Loading...
HomeMy WebLinkAbout38431-Z Town of Southold Annex 11/17/2014 ` P.O.Box 1179 7. 54375 Main Road • ��r Southold,New York 11971 sot". CERTIFICATE OF OCCUPANCY No: 37275 Date: 11/17/2014 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 1800 Westphalia Rd, Mattituck, SCTM#: 473889 Sec/Block/Lot: 114.-7-12.3 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated 10/9/2013 pursuant to which Building Permit No. 38431 dated 10/21/2013 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 IN-GROUND SWIMMING POOL FENCED TO CODE PER ZBA DECISION#6535 DATED 03-15-2012, AS APPLIED FOR The certificate is issued to Hall,David&Charnas Hall, Suzanne (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 38431 03-12-2014 PLUMBERS CERTIFICATION DATED A e ignat re TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 'aSOUTHOLD, NY A 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#: 38431 Date: 10/21/2013 Permission is hereby granted to: Hall, David & Charnas Hall, Suzanne 1800 Westphalia Ave Mattituck, NY 11952 To: construct an accessory In-Ground Swimming Pool, per ZBA decision #6535, fenced to code At premises located at: 1800 Westphalia Rd, Mattituck SCTM #473889 Sec/Block/Lot# 114.-7-12.3 Pursuant to application dated 10/9/2013 and approved by the Building Inspector. To expire on 4/22/2015. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 i CSC. Building Inspector Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings,property lines,streets,and unusual natural or topographic features. 2. Final Approval from Health Dept.of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1%lead. 5. 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 . Certificate of Occupancy-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 Pre-existing Building- $100.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy-Residential $15.00,Commercial $15.00 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: 2-1�Ll4�r;�{ T House No. I Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000,Section 1�7 Block Lot �a� Subdivision Filed Map. Lot: Permit No. 3'8L!. �3 Date of Permit. fL' 21-/.3 Applicant: Health Dept.Approval: Underwriters Approval: Planning Board-Approval: Request for: Temporary Certificate- Final Certificate: � heck ( one) e. Fee Submitted:$ 1 Applicant Signature pF SO(/r�o \ Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 CIO �o roger.riche rt(d_)town.southold.ny.us Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: David Hall Address: 1800 Westphalia Ave City: Mattituck St: NY Zip: 11952 Building Permit#: 38431 Section: 114 Block: 7 Lot: 12.3 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 Basement Service Only Commerical Outdoor X 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 30a A/C Blower Range Recpt Fluorescent Fixture Pumps 1 Transformer Appliances Dryer Recpt Emergency Fixture Time Clocks 1 Disconnect Switches 1 Twist Lock Exit Fixtures 11 TVSS Other Equipment: in ground swimming pool to include, bonding, 2-pool lights, 1-GFCI circuit breaker, 1-salt generator, 1-heat pump Notes: Inspector Signature: Date: March 12 2014 81-Cert Electrical Compliance Form.xls pF SOUl�o6 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ J FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ j ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE 2' v �-37 INSPECTOR �` i oF sooryo� N ie i oouKty, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLUMBING [ ] FOUNDATION 2ND INSULATtON [ ] FRAMING / STRAPPING ] FINAL/ &p [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VI TA [ ] CAULKING REMARKS: W Aeoc, IrI7) �I PC.:4f7 DATE NSPECTOR i oF souryolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] R GH P BING [ ] FOUNDATION 2ND [ ] S A N FRAMING / STRAPPING [ ] FI AL bLl- FIREPLACE A CHIMNEY [ ] FIR INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] CAULKING REMARKS: FN DATE INSPECTOR • r 11 . INOMATION Psk ODB r , RVA NO Ion r"DWOM .- 1 1: :��► r 0 0 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. ,3� 3 Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Examined �D 2 ,2013 Single& Separate Storm-Water Assessment Form Contact: J Approved f 20/.3 Mail to: Disapproved a/c Phone: Expiration ��,20 Building Inspector .11,1 OCT - 9 2013 IV APPLICATION FOR BUILDING PERMIT I -- ---- Date , 20 13 T INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County,New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. °'AMEDIATRY" (Signature of applicant or name, if a corporation) `I:CLOSE POOL TC "DE - T'�Oy i9� c UPON COMPLETION R )�W77 Z�� PW-�� BEFORE"WATER' � State whether applicant is owner, lessee, agent, architect, engineer, general IDA411T2 f � *.*rW FEE:__> 5��'. —BY_41� I FOR rTf E Name of owner of premises �{ (,, ��1l 765-1802 8 AM TO 4 PMFO► i OWING-INSPECTIONS (As on the tax rol l or lategOd efd1 TION-TWO REQ. UIRED If app iyapt is a orporation, signat re o duly authorized officer FOR POURED CONCRETE 2. ROUGH-FPAVINII cl (Name and title of corporate officer) STRAPPING, ELEC 3. INSULATION Builders License No. 4L� & �` Plumbers License No. R �� Electricians License No. AU NEW Other Trade's License No. a3 �er e u D`�N OR CONSTRUCTION ERRO S. �' LSC 1. Location of land on which proposed work w'11 be done: / 0D0 House Number Street Hamlet WATER RUNOFF { PURSUANT TJ CH TER 236 County Tax Map No. 1000 Section 1 Block n' 7 TLotTr,A'I Mg. Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 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: Fronx Depth 3�oa Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES E�""N""O '/Will excess fill be removed from premises? YES GNO 14. Names of Owner of premises_/ty�� ���� AddresslXr7r� rr , i�J Phone No. /�7' �r Vr Name of Architect Address Tr'' ` Phone No Name of Contractor A 7c6j/rwV 'W Gr¢✓e Address 9 2t i/'`JIQ, Phone No. G 9 t- aft` 41Y Yk-4rr,'�KW 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. j 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, +CONNIE D. BUNCH Notary Public,State of Now York (S)He is the No.01SU6185050 (Contractor, Agent, Corporate Officer, etc.) ua i ie in Suffolk Commission �Expires April 4,21 of said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ti Sw�rn tp before me this ' 1 day of,.© '�/� 20 .Notary Public Signature of Applicant 1 BOARD MEMBERS Southold Town Hall Leslie Kanes Weisman,Chairperson ��0�$O!/jy0 53095 Main Road-P.O. Box 1179 Southold,NY 11971-0959 James Dinizio,Jr. Office Location: Gerard P.Goehringer Town Annex/First Floor,Capital One Bank George Horning 54375 Main Road(at Youngs Avenue) Ken Schneider ��� Southold,NY 11971 http://southoldtown.northfork.net ZONING BOARD OF APPEALS TOWN OF SOUTHOLD Tel.(631)765-1809-Fax(631)765-9064 FINDINGS,DELIBERATIONS AND DETERMINATION MEETING OF MARCH 15,2012 ZBA FILE:6535 NAME OF APPLICANT:David M. Hall PROPERTY LOCATION: 1800 Westphalia Rd., Mattituck,NY SCTM: 1000-114-7-12.3 SEORA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this application and determines that this review falls under the Type II category of the State's List of Actions, without further steps under SEQRA. PROPERTY FACTS/DESCRIPTION: The Applicant's property is a 30,715 parcel in the R-40 Zone. The northerly lot line measures 100ft., the easterly lot line measures 260ft. The southerly lot line measures 128.12ft along Westphalia Rd., and the westerly lot line measures 258.58 along a private ROW. The property is improved with a single family dwelling with a deck, and an accessory shed, as shown, with proposed new garage and pool, on the site survey drawn by John T. Metzger,Licensed Surveyor,dated Nov. 7,2011, last revised Feb 3,2012. BASIS OF APPLICATION: Request for Variance from Article III Code Section 280-15 and 15(C)and the Building Inspector's November 29,2011 Notice of Disapproval based on an application for building permit for an accessory in-ground swimming pool and accessory garage; 1)accessories are proposed in other than the code required rear yard,2)proposed accessory garage at more than the code required maximum square footage of 750 sq.ft. on lots 20,000-60,000 sq. ft. RELIEF REQUESTED: The applicant requests two variances to construct a 819 sq. ft. accessory garage in a front yard area, when Town Code allows a maximum 750 sq. ft. size and to be located in a rear yard area; and another variance to construct an in ground pool in a front yard area,when Code requires accessory structures to be located in a rear yard. ADDITIONAL INFORMATION: An adjacent neighbor, on a downhill grade from the applicant's property, was present at each public hearing to express concerns about runoff,and asking for on site containment of storm water. AMENDED APPLICATION: During the hearing,the applicant was asked to address the concerns of the adjoining neighbor regarding the drainage from his property onto hers. The applicant on February 14, 2012 submitted a site plan showing two dry wells added to contain storm water runoff on site, and the removal of an impervious problematic sidewalk,bringing the plan into more conformity with the codes. FINDINGS OF FACT/REASONS FOR BOARD ACTION: The Zoning Board of Appeals held a public hearing on this application on February 2, 2012, and March 1, 2012,at which time written and oral evidence were presented. Based upon all testimony,documentation, personal Page 2 of 3—March 15,2012 ZBA File#6535-Hall CTM: 1000-114-7-12.3 inspection of the property and surrounding neighborhood,and other evidence,the Zoning Board finds the following facts to be true and relevant and makes the following findings: 1. Town Law 4267-b(3)(b)(1). Grant of the variances will not produce an undesirable change in the character of the neighborhood or a detriment to nearby properties. The applicant has a very small rear yard, and two comparatively large front yards due to the original placement of the existing single-family dwelling on the subject property. This excludes any rear yard location for the proposed garage and pool. Because a garage and a pool are customary and incidental accessory structures to single family dwellings, and because these proposed structures will have large setbacks, the placement in the front yard area is in accord with the existing residential character of the neighborhood. 2. Town Law 4267-b(3)(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. The applicant has insufficient rear yard for a garage or pool. 3. Town Law 6267-b(3)(b)(3). The variances granted herein are mathematically substantial, representing 100% relief from the code required rear yard placement of accessory structures.The increased size of the proposed garage is 69 sq. ft.or 9.2%more than allowed by code,and is substantial in the context of a proposed nonconforming front yard location. However, the large front yard setbacks for the garage and pool mitigate the fact that these accessory structures should,according to Code, be located with a rear yard area. 4. Town Law 4267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential community will have an adverse impact on the physical or environmental conditions in the neighborhood. The applicant took care to address actual and potential downhill storm water runoff onto adjacent property, and proposes appropriate on site containment of storm water with the installation of drywells and downspouts. 5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created because the applicant purchased the parcel after the Zoning Code was in effect and it is presumed that the applicant had actual or constructive knowledge of the limitations on the use of the parcel under the Zoning Code in effect prior to or at the time of purchase. 6.Town Law 4267-b. Grant of the requested relief, with the mitigating drainage proposal, is the minimum action necessary and adequate to enable the applicant to enjoy the benefit of an accessory garage and in-ground swimming pool while preserving and protecting the character of the neighborhood and the health, safety and welfare of the community. RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under New York Town Law 267-B, motion was offered by Member Homing, seconded by Member Goehringer,and duly carried,to GRANT, the variancelvariances as applied for, and shown on the survey prepared by John T. Metzger, L.S. Peconic Surveyors dated November 7, 2011 last revised February 3, 2012 and the drawings prepared by Architechnologies,Frank Notaro,Architect, labeled pages A-1 through A-3 last revised 1-26-12. i Any deviation from the survey,site plan and/or architectural drawings cited in this decision will result in delays and/or a possible denial by the Building Department of a building permit, and may require a new application and public hearing before the Zoning Board of Appeals. I Any deviation from the variances) granted herein as shown on the architectural drawings, site plan and/or survey cited above, such as alterations, extensions, or demolitions, are not authorized under this application when involving noneonformities under the zoning code. This action does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the Zoning Code, other than such uses, setbacks and other features as are expressly addressed in this action. i Page 3 of 3—March 15,2012 ZBA File#6535-Hall CTM: 1000-114-7-12.3 The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of nonconformity. Vote of the Board. Ayes:Members Weisman(Chairperson), Goehringer,Schneider,Dinizio, Horning. This Resolution was duly adopted(5-0). Leslie Kanes Weisman,Cfiairperson Approved for filing 3 0 /2012 45-,1 Scott A. Russell d°s � James A. Richter, R.A. SUPERVISOR Michael M. Collins, P.E. SOUTHOLD TOWN HALL-P.O.Box 1179 Z p �I 53095 Main Road-SOUTHOLVANEW YORK 11971 Telephone#: (631)-765-1560 A Fax#: (631 MICHAEL.COLLINS®TOWN.SOUTHOLD.NY.US 11�f JAMIE.RICIT OLD.NY.US Office of the Engin :i� J `' Town of Southold +1� 2013 STORMWATER MANAGEMENT CONTROL PLAN ET ( TO BE COMPLETED BY THE APPLICANT TO: ENGINEERING DEPARTMENT PLEASE ATTACH THE FOLLOWING PXjWxS or IMORNATION.- FROM: BUILDING DEPARTMENT ❑ Copy of completed Application for Building Permit DATE: ❑ Stormwater Management Control Plan APPLICANT: /�.�� �/G .,C�/f�.�� ❑ Completed Chapter 236 Stormwater S.C.T.M. *: Review Checklist PROPERTY ADDRESS: lLrW BRIEF PROJECT DESCRIPTION: L ;� ( .-r tcJ�nratc% fit✓ ac U! L r`0,J Lt)e Rc 1oA, S,6 e% C..�7 ** OR ENGI G DEPARTMENT USE ONLY Reviewed By: Com/ Date: APP ved: I Ad onal Information Required: SURVEY OF PROPERTY AREA = 30,715 SQ. FT. --- AT MATTITUCK ����, N OF SO UTHOLD S OL COUNTY, N.Y. o� r-4 Lu 1000-114-07-12.3 N ,�, $a 0 K SCALK 1"--40' wEIJ- e>i NOVEMBER 7, 2011 NOV. !6 20!! !r•v oAEI S FM3,L2GD01 AUG.9,2012(oddUions) POW FORAPPROVALOFCoNSMJMMFORA CP:i S1N=FAWYRE81DE=AND DATE PROPOSED NEW SEPTIC SYSTEM \ r I-II•pj . "fTM MMCAL SEPTIC TAMTOTAt.;��. S x ODMS \ •yry0 2-'r LEA NNG Poa.s a r■a DEEP s DOMES NTH �y. T►IRBE tMTE OF APPROVAL COLLAR ISWI 3'MILL ABOVE GROUNDWA TER 4 CP"'' EXISTM CESSFDOLS TO REMOVES a AbWd=r-CM o(exiAint ss aM"CM must be in S'tP s ti'tpT WELL cwnformsricew4npirementSubmit 15a'+ th ._..�- \'`I-�� gym• �k NOTE CHANCES) DY Wt.01 HMO Services ASPHALT �`. '4dpy � t` r. ./^ �,�C..: �e pQ fGI�� u•`^+/'�IIM tai rs, T.11. .,, .,• sTfu(T t , �O i,3' SiiW EL20.2' /(o�,,�. � ......... g n •�. C `Y ndtn row, 5ry sr111N1 -� WELL ` "p�� P �w srooI M ?� Iso- 6 a► \a► 1y 4 saa' Aw now"* a ?6, � �,,y ar /A��L��p��AST C'c�y'R .>• Now ALrf am Ar r 00106 . � 4'2• ® 4r ��S � , PACE sear/AM AA W V c�V Pas1 ea _. *t4 CLEL N�ObQ,QO, &Rpp F•n F f r 'rren w1&t outl np 25.0' N, fOCf. ve O 4 COR Tom„ ��1�rT�28T1?I w0�� £C23ZJw '"rKrt_ Int As,, O CL.EL / ems . • 23.6' _Wi"F•"�O 0 8' �04,0 a� SEPTIC 150'+ 0 . WELL / 0 oefP of CPsa. ELEVATONS ARE REFERENCED TO AN ASSUMED DATUM S(,4"E'Y r I Om familiar with the STANDARDS FOR APPROVAL AND CONSTRUCTION OF SUBSURFACE SEWAGE f DISPOSAL SYSTEMS FOR SINGLE FAMILY RESIDENCES ' and will obide by the conditions set forth therein and on the IQ permit to construct. i 1 Are location of wells and cesspools shown hereon are from field observations and or from data obtained from others. / '! Tf r.. NO, 49B ANY ALTERATION OR ADDmON TO THIS SURVEY IS A VJOLA77ON �PECONIC M VEY-ORS. P.C. OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. (631) 765-5020 FAX (631) 765-179 EXCEPT AS PER SECTION 7209-SUDDIOSION 2. ALL CERTIFICATIONS = MONUMENT P.O. BOX 909 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 12307RAVELER STREET[j, r� SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR • = REBAR 111-21 l WHOSE SIGNATURE PPEARS HEREON. SDUTHOLD, N.Y. 11971 ra Town Hall Annex 54375 Main Road Telephone(6311))7865-11802 P.O.Box 1179 Q r0 enrichertCa'a`w(6ri soUTlloltl ny US Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: r` d �.jf�rh;�/ Date: l Company Name: li a�f/ r,✓!l C41e Name: License No.: Address: Phone No.: JOBSITE INFORMATION: (*Indicates required information) *Name: lof46 *Address: ,p 14�s a *Cross Street: *Phone No.: Permit No.: �j g Tax-Map District: 1000 Section: r y Block:�_ Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) e5LeCw1*_ PDVG- (Please Circle All That Apply) *Is job ready for inspection: YES/� Rough In Final *Do-you need a Temp Certificate: YES 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 .82=Request for Inspection Form ",,,t 'v t -� 30,715 SQ. FT. ' SURVEY OF AT MAT TOWN OF SF FOL SCAT, 16-4 WELL NQ 7s NOV. l I FEB, '. REM WED CP. FEB 14 2012 BOARD OF APPEALS PROPOSED NEW SEPTIC SYSTEM l6 BEDROOMSI ti X\" 1 - 1500 GAL. PRECAST CYLNVDRICAL SEPTIC TAME �O 8' 0 x 5'U" DEPTH41 O 2 - LEACHM POOLS 8' 0x8'DEEP ZDOWSNTH , R/ 3' SAM COLLAR (SW) 3'MK ABOVE' �- qLr kD � C WATER C EXIST7W6 CESSPOOLS:TO REi/MM ¢10 y'4Rr WI • ' qey` %Dy 15( �CIO v► ��. .o• e 63, p0� OfASNALT d s,, 60 C r^ fie¢: t+' CV �v RA lf „ z WELL ' (O FE) TEST HOLE DATA M r r1N cDONALD GEOSCIENCE 10/28/2011 � ,w t, • / �.flr`. ,�` }• EL 2a2' as' DARK BROWN L, fy qtr t 1` •� BROW SJLTY S x•242. p ,�� } ,►� i U y PALE BROWN Fi p TQC CL.EL. Af70�. Oat F 17' 25.Q' a/(/�V;4, A ,__ ZA FINAL SEE DECIS MAP NO WA7ER ENCOU� r *A4410 4 .6! . SEPTIC I.W+ '/ WELL C •fir- ELEVA nONS ARE REFER A�� aA M I am familiar with the STAAVA OfF APP 'V'AL cw' AND CONSTRttCFM OFS`LIB; fW DISPOSAL SYSTlS FOft S1tlfSCES and will abide by the conditions set forth therein and on the k permit to construct. y The location of wells and cesspools shown hereon are from field observations and or frorn data obtained from others. .YS. Ll( ANY ALTERATION OR ADDITION TO THIS SURVEY 15 A VIOLATION 40ECON "VE ORS, P.C. OF SEC 770N 7209 OF 7HE NEW YORK STAJ EDUCA77ON LA 1K (631) 765-5020 FAX (631, EXCEPT AS PER SECTION 7209—SUBVIWSW 2 ALL CERTIFICATTANS MONUMENT P.O. BOX 909 = HEREON ARE VALES FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 TRAVELER SA�?ECTFj � = REBAR SAND MAP OR COPIES BEAR THE 1�fPRESSED SEAL OF THE SURVEYOR SOUTHOLD, N.Y. 1971 WHOSE SIGNATURE APPEARS HEREON, , 706 b-K)C,V6-le LdWt� t,)14 PI g' a� � t :3 s��.mss• ,, Lit., i ,off i .�. NAME. GATE; Soe HAPE!- BORDER PATTERN._ WALL PATTERN.-,..,,..,. FLOOR PATTERN. CORNERS: DEPTHs- HUN(-' OVERLAP (cirds one) 20 GAUGE 27 GAUGE fled° ®ns} JF o