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HomeMy WebLinkAbout36400-Z f Towu of Southold Auaex 9/17/2013 P.O. Box 1179 54375 Maio Road ~ Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 36501 Date: 9/16/2013 THIS CERTIFIES that the building ALTERATION Location of Property: 495 MAPLE LANE ORIENT,N.Y. 11957, SCTM 473889 Sec/Block/Lot: 17.-2-3.1 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this ofliced dated 5/18/20] 1 pursuant to which Building Permit No. 36400 dated 5/18/2011 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 to an existing accessory garage for temporary artists workshop (non-sleeping non cooking) with temporary full bathroom Upon sale/transfer of this property the building shall be returned to an accessory stora%_ ~araee including removal of the shower and all plumbing heating and cooling (except for half bath) shall be removed and the garage doors shall be restored as per ZBA #6298 dated 8/27/09 The certificate is issued to AMORY H. MILLARD (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL R10-08-0026 3/26/13 ELECTRICAL CERTIFICATE NO. 36400 12/2/11 PLUMBERS CERTIFICATION DATED 3/6/12 alter Marczewski A ed S~ atur yo~rsocxc TOWN OF SOUTHOLD °as~ BUILDING DEPARTMENT ~ ~ ~ TOWN CLERK'S OFFICE o • ~ SOUTHOLD,NY y~rQj ~ ,~a6?,. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit 36400 Date: 5/18/2011 Permission is hereby granted to: AMORY H. MILLARD 435 EAST 57TH STREET APT 4C NEW YORK, N.Y. 10022 - To: ALTERATIONS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR (WINDOWS AND DOORS)REPLACES EXPIRED BUILDING PERMIT # 34124 At premises located at: 495 MAPLE LANE ORIENT,N.Y. 11957 SCTM # 473889 Sec/Block/Lot # 17.-2-3.1 Pursuant to application dated 5/18/2011 and approved by the Building Inspector. To expire on 11/18/2012. Fees: PERMIT RENEWAL $144.80 Total: $144.80 ilding Inspector 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. 34124 Z Date AUGUST 28, 2008 Permission is hereby granted to: MANSON AND MILLARD 495 MAPLE LANE ORIENT,NY 11957 for ALTERATIONS TO AN EXISTING ACCESSORY GARAGE AS APPLIED FOR (WINDOWS AND DOORS) at premises located at 495 MAPLE LA ORIENT County Tax Map No. 473889 Section 017 Block 0002 Lot No. 003.001 pursuant to application dated JULY X24, 2008 and approved by the Building Inspector to expire on FE RifARY 28, 20i Fee $ 289.60 uthoriz Si ature ORIGINAL Rev. 5/8/02 / Form No. 6 J~ /L/~ " G I ~ Z TOWN OF SOUTHULD V~/ ~U BUILDING LIEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPakNCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate Location of all buildings, property lines, streets, and unusual natural ar .topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that rho solder used in system contaias less than 2/10 of 1% read. 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 Boazd Approval bf completed site plan requirements. B. For existing buildings (prior to April 9, 1957)- non-conforming uses, or buildings and "pre-existing" lead 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$uilding Inspector shall state the reasons therefor in writing to the applicant. G Fees I. Certificate ofOccupancy -New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00, .Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00: 2_ Certificate of Occupancy on Preexisting Building - $100.00 3. Capy of Czrtificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy -Residential $.15.00, Commercial $.1/5.0`0 `r Date. T /027 New Construction: rr Old or P/re~-ex~i~sti_ngpB~uilding: ~ ch k ne) . Location of Property: 'T~ ~ V V \ LIJd-~1~ ~~~.h-~ House No. Str~eenE J Hamlet Owner ar Owners of Property: 1 ? \ ~ l ~1~ U Suffolk County Tax Map No 1000, Section ~ ~ Block Lot _3 • ~ Subdivision Filed Map. Lot: pmt I.lq. Date of Permit. Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: ~ (check one) Fee Submitted: $ 5~ . ~/~G~/ T ApDII nt Sienature ~o~~pF SOUTyolo Town Hall Annex y Telephone (631) 765-1802 54375 Main Road ~ Fax (631) 765-9502 P.o. sox I n9 roper.richert(a~town.southold.nv.us Southold, NY 11971-0959 ~ o~y~0UNT1 ?cam BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Amory Millard Address: 495 Maple Lane City: Orient St: NY Zip: 11957 Building Permit#: 36400 Section: 17 Block: 2 Lot: 3.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE contractor: DBA: Big Blue Electric License No: 35348-me SITE DETAILS Office Use Only Residential X Indoor X Basement Service Only Commerical Outdoor X 1st Floor X Pool New Renovation X 2nd Floor X Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt 24 Ceiling Fixtures 12 HID Fixures Service 3 ph Hot Water GFCI Recpt 3 Wall Fixtures 5 Smoke Detectors Main Panel A/C Condenser 1 Single Recpt Recessed Fixtures 7 CO Detectors Sub Panel A/C Blower 1 Range Recpt Fluorescent Fixure Pumps Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks Disconnect Switches 15 Tvnst Lock Exit Fixtures TVSS Other Equipment 2-COn1d0 SfT101(e~CO deteCtOrS Notes: Inspector Signature: ~•-e Date: Dec 2 2011 81-Cert Electrical Compliance Farm ~yilFFO(,~ "C~~w~n Hail, 5 tii95 ~4ain Ro~+d ~ ~ F'ax (E3]) 765-9502 P.O. Boa 1179 ~ Telephone 1631)'765-1502 ]nutiiold. :vea~'v'r+rk 71971-0959 RUIL.DING DEPARTMENT TOWN OF 8OUTIiOLi) CER'TIFICATIUN Date: E~..~._zU/Z Building Yetra,t tio. _ ~ 6 ~UU ownet: ~/n~~~% - r~'Ji~%/~v X95"h'I/~j~le L~si/~ (p1'lease primp) Y?umber: _L(~~"L~C~:._~~K-C"Z>%~_e9S~«_ (Please. print) t certify that the solder used in the water supply systettt e<mtains less than 7/10 of 1 lead. I~ Plum ers Signature) Su~ol~; to hetore me this day at _~AilGt1_-> 2~_~~_ CONNIE D. BUNCH Notary Public, State of New York ~nv~ No.OtBU6185050 ~P- _ QueNfied in Suffolk County C '~~f Commission Expires April 14, 2 ~~a '.votary puhlic.JU ~ i_!!__S.--County: labs www.h2mlabc.cnm LABORATORYRESULT$ s>6 eroae Haloes woea , n+eimne, Nv Resuks for the samples antl analytes requestetl Samola Information TEL: (631) 6943000 FA%: (631) 420.8938 NVSDOH IDk104T8 Type :Potable Water HARRY GOLDMAN WATER TESTING Origin :Distribution 8700 MAIN ROAD Lab No.: 1208085-001q Routine MATTITUCK, NV 11952 Client Sampla ID.: AMORY MILLARD Attn To 495 MAPLE LANE,ORIENT SOURCE(SLOP Federal ID SINK) CONY GARAGE FLOW- Colleded : 7/3i/2012 12:02:00 PM Point No : 9GPM/WR30MIN. (1 FAUC AND 1 HOSE BIB) Received :S/1 /20123:00:00 PM Location: (f 000-17'2-3.1/R10-0&0026) Collected By : AF99 Paramwierfsl Resuhs Onwlifiwr D.F. Ilnhs I imit Mwihnrl Numhwr Analv>wA E Coli Absent 1 N/A Absent Readycult 08/01/20124:15 PM Total Coliform Negative 1 N/A Negative Readycult 08/01/20124:15 PM Free Chlorine Residual (field) < 0.1 + 1 mg/L M4500-CI G 07/31/2012 Result(s) reported meet(s) NVS Regulatory Limg(s). Result(s) gagged with ,a Exceetl NVS Regulatory Limtt(s). Limn noted. Oualigers: E =Value above quantitation range t1 - B =Found in Blank ,~VI'^~f1~- D.F. =Dilution Factor D =Results for Dilution H =Received/analyzed outside of analytical holding time pA Manager + = ELAP / NELAC does not offer cert'rfication for this analyte c =Calibration acceptability criteria exceedetl for this analyle r =Reporting limit below calibration range J =Estimated value -below calibration range s =Recovery exceedetl control limits for this analyse N =Indicates presumptive evidence of compound Date Reoorted : 8/6/2012 Pa[;e 1 of 2 H2M LABS /NC labs 575 Broad Hallow Road Memdle, NY17747 Sample Receipt Checklist TEL: (631) 694-3040 FAX: (63]) 420.Y436 Websile.' ~^+~w_A2mLhe.cnm Client Name HGQ Date and Time Received: 8/1/2012 3:00:00 PM Work Order Number: 7208Ug5 RcplNO: 1 Received by: Lloyd Olsen Completed by: Reviewed by: Completed Date: 8/1/2012 Reviewed Date: 8/4/2012 2:45:32 PM Carrier name: H2M Pickup Chain of custody present? Ves No ? Chain of custody signed when relinquished and received? Yes? No ? Chain of custody agrees with sample labels? Yes ?d No ? Are matrices correctly identified on Chain of custody? Ves ~ No ? Is it clear what analyses were requested? Yes No ? Custody seals intact on sample bottles? Yes ? No ? Not Present Samples in proper container/bottle? Yes © No ? Were correct preservatives used and noted? Yes No ? Preservative added to bottles: Sample Condition? Intact ~ Broken ? Leaking ? Sufficient Sample volume for indicated test? Yes © No ? Were container labels complete (ID, Pres, Date)? Yes No ? All samples received within holding time? Yes ?~I No ? Was an attempt made to cool the samples? Ves No ? All samples received at a temp. of > 0° C to 6.0° C? Yes? No ? Response when temperature is outside of range: Sample Temp. taken and recorded upon receipt? Yes No ? To 4.1 ° Water -Were bubbles absent in VOC vials? Yes ? No ? No Vials Water -Was there Chlorine Present? Yes ? No © NA ? Water - pH acceptable upon receipt? Yes ? No ? No Water Are Samples considered acceptable? Yes No ? Custody Seals present? Yes ? No Airbill or Sticker? Air Bill ? Sticker ? Not Present Airbill No: Case Number: SDG: SAS: Any No response should be detailed in the comments section below, it applicable. Client Contacted? ? Yes No Person Contacted: Contact Mode: ? Phone: ? Fax: ? Email: ? In Person: Client Instructions: Date Contactetl: Contacted By: Regarding: Comments: CorrectiveACtion: Page 2 of 2 FORM NO. 3 NOTICE OF DISAPPROVAL DATE: August 4, 2008 TO: Ronnie Hill (Mason) PO Box 551 East Marion, NY 11939 Please take notice that your application dated July 24, 2008 For permit to construct additions and alterations to an existing accessory ¢azage converting it from a garage to an art studio at Location of property: 495 Maple Lane, Orient, NY County Tax Map No. 1000 -Section 17 Block 2 Lot 3_1 Is returned herewith and disapproved on the following grounds: The proposed additions and alterations to this existing accessorygarage on a conforming 2 acre azce] in the Residential R-40 District is not permitted pursuant to Article XXIII Section 280-122 which states: "Nothing in this article shall be deemed to prevent the remodeling reconstruction or enlargement of anon-conforming building containing a conforming use provided that such action does not create any new non-wnformance or increase the degree ofnon-conformance with regazd to the regulationspertaining to such buildings " The existine accessory garage is located in the front yard Pursuant to the ZBA's interpretation in Walz (#5309), such additions and alterations will thus constitute an increase in the decree of non- conformance. The existing accessory garage was issued a vaziance (54621 on February 12 2004 to allow the accessory building in the front yard. However the applicant is proposing a change in use as well as new additions and alterations to the building. This Notice of Disanoroval was written based on plans si¢ned by Brian Billines RA dated 6/16/8. Authorized Signature Note to Applicant: Any change or deviation to the above referenced application, may require fw•ther review by the Southold Town Building Department. CC: file, Z.B.A. Office Location: ~o~~OF SOUjy~lo Mailing Address: Town Annex /First Floor, Capital One Bank ~ ~ 53095 Main Road 54375 Main Road (at Youngs Avenue) ~ ~ P.O. Box 1179 Southold, NY 11971 ~ • ~O Southold, NY 11971-0959 °~~.co~ ~ http:!(southoldtown.northfork.net _ BOARD OF APFEALS D ~ ~ ~ U TOWN OF SOUTHOLD ~ I Tel. (631) 765-1809 Fax (631) 763-9064 , AUG 2 $ ~ ~ DELIBERATIONS, FINDINGS, AND DECISION B1D~pEp1 MEETING HELD AUGUST 27, 2009 iowN of soutNO~e ZBA FILE # 6298 - DIANE MANSON and AMORY MILLARD PROPERTY LOCATION: 495 Maple Lane, Orient CTM 17-2-3.1 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 SEORA. 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 April 21, 2009 stating that this application is considered a matter for local determination as there appears to be no significant county-wide orinter-community impact. PROPERTY FACTS/DESCRIPTION: The subject property is a conforming 2 acre parcel (89,140 Sq. Ft.) in the Residential R-00 District with frontage along three rights-of-way: (a) 380.35 feet along the southerly property line and 25 ft. wide right-of-way, (b) 283.51 feet along the easterly lot line and 25 ft. wide right-of-way; (c) 448.79 lin.ft. along the northerly property line and 25 ft. wide right-of-way. The parcel is improved with a two story frame house with deck, accessory swimm~g pool, and ?wo accessory garages as shown on the plat maps dated 10-31-08 prepared by Billings Turoff Architects: BASIS OF APPLICATION: Requests for Variances under Sections 280-13C and 280-122, based on an application for a building permit to construct additions and alterations to an existing accessory building (currently a garage) and proposing to convert the existing garage, with or without the proposed additions, to an art studio or habitable space which is not a permitted. use in accessory buildings. The Building Inspector's January 26, 2009 amended Notice of Disapproval reasons for disapproving the application are: (1) the existing accessory garage is located in a front yard as per Variance #5462 issued 2/12Y2004; under ZBA Zoning Code Interpretation # 5039 (Walz), the proposed additions and alterations will constitute an increase in the degree of nonconformance, and (2) the proposed layout of the building appears to create habitable space, which is not permitted in accessory buildings. Page 2 - Augus[ 27, 2009 ZBA File # 6298 -Diane Manson and Amory Millard Property Location: 495 MapleLane, Orient; CTM 17-2J.1 FINDINGS OF FACT LWRP: This application. is not subject to review under Chapter 268 because the variance relief requested does not involve features that relate to a regulated natural feature or a bulkhead or other shoreline. RELIEF REQUESTED: The applicant proposes to convert an existing unheated accessory garage into an artist's studio with a full bathroom and slop sink, and removable HVAC system (no ductwork to be installed in the walls). ADDITIONAL INFORMATION: The existing garage was granted a variance by the ZBA for a nonconforming location in a front yard in 1994 (#5462). In 2007 the property was sold to the applicant who obtained a Building Permit (#34124) in 2006 to remove and replace the existing windows and doors (changing garage type doors to French double doors)., At the Public Hearing on July 30, 2009, the applicant Diane Manson testified that she is employed as an artist who works in animation and children's television programming. She stated that the proposed change in use of the existing storage garage to an artist's studio was because she is frequently in residence in Orient year-round and needs to work from her home location at those times. She also said that she has a documented medical condition that requires frequent use of a toilet and shower. Moreover, she has no objection to the removal of the bathroom and proposed HVAC system should she transfer ownership of the subject property. Further that she has no intention of establishing sleeping space or cooking facilities in the proposed studio. REASONS FOR BOARD ACTION: On the basis of testimony presented, materials submitted and personal inspections, the Board makes the following findings: 1. Town Law 5267-b(3)(b)(3)(1). Grant of the relief will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The subject property is a conforming 2 acre parcel with three front yards and a swimming pool in the rear yard. The accessory structure has been in its current front yard location since 1994. No changes in size or location are being proposed. The replacement of doors and windows on the exterior elevations will improve the appearance. The proposed use as an artist's studio is solely for the applicant's professional use which. is a quite occupation that requires no equipment that would create noise or disturbance to the neighborhood. 2. Town Law §267-b(3)I(b)(2). The benefit sought by the applicant cannot be achieved by some method, feasible for the applicant to pursue; other than an area variance. With regard to the front yard location, the alterations to the windows and doors cannot be achieved without a variance because pursuant to ZBA's Walz Interpretation (File # 5039) these alterations 4vill increase the degree of non-conformance. With regard to the proposed habitable space, the code permits a half bath in an accessory structure but does not permit a full bath, which the applicant needs to accommodate her medical condition. 3. Town Law 5267-b(3)(b)(3). The variance granted herein is not substantial in terms of the front yard location since the structure already has a variance for this non-conforming location. With regard to the proposed change in use from an accessory storage garage to an artist's workshop (as applied for), the variance granted herein is substantial but will be mitigated by the imposition of conditions that will limit its use solely to the applicant/owner. 4. Town Law 5267-b(3)(b)(51. The difficulty has not been self-created, but it the result of the location of the existing garage in a front yard grid the applicant's medical condition. 5. Town Law 5267-b(3)(b)(4). No evidence has been submitted to suggest that a variance in this residential community will have art adverse impact on the physical or environmental conditions in the neighborhood. The Page.3 -August 27, 2009 ZBA File # 6298 -Diane Manson and Anwry Millard Property Location: 495 Maple Lane, Orient; CTM 17-2-3.1 existing accessory garage was designed to avoid sight line concerns by neighbors, is fitted with gutters and leaders, and will cause no drainage problems. 6. Town Law 6267-b. Grant of the requested relief is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an accessory artist's studio with full bath and slop sink while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. The Board finds, upon applying the balancing test, that the benefit to the applicant in granting the requested relief for a change in use of the existing accessory garage to an accessory artist painting workshop with temporary full bathroom, outweighs any detriment to 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 Member Weisman, seconded by Member Simon, and duly carried, to GRANT the variance, as applied for and shown on the architectural drawings by Billings Turoff Architects labeled drawing numbers T.Ot,'~.O1 and G.O2, dated 10-31-Ot3, subject to the following CONDITIONS: r. 1. The applicant-owner shall prepare and submit Covenants and Restrictions for review and approval by the Board of Appeals, and the appl(cant shall file same with the Clerk of Suffolk County (with a conformgd copy of the filing submitted to the Town), before a Certificate of Occupancy shall be issued which shall stipulate that: , a. The temporary use of the accessory structure as the artist's workshop with temporary full bathroom shall expire with the Sale/transfer of the property by the applicanUartist Diane Manson to any other person, and all plumbing, heating and cooling shall be removed (EXCEPT FOR AHALF-BATH AS PER CODE MAY REMAIN). b. The temporary artist workshop shall be returned to an accessory storagelgarage structure, including removal of the shower or bath (allowing only as per code ahalf-bathroom (sink and toilet) in anon-habitable accessory buildtng and the restoration of garage doors. 2. Sleeping or cookingln this accessory building is strictly prohibited. 3. Upon transfer of the, property, the Building Department shall void the Certificate of Occupancy for the existing accessory building. Tfe applicant-owner or subsequent owners shall obtain a new Certificate of Occupancy after complying with -the abd}ie conditions and converting the building to acode-permitted accessory garagelstorage building. ` 4. There shall be no on `Site sales or displays for customers. 5. The owner shall consent to the inspection of the premises by the Board of Appeals a minimum of one inspection for every five-year period and immediately prior to transfer of the property. 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 Page•4 -August 27, 2009 ZBA File # 6298 -Diane Manson and Amory Millard Property Location: 495 Maple Cane, Odenk CTM 17-2-3.1 subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. The Board reserves the-right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconfonnity. Vote of the Board: Ayes: Members GoehnJr gef(Chairman), Simon, We' , and S er. his Resolution was duly adopted (4-0). - GERARD P. GOEHRINGER, HAIRMAN 7 /2009 I~,' Approved for Filing ~ 1 ~ ~O~~,OF SOUTyo~ ~`"~nu~n,'~~ TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FQ~NDATION 2ND [ ]INSULATION [ /FRAMING /STRAPPING [ j FINAL [ ]FIREPLACE 8~ CNIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONS'IRUCi10N [ ] FI_RE/~RESISTANT PENETRATION REMARKS: ~ ~ g``-` DATE ~ INSPECTOR I I ~o~,~oe souryo6 `t~© TOWN OF SOUTHOLD BUILDING DEPT. i% ~ ass., soz 1 1 NSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ]FlRE SAFETY INSPECTION [ ]FlRE RESISTANT CONS7RllCTION [ ]FlRE RESISTANT PENETRATION ELECTRICAL (ROUGH) [ ]ELECTRICAL (FlNAL) REMARKS: 1~.~~u-e-~-- C~'c~-~. DATE f ! INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMING I STRAPPING [ ]FINAL [ j FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ ]ELECTRICAL TROUGH) [ ]ELECTRICAL (FINAL) REMARKS: ~ 1~-~~~ - DATE INSPECTOR ~L o~,~OF 80~r~ (Q TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] RO LBG. [ ]FOUNDATION 2ND [ NSULATION [ ]FRAMING /STRAPPING [ ]FINAL [ ]FIREPLACE 8~ CHIMNEY [ ] Fi INSPECTION [ ] RRE RESISTANT CONSTRUCTION [ FIRE RESISTANT PENETRATION [ ]ELECTRICAL (ROUGH) [ ]ELECTRICAL (FINAL) REMARKS: SMJC~~~ DATE INSPECTOR , _T_ _ . _ C~+~ ~l~* }®1~ ~ TOWN OF SOUTNOLD BUILDING DEPT. 765-1802 INSPECTION ,3~` [ ]FOUNDATION i ST [ ]ROUGH PLBG. l? ~ [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMING I STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FlRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PEIIETRATION [ ]ELECTRICAL TROUGH)ELECTRICAL (FINAL) REMARKS: ~ DATE ~ INSPECTOR ~(U~ ~ o'~+~FaWil~ +F®'i TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [ ]FOUNDATION 2ND [ ] INSU TION [ ]FRAMING /STRAPPING [ INAL [ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION [ l FlRE RESISTANT CONS1RIlCTION [ ] FIRE RESISTANT PENETRATION [ ]ELECTRICAL (/R~OUGN) [ ]ELECTRICAL (FINAL) REMARKS: (~n~_~---~-~cA~ C:F'.~- ~-~D~ DATE l~ INSPECTOR _ _ _ _ _ ~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH P G. [ ]FOUNDATION 2ND [ ] IN ATION [ ]FRAMING /STRAPPING [ INAL [ ] FIREPLACE A CHIMNEY [ ]FIRE SAFETY INSPECTION [ ] FNiE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION [ l ELECTRICAL (ROUGH) [ l ELEC7RN:AL (FINAL) REMARKS: L DATE ~ ~ ~ INSPECTOR CONAVIENTS F1ELD INS EL'TION REPORT DATE ~ ~ I ~ a FOUNDATION (1ST) q C m \ ~ FOUNDATION (2ND) ~O vi y~~ - ROUG$ FRAMIIvG & PLUIvISING . ~ a x' N~ y IN~ITLATION PER N. Y. - _ _ STATE EINERGY CORE ~ 1~ ~ FIlVAL oZ ! / ADDITIONAL CONIl`~N'TS ~ 1 m b _ ee~ s .Z m G(7. ~J ~ ~ z t C- b ~ 1,~ !J ~W ~ f K z . J 7r~ x 7~' t=7 0 x O o Gc ~ ~~j b L_' 4- w -y ' TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN IIALL Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board appal FAX: (631) 765-9502 , / Survey www.northfork.neUSouthold/ FERMITNO. ~ 7 ~o~yi? Check Septic Form N.Y.S.D.E.C. Examined {t 20~ - Contact:Trustees Approved--- , 20 ..~UL 2 ~4 Mail to: Disapproved a/c 1 l/~jyi / Phone: 177- Expiration , 20_ ild' g pe APPLICATION FOR BUILDING PERMIT Date Julv 16 , 20 08 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 azeas, 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 Pemut to the applicant. Such a pemrit 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 pernvt 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 Sc uthold, 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 Golf View Court. PO Box 551. East Marion. NY 11939 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Agent for Owner Name of owner of premises Amorv Millard and Diane Manson (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: 495 Maple Lane, Orient NY 11957 House Number Street Hamlet County Tax Map No. 1000 Section 17 Block 02 Lot 3.1 Subdivision Filed Map No.~Lot (Name) ' 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Accessory Garage b. Intended use and occupancyAccessorv Structure (painting studio) 3. Nature of work (check which applicable): New Building Addition Alteration ? Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 34.7 Reaz 34.7 Depth 36.3 Height 24 Number of Stories One & one half story Dimensions of same structure with alterations or additions: Front 34.7 Rear 3a.~ Depth 36.3 Height 24 Number of Stories One & one half story 8. Dimensions of entire new construction: Front Reaz Depth Height Number of Stories 9. Size of lot: Front Aonrox 380.35 Rear Approx 334.08 Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated R-80 Residential Low Density 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ 13. Will lot be re-graded? YES NO ? Will excess fill be removed from premises? YES NO ? 14. Names of Owner of premises A.Millard & D Manson Address 495 Maple Ln Orient Phone No. Name of Architect @illlinos Turoff Address 1 FO W 5 t NY NY Phone No 212-924-9087 Name of Contractor Address Phone No. I S 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 MAYBE REQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES_ _ NO ? * IF YES, D.E.C. PERMTI'S MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) S S: COiTNT'Y OF Suffolk ) Ronnie Hill for rlh Land Planning Services, Inc. being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S H~isthe Agent (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 aze true to the best of his knowledge and belief; and that the work will be performed in the manner se[ forth in the application filed therewith. Swom to before me this ~i t-(_ day of fit=, lam- 204~L _ ~ ~ ( Notary Public Signat of Applic. ~yNp, OruENi~A~Mtw 1bk f~~ ~M lrwry~ ~Q~~Of SOUI'yo~ Town Halt Annex ~ # Telephone f63U 799&5pp-L22802 54375 Main Road ~ roger.richert~~o`wri.southold.nv.us r.o. Box 117s • ~p~ Southold, lVY 11971-0959 _vVnl~~ BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: j~jiq {3~te,~ ~/~~}-Q~`t GLG Date: ~ ~ _ Company Name: ~ E £ ~ LLG Name: ; tf~s3~ License No.: 3,j 3 NJ~ Address: sp ~ N. ? )l4fZ Phone No.: - ) - y3~, JOBSITE INFORMATION: ("Indicates required information) *Address: 1~9~ ~p~~ L,~nJ~ *Cross Street: Mina *Phone No.: _ /„31 ~3~.3'SoSZ Permit No-: 36ybc"~ Tax Map District: 1000 Section: Block: Lot: 3,_.) *BRIEF DESCRIPTION OF WORK (Please Print Clearly) A.~.l/~,g~,y¢~d,~ (Please Circle All That Apply) *Is job ready for inspection: ES NO Rough In ~ Final *Do you need a Temp Certificate: YES / NO Temp Information (If needed) ~ *Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other *New Service: Re-connect Underground Number of Meters Change of Service Overhead ~ Additional Information: PAYMENT DUE WITH APPLICATION q`u ~ ~ ~ 82-Request for Inspection Form dll_ I --~--e r' • 600 - "~'~2~ 3 ~ 'SOW N OF SOUTHOLD OPERTY ~tEC®RD ~CI~R~ , ` • OWNER STREET VILLAGE DISTRICT SUB. LOT _ FORMER OWN N E ACREAGE " .{•I ~ ~ ~ 7 ~ r~l:~s~l - -t - - i S W TYPE OF BUILDING ~ 0. v1 f ~ Y'v ~~e~/~ SEAS. VL. FARM COMM. IND. CB. ~ MISC. LAND - IMP. TOTAL DATE REMARKS .e r ~ a J ~ a o 0 0 S -CO S+a" P , f O ~ !k ~ IQ } .rlrJ ( f' G' O fU C9 f l f?~::-~.)L~1 ~{-o~Y.: ~.`Fr.:tr'{.~f(-~(- :=.c~ Uc~F= -`F~~ ~ I~"J~c~. ~J l.J ? ...~I"~ri ~ lzhr'~~' lu i ~,~=c' ~ ~k1Y2s i r- a-~L ~ '"3~~ ~ ~ ~ ~ ~ 85 ~E~~B~2- co~s-~ r~dQ!~:©~y~ a-/4f~y,~~i<~w ~~ae~ Z AGE . ~ a ~ I~DING CO ~I 10 2.__ ~ 8 ~P~ 30328 (~CCPSSO ~ ~(1~S W 7 ~w. ~d tao~J p~ O ~MAL 1/ ©TjBE Ze ~ ABOVE I L iz~ Z S VPS ~Sf /0 MII~Q C~VIO~/ S,/ ~Y-arm. --t~rTO-- P r cue m ~ `C { eS Tillable 1 O O Tilable 2 liJ 2QJ~ l~ S'~pO _I~ 2m~ R~ce~~rn~ cna~ 6~ek- \ OT'7p~ 1 Tillable 3 Woodland Swampland Brushland s ~ Ho~~se Plot Tato I S' ~ / i r..~ A kf 1 4/37 I 3 (e r M. BI S ~ 68Z s 2~I 3.58/ Foundation I ~ Bath ~ r tension ~.S Basement i qp :~i ~ Floors r l~ xt n~ion ~ ~ 98J ~5 2 2 ~ 3 Ext. Walls ~ i ~ Interior Finish ~ ~ GJ/ Extension Fire Ploce Yu'u<~, Heat l~ c_ - - ~2 (2K33 3Qcp ~ ~ y Porch . ~ Attic 3'l,rr;T Porch Rooms 1st Floor Patio Rooms 2nd Floor Garage ~ ~ ~ f/? ~ Driveway O. B. - _ ' ~ _ 40 9 ~a ~ ~ .:.mow- ~ e ~ A..~- ~'":--ta~a~' r. ~ rtOWN OF SOU ROPERTY RECORD CAkD z_ - /y ER STREET' VILLAGE DIST. SUB. LOT t`~ GS q.- K;1=- y DES C FORMER OWNER E C,,,~, P`C~/S/ ' ~j(, TYPE OF BUILDING r"1 ~ I I~ RES. SEAS. VL. 3 FARM COl~h1. CB. l~AICS. Mkt. Value LAND IMP. ,TOTAL DATE REMARKS ~ S o--~ 6 G ~v~ ~~7oc~' S ~~.~I i %~.t<'~JF..~~,~il- L~ ~~2' ~ t~--~~? L ~7- ~-z ` AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Volue Acre Tilioble FRONTAGE ON WATER Woodland FRONTAGE ON ROAD ~ ° ~ / Meadowland DEPTH House Plot BULKHEAD Total DOCK _ TRIM 3 w ?4 10 C _ Exteruian C~,,,rSz~ O 8 Extension ~ 4> Extensan 2N X21 ~ 57fQ 2Z~ 12 ~2oar11 Foundation Bath Dinette YU Porch l0 i5o C,~Z2 Basement Floors K. Porch 12 k2~~ ~ 2arP, 2 Ext. Walls Interior Finish LR. Breezeway Fire Place Heat DR. Garage o Type Roof Rooms lst Floor ER. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total 0 r a x 0 0 rn m .n m N n ` a~ wf,~,- :~f ..f` ~ _ , i . „ :y'. - ' 2 4_ - - - ~a " " Foundation Bath M. Blc~ ~ ~i gi`-~, ~ - Extension ~ , ~ ~ 3 ~ y ~ Basement ~ Floors i ~ y ~ ~ ~_Z t ~ ` ~ t L - - - - - ,Extension , ~ ~ ~ i Ext. Walls I i! ~ Interior Finish - - Extancinn - I ! I ~ ~ ~ ~ - 1?-~3.~ TO :TOWN OF SOUTHOLD FROM : DIANA MANSON RE :BUILDING PERMIT #34124 FOR 495 MAPLE LANE, ORIENT Tuesday 26~h January, 2010 Dear Sirs This is to request asix-month extension on Building Permit # 34124. We appreciate your consideration in this matter and look forward to your response. Yours sincerely, • ~ anson D ~ D JAN 282010 ; BLDG.DEP~. tOWN OF SOUiHOtD hO~~pF SOUTyOIo Town Hall Annex yy Telephone (631) 765-7802 54375 Main Road ~ T Fax (631) 765-9502 P.O. Box 1179 Southold, NY 11971-0959 ~ ~ o~yCOU~,~~ BUILDING DEPARTMENT TOWN OF SOUTHC~OLD ~ t February 3, 2U92 e~~~ ~ Amory H. Millard ast 57t~ St A t 4C 435E p New York, NY 10022 495 Maple,J~ie, Orient TO WHOM IT MAY CONCERN: The Foll wing Item(s) Are Needed To Complete Your Certificate of Occupancy: application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificlate. ~ ~ 1 Z/ A fee of $50.00. ~ ~ ` 2 Final Health Department Approval. PlUmberS SOlder Certificate. (All permits involving plumbing after 4/1/84) Trustees Certificate of Compliance. (Town Trustees u~ss-1ss2) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. -Bob Fisher Final Landmark Preservation approval. BUILDING PERMIT: 36400 -Additions to existing Accessory Garage y, size or wt: rront .....1n!?. Kear , ...,~„~.`t-... Deptn l.`?.,7..... . 10. Date of Purchase ~.Q °./~r~a,,; , , , , , , , , , ,Name of Forme Owner SI'C~2~1/, , ~~~~i4T.E, , , , , , , 11. Zone or use district in which p~emises are situated .....A . 1.~. Does proposed construction violate any zoning law, ordinance or regula 'on:....14~!> . . 13. Will lqt be regraded ~ Will e ce s fill a ~e,~noved from presr,ises: Yes (~Io~ 14. Name of Owner of premises .~Wltlt.ls!:. t2~~V~,S.. Address~nyA ~Sr .~r .463.;x.. Phone No.~ ~ .`f.`E•`ID.lr~l Name of Architect ......../`fQ!J,E ..............Address , ...Phone No............... . Name of Contractor . ................Address ...........Phone No............... . PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or propos d, and, indicate aU set-back dimensions from property lines. Give street and block number or description according to dee ,and show street names and indicate whether interior oi• corner lot. f'~U. 6uit.Dri,1GS sHown( Cu~zrtENn`I i:~C]ST .NT i~.qg MAC E l.~-NC, oezic-rv7 . SKA bEp ~41t~ A S liou~ D b`t~ t pE b~ UC . IX-XXK LINE SHf1U1S ~12>:!_OCATIOQJ 6h ~6NCF i=pl'~ Pp0 i i i i i' - - ~ i - - ~ ~ \_--l ~ ~ ~ ~ r 1 j i ~ /J 1 ° ` ~xx~...ry"""~~~~-/-.:- lark t yo-. ''Y ~ Vk' FeY~ 4S s a6~ t fC~ STATE OF NEW YORK, ; S S COUNTY OF ..S.u~F?l-K-...... ~ , S b . R,~.V . . . . being duly s orn. deposes and says that he is the auolicant N ~unvat uc rnurrml . AT ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 100p-17-Q2-31 SCALE 1 X40' AUGUST 22, 2003 )i 1 I ~ ANDRA GEORGE H, ROW50M N /D/F LDNG BEACH CDMMQNERS ' ~~I / OLO CEMETERY ~ I ~ ~ ~ B j 25 RICH7 OF N8935'S0"E _ _ _ _ _ B-7G'- _ _ - - _ ~ , _ i WAY / JrT~~45 ~__N run - - - - 25' R.O"W.'~"~,~ J~`. , ~ p6 _ - ~ ~ ea ~ ~ i y ~C e ~-_~I~T i ~ ~ P ~ ~ r ~ I ~e m biz ? o-w 2J~ R ! 3Vc ' ~ , ~ ~ ~v// Wh ~ ~ ~~T~ P C3i I ~ 32 W ~ ~ 2 rte . I ~i f / ~ i ~ ~ ~ a ~ I - ~f q' ~ .r m.a j ~ ~ ~ ~z~ , ~ ~f f _ % r _ ~ ~ ip w _ n u ~ ~ i _J~_-__` roawr a. ao< , N~59'i0 ~ "~~25'R.O.W. ~ a W - H/D/F BARBARA ,qµ~R tr _ emu, JAY KENNEDY _ N/D/f HAR(kp L. # KA7H(EF/y l ~I RA(tn~, I 1 _ ~q~~/~ I a~' BUILDING~jPERMIT EXA.I\4IN(E~R CHECKLIST *Date Submitted: 7 /a" l/~7 *Date Revi7e~wed:_gl_/96f~~ Applicant: ~~111'1 l Q ~ ~ -1'OlZ r~ h I~~Ctnnr:~pwner: ~moru l-~ ~ ~ Q~~ ~IQ/)a ~Cl /ISOYO Architect/Engineer: t, ~ ~ _ ~ Estimated Cost: SCTAI# 1000- 1 ~ - o~ - ~ • ~ Subdivision: 7,one: Conforming? ~-Q Property Address: ~ 4Q ~ City: ~{r I t?-i~~ Pre COs?~~` Buildin Permits (O en/Expired): BP~,7'{ -Z / C/0 Z-/ 35(oy, Info: 5~ BP(o57a--Z 1 C/0 Z-~~ Info: rS BP ~ ~~Z / C/0 Z-, Info:-- BP /~'SYI -Z l C(0 Z-i 1Y3, Info~.llpw~teu~b-BP,~o l C10 Z- U83 ,Info: Ct,c~ Single & Separate Search Required? Y or® Determination: ~{u s ~nR w c ~n ~ m,' ~g REQ. Lot Size: ~ i~ o ° ACT, Lot Size: ® RE 7Q. Lot Cov. ~CT. Lot Cov. REQ. Front ACT. Front REQ Side CT. Side REQ. Rear PROP. Rear REQ. Height ACT. Height - / - ~ cwt r~ Pro'ectDescriptiou: ~ l D+ ~ ~ ~ ~ "L S i n Waterfront? Y or® [f yes, water body: Panel# ~ Flood Zoue: Bulkhead/Bluff Distance: ADDITIONAL APPROVALS REQUIRED Suffolk County Ilealth: Y o~ If yes, *Bed#: *Dale: /Permit#: Town Septic: Y or l - If no, certification required: Y or N Received: Y or N By: NYS DEC: rRE-nrcvv~e Y~oi~ Date: Permit M: _ or NJ Letter- Notes: Southold Trustees: Y or(N~ Date: Permit , or NJ Letter-Notes: _ Southold Z[3A: Y or N -Date: ~!l, Permit , -Notes: Southold Planning: Y or I~] Date: _I_/, Permit -Notes: Town Landmark C of A: Y or~TE: / *NYS CODE Compliance (page 2): Y or N Notes: Fee Structure: Calculation: Foundation: SF I, ~ SF)- ~_SF)= SF X $ _ First Floor: _ _ _ _Sl~ ~ Liitial Fee: _ ~ Additional Fee Second Flour: SF O~ Other: SF 2. ( SF)- SF)= SF X $ Total: SF + Initial Fee: $ + Additional Fee $ TOTAL:$ NE~i~ YORK STATE CODE COMPLIANCE CHECI~LI5T CLIIvIATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Wind Speed:. 120MPH Seismic Design Category: B _ Weathering: Severe Frost Depth: 36" Termite: M-H Decay: S-M • Design Temp: I1 Ice Shield Underlay: YE5 ~ Flood Hazards: USE/OCCUPANCY CLASSIFICATION: • HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA.: ENGINEERED/PRESCRIPTNE FULL FRAIvIING DESIGN ELEMENTS: Y/N READERS: Y/N WALL STUDS: Y/N GLRDERS> Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RATTERS: Y/N LUMBER SPECIES AND GRADE: Y/N DESIGN LOAD CALCULATIONS: Y/N .LIVE: Y/N DS.AD: Y/N SNOW: Y/N SEISMIC: Y/N WIND: 1'/1~ WINDOW AM) DOC)R SCHEDULE: ~A4ISSLI+;'CL,ST REQUIREMENTS: Y/[V LGRI?SS 5.7 S.E.: Y/N ~ LIGHT 8%: Y/N krliNT 4 io: Y/N NAILING/CONSTRUCTION SCHEDiTLl;: Y/N MEANS OF EGIZPSS Y/N PLUMBING R]SER DIAGRAM: Y/N LOCATION OP PIRI PROTECTION EQUIPMENT. Y/N TRL7SS DG>iGN Y'iN CI;RTITICATION: YIN ENERGY CALLS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) J~~ ~(z~l i~ - ~I~Tf~Itc~r-~. L ~~~~/Lt c/~C .fin.) Sc~LRT l c~v~7i ~~~Q tr`-~e. ~C~L ~~rz~ 1__.~ ~ ~ ~ ~ S F-}op 7~~ ~22~ 0 rid 1~ ~1 r ~ a;, 3~ 3lDu. DE°T. T~p;a rF SDliTiIOLD ~ 36yoo u~z Bu~~~~NG PERMIT ISSUED TO ~L~ RD DATE 5' fig' ~I ADDRESS yg`->' ~aPL°'-' la her ('RI f Al This notice must be displayed during construction and returned to Building Dept. to get a certificate of occupancy upon completion of work. BUILDING INSPECTOR'S OFFICE, TOWN OF SOUTHOLD SOUTHOLD, N.Y. 0~ SCDHS Re/. # RIO-08-0026 ~ E7(CAYATION INSPECTWN 4@EQUIREO <'s. FOR $ANi7ARtl sNaTL'M ~ /SUBSURFACE SEWAGE DISPOSAL ~ ~ ®Y HEALTH DEp,RRP'FNENT ~ PROPOSED NEW L;EPTIC SYSTEM SYSTEM DESIGN ~ ~ SURVEY OF PROPERTY BYI JOSEPH FISCNETTI, P.E. 4 BEDROOMS ~~n rn _ _ HOBART ROAD ('PRECAST 1000 GAL PRECAST SEPTIC TANK ~ ~ ~ AT ORIENT i SOUTHOLD N.Y. 1197) 2 SW COLBLAREP LEACHING POOLS WITH 3' SAND vm ca rn TC)WN OF SOUTHOLD (6311 765-1954 _ pr_ FILL OR REMOVE EX!STWr, SEPTIC SYSTEM ~ SUFFOLK COUNTYr N Y APAtIry ~ ~ 1000-17-02-3.1 7 SCALE.' 1'=T0' ' mod'' AUGUST 22, 2003 ter ~tn9~g~ M11er BP Inc JUNE 12, 2004 (FOUNOA RON LOCA RON) ffWk Cotrn Fecfed By ry-hQ 0 - DECEMBER 17, 2006 (CERTIFICA BONS) ty Dept. t~f h#ealUi Sarvivos. eP. FEBRUARr z 1008 (a.D.R. x UPDATE) III 852,5700, 40 Hours In FEd. 2D, 2008 TA00/TION51 To Schedule Advance, AP2~L 1o ZoN0lrwb"n~J I Inspecticn(s). ~ JUNE 21, 2010 (REVISIONS) ~ LL I UFFOLKCOUNTYDEPARTMENTOFHEALTHSERVICES ~ ~ ANDRA & GEORGE H. ROWSOM PERMIT FOR APPROVAL 01=tiONSrRUC710NFORA (DwEUwc) N/0/F LONG BEACH COMMONERS ~ (DwEUwc) SINGLE FAMILY ciESI©ENCE AND (VACANT) WELL &C. P. ]50'+ f _ _ _ 8~ / BRA LeL - - - - - N89'55'50"E- - - - - - - - - - -280.76' ~ 7~~YA' x/25' RIGHT OF _ ~ ATE ~ td.E:. REF. t' -~0°G WAY ~ - 15' R.O.W. ~ V~. ~1.#5'O unurv'____ _ ~r~LN ~7+~~ \ / ~O OE P VE - _ ~ $ ___.~3.3 __~-fP&E:~, JA- _'Or.RY~-~-~'-,`~---_ 'unutt V ~ V i TOTAL MUM SEDROOfviu / ` ~'V __PPE ~___--y~~`~~___,\ ~ i p150~0 PIRESTHREE YEARS'rROIl4 GATEOF.4P OVAL - 0 _ _ . ~ ~ _ _ ~~~etL' - _ ' - _ _ ~'-eo _ ea ''~:rr • _ a;` ~ unutt ~^0 i~ i~ ? _ ' i' /-X_. X_ i i I I q I I \ ~j ~ i ~ j I i I A/ 4 , ~ r ~ i, FbSA X ~ X I 1 ~ I ` ~ , / i I ~ I / \ ' /1 / / / RrOayaezj~'~ Inc ' ~ Syr 0>;p C,1 MME ~ ~ _ I i `S, ) % I rr' ;I Py ~ , ~ ~ N f ~ + ~EDq~ ya~,N ~ P„• _ CE' I i i\ ``i 1 ` i i i i i Q ~ ~ h / ~ RLm2 ~ (1 j2~'.O ~j 5 / I ! I_ i li i \ i ~ i i i ~ :j ~ ~ TEST HOLE DATA ak 2 m ~ Q ~ I 4^ s~ = I I ~ _ I L ~ ~ , / / ~ i p• Q" BY Mc00NAL0 GEOSCIENCE ' Z •1 T .0 4 Q`' J s X W I ~ l ~ sa , \ ~ ~ I I l A / 't S tl' , ~px 5/19/10 Lp,~. U' ' / I I ( ~ t,~ ~ s+/$ ~ I . i! i i l l l L G rl O. y Y~ Q I I 1 ~ e~ q ~ Qp~ ! / l ~4r F.^ am', ~ rso < : i i ~ / Q\ .h9 \ ~ s DARK BROWN LOAM d. I I ~ U ,.r I / 1 /~'yu'~'3 ` j~ l , .J ~ ~ , F~ - ' ; ' , ; `V ~ Q~ \ W BROwN sw rY saND sM W I h2 T>` ' ~L ~`~Q / OF~.~ - .~9V Tl L~ ,,f VT Ly' ___'IS' O I Ft, > ~ 2 I ` +a'< I ~0 ; T' i' / /i .'q _ i' <r i , ~ BROWN FINE TO COARSE vYr , F. I O\ ~2 W ~ 'r / X - / \O SAND SW o-0] I /L V ~ /6'vt / i~ ri~i z/e i ~s~HLI'E` J1- A~ /i ~ ~e w SILTY SAND AN MBROWN I'~) I--' EL SA? NK _ - _ _ - ~ ' . 'ice FA. ~ - t' £<_JI A , l d I ~ 0.. _ _ /J/ /i //~/N L.IR. Xi rso ~ ;//I/~/ J O 2!9.72' 4Hm---R~~~~i°-P ~A/e _ eB~ Le~ ' /`i / li fn - . _A IERL/NE LK RO.W. NB3~ ~25' _ ? ~ .r 9'40' _ R.O.W. W W E'L •W.r' sTavErBlar ROAR _ - _ --~--=-"_l \ ~ J K \ )80.35' ~ IES7 HOLE DATA #1 ~ HWSE _ / Ep .zxr BY Mc00NALD GEOSCIENCE m O KQ( _ fERQI/MY 1BOd _ EL 1/. /O/F BARBARA JEWLER & N DARK eaoxN sANBr LOAN a JAY KENNEDY ~ - CP. 150' + HOUSE BROXN 5Ltt SAND SY s stammustbain - antofe>< ting~itaxY Y N~O~ HgROLG BROW(/ SLtt SANB W1H CRAKL NL ancewith cpaxmcei~~:eL[~exL""°utSubmit PAR L `Y KA7}{LEEN rv Lr COmfO ~.3 ;ti/14f• Cp SON U (OL1EL(/NG PALE aRaxN VLtt sANB SN rN:, p,5_~,^• / am /ami/Tar with the STANDARDS FOR APPROVAL 150' ) comps red form q,vD CON57RUCTION OF SUB.SURF4 CE SEWAGE WE[L COCA Rn./ L~NUwN A -"`-~~~Y DISPOSAL SYSTEMS FOR SLVGLE FAMILY RESIDENCES zp _ and wit! abide by the candllians set larlh Therein and on the <y perms! to COnSIr(ICI. _ BROMN ANO PALE BRpMN SAND 9LT ANO 9LT ML MAIN ~ ROAD ($'j2 25) The locolions al wells and cesspools ~ ;ha wn hereon ire lrom Held abservo/ians ~ WATER /N BRONN SAfDY yLT ANO 91.TY SAND ML k SM and ar lrom dulR obtained lrom others. EL -zse• T> OP NE WATER IN ~Sf SW M CT> CERTIFIED TO: ~ ~NT~61~` d' AMORY H. MILLARD ~0 ~i c~A ELEVATIONS REFERENCED TO AN ASSUMED DATUM. ~ iL. DIANE MANSON yfi, . yp MONUMENT FIDELITY NATIONAL TITLE INSURANCE COMPANY - ~ = p/pE OF NEW YORK ~ , - p. PROPOSED ELEVATION WELLS FARGO BANK, N. A. / ~ 496tig p- NO. 49678 ANY AL 7ERA RON OR ADDITION 70 THIS SURVEY lS A NOLARON ECONIC V AREA=85,140 S0. FT OF SECTION 72090E THE NEW YORK STATE EDUCATION LAW. ' EXCEPT AS PER SECTON 7209-SUBOIV]SION 2 ALL CERTIFICARONS (631) 765-5020 FAX (631) 765-1797 HEREON ARE VACIO FOR THIS MAP AND COPIES THEREOF ONLY lF P.O. BOX 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRAVELER STREET 03-225 WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971