGY CODE F~ ' ~~, "~(~'.x~) ~DITION~ COUNTS '7 7 · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Disapproved a/c Expiration I 2008 b~.DG DEPT. Building Inspector 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 Flood Permit Storm-Water Assessment Form Contact: Mail to: ~Tt'uJ - J/?- dj? Phone: t APPLICATION FOR BUILDING PERMIT Date ,20 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. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street l~let County Tax Map No. 1000 Section //~/7/ Block /3 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~, L//?4~ b. Intended use and occupancy /b/~) C~'~G-~/ 3. Nature of work (check which applicable): New Building / Addition Alteration Repair Removal Demolition Other Work 4. Estimated Cost fffi~ O] O 0 0 Fee 5. If dwelling, number of dwelling units If garage, number of cars ,~' (Description) .(To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. 8. Dimensions of entire new construction: Front ~ {-) Height ~, c¢ / Number of Stories 9. Size oflot: Front Rear qq'q5 Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front /C2/~f Rear Depth Height Number of Stories Rea,' b JT' .Depth Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES __ NO 13. Will lot be re-graded? YES__ NO V/Will excess fill be removed from premises? YES __ NO__ 14. Names of Owner of premises ~l / /l'~ .~/~Address~lT~-/~/~/~-/~ PhoneNo..~/~ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO [// * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. / 18. Are there any covenants and restrictions with respect to this property? * YES __ NO V"' · IF YES, PROVIDE A COPY. STATE OF NEW YORK) ~ SS: C OLINTY O~'~e~)~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the Notae/Public, Slate of New Y~ (Contractor, Agent, Corporate Officer, etc.) ^ N0.01BU6185050 ~ uualified in Suffolk County uommission Expires April 14,20 I ~,~,~,~,~,~,~,~,~,~- 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 ~_~C- dayof (~C~;;~0~4 20 0oc Notary Public CONNED. BUNCH ...-~ Nota;~Slld~k~ N~'c .. of .N~ew L// /S ~gf[at ure/Applic ant May 04 09 11:54a Nigel Robert Williamson 631,765,4156 p.1 James F. King, President Jill M. Doherty, Vice-Pres/dent Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 $0uthold, New York 11971-0959 Telephone (631 ~ 765-1892 Fax (631~ 765-6641 BOARD OF TOWN TRUSTEES TOWN OF $OUTHOLD March 23, 2009 Mr. Nigel Robert Williamson, Architect P.O. Box 1758 Southold, NY 11971 RE: PHYLLIS KAUFER iI~-1-~ NASSAU POINT ROAD, CUTCHOGUE r SCTM# 104-13-12 Dear Mr. Williamson: The Southold Town Board of Trustees reviewed the site plan prepared by Ronald P. Constantine. Architect, last dated September 29, 2008, and received on March 20, 2009, and determined that the construction of a new garage is out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111 ) no permit is required. Please be advised, however, that no constructLon, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, or within 1 Off landward from the top of the bluff, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction 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. This determination is not a determination from any other agency. May 04 09 11:54a Nigel Rober[ Williamson 631.765.4156 p.2 If yOU have any further questions, please do not hesitate to call. Sincerely, Board of Trustees JFK:eac New York State Department of Environmental Conservation Division of Environmental Permits, Region One SUNY ~ Stony Brook, 50 Circle Road, Stony Brook, NY 11790-3409 Phone: (631)~.~,!..0403 · Fax: (631)444-0360 Website: www.dec, nv. Qov Alexander B. Grannis Commissioner LETTER OF NON-JURISDICTION: TIDAL WETLANDS ACT April29,2009 Ms. Phyllis Kaufer 21 Bedford Avenue Rockville Center, NY 11570 Re: DEC~ 1-4738-00691/00003 3175 Nassau Point Road Cutchogue, NY 11935 SCTM~ 1000-104-13-12 Dear Ms. Kaufer: Based on the information you have submitted, the New York State Department of Environmental Conservation has determined that: The portion of your property which is located landward of a functional and substantial man- made structure (a bulkhead) greater than 100' in length, constructed prior to 8120/77 as evidenced on Aerial Image Resources Photograph AGC# 67075 and as shown on the site plan prepared by Ronald P. Constantine on September 29, 2008, is beyond the jurisdiction of Article 25 (Tidal Wetlands). Therefore, in accordance with the current Tidal Wetlands Land Use Regulations (6NYCRR Part 661) no permit is required under the Tidal Wetlands Act. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary, 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 surface or vegetation within Tidal Wetlands jurisdiction which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and your project (i.e. a 15' to 20' wide construction area) or erecting a temporary fence, barrier, or hay bale berm. Please be fudher advised that this letter does not relieve you of the responsibility of obtaining any necessary permits or approvals from other agencies. Very truly your~,~ ura J. · Permit Administrator sla cc: Nigel Robert Williamson . Town o_ f Southold Erosmn, Sedimentation & Storm.Water Run-off ASSESSMENT FOI;M PROPERTY LOCATION: S.C.T.M. #: THE FOLLOWING ACTIONS IRAY REQUIRE THE SUBMISSION OF A PROFESSIONAL IN THE STATE OF NEW lie__m N.umber: 1 2 3 4 5 6 7 8 9 (NOTE: A Check Mark (.~) for each Question is Required for a Complete Application) Ye~s hl_~o Will this Projec( Retain All Storm.Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all mn-off crealed by site clearing and/or consbuction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Slmclures Indicating Size & Location? This Ilem shall include all Proposed Grade Changes and Slopes Con,roi(lng Surface WaterFIow! Will this Preject Require any Land Fil!ing, Grading or Excavation where them is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? Will this Application Require Land Dislurblng Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Nalural Water Course Running hrough the Site? Is this Project within the Truslees judsdiclion or within One Hundred (100' 1eat ota Welland or Beach? Will there be Site preparation on Exisling Grade Slopes which Exceed Fifteen (15) leal olVerlical Rise to One Hundred (100') of Horizontal Dislance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off into and/or in the direclion of a Town fight-or-way? Will this Project Require Ihe Placement ol Material, Removal of Vegelaiion and/or the Construclion of any Item Within the Town Right*of-Way or Road Shoulder Area? (This item will NOT include the Installalion of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE: If Any Answer to Questions One through Nine 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! EXEMPTION~ Ye~s Does Ihis project meet the minimum standards for classiticalion as an Agricultural Project? ./ Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Conlrol Plan is NOT Requtredl V STATE OF NEVer YORK, couN ss That I ......................................... being dub, sworn, deposes and says flint he/she is fl~e apphcm~t for Permit, And that he/she is the Owner and/or representative of the Owner of Owner's, and is duly authorized to perform or have per£ormed the said work and to make and file this application; that all statements contained in this application are true to the best o£his knowletjlge and belied and that fl~c work will be performed in the manner set forth in the application filed herewith. ~ , Sworn to before me this; ................... .................... ............. ................................................. · ~m~. U...iJUI~CH ............... Nom~..Public, State of New York .......................... r~o. 0tBU6185050 ' 0ualn3ed in Suffo k County FORM - O6107 Commission Expires April 14, 20 )~ ACORDT CERTiFiCATE OF LIABILITY NSURANCE 6/1/2009 PRODUCER Phone# 631-369-9600 Riverhead Lighthouse, Inc. 221 West Main Street Riverhead NY, 11901 CORP. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ~ NAIC # INSURERS AFFORDING COVERAGE Po Box 271 Laurel, NY 11948 IINSURERA: Nova Casualty INSURER B: ~INSURER C; INSURER COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR DB' POLICY EFFECTIVE POLICY EXPIRATION , ~7~ ERCI^~- eENE~L L,AS,U~ ~"~,SESf~ .......... > : 100,000 A I~ }C~IMSMADE ~ OCCUR NYAPA07698 , 06/04/09 06/04/10 ....O.~L~*OV,.,.~.'~D~'~'*"'°"'"""'°" I = 1,00o,oo05'00° G EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COM~/OP AGG $ mm EXCESS/U M*RELLA L[AalL~ J J EACH OCCURRENCE  OTHER I E,L DISEASE- POLICY LJMIT m $ CERTIFICATE HOLDER CANCELLATION TOWN OF SOUTHOLD 53095 MAIN RD PO BOX 1179 SOUTHOLD, NY 11971 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ~$SUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE ~HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL ACORD 25 (2001108) ©ACORD CORPORATION 1988 New York State Insurance Fund Workers' Compensation & Disability Benefits Specialists Since 1914 8 CORPORATE CENTER DR, 3RD FLR, MELVILLE, NEW YORK 11747-3129 Phone: (631) 7564300 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ZORLUCORP PO BOX197 CUTCHOGUE NY 11935 POLICYHOLDER ZORLU CORP PO BOX197 CUTCHOGUE POLICY NUMBER NY 11935 CERTIFICATE HOLDER TOWN OF SOUTHOLD GEORGE GILLEN BLDG INSP PO BOX 1179 _SOUTHOLD NY 11971 CERTIFICATE NUMBER I PERIOD COVERED BY THIS CERTIFICATE I DATE 661236 09/18/2008 TO 09/18/2009 6/1/2009 I 1463 654-2 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WiTH THE NEW YORK STATE INSURANCE FUND UNDER POLICY NO. 1463 654-2 UNTIL 09/18/2009, COVERING THE ENTIRE OBLIGATION OF THIS POLICYHOLDER FOR WORKERS' COMPENSATION UNDER THE NEW YORK WORKERS' COMPENSATION LAW WITH RESPECT TO ALL OPERATIONS IN THE STATE OF NEW YORK, EXCEPT AS INDICATED BELOW, AND, WITH RESPECT TO OPERATIONS OUTSIDE OF NEW YORK, TO THE POLICYHOLDER'S REGULAR NEW YORK STATE EMPLOYEES ONLY. IF SAID POLICY IS CANCELLED, OR CHANGED PRIOR TO 09/18/2009 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRITTEN NOTICE OF SUCH CANCELLATION WILL BE GIVEN TO THE CERTIFICATE HOLDER ABOVE. NOTICE BY REGULAR MAIL SO ADDRESSED SHALL BE SUFFICIENT COMPLIANCE WITH THIS PROVISION. THE NEW YORK STATE INSURANCE FUND DOES NOT ASSUME ANY LIABILITY IN THE EVENT OF FAILURE TO GIVE SUCH NOTICE. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICY. U-26,3 NEW YORK STATE INSURANCE FUND DIRECTOR,INSURANCE FUND UNDERWRITING This cer[ificate can be vatidated on our web site at https://www.nysif.com/cer'dcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 189498721 OF SOUTHOLD P~OPERTY VI LLAGE OWNER STREET ,,...:(~ ~ /~..., FORMER O,WN,F_.~R~r-O.~.~ ~. 1~0' N ~~ s~As. VL ~*~M W RECORD CARD DISTRICT [ SUB. ACREAGE TYPE OF BUILDING LAND ~ IMP. TOTAL ~,00 .~0 {~ (0,3 ~/0o 0 COMM. [ IND. CB. I MISC. DATE AGE NEW 7 Z/aa ~qLo t 3 NORMAL BUILDING CONDITION BELOW ABOVE Farm Acre Value Per Acre Value 'illable 1 'illable 2 'illable 3 Voodland wampland rushland 'ctal -louse Plot 104.-13-12 3/08 M. Bldg. Extension Extension Extension Foundation Basement Ext. Walls Fire Place Both Floors Interior Finish Heat Attic Porch ~' :'""'~"*'~ Porch Rooms 1st Floor Patio Rooms 2nd Floor Driveway ~ 0 ~ : ~B Foundation iB°th i ~ / Bldg. Extension - . ~ ! Bath Foundatlon _ _- ~ ~ - ' I Floors - -- I-- ~lnteror Finish Ext. Wa s - 5UR'v'E"r' OF LOT 14- "Amended 1,4Ol2 A, No..e.ec~u PoinT." F::lled Aucju¢l;. 16, Iq22, Hap No. I..5~ .~ITUATE: ~AIJ POINT TOHN: 50UtHOL~ SUFFOLK C~UNT~, N~ · HONUMENT I=OUN~ Av~rc~e clrod~ c:~'ound Fourlc:lc:lfr, lon= ICl.-/' hel~lh~ Fb-HA FLOOD ZOI~-~ REFER:ENC, E FIRM MAP No. ~10~01~>4 ALl BUIL~>IN~ IN FLOOD ZONE X Ar¢~ = 0.~1~ ~r¢~ ~RAPHIC, 5~,ALE I"= 40' JUN 3 2009 BLDG. DEPT. TOWN OF SOUTHOLD N S JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-\\Compaqserverkpros\09\09-138.pro ..... . ~i-'~ ~ n~r d tiM) ~1 ~ ~lhd ~ ~ ~uc~ m 1 1~ ~1 ~ ~ COMPLY WITH ALL CODES 0F NEW YORK STATE & TOWN CODE8 HoG FM~ ~ ~ ~ s~ ~ ~ ~, ~ AS REQUIRED AND CONDITION8 OF SOUTHOLD TO?~,kl 2~,~ 4~ required by me ~, M~elt dr,~ stM be ~ecured ~o, Se~en R310 a~ll~l 1 CAI MAllO A~IO OEO~RAP~IO O~N C~II'T'~RI~ ~ Ihe mM ~ nM le~ than ~ix faatenem per ~ip sti~gle (Due to 1 D ~LO0~ ~0~ ,,._.~ 0~ ~ r,,~, ~ ~ ~ ~' COMPLV WITH CHAPTER "46" FOREST ~ paRER ,+.~SOCL~TION (AFL"=/,) WOOD -- CERTIFICATION OF I~WEt. LING~FRAI~E ~ STRUCTIO~ &~'N~q' FC~ ONE" a~O 'IWO'F/MLY(wFCM) 1M ~ W~O ~SOUTHoLDFLOOD DAMAGETowNPREVENTIONcoDE. NAILINGREQUiRED. & CONNECTIONS .(~ .~-~ ~ .... ~ ~ F-.LI~ FLO00 SHOW UNDERWR TER$ C~:RTi~iCAT~ RETAIN STORM WATER RUNOFF , RE(~JIP, Eo OCCUPANCY OR USE IS UNLAWFUL OF OCCUPANCY [~ ~ 'FRAMING UNTIL SURVEY U FOUNDATI04 . TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 4. RNAL- CONSTRUCTION MUST ALL CONSTRUCTION SHALL MEET THE , ~ REQUIREMEN TS OF THE CODES OF NEW YORKSTATE. NOT RESPONSiBLE FOR OESIGN OR CONSTRUCTION ERRORS. ALL CONSTRUCT/ON SHALL MEET TFiE REQUIREMENTS OF THE CODES OF N~W YORK STATE. 0 1'2- WOOD FF{AME CONSTRUCTION MANUAL ANSUAF&PA 2001 EDITION T~M.~ ~]t~ MINIMI.IM UNI~Y Dim ~ LWE ~ ,Mi UwLMd{ AMEI~CAN FOREffr ,A/M~ PAI~dR ,:%,~OCIKflON (lIFl~A)WOOD h P..JMAT~ ~D GEOGRAPHK3 DID~(~N C~,ffERIA K)im, - shMI oomlMy ,~tm ~ F 1667. ~fft~lt ~ing~ ~ haw ~ m~nlmum requtm(l by. mm. nufnGtumr, i~ Ell)ccc ,, I '1 J L4__L _ s'xx F'- ')