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34827-Z
FORM NO. 4 TOWN OF SOUTBOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34567 Date: 10/12/10 THIS CERTIFIES that ~he building ADDITIONS/ALTERATIONS ~ocatio~ of Property: 700 TEEPEE TRAIL SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax~4ap NO. 473889 Section 87 Block 2 Lot 25 Subdivision Filed Map No. __ Lot NO. -- conforms substantially to the Application for Building Permit heretofore filed in ~h~s office dated JUNE 16, 2009 ~]~-g Per~/t No. 34827-z dated JULY 1, 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 ALTERATIONS ~ ADDITIONS, INCLUDING RECONSTRUCTION OF DECKING AND 2ND FLOOR BALCONY, OUTDOOR SHOWER AND MASONRY BARBEQUE, TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to CAROL PUFAHL of the aforesaid building. ( OWNER ) ~UM~O~K CO~F~Y ~pA~T~E~T OF HFu%LTH APPRfFqA~ R10-08-0076 03/31/10 ~.~CT~_I~ ~KTIFICA~NO. 10-1238 08/04/10 PL~ERS tmu~TIFICATI~DA'r~ 09/03/10 PECONIC PLUMBING & HEAT Rev. 1/81 FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z-34604 Date: 10/12/10 THIS CERTIFIES thmt the bui]~-g ACCESSORY Locatio~ of Property: 700 TEEPEE TRAIL SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 87 Block 2 Lot 25 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in ~h~ office dated JUNE 16, 2009 purs-m--t to Bllilding P~r~t No. 34827-Z dated JULY 1, 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 DECK WITH HOT TUB AS APPLIED FOR. Tile certificate is issued to CAROL PUFANL of the aforesaid building. (OWNER) ~u.u'~l~[ C~O'[]~I'Y DEPAI~T~T OF ~EALTH APPRO%rAL ~'~.~q..-~.-~.IOl~., ~TIIriCATH NO. ~ mTIFICATI(]~ N/A 101-7426 ~0/01/10 N/A Rev. 1/81 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. 34827 Z Date JULY 1, 2009 Permission is hereby granted to: ROBERT & CAROL PUFAHL 164 E. SHORE RD. HUNTINGTON,NY 11743 for : SECOND STORY ADDITIION/ALTERATIONS TO EXISTING SFD, ALSO REBUILD OUTDOOR SHOWER, RELOCATE HOT TUB(2CO'S REQ'D) PER NYSDEC&TRUSTEES&APPR'D PLANS at premises located at County Tax Map No. 473889 Section 087 purs,,~nt to application dated JUNE Building Inspector to wire on JANUARY 700 TEEPEE TRAIL SOUTHOLD Block 0002 Lot No. 025 16, 2009 and approved by the 1, 2011. Fee $ 1,321.21 Authorized Signature Rev. 5/8/02 ORIGINAL Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be fried 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 fi'om 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. 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 Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additi0us to dwelling $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 Occapancy on Pre-existing Building - $100.00 3. Copy of Certificate ofOecupancy - $.25 . 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ~'e~t) '~J'O New Construction: Old or Pre-existing Building: LoeationofProperty: '~ OO -~~" --'~g~'l; [ House No. Street Ow.erorOwn ofProp y: Suffolk County Tax Map No 1000, Section ~l~j "7 Block ~. Lot ~t~--° Subdivision Pe t No. %qq Q Health Dept. Approval: Date of Permit. Filed Map. Applicant: Underwriters Approval: (check one) Hamlet Lot: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ frO-q~-~ c. 3, t,0 q" Final Certificate: (check one) AppliCant ~gnatu~ - - Electrical Inspectors, Inc. 30~ East Meadow Avmue F.a~t Meadow. NY 11554 Offi~: ($16) 7944)400 (631 ~7474 F~: (516) 7~-~ W~: ~.c~li~,~m ~il: inf~ffi~lin~t~.~m Mail To: Pinfi El~c Vin~t Pinfi ~6 Colonial 5~ ~ No~ ~ 11731 Li~: 33~ME Cen0'wtue ~=~-r: 10-1238 Municipality: Southold, Town Of In.~pector: 124 It~ue Date: 8/4/2010 Pufnhl 700 Tee Pee Trail Southold, NY 11971 ELECTRICAL APPR O VAt, CERTIFICATE AREAS LISTED BELOW ARE APPROVED BY INSPECTION AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE No visual defec~ were found for the ~ inqx~fion provided. No obvious unsatisf~tmy conditions v,e~e found in the herein below only. Reshtential Inspection Isaand 2nd Floor Additions ~/~t Pro, r: ~ 2 ~ I~ngng Room. IC#o~e~ I'~ry I~, l,~lnS.~ ~'~' ~r. Porca. Uedu~lcat 2nd Floor: Bathroom. Bedroom. Laundry Roo~, Ma~ter Batlwoo~ Mm-t~r B~droo~ F/elk-In 39- Duple~ Receptacles. 10- GFI Receptacles. 1- SO,Imp ~lngle Receptacle. I- 20dngo Appliance R~ep~wle. 30- Swlw, be~ l- Dimmer. l. $Odr~o O~en. 1- 40,~mp Cook Top, $7. Recetsed FlyJur~. $. Fhtore~t Fl, x'ture& lO- Itw~ndettnmt Fl~ture$. 17- Flail S~oneet. 4- Paddle Fan O~tlet~, 5- it Fans. 400Amp Stngle Phase U~nd Serviee/CB/l Meter. 200Amp Main Pnnel/4OCkt.v~6 Used. 200Arap Single Phate panel/4OCkts/$4 U~ed. * Rough 3/2/10 Final 8/2/10 Richard M. Bivone ~ __ ,, Not valid units signed by an ...... ri'l Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHO~,r~ CERTIFICATION Date: lead. I certify that the solder used in the water supply system contains less than 2/10 of 1% Sworn to before me this dayof .~/c_,, , 20/~ Notary Publi~ounty TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION ~FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2'ND [ ] INSULATION [ ] I:WINO ! STI~IHI [ ] FINAL [ ] fiREPLACE & CHIMNEY [ ] FIRE SAFETY [ ] i:ml{lli~l~C{~lml~-riwi [, ] I:mlllllrAXrl~rl~dmeH REMARKS:~ DATE ) ~)' "'3 -- o ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 INSPECTION ~,,FOUNDATION 1ST FOUNDATION 2ND FRAMING I STRAPPING FIREPLACE & (~IIMNEY [ ] RRE RESISTANT (X)B'TmJf~N [ ROUGH PLBG. INSULATION FINAL FEIE SAFETY INSPECTlCm ] FIlE IIESISTANT PBik'TRATION REMARKS: DATE / TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION ¶ST [ ] FOUNDATION 2ND [ ] FIRB~.ACE & CHIMNEY [ ] FmRESlSI'JUlTC(M'nWCTI0N [ ROUGH PLBG. INSULATION FINAL FraE U.':ETY mSFECncH REMARKS: DATE / -- cS/- / ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY INSPECTION ~ROUGH PLBG. [ [ [ ] INSULATION [ [ ] FINAL [ [ ] FIRESAFEYYINSPECRON [ ]RRERESSTANTC0NSnU~'n0N [ ]RRERES~TANTPENETRA~0N REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEFT. 765-1802 INSPECTION ] FOUNDATION 1ST ] FOUNDATION 2ND ] FRAMING / S'rlMi~'ING ] FIREPLACE & CHIMNEY [ [ ] ROUGH PLBG. [ [ ] INSULATION [ [ ] FINAL [ [ ] FlnESdU:ETYmSPECT10N REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION t ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS:__ DATE INSPECTOR ~~ TOWN OF SOUTHOLD BUILDING DEPT. 76S-t802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING/STRAi~NG [ ] ROUGH PLBG. ~INSULATION [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAr,-, T' INSPECTION [ ] ~.~'r~'~ [ ] Frae nEmTANT PEmTP, A'nOfl ' REMARKS: DATE ~ --/~"'-/0 iNSPECTOR ~//---~~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 'I ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ]~l&iffJl~PiNO [ ]FINAL [ ~ FIREPLACE & CHIMNEY [ ] FIlE SAFETY BISPECTI0N [ ] ~'r~~ [ ] F~r~rr~rrm~o~ REMARKS: ~~~l~ Bd~ ~i ~~/ - TOWN OF SOUTHOLD BUILDING DEPT. 76~-1802 INSPECTION ~~[*/~FFOUNDATION 1ST [ ] ROUGH PLBG. ~ [[ ]] ~M~GA~Is~DNG [[ ]] 'FiNNSAULLATION [ ] FIREPLACE & CHIMNEY [ ] RIlE SAFETY ~ [ ]mmmm'mm'~m~m~'tm~ [ imm .mj~T/tm'~ REMA~NK, S~~ ~CTOR ~ TOWN OF $OUTHOLD BUILDING DEPT. ?M,-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN~A/I~TION [ ] FRAMIN~ I STRAIqqNG [//] FINAL [ ] Fllm/q.kOE&m~ [ ] FIIIESAFETYIISFEOTION [ ] mE~~ [ ] FmEmSm2uerFeEnumofl DATE ~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 76S-1802 INSPECTION FOUNDATION l ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INS~JkATION FRAMING I STRAPPING [ ,.-]"FINAL FmB~4CE&CHmNEY [ ] F~ESJd:ETYmm,ECTKm ]Fmm~commu~ [ ]FmEmml'JUCrI,BLrTnAT~i DATE ~ INSPECTOR TOWN OF $OUTHOL1) BUILDING DEPARTMENT TOWN HALL SOUI'HOLD, NY 11971 TEL: (631) 763-1802 FAX: (631) 765-9502 SoutholdTow~LNorthFork. net ,20. PERMIT NO. BUILDING PERMIT APPLICATION CHECKLLSI Board of Health 4 sets of Building Plans Phnr~$ Board approval Survey Sept/c Form N.Y.$.D.E.C. Tmstees Sto~n-Watcr Assessment Form Contact: Approved ~ 20 Mail to: Disapproved ~/c Phone: Expiration _, 20 FOR BI. III.DING PERMIT b. Plot plan she ~ ~ ~ m~ premises, relationship to adjolni~g premises er public sires or c. The work covered by this application may not be ~ommenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the pt~e-,i~e$ avsilnhl¢ for inspection throv~h,mt the work. e. No bu/ld!ng shs!l be occupied.or used in whole or/n part for any purpose what so ever until the Build/ng Inspector issues a Certificate of Occupancy. f. Every building permit ~hnH expire if the work authorized hs_~ not comme~lced within 12 months after the date of issttall~o or has not beell (xlmplet~[ within 18 montb~ ~ such date. If no zonin_.~ ~ts or oth~ l~.~!~t/on.q ~g the property have been en~l in the interim, the Building Inspector may anth__ofize, in writing, the extension of the l~mit for an addition six months. Thereafter, a now permit shs!! be mqu/red. APPLICATION IS HEREBY MADE to the Building Depaximent for the issuance of a Bull&ins Permit pursuant to the BuiMin$ Zone Opti~ of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or pp. cam .agrees ~o c~xnpiy wire au appt~mie ,,ws, o~i,~,~s, buildins cod~ ' . ~ ' ,,a ,~,a,~i, State whether applicant is.~. lmse~ 4q~t,~'~m~E/aesr, ~~, ~ plm~mr or-tm/lder Name ofowner ofpremises ~/~7 ~{~-~C (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and t/fie of corporate officer) Builders License No. [4~1~' ~'. Plumbers License No. -- _ Electricians Licease No. ---- Other Trade*s License No. L°c~n~.f l~=~ °~.Av~ch pr°p°sed w°rk will be done: House Number Street Hamlet County Tnx Map No. 1000 Section Subdivision /qOkl Block FiledMap No. 2. State existing use and occupancy ofpremises and intended use and occupancy of proposed co--action: a. Bxisting uso and occupancy ~,~t.e. F~la~' fU~'&H ~t4~,t ~.e-~. 3. Nature of work (check which applicable): New Building Addition Alt~aiion ~' Rel r 4. Estimated Cost Removal Demolition 5. If dwellinS, number ofdwelli-E units If garage, number of cam '4 Other Work I~aov~-~ ~'~! '~' ~-se. (Description) (To be paid on filing this application) Nmnber of dwelling units on each floor ~,4~ 6. If business, commercial or mixed occupancy, specify nature a~. exteat of each type ofuse. 7. Dimensions ofexistin~ structures, if any: Front ~ ~- ~" Rear ~(- ~'~ ~ Height. ~'~- - 4 '~ e~r,e Number of Storles ~ Dimensions of same structure with alterations or additions: Front ~l. lc, Depth ~'7 ~ Height~ Z~,'- ,a,,' '~ m~ Number of S'torie. s 8. ~'lme~smnsoz ' :Front ~l/&. Rear 7o~" Depth,, Height( 4:0' Number of Btofies. ' 9. Size oflot: Front Ioo ' Rear ~4' Depth ~'?-.~.~ A¥~,t_ ~ 10. Date of Porchase I~[~.~ .Name of Former Owner Rear 11. Zone or use dislxict in whic~ premi.~s are situated g-~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO )<~ 13. Will lot be re-graded? YES NO~(' Will excess fill bc removed t~om premises? yEs NO ~ · 1&4 ~ "~4Oi~ ~ ' 16. Provide su~ey, 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 vzuvide topographical data on survey. 18. Are there any cov~mnts and r~a-iotions with respect to this property? * YES NO )4, · 1~ YES, PROVIDE A COPY. STATE OF ~ YORK) SS: COUm'Y O~ ) ~e of ~ ~i. of ~d o~ or o~ s~ ~t ~ ~m ~ Swo~_o before mc this//.. ~ dayof ~ , 20.10 TOWN OF SOUTHOLD BUILDING DEPARTMENT. TOWN HALL SOUTItOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net ^pproved Disapproved a/¢ I I , 2o II PERMIT NO. BUILDING PERM1T APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 se~s of Building Plans Planning Board approval Survey. Check Septic Form N.Y.S.D.E.C. Trustees Storm-Water Assessment Form Contact: Mailto: Phone: Building Inspector I .... I~ Date ~vo~ l~ ,20On ~ ~STRUCTIONS s~s ofpl~, acc~ plot pl~ to scale. F~ acco~g to sch~ule. b: Plot pl~ show~g location of lot ~d of b~l~gs on p~ses, ~lations~p to adjoining pr~ses er public s~ts or ~e~, ~d wate~ays. c. ~e work covc~ by ~s application ~y not be Comm~e~ ~fo~ issu~cc of Buil&ng P~t. d. Upon approv~ offs applica~on, ~e B~g ~pector will issue a B~g Pe~t to ~e applic~t. Such a ~it sh~ be k~t on ~e p~s a~able for ~s~c~on ~u~out ~e work. e. No b~g s~l ~ ~cupi~ or used ~ whole or ~ p~ for ~y p~ose what so ever ~t~ ~c B~l~g ~s~ctor issues a Ce~ificatc of Occup~cy. f. Eve~ b~l~g ~t shall exp~ if~e work authored has not comm~c~ wit~n 12 monks a~ ~e ~te of iss~ce or ~ not ~ completed wi~ 18 monks ~om such ~te. If no zo~g ~ts or oth~ ~ations aff~t~g ~e pro~ ~ve ~ ~ ~ ~e ~t~, ~e B~l~g ~pector may aurora, ~ wffi~g, ~e ext~ion of~e p~t for ~ ~PLICA~ON IS ~BY ~E to ~ B~l~g Dep~t for~e iss~ce of a B~l~g Pe~t p~t to ~e Buil~g ~ne ~inancc of~e To~ of Sou~ol~ Suffo~ Cowry, New YorL ~d o~ applicable ~ws, O~ces or Re~latiom, for ~e co~ction of b~gs, ~om, or ~te~ons or for ~ov~ er ~emoli~on as h~ ~s~. ~c a~lic~t a~s to comply wi~ ~1 applicable ~ws, o~ees, bu~g code, ho~~ons, ~d to admi~ State wh~ applic~t is owns, lessee, agent,~e~ ~ne~, g~ ~n~actor, elec~ci~, pl~b~ or build~ (As on the t~ roll or latest deal) if applic~t is a co.ration, sipa~e of duiy au~odzd o~ (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 500 7" ft-OL,b Hamlet County Tax Map No. 1000 Section Subdivision MOI, I t~- K~MA tO /t'77~ ~S (Nme) g7 Block . ~ Lot ~ , Fil~l MaP. No. :i~t~-,, Lot ~' 2. State existing use and occupancy of premises and intended use and occupancy of, proposed construction: a. Existing use and occupancy <~/Id~E. Flh~tlLt/ ~eESIbEIdd~' b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost ~ .~/Zgtg0. 5. If dwelling, number of dwelling units If garage, number of cars ~ Addition t/ Other Work F~ Alteration (Description) (To be paid on filing this ap~}lication) Number of dwelling units on each floor ,O/~ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing slxuctures, if any: Front Height oq~ / -/-/a ¢0 Number of Stories ~ Dimensions of same structure with alterations or additions: Front Depth qo~/ -/~9/~ Height ,,q,~' - ~// Numb-; Dimensions of entire new construction: Front /'J'/.4- Rear Height Number of Stories Size oflot: Front /0~' Rear JgF' Depth 10. Date of Purchase ]q ~ NameofFormerOwner l.d/ldbSW,4 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO V/ 13. Will lot be re-graded? YES__ NO ?/Will excess fill be removed from premises? YES NO 14. Names of Owner of premises ~/}~.0L t0tJF~fitC Address#d~T/Kl&Tr_)l.) AlYa~Phone No. ~a3/- 27/-/7d,7 Name of Architect [~oName of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V/ 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 V' 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: COUNTY OF ) r~lqb~.EO.) 0~, ,~?l'b[17'~ ~'. /~.~./~. being duly swom, deposes and says that (s)he is the applieant (Name of individual sj~tming con{met) above named, (~He is the /~ '/'/~-~/t6/~'~'~ 7' (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 __ ~ ~]q '~x / Notary l~ublic Cl~ar~l~~~~ ~,gna~of Applicant Jill M. Doherty, President James F. King, Vice-President Dave Bergen Bob Ghosio, Jr. John Bredemeyer Town Hall Annex 54375 Msin Road P.O. Box 1179 Southold, New York 119714)959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mamh 17, 2010 Mr. Andrew J. Schmitz III, A.I.A. 23 Green Street, Suite 202 Huntington, NY 11743 RE: ROBERT PUFAHL 700 TEEPEE TRAIL, SOUTHOLD SCTM# 87-2-25 APR 2 7 20~0 BLDG. DEPT. ; TOWN OF SOUTHOLO Dear Mr. Schmitz II1: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting hell on Wednesday, March 17, 2010: RESOLVED, that the Southold Town Board of Trustees APPROVE the Amendment to Wetland Permit #6979 to replace the railings and deck surface on the existing second- floor deck; remove the existing built-in barbeque and replace with a masonry barbecue in a new location; square off the existing section of an existing deck; add deck area over near new barbeque; place relocated hot tub onto a deck structure instead of a slab on grade; remove and replace the deck surface finish; remove and replace the existing deck railing; and repair or rebuild sections of the deck structure as required, and as depicted on the revised site plan prepared by Andrew J. Schmitz III & Associates A.I.A. last dated February 16, 2010, and stamped approved on April 9, 2010. Any other activity within 100' of the wetland boundary requires a permit from this office. This is not a determination from any other agency. If you have any questions, please call our office at (631) 765-1892. Sincerely, President, Board of Trustees JMD:eac BOARD OF SOUTHOLD TOWN TRUSTEES sOUTHOLD, NEW YORK PERMIT NO. 697...._~9 DATE: OCTOBER 15 2008 ISSUED TO: CAROL PUFAIIL PROPERTY ADDRESS: 700 TEEPEE TRAIL SOUTHOLD SCTM887-2-25 AUTHORIZATION Pursuant to the provisions of Chepter 275 and/or Chapm- 111 of the Town Code Of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the mcetha_g held on ~ in consideration of application fee in the sum of $~5_Q.~id by Terms and Conditions as stated in ~he Resolution, the Southold Town Board of Trustees authorizes and following: Wetland Permit to construct a second-story roster bedroom/bathroom addition onto the existing dwelling, remove and install new sanitary system, relocate existing hot tub, rebuild existing outdoor shower, replace the roof and siding on the dwelling, drywells for roof drainage, and as depicted on the site plan prepared by Andrew J. Schmii2 III dated September 8, 2008. IN WITNESS WHEREOF, the said Board of Tmstces hereby causes its Corporate Seal to he affixed, and these presents to be subscribed by a majority of the said Board as of this dam. James Kin~ TERMS AND CONDITIONS The Permitt~e, Carol PufahL residlm, at 700 Teeoee Trail..~,mo~a NY, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pm'su~ to this pei~it, and the said P~mlttee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the completo exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period °f24 months, Which is considered to be the estimated time required to complete the work involved, but should circumstances wanant, request for an exteosion may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Pa'mittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorizati°n was originally obtained. That the work involved will be subjo:t to the inspection and aPproval of the Board or its agents, and non-compliance with the provisions of the ori~n~ai,~ application may be cause for revocation of this Permit by resolution of the said Board. That there will beno unreasonable ~nterference with navigation as a result ({fthe work herein authorized. ' ~ ': That there shall be no interference with the right Of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work heroin authorized, or if, in the opinion of the Board of Tmste~, thc work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Tdwn of Southold. That thc said Board will be notified by the Pe~mlttee of the n 6f the work authorized. ~ ' That the Permittee will obt/fiu all other penults ~d conseuts that ~hayb~uired supplemnental to this permit, which may be subject to revoke upou fa{]~h-e to ob~in same. Jill M. Doherty, President Jame~ F. King, Vice-President Dave Bergen Bob G. ho~io, Jr. John Bredemeyer Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0566C Date~ THIS CERTIFIES that the replacement of railinos and deck surface on existing second-floor deck~ removal of existing barbequ¢ and reolacement with a masonry barbeque in a new location~ square off of existing section of a d~k- new deck area over near new barbeaue: nlacement of reloc_~t _~_ hot tub onto a deck shn~c0_~; removal and re01ac~nent of deck surface finish; removal and replacement of existina d~ railina; and reoair/rebuild of sections of deck At 700 Teepee Trail. Southold Suffolk County Tax Map #87-2-25 Conforms to the application for a Trustees Permit heretofore filed in this otfiee dated 9/11/08 pursuant to which Trustees Wetland Permit g6979 dated lO/15/08 was issued and Amended on 3/17/10 and conforms to all of the requirements and Conditions of the appflcable provisions of law. The project for which this certificate fa being issued is for the r~placement of railim,~ and d~k surface on existing second-floor deck: r~nnoval of existing barbeaue and replac~nent with a masonry barbeque in a new location: sauare off of existing section of a deck~ new deck area over near new barbeaue; vlacement of relocated hot tub onto a deck st~mmre; removal and r_~_!~cemem of deck surface finish~ rera0val and reolacement of existing d_~c~lc railing: and repair/rebuild of sections of deck. The certificate is issued to ~AHL owner of the aforesaid property. rized Signamr~ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03876 PERMIT Under the Environmental Conservation Lnw_.~__~ Permittee and Facility Information Permit Issued To: CAROL PUFAHL 164 E SHORE RD HUNTINGTON, NY 11743 Facility: PUFAHL PROPERTY 700 TEEPEE TRAIL SOUTHOLD, NY 11971 Facility Application Contact: A~r~REXV J SCmmTZ, m 23 GREEN ST STE 202 HUNTINGTON, NY 11743 (631) 271-9303 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 715.9 NYTM-N: 4545.8 Latitude: 41002'05.3" Longitude: 72025'53-9" Authorized Activity: Construct a second story addition to an existing single family dwelling. Relocate hot tub, remove and replace outdoor shower. Remove existing sanitary system and install new sanitary system. All work must be done in accordance with the attached plans prepared by Andrew J. Schmitz IH last revised December 18, 2008 and stamped approved by NYSDEC on April 10, 2009. Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-03876/00001 New Permit Effective Date: NYSDEC Approval Expiration Date: By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: GEORGE W HAMMARTH, Deputy Regional Permit Administrator NYSD C REaIO 1 ^d ss .f'Z s,.,NY STONY' OO I50 RD Page I of 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-473803876 Distribution List ANDREW J SCHMITZ, III SHERRI L AICHER Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERM1TTEE OBLIGATIONS lNATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS 1. Notice of Commencement At least 48 hours prior to commencement of the project, the perrnittee and contractor shall sign and return the top portion of the enclosed notification form certifying that they are fully aware of and understand all terms and conditions of this pormit. Within 30 days of completion of project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work. 2. No Construction Debris in Wetland or Adjacent Area Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in wetlands and/or protected buffer areas. 3. Storage of Equipment, Materials The storage of construction equipment and materials shall be coILfi, xled within the project work area and/or upland areas greater than 100 linear feet from the tidal wetland boundary. 4. Area of Disturbance for Structures Disturbance to the natural vegetation or topography greater than 25 feet seaward of the approved structure is prohibited. $. Install, Maintain Erosion Controls Necessary erosion control measures, i.e., straw bales, silt fencing, etc., are to be placed on the downslope edge of any disturbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is to be maintained in good and functional condition until thick vegetative cover is established. 6. Runoff Directed to Upland Drywells Roof runoff shall be directed to drywells a minimum of 100 linear feet landward of the tidal wetland boundary for immediate on-site recharge. 7. No Hot Tub Diseharge~ to Wetland There shall be no draining of hot tub water directly or indirectly into wetlands or protected buffer areas. 8. Sanitary System Leaching Pools above Groundwater Sanitary system leaching pools shall be located a minimum of 2 feet above seasonal high groundwater. Page 2 of 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-473803876 9. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the sm~cture or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation, or for other purposes, and no claim or right to compensation shall accrue fi~m any such damage. 10. Confornmnre With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicanfs agent as part of the permit application. Such approved plans were ~ by Andrew J. Schmitz HI last revised December 18, 2008. 11. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in thc position of the ~ or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of thc State, or cause loss or desmpzfiun of the natm~ resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this pw~it, the s~ucture, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and n~anner as the Depmh~ent of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made again~ the State of New York on account of any such removal or alteration. 12. Precautions Against Contamination of Waters All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, conc~te, leachate or any other environmentally deleterious materials associated with the project. 13. State May Require Site Restoration ffupon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the S~_at_~ of New York on account of any such removal or alteration. Page 3 of 5 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1.473803876 . . GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The l~zo~itted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an authorized xt~pres~ntative of the DepmU,,ent of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such r~presentative may order the work suspended pursuant to ECL 71 - 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Departmenfs representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 2. Relationship of thb PermR to Other Department Order~ and De~erminatious Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. 3. Applications For Permit Renewals, Modifications or Tr*nafers The permittee must submit a separate written application to the Depmh~ent for permit renewal, modification or transfer of this petaiit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or mmsfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or lransfer are to be submitted to: Regional Permit Adminlslrator NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOK[50 CIRCLE RD STONY BROOK, NY11790 -3409 4. Submission of Renewal Application The pennittec must submit a renewal application at least 30 days before p~.i-fit expiration for the following permit authorizations: Tidal Wetlands. $. Permit Modifications, Suspensions and Revocations by the Department The Depmhaent reserves the fight to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittec to comply with any terms or conditions of the permit; c. exceeding the scope of the project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; Page 4 of $ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03876 e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit mmsfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS I Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Depa~huent of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the penuittce's acts or omissions in connection with the permittce's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnificarion does not extend to any claims, suits, actions, or damages to the extent atlributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any cirizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit . The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this pemait, including all special conditions while acting as the permittce's agent with respe~ to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittec. Item C: Permittee Responsible for Obtslnlng Other Required Permits The permittce is responsible for obtaining any other permits, approvals, lands, easements and rights-of- way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the · · · ' ' of riparian rights of others in order to perform the permitted work nor does it anthoxaze the nnpmrment any rights, rifle, or interest in real or personal property held or vested in a person not a party to the permit. Page 5 of 5 Town of __ __ $outhold Erosion, Sedimentation & Storm-Water Run-off A88E88MENT FOI{M PROPERTY LOCATION: S,C.T.M. #: THE FOIl. OWING A~I'ION8 MAY REQUIRE '~lE 8UBMIBSlON OF A 1000 ~? O~ 25 ~I'OI~I-WATE GRADING DRAINAGE AND EROSION CONtrOL PLaN ~ ~ ~ ~ CERTIFIED BY A DESlG E 8T E O EW Y0 K. Item Number:, (NOTE: A Check Mark (~) for each Question is Required for a Complete Applloation) Yes No '1 Will this Preject Retain All Sterm-Watar Run-Off Generated by a Two (2') Inch Rainfall on Site? (This item will include all mn-off created by site deering and/o~ construc~on activities es ~11 as all Site -- Improvements and the permanent creation oflmpo~vlous eurfacas.) Not entire site, just 2 Di~h"r~e°~l~". s""u~%uC~ Show ~' Propo.ed D.~""O* S~m~. ,.dica,ng S~e & Lo~tion? ~ This Item shell include all Proposed Grade Changes and Slopes Controlling gwface Wated=lowi 3 Will this Project Require any Land Filling, Grading or Excavation where there Is a change to the Natural r'~ Existing Grade Involving mom than 200 Cubic Yards of Material within any Pamel? 4 Witi this Application Require Land Disturbing Activities Encompassing an Area in Excess of ~'1 Five Thousand (5,000) Square Feet of Ground Surface? S Is there a Natural Water Course Running through the Site? ~ Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? ~ 6 oneWill IhereHundredbe Site(100,)prepamtiOnof Horizontal°n ExlstingDistance?Grade Slopes which Exceed Fifteen (15) feet o1 Vertical Rise to r~ 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Sterol-Water Run-Off r~ into and/or in the direction of a Town right-of-way? 8 Will this Project Require the Placement of Material Removal of Vegetation end/or the Construct on of r"~ any Item Within the Tow~ Right-of-Way or Road Shoulder Area? L~J (This item wlti NOT include the Inste(lotlon of Ddveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? r~ NOTE: if Any Answer to Questions One through Nine I$ Answered with a Check Mai~K th the Box, · Storm-Water, Grading, Drainage & Erosion Control Plan Is Required end Must be Submitted for Revtew Prior to Issuance of Any Building Permit EXEMPTION: Ye.__~s N._R Does this project meet the minimum standards for classification as an Agricultural Projed~' Note: You Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl __ STATE OF NEW'YORK, COUNTY OF ........................................... SS That I, .~..w.....J..........~...~.~..z.....I...I..I.. ........................... being duly sworn, de'poses and says that he/she is the applicant for PenvJt, (Name of ~dlvldual signing Document) And that he/s~tis the ......Ar.cbkt~ct..../...Agent ....................................................................................................................... (Owner, Contractor, Agent, Coq~omte Office*', etc~) Owner and/or representative of the Owner of Owner's, 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 herewith. Sworn to before me this; ........ /...~....~... ......................... day of ...~ ......................... 20.~ FORM 06107 ammkd In Surfak County /~-~ ~-~?-z-zs" TOWN OF SOUTHOLD PROPE Y RECORD CARD 'i~O'W. NJ~ STREET ?~)0 VILI.~G£ DIST, SUB. LOT ~ /.~. ~,/{~.~W~,~. S W ~ILDING R~. ~ lO~ s~s. VL . FA~ c~ cB. Mlcs. Mkt, Value - ~ND AGE ,~ BOILOING cONDITION N~ NOeL ~LOw ~BOVE FA~ Acr~ Valu~ P~r V~lu~ ' W~I~ FRONTA%E ON ROAD /~o ~ DEPTH H~ ~ ~,.~ BU~H~D Totel D~K .~arage Patio COLOR TRIM/'Y~T-" Foundation Basement C: E/] ~d [ Floors Ext. Walls Interior Finish Fire Place / Heat Type Roof Rooms Ist Floor Recreation Room Rooms 2nd Floor Dormer Driveway LR. DR. REScheck,S. oftware Version .4..2..0 Compl,ance Cert,fmcate Project Title: Pufahl Residence Enaq]y Code: 2007 New York Energy Consewatlon Construction Code Location: Suffolk County, New York Constmctioa Type: De~ched I or 2 Family Heating Type: Electric (Include~ heat pump~) Glaxin9 Ama Pement~-ge: 12% Heating Degree Deys: 5750 Construction Site: 700 Teepee Tra~l Southold, NY 11971 Owner/Agent: Mr. & Mrs, Robert Pufahl 164 East Shorn Road Huntington Bay, NY 11743 JUN 30 W BLDG. DEP~ Designer/Contractor: Andrew J. Schlitz III Andrew J. Schlitz lmm & As.'~aciatos A.I.A. 23 Green Street Suite 202 Huntington, NY 11743 631-271-9303 andyschmitz@verlzon,cet Compliance: 0.(P/e Bet~r Than Code Maximum UA: 62 Your UA: 92 Wall 1: Wood Frame, 16" o.c. Window 1: Wood Frame:Double Pane with Low-E Ceiling 1: Cathedral Ceiling (no attic) Floor 2: All-Wood Joist/Truss:Over Urmonditloned Space 542 21.0 2.1 26 64 0.300 19 620 38.0 1.7 16 41 38.0 1.3 I The proposed building represented In this document is consistent with the b~ddir~l~olana, specifications, and other cstcelaflona submitted with this permit application. The proposed systems have been dealgned t Energy Conservation Cocetruction Code requirements. When a Registered Design Professional h~,a/Wped and ~ll~/~d~thls pege, they~at',~ attesting that to the best of his/her kn~w~edge~bst~ef~andprofces~na~j~dgmant~s~chp~a~s~r(~p~3~icati~nsare~/~ianoe~~ Dat~;~.._.~.~_~_j~4.1l~::3'~ ,~. '~'J~.4~'~?. "Ill' ~ r ~ ~ Project Title: Pufahl Residence Report date: 12/15/08 Data ~ename: Pufahl.rck Page I of 1 SeTM#1000- ~q- ~ - ~5~ Su,division: Property Address:TOO Tea_~o~e /--2 *Date Submitted:~/ //~/06/0~ *Date Reviewed:~/~06/O~ )~O~-- Estimated Cost: ~Og~trz~ ~ne: ~-~ Conforming? Ci~: ~v~ ~ Pre COs? Buil.~qg Permits (Open/Expirq4t):~BP /~/o~5-Z / C/O Z- // ~/5~ Info: /~/ ~ BP/Y~-Z / ~0 ~ ~y~ ~o: ~ ~ -Z/~ ,~o: BP -Z/~0~ ,Info:_ 8~gle & Separate Search Required? Y or~eterminaflon: ~Q.~tSizi: ~o a~ ,ACT.~tS~: 4~ ~C ~Q. MtCov.~A~.~tCov. ~Q. Front~ ACT. Front ~Q Side A~. Side ~Q. Re~ PROP. R~ ~Q.' Height ACT. HeiSt Waterfront?~r N? If yes, water body: ~j~Panel# ADDITIONAL APPROVALS"-~ (JREQ~tlEED /~t~ Flood ~e._. ~3~khead/Bluff Distance: Suffolk County Health,or N-Ifyes, *Bed#: q *Date: ~(/~.___~*Permit#: f~ [00~ ~{)~0 Town Septic&ri - If no, eer~flon required: Y or N Received: Y or N By: ~S D'C: PR..~,na~of N- Date: ~/~l ~ Permit ~: [L{~ 0~/~ or NJ Letter- Notes: SoutholdTruste,:~orN'-Date:~/ ~;0i Permit#: eq~ or NJ Letter- Notes: Southold ZBA: Y o~ - Date: ~/ / Permit ~: - Notes: Southoid Planning: Y or,Date: I__1 Permit ~: - Notes: Town Landmark C of ~: Y or/DTE: / / *~CODE Compliance ~age 2~r N ,,Fee Structure: Foundation: First Floor: Second Floor: Other: Total: Calculation: 1.( c~l 5-qSF)-( ~70 SF /4v4-P'~o~ SF 2.( SF)-( SF SF)= l 3Oq SF ×*.. qO 4 5~, ~'~ + Initial Fee: $~D~ - Additional Fee ( ): SF)= sr X $ __=$ + Initial Fee: + Additional Fee ( ): TOTAL: NEW YORK STATE CODE COMPLIANCE CHECKLIST Weathering: ~ewre: Frost Depth: 36" : Termite: M-H , D=ig. T.~: 1~ 'Ice Saleld Underlay: ~ r, ~oodHazards: ~B OF CONSTRHCTION: ~L ~G DESIGN ELEME~S~~ ~ERS: Y~ W~L ST~S: Y~ G~ERS: Y~ CEDING JOISTS: Y~ FLOOR JOISTS: Y~ ROOF ~TERS: L~BER SPECIES ~D G~E: Y~ ~OW ~ DOO~ · MISSLE TEST LIGHT 8~ --Vo :~/N NAIL~G/CONSTRU~ION 8CHEDULE~ ~S OF EG~SS~ ~SER DIAG--: ~ PL~B~G LOCATION OF F~ PROTECTION BQU2MENT: Y~ TRUSS DESIGN: Y/N CERTIFICATION:/Y~N ENERGY CALCS :~/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) JT~DITH T. TERRY TOWN CLErtK o " ;::' ~ Town Hall. §30q5 I~.tain Rea ·" P.O. Box 117q OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 2~, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two [2] new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93)],' and "Certificate of Compliance for Development in Special Flood Hazard Area [CLC(93)]. BLDG. DE~. TOWN OF SO,;W~OLD Southold Town Clerk August 25, 1993 TOWN OF SOUTHOLD APPLICATION # PAGE 1 of 4 FLOODPLAIN DE' rELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sic'n/: 1. No work may start until a permit is i~ued. 2. Thc permit may be revoked ii' any f~Lsc statements ~re made herein. 3. If revoked, all work must cede until permit ia rc-i~sued. 4. Development shall not be used or occupied until a Certificate of Compliance is iasucd. 5. The permit will expire it' ho work is commenced within six months of issuance. 6. ApplicaJlt is hereby iffi'ormed that other permits may be required to f~dfil! local, state a~d federal regulatory requirements. ' 7. Applicant hereby give~ con.sent to the Local Administrator or his/her representative to make l~ea~ooable inspectious required to vetlfy compliance. 8. I, THE APPLICANT, CERTIFY THAT E1N AND IN ATTACHMENTS TO (AJ'PLICANT'S smtq^ruaE) SECTION 2: PROPOSED DEVELOPMENT (To be comuleted bv APPLICA~mD ~IA,,M ~ ~DRESS T~LEPHONE APPLICANT ~,,/j. ~O.~l,a'rt3L '/'~ &~r,a~ ,~', ,~n'z ,'t~t. ~ onu'nu~'~t,~,V, irta5 ~-51. g'/I-q~3, BUILDER To avoid delay in pro,"-*_.*hag the application, ple~e provide enough information to easily idcutlb/the project location. Provide tho street addresa, lot number or legal desc~ption (attach) and, outside urban areas, the distanen to the nearest intersecting road or well-known landmark. A sketch attached to thla application showing the project location would be helpful. FDP(93) APPLICATION PAGE 2 OF a DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT A(2TIVITY [] New Structttr¢ ~i~Addltion Ji~ Altcratioa [] R¢locatioa 12 Dcmolitioo [3 Replacement TR RE TYPE gRResidential (1-a Family) esidential (More than 4 Family) [] Non-residential (FloodprooFmg? [] Yes) [] Combined Use (Residential & Commercial) t"l Manufacttu'ed (Mobile) Home (In Manu- factured Home Park? [] Yes) ESTIMATED COST OF PROJECT B. OTHER DEVELOPMENT ACTIVITIES: [] Fill El Mining [] Drilling ~l~Grading [] Excavation (Except for Structural Development Checked Above) [] Watercourse Alteration (Including Dredging and Channel Modificationa) [] Drainage Improvementa (Including Culvert Work) [] Road, Street or Bridge Construction [] Subdivision (New or Exoansion) ~i~lndividual Water ort~wer System-~ ~ Other (Please Speedy) ~f~ After completlag SECTION 2, APPLICANT should submit form to Local Administrator for review. ~E(TTIQN 9: FLQODPLAIN DETERMINATION [To be comt~leted bv LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: 13 IS NOT located in a Special Flood Hazard Area CNotif7 the applicant that thc application review is complete and NO FLOODPLAIN DEVELOPMENT pER.MIT IS R~QUIRED). [] Is located ia a Special Flood Hazard Aren. FIRM zone de~ignation ia 100-Year flood elevation at thc site ia: Ft. NGVD (MSL) [] Unavailable [] The proposed development is located in a floodway. FBF'M Panel No. Dated [] Sec Section 4 for additional instructions. SIGNED DATE APPLICATION PAGE 3 OF 4 SECTION 4: ADDITIONAL INFORMATION REOUIRED (To be comnleted by LOCAL ADMINISTRATOR) Thc applicant must submit the documents checked below before the application ~ bc processed: I-I A site plan showing the location of all cxisting ~mctus~, water bodics, adj?.ent roads, lot rllmeusious and proposed development. 13 Devclopment plans, &awn to scale, and spcc~cations, including where applicable: details for anchoring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the t'u'st floor, detags of floodproo£mg of utUities located b~low thc ['ti~t floor and dctalk of codosures below thc flr~ floor. Alsu, n Subdivision or other dcvelopmant plans (If the subdivision or other development exceeds 50 lots or 5 acres, whlchev~r is the lesser, the applicant must provide tOO-year flood elevations if they are not otherwise available). n Plnus showing the extent of watercourse relocation nad/or landform alteration.',. [] Top of n~v l'dl elevation Ft. NGVD (MSL). Floodproofmg protection level (non-rcaidcntial only) Ii. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or Certification from a registered engineer that thc proposed activity in a regulatory floodway w~ not result in any increase in the height of the lO0-year flood. A copy of all data and calculations supporting this finding must also he submitted. 0 Other:. SECTION 5: PERMIT DETERMINATION tTo he completed by LOCAL ADMINISTRATOR~ I have deteamlned that thc proposed activity:. A. iq Is B. 0 Is not in couformnacc with provisions o[ Local Law ~ .... 19 attached to and made part of this pe~nit. · Thc permit is issued subject to thc conditions SIGNED , D~.TE ~ thc Local Administrator may issue a Dcvclopmcnt Permit 'upon payment of d~.signatcd fee. ~ the Loc~ Admin~tratur will provide a wrlttcn summary of deficiencies. Applicant may revise and resubmit an application to the Local ^dmini~trator or may reque~ a hearing from the Board of Appeals. APPEA, LS: Appealed to Board of Appeals? [] Yes [] No Hearing date: Appeals Board Decision -- Approved? [3 Yes Conditions 12] No APPLICATION PAGE 4 OF 4 SECTION 6: AS-BUILT ELEVATIONS (To b~ submitted by APPLICANT ~efore Certificate of Comoliapce is issued] The followlz~g Jz~ormation must Ix: provided for project structures. This section must be completed by a registered professional engineer or a llc~n.~d land surveyor (or attach a cma. ification to this application). Comple. tc 1 or 2 below. Actual (As-Built) Elevation of the top of the lowest floor, including basement Cm Coastal High Hazard Areas. bottom of lowest ~truontral'member of the lowest floor, excluding p,~ng and columns) ~ ~. ~OVU (~S~.). 2. Actual (As-Built) Elevation of floodproo£mg protection is FF. NGVD (MSL). NOTE: Any work performed prior to submittal of thc abov~ information is at the risk of the Appllca.at. SECTION 7: COMPLIANCE ACTION Cio be comulctcd bv LOCAL ADMINISTRATOR] The LOCAL ADMINIb-I-~,ATOR will complete this section as applicable based on inspection of the project to cnsurc complianc~ with thc community's local law for flood damage prevention. l~SP~Ci'iON$: DATE BY DEFICFEN~J, iH-.S? I-1 YES I-I NO DATE BY DEFICIENCIES? O YES r'l NO DATE BY DEFI~CIES? r'l YF_S I-I NO SECTION 8: CERTIFICATE OF COMPLIANCEFI'o be comulete, d by l.~ ADMINISTRATOR] Certificate of Compliance issued: DATE: BY: Attachment B S~MPLE CERTIFICATE OF COMPLI]~NCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZ, AR.D AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED 'AT: ¢~.. ~, OWNERS NAME AND ADDRESS: PERMIT NO. ~t~ PERMIT DATE CHECK ONE: P1 1~ BUILDING '~EXISTING BUILDING II.VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED:. DATED: COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # ,19.._, AS MODIFIED BY VARIANCE # DATED ' SIGNED: DATED: P. O. Box 1179 Southold, NY 11971 Southold, NY 11971 Dear Ms. Toth: June 15, 2009 53095 Route 25 P. O. Box 1179 Southold, NY 11971 ~00 '1'~ Trail Soulhold, NY 11971 SCTM ;H 000-067-02-025 1. Apflgk:~dion for' bl.dlding p~lTvdt. . 3. Permit Boerd of Town Trustees. 4. Permit- D.E.C. 5. Pem~t - He~ _Depa~r~ 530~ ROute 25 P. O. B;~ 1179 Southold, NY 11971 Re: Bui~ng Pen~ ~ 700 Teepee Trldl $~lllOld, NY 11971 A,<'tdrt~ J. Sdlmilz III& As~:x~iM~ A.I.A. l. lulllbtgton, NY 11743 ¢~~~IATES AIA P. O. Box 1179 Southoid~ NY 11971 Re: Carol Pufahl resk:~x=e 700 Teepee Trail Sou~hold, NY 11971 1. Flood PI.n ~,F~ (. ~S~c. 1 &Sec. 2 (X)ml~). 3. (3ener.! ~8 ~ ~. 4. General conb'aclor'8 Iic~ ~. P. O. Box 1179 Soulhold, NY 11971 Re: R°b~t Pufahl residence 7O0 Teepee Trail Soulhoid, NY 11971 SCTM #1000-087-02-025 Dear Building Department: . de¢~ were in poor condition and needed to be reconstructed, we ~uso ~ec~e= house. His license and insurance infon~ation is already on ~m. owner of the home. The n~ sulxnitted do=un~ts retlect th~.'" ' E~lzal~=am~n ASSOCIATES AIA HOME IMPROVE]~ENT CONTRACTOR LICENSE HARRY P BIFULCO III 18999-H r~ =~v,,=~ 07~01/2011 ;mor, ucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE I C S AGENCY, INC DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE 310 WILLIS AVENUE POUCIES BELOW. MINEOLA, N Y COMPANIES AFFORDING COVERAGE 115 01 COMPANY LETTER A GEMINI INS CO COMPANY INURED LETTER B HARTFORD INS CO GOLDEN OAK, INC. COMPANY PO BOX 1179 LErrER C NATIONAL UNION FIRE HUNTINGTON COMPANY NEW YORK LETTER D 11743-0000 COMPANY LETTER E THIS IS TO CERTIFY I~HAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NO~%S'm~STANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI~ CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUClEB DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. EMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER DATE(MMID DIYY) DA'I~(MMIDDIYY) LIMITS GENERAL LIABIUTY GENERAL AGGREGATE $ 2 t 000 ~ 00 ~2~ X :OMMERCIALGENERALLIABILIT~ VIGP010099 12/17/0S 12/17/09 PRODUCTS-COMP/OPAGG. $ 2, 000, 000 LAIMSMAD~ OCCUR. PERSONAL & ADV. INJURY $ i · 000 I 00 )WNER'B&CONTRACTOR'SPROT. EACHOCCURRENCE $It 000~ 000 X BLKT ]~DDL INSD FIRE DAMAGE(Anyoneflre) $ 50 ( 000 ~C.E~N~ (~.yma perso~ $ 5 ( 000 AUTOMOBILE LIABILITY COMBINED SINGLE $ B ANYAUTO 12UEC UJ9607 02/27/0~c 02/27/10L'M~T 1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS =er person) X HIRED AUTOS BODILYINJURY X NON-OWNED AUTOS (Par accident) GARAGE LtABILITY PROPERTY DAMAGE $ EXCE~ LIABILITY EACH OCCURRENCE $ i I 000 , 00 C X UMBRELLAFGRM EBOC27725348 12/17/0~ 12/17/09 AGGREGATE $ 1,000,00C OTHER T.AN UM ERELLA FORM i [ : :: WOa~R.SCOM.~NSAT,O. I STATUTORYL'M'TS AND EACH ACCIDENT $ EMPLOYER~' LIABILITY DISEASE 'POLICY LIMIT $ DISEASE -EACH EMPLOYEE $ OTHER ~ESCR~.~ON OF OPaRAT~ONS/LOC^T~ONS~VEH~GLES/S,aG~AL ~TEMS CERTIFICATE I-IOLDER IS INCLUDED AS AN ADDITIONAL INSURED. SHOULD ANY OF THE ABOVE DESCRIBED POUOIES BECANOELLED BEFORETHE TO.. OF SO T OL °ATE THE.OF. THE .U. COMP-- .LL .--VOR P.O. BOX 1179 MAIL 30 DAYSWRFF~'ENNOTICETOTHECERTIFICATEHOLDERNAMEDTOTHE SOUTI-IOLD, NY 11971 LE~T..UT ~A,LUBE TO MA,L SUCH .OTICE SHALL IMPOSE .O ORL~TIC. OR AUTHORIZE D REFREe~= NTA'rlvE New York State Insurance Fund Worlters' Compensation & Disability Benefits Specialists Since 1914 199 CHURCH STREET, NEW YORK, N.Y. 10007-1100 Phone: (888) 997-3863 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE GOLDEN OAK INC PO BOX 1179 HUNTINGTON NY 11743 POLICYHOLDER CERTIFICATE HOLDER GOLDEN OAK INC TOWN OF SOUTHOLD PO BOX 1179 PO BOX 1179 HUNTINGTON NYl1743 SOUTHOLD NY 11971 POLICY NUMBER CERTIFICATE NUMBER PERIOD COVERED BY THIS CERTIFICATE DATE Z 1169 041-9 825250 02/03/2009 TO 01/01/2011 1019/2009 THIS IS TO CERTIFY THAT THE POLICYHOLDER NAMED ABOVE IS INSURED WITH THE NE'~N YORK STATE INSURANCE FUND UNDER POLICY NO. 1169041-9 UNTIL 01/01/2011, 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 01/01/2011 IN SUCH MANNER AS TO AFFECT THIS CERTIFICATE, 10 DAYS WRH ~N 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 MAi l uR OF INFORMATION ONLY ANDCONFERS NO RIGHTS NOR INSURANCE COVERAGE UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POMCY. U-26.3 NEW YORK STATE INSURANCE FUND DIRECTOR, INSURANCE FUND UNDERWRITING This certificate can be validated on our web site at https://www.nysif, com/cerFcertval.asp or by calling (888) 875-5790 VALIDATION NUMBER: 489937058 88/89/2818 15:18 ~T# 5031 IND# - 16 JOB# 73 CONST.UCTmN BOX 1179 WEB$1TE: www. budlumlnr, oom ~u&~'. p.o, dP ~ NY 11743 11-4~4-6099 HODEL# HSE~O EBT# TEEPEE TRAIL 8QUTHOLD P~GE 01/03 0~ DER# 1S1~ ;/05/~} * * * C H A R i; E ~i A L E * WHEN IN ~133 X 6/8 AVALON 60 HIN DR PH ~-5/8"-5" SPLIT ~/B LEFT HAND PATTI 3-5 WEEKS 691.7t )I.71 &~.~l 534.12 Pt*em: P~ lteam ~.com> Datec ]~[on, 9 ,amS 2010 IS: 14:46 -.0400 To: ~Brian Domvn, <lxian~buflhnba..com~ tO: BUR? BUT/D/KG HA,T'ERLRI,~ -IT/* 51 WBST II/L~T.~ ROAD flUNTZNG'F(~q STA'/~/OH ~.NY 11'/46 (~JST I41JI~,LR 0O0370 ORDER ML~BR 5842'~9-00 ORDER DA?8 04/01/2010 EST. ~IP ~ 04/27/2010 P.O. ~R 5031 TEI~S Dl10 8HZP** ~OX.DEN O~R.K 402842 O~-3 C~Z La'~ lO~' SPLZ? FA,RP~ UlqZT 2~8"X6'9" ,[H] S/O- 2868 1-3[4" 60MXN.AVAL4:M('J'EXT.FZI~ DR ,0MSP~ZT HAND ;SZMb"Y..~ BORE 2 3/8 - 2 1/8 ,$0 I(ZN FACTORY PR.TCZ · 00 $/9/20J03:16 PM I ~28~ 68;wz~,l P!~J~, (~I~CK ACI~qO~r~VDG~34~ CARSt~'I~I~Y. UPON I~C~IPI' O~i' SIGNED ~EDG~I4~ yOUR ORD~iq. W'rLl~ BE PROCE~D l~ O~JTI~I~D .R~C:IAL ORDgR8 C.P, ITNO~ BR CHANGED, CANCF.~L.ED OR R~.I'UitNF, D. 8~/2g10 3:16 PM A ./-1 SUFFOLK COUNTY D~PAR.ThffiNT OF HEALTH SERVIC~ ~S ~gg YEA~ FROM DA~ OF ~P~V~ lllll ~liiii ~ ~ ' J-2 LOT ,. LC) r : / J'-I LOC~TIOPI ./'-2 iiI ENCLOSE POOL TO CODE UPON COMPLETION ' ~, BEFORE "WATER. ,,,. BR I CP-. CFIP [NG UNDaWRrr,~RS CER'nFa'rr- OCC U PAI' CY 0 R RaU, EO USE IS Ut LAWFUL 6' BANI) FROSTPROnF ,WITHOU' CERTIFICATE c,-.,~lc ~ ~-,' , OF OCCU )ANCY ? DATE:~_Z. ~__L__.~ BP #'~LI~'/'6~'~T"~! ., EL,EV -[. '-I~',. . F~E: ...... e/ ., _. ....~.', REOUIREM~-N'FS OI THE CODES'OF NEV~ ALLCONSTRUCTIO~SH:ALL ~L£V -3'-0' YORK STATE. NO~ 'RESPONSIbLE. FOR M[:¥T ]¥1E ~C)UIr~EMENTS OF THE . CUD~$ OF NEVv' YORK STATE. . IEL~V -~ '- 0~ RETAIN STORM WA"I:ER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. m ELEV -5'-0' 6' MIN, 1 114° TRAP RIDCK 6' MIN, I l/4° TRAP ROCK J O n d ITRDL JOINT \ .,rB~D E 5 -0' DEPTH ~ / E~, FULLY Up PBDL T (MAX SP~l~ / ' ".' T 5' O,C,)----'~ ..' ' £,L£v -e'-o' ~,-; , '" 7~' 3' : EL.E? :3'-0' W/SI KAFLEX- 1¢~ S *F_P, LI & POLYETHYLENE ~ACKER ' " Ag~TIDNAL #4 RE:JARS ELEV -~"-0' ~...:,. ...... ,. ELEV CENTEREO ~ C~NT~L J~INT ' .~' ........ ' oF ALE BARS ACROSS JDINT -3' · ~--6' MIN, ,1 1/4' TRAP ROCK "~" , DATE ~SCRI PT I ON .?'~?: :~r??. ' SCALE' 1' = [ -0 ~i~,~J~tbNI~~, mC ' , , --> I H. tELLF:NIO 10~ATION HAP N NOTES: ~IC, AL ~RUB PLANTIN~ 0¢ TREE 'FO REMOVEI2% %o~C ¢_.~0 '\ N S 'f~PIC~AL I~E PLANTIN~ '\, PLANT Young & Young 11901 PAVemeNT/ J~LK,~ i~ C~U~INJ~i LEGEND cc ~ EOf= = C42N~4~T~H~A~ ~ ~IZ~ 4 5 I'rt~ I2ATA TOTA~L AP,~A = 1.51qO AC'P,,E5 EN~,INEEt~'5 GE~.TIt=IC.,ATION 1 JOHN DIANNARI5 HELLENIO DNAE,~-. 514.5 HAIN ROAD r:A~T HA~ION, NFI~I 'r'Of~K IIq~q RESTAURANT HELLENIC, f tESTAUt NT /Nb Ems~ Hmrlon, Town oF 5ouf, holct SufFolk County, New York Ooun~B TOX Hop ~l~l~t I000 N¥5120T C, cl5¢ No: 04-84F:' FRENC, H DtR. AIN DEC, TION N'rD C~ONC, RETE 51DEIqALK 5EC, TION NT5 GL Ff~AHE // ~t~TE LOGATION IqlTHIN FI~ENC. H ~RAIN DI~IALE NT5 GATGH BASIN 2' x 4' FLUSH ~f~ATE l///////////// A~PHAq_T PAVEMENT E~GTION NT~ DRAINAGE pipe OTOR~ Y~ATEt~ JLEAC...t-IIN~ POOL NT~ Young & Young 11901 EN~INEER'~ C. ERTIFI~,ATION O~NE~ JOHN ~IANNARI~ HELLENIC., DNAC, K BAP. DI4~ HAIN ROAD EAST 1ViAl. iON, NE~ ¥O~K, IIq~q tRESTAURANT HELLENIG REOTAU NT Al; Em¢~ ~mrlon, To~n oF 5out:hold SuFfolk C..ounf. w, New 'Cork N'r'SgOt ¢~(2~e No: O4-~4P ML,~D LOAM 10' ,11' 17' Q./EPTIC TA/IK 1200 GALLO~ u/./LAFb ~ , ~T ',-~';~"'~ ~ , ' ~ ' ¢¢~. ~ st ~R ~V 1228' LOT ~ ~ %. -. / ' / '. NYSDEC J : APPROVED AS PER TERMS ', J , AND CONDITIONS OF . .. /4~ I ', ,,' .~ ~ .~'~ .--~ ..' "-... / ~ ',--' ~ W~TE~ EdCOURfE~_D 04' 15ELOW.ZU~P~CE .~,~v.4 LOT ,% ' ~ n/a~. ~'m"' I ~ P[T~ ~m~ m~ %' :N ~G~V~[W~ ,r~.,"~ ~ /.c~ ~1~ I ~ , LOT " .... ~./ I ~x , / , , ~, / ~ _..,: .:_ ~ ~ ~ ~ ""~"" 'x / ' 'k ~0~ O~ PO~HE~ TOT*L LOT " , APR 2 7 20i0 / /=2 EX-3 WOOD DECK (~) EX~I/IG REAR PECK PLA/I · DEMOLITIO/I AIOTE : JT-CTIOPIf or THE E,~FF[/1G P[-CK~TRUCTURE~/HALL 15[ REPL~CEP DUE TO DETERIORATIO/I Or MATERIAL~ ~QIJAI2E POOTAGE~ EXG DECK u/JTAIRf = tO05 sq fi. I I I I ~ R~R PECK PLAA ' FOU/'iDATIO/I/~RUCTURE ~ ~OTE. REPLACE./'ECTIO/t.f Or THE EXI/TI/1G DECK,/'IRUCTURE DUE TO DETERIORATIO/t OF MATERIAL,/' IF REQUIRED ALL DECKJ'TRUCTURAL WOOD MEMIbEP,/' ARE TREATED. PROVIDE ALUHI/1UM CAP OVER TOP OF (2) 2' x 12" PEAl'J/ GRQ//,/'QUARE FOOTAGE: EXG DECK w/J"1-AIP,/' = 1065 ,sq. ft. REJIOVATED DECK w/,/'TAIRJ' = 1259 .sq. A-9 ~ ~ .¥.. by/he ~mer. T~e Contractor ~O~ comply ~ aU ra~ ~d regulatlom bear,rig on the co,duct of t~e ~ork and ~hal notify the Yr~ M~.TAL/' WOOD .4~ID PL~TIC ;edar ~lllq9~ ~AMIL)' ROOM _/1EW LOWER WOOD PECk, R~7~OVAT~D DECK LIV~GROOM RENOVATED WOOD DECK ~ BEDROOM PECK PLA/I ~_OTE f~fTALL 5/4" x 0" CEDAR DECN~G fO THE U~PE~qDE or PECK JOl~%Z. PROVIDE 1/4"fPACI~6 5ETWEE~ 50ARDf ~REAR PECK PLA~ OVATED DECK '.'/~TAIR/= 1259 .~q. fi, ~ RAILING E~D PO~T A-lO $× (~) PIED / DECK DETAIL A-11 (~) RAILI/IG DETAIL CO,dTRACTOR ,dOTE (~BBQ * LOWER PLA/I (~ EblbQ .,/"-FORAGE AREA PLA/i C O/tTI?~ C TO~/YOT~. MIDDLE PL,~u~i 00 0 0 ¸ll (~ F3F3Q · ELEVATIO/i C O/YTI?4C TOI7/YO T~. · J'ECTIO/'I (~ blS© · COU/'tTERTOP PLA/'t A-12 ]2' (~/IORTHWFF~Q- ELEVATIO/"I LJ LJ LI LJ (~/'OUTHEA~ ELEVATIO./I LJ L~ L (~J'OUTHWEj'T ELEVATIO/I _L I I L ~ L~J LJ L~J~ LJ }: } A-13 Om. x~ 0 ox -ir- R ~ 2~: R = ~ I [ u~ : ' ONLEADC~TENTBEFORE ~"~ SOLDER USED IN,~T R zx~~~ ~ ~ ~ ~l ~ ~ RETAI~ STORM WATER RUNOFF ALL CONSTRUCTION SHALL SUPPLY~YSTEMcANNOT "~ ~ ~'~"~ ~' I. LOOD ONE APPROVED AS NOTED [ FLOOD DAJMAGE PREVENTION SOUTHOLD T~N ~. NOTIFY BUILDING DEPARTMENT AT. FOLLOWING INSPECTIONS: "ROUGH'FRAMiNG&PLUMBING ~ ~' COMPLY WITH ALL CODES OF 3. INSULATION cERTIFICATION oF NEW YORK STATE & TOWN CODES 4. FINAL - CONSTRUCTION MUST s, AS REaUiRE9 AN~ CONDmONS OF. ,~ com,~, ~o~ c.c. CCUPANCY '~ ALL CONSTRUCTION SHALL MEET THE SO~HOLDTOWN ZBA REQUIREMENTS OFTHE CODESOFNEW SOUTH~DTOWNP~NING~AED YORK STATE, NOT RESPONSIBLE FOR ~ DESIGN OR CONSTRUCTION ERRORS' ITHOUT CERTIFICATE SOUTHOLD TOWN TRUSTEES OCCUPANCY C~AGE OUTPOOR /~OW~ C.-120/'£ fQUAI~. I~OOTAG~_ : tbrJ~ooH II II II II Ii II '0 E. IXJ/TI/"IG rlRj"T fLOOR, PL,,M'I ,' gE. MOL T O,Pl mOT~T ~,~ o_om mox~n~ TO r~ F- OPE/i TO LIVI,~G [200M BELOW -i i G E IXI/TI/'IG./ECO/IP ~LOOR PLA/I ] ( r j, I~Xl/TI/'IG i L_~J 0 E IXI/I-IAIG / PROPO./'E.P fOU/'tPATIO/'t PLA/'t~,,,..,._o. EXI/TI/tG 1%/0 CAR G/LRAGE L~_~J II DECK ~ [] AI-rll L~U/~p~v ~ ~o? ® B~OC)~ # 1 000 ~Xl/'rptG WOOD D~CK G PROPOJ%P rlPj'T ~LOOR PLA/I ~%~!1/'~''1'-0' CO : A I-I WOOD A-2 A i ,© iii I!1 '1 ,L__ L I 1 ~]TIC / MECH /PACE RE/~OVATD) bATHROOM EXl/TPIG ~Xl/TI/'IG CRAWL/PACE GUk./T t:SD2ROOMj'kCTIO/~ HALL LAU/~PRY HA/TILR 6ATMROOM ~ CRAWL Q MAi-I-ER FSATHROOMJ'ECTIO/'I 12' [107,108, I0~, 11( P,~MI~ Roo~ HA/-rc2 MA/TER ~DROOM ROOM ~XI/TI/'IG CRAWL/PAC~- I I LIVI/'I~].O OM G MAJTER DEPROOM/ECTIO/t / / Table ~.7 WPCM WOOD PRAME CO/~J~RUCTIO/~I M~IU~L 1995J15C - MI~H Wt/~D P_UITiO/~ (Prescriptive Alternative to Table 3.3) Table 33 Wall $11eatMfll~ Attachment Requirements for Wind Loads A-5 // ,. ,,~ ~ m~TmO~ ~ ~ ~ ~o~r. 10 UP TO ~ ~TE~,~.~ 11 ~ ~T[ TO POU~DATIO~ 12 0 TO b~ ~ P~ T~ICAL AT ALL ~E~ ~T~IOR CO~ : PURPO~ OP CETAI~ ARE TO 7[PICT TIE ~0~ ~Z~IM~O~ ~RO~TIE 0~. ~UMB~ OP PRAMi~G MEM~. CO~C~ACT~P~ALL P~E~ TO TNE ~% A~P~CTIO~ TO PE~PMI~E PPA~I~G MEMSEP%. I O/'IORTMEA/T ELEVATIO/'I A-7 Q/"IORTM WE../]' ELEV,ATIO/'I Q PECK RAILI/'IG PETAIL L G./'OUTHW~:-I- ELEVATIO/1 [] /10TJHOW/10/1 GJ'OUTHEAJ'T ELEVATIO.,fl [] /10TJtflOW/10/1ELEV~TIO/~ 0 PRO~T DOOR ELEVATIO/t A-8 10' 11' 17' PRO IO/9 CO/iTROL DETAIL 5 PRO IO/9 CO/iTROL DETAIL ~ ,~,,o, /~0~/012 ffORMERbv LUH[:~/MARYWEIJ~ REVOCAISLE T~U.,rl- LOT (~) LOCATIO/'t ~, ~ MOW OR PORMER~ " '", / (4' , f-1 To'fei 449,27 ,~q. ff. x 2'* m~l = O) Z-O" d~. x 4" co.cm~ co~r (1) 6'-0' clc~ x ~'-6" r~cj = (1) 8'-0' ~m. x 6" la~m top .,~71.08 m:I. ft. 95.18 cu. ft. ~ ALL,~OU,'~¢~I __ LUH~ MAR~ELD REVOCABLE LOT ~ 147.8 ~ fl. ~ '' ~ ~ .,,~ ~ ~ '" X %. , ~.. 10' 11' 17' HOlE 150RI~IG G,/'EI;q'IC TA/tK 1200 GALLO~ w/~l_AIb LOCATIO/t ./'-.5