The URL can be used to link to this page

Home My WebLink About37581-ZTown of Southold Annex P.O. Box 1179 54375 Main Road Southold, New York 11971 CERTIFICATE OF OCCUPANCY No: 37392 Date: THIS CERTIFIES that the building IN GROUND POOL Location of Property: SCTM #: 473889 570 Maple Ave, Mattituck, Sec/Block/Lot: 107.-3-3.1 Subdivision: Filed Map No. conforms substantially to the Application for Building Permit heretofore 1/21/2015 1/21/2015 Lot No. filed in this office dated 6/13/2012 pursuant to which Building Permit No. 37581 dated 10/16/2012 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 AS APPLIED FOR The certificate is issued to Cahill, Thomas & Cahill, Mary Lou (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 37581 07-01-2013 A ed ignatu e TOWN OF SOUTHOLD �}T BUILDING DEPARTMENT TOWN CLERK'S OFFICE '$ SOUTHOLD, NY 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 #: 37581 Date: 10/16/2012 Permission is hereby granted to: Cahill, Thomas & Cahill, Mary Lou 570 Maple Ave Mattituck, NY 11952 To: construct an inground swimming pool per Trustees permit indicating fencing At premises located at: 570 Maple Ave, Mattituck SCTM # 473889 Sec/Block/Lot # 107.-3-3.1 Pursuant to application dated 6/13/2012 To expire on 4/17/2014. Fees: and approved by the Building Inspector. SWIMMING POOLS - IN -GROUND WITH FENCE ENCLOSURE CO - SWIMMING POOL Total: Building Inspector $250.00 $50.00 $300.00 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 andunusual 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 $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: 570 MoTI.-rue X House No. j Street Hamlet Owner or Owners of Property: '—fho r4hs Suffolk County Tax Map No 1000, Section 107 Block .3 Lot Subdivision Filed Map. Lot: Permit No. Date of Permit. ld i - I z Applicant: y Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: (check one) Fee Submitted: $ 5a fjc \ , Applicant Signature Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD Telephone (631) 765-1802 Fax(631)765-9502 roger.richert(cDtown.southold. ny.us CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Thomas Cahill Address: 570 Maple Ave City: Mattituck St: NY Zip: 11952 Building Permit #: 37581 Section: 107 Block: 3 Lot: 3.1 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: USI Electric License No: 2740 -me SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor x 1 st 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 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel 1-30 A/C Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks Disconnect Switches 2 Twist Lock Exit Fixtures TVSS Other Equipment: in ground swimming pool to include, bonding, 1 -pool light, 2-GFCI circuit breakers 1 -pool heater Notes: Inspector Signature: Date: July 1 2013 Electrical Certificate.xls pF SOpr�o6 col TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLEIG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) ELECTRICAL (FINAL) REMARKS: DATE --Z7 INSPECTO U pF SO(/Tyo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 / INSPECTION ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION [ ] ELECTRICAL (ROUGH) [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIRE RESISTANT PENETRATION ] ELECTRI (FINAL) REMARKS: DATE � �� INSPECTOR 37,q/-z�, oF souTyo6 N .lug TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] R GH PLBG. [ ]FOUNDATION 2ND [ NSULATION ( ] FRAMING / STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) DATE l� 3 INSPECTOR FIELD iNSPTCT`xON tEPnRT FOUNDA TION (1ST) NNMN�N!N�NNr DA COMNZNTS �- tv oQ FOUNDATION (2ND) _ -o t� • ROUGH FiA,NIING & PLUMBING J O H IN$ULATIgN PER N.Y. STATE ENERGY CODE y FINAL VA D {J F ADDITIONAL COMMENTS P3 pOC. kca 0 2Sd - 0 x566 If Z m z f 7 �tv TOWN OF SOUTHOIA,) , BUILDING DEPABilj� ENT TOWN HALL SOUTHOLD, NY 11971 TEL: 765-1802 Examined 7��L 20/,,7 Approved , 201 Disapproved a/c BUILDING PERMIT APPLICATION CHECKLIST PERMIT NO. --37-5 �1 Do you have or need the following, before applying ? Board of Health _ 3 sets of Building Plans Survey Check Septic Form NX.S.D.E.C. Trustees Contact: Mail to: _ t Phone:_ L � SUN 1 3 2012 Building Inspector Btn� �Ee1' PPLICATION FOR BUILDING PERMIT 10�,�fs OF 50L':ZH01.D Date_ ( '20 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 areas, and waterways. c. The work covered by this application may not be cornmenced 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��-ver until a Certificate of Occupancy is issued by the Building Inspector. 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, an egulations, and to admit authorized inspectors on premises and in building for necessary inspections. "IMMEDIATELY" DO NOT PROCE-EDWITR ENCLOSE P DOL TO CODE FRAMING UNTIL SUR (Signature of applicant okAiame, if a corporation) UPON COMPLETION 'OF FOUNDATI0— LOCATION BEFORE "WATER" HAS BEEN APPROVED. q Zq kt ,ZSX 14, Il ec Pc1 W [I7by (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder n_ _ I. _ APPROVED AS NOTED I Name of owner of premises C (as on the tax roll or If applicant is a corporation, signature of duly authorized officer (Name and title of corporate of `( Builders License No. 3�,j F IS UNLAWFUL Plumbers License No. Electricians License No. -27q `= Other Trade's License No. 1. Location of land on which proposed work will be done: 5'70 MA-ze. LA-Tult House Number Street County Tax Map No. 1000 Subdivision (Name) DATE; WffllY) BUILDING DEPARTMENT AT T65-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ROUGH • FRAMING PLJMBING, STRAPPING ELECTRICAL & CAULKING INSULATION 1 FINAL- CONSTRUCTION & ELECTRICAL MUST BE COMPLETE FOR C 0. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR oESIGE I %% NOFF PURSUANT TO CHAPTER 236 ,J� Tvck. OIr THE TOWN CODE Hd*300104 A I Section 107 Block 3q Filed Map No. �_, - ,,x>✓crt ELECTRICAL INMITICf5E 2. State existing use and occupancy of premises and a. Existing use and occupancy b. Intended use and occupancy - 96, � Al rALL use and occupancy of proposed construction: P 3. Nature of work (check which applicable): New Building _Addition _ Alteration Repair Removal Demolition Other Work 1woukio V►N4L� �w►vnmNy (Description) 4. Estimated Cost 14QD0 Fee 5. If dwelling, number of dwelling units If garage, number of cars (to be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7 Dimensions of existing structures, if any: Front 76 Rear 7) - Height Height Number of Stories a' z. Dimensions of same structure with alterations or additions: Front Depth Height. 8. Dimensions of entire new construction: Front 14f Height Number of Stories Number of Stories Depth TO' Rear Rear 1� __Depth W 9. Size of lot: Front (25 , Rear )42-' DPpth 312- y7K 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: NO 13. Will lot be re -graded Pa Ail* 0a'.. Will excess fill be removed from premises YES NO 14. Names of Owner of premises nn ��-ke �� 7-139 fho��S C��lwL Address Phone No. Name of Architect" -Th ,t 9 Qe,ll� 1% Address 4 &ze,- Ld Sm moW Phone No 71g -788P Name of Contractor Address -----Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES O • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY ED 16. Provide survey, to scale, with accurate foundation plan and distances io property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NSW YORK) ' .t SS: COUNTY OF (� QS being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the7� (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 true to the best of his knowledge and belief, and that the work will be performed in the manner set forth in the application filed therewith. Sworn �tQ before me this day of `uh� 20/�Z hjotary, Public MARGARET A. Kl NLY Notary Public - State of Now Yak No. 01 K16021 I I I Ouallfied in Suffolk County My Commission Expires March 8, 2010 Signature of BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. ,7873 DATE: AUGUST 22.2012 ISSUED TO: THOMAS CAHILL PROPERTY ADDRESS: 570 MAPLE LANE, MATTITUCK SCTM# 107-3-3.1 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on August 22, 2012, and in consideration of application fee in the sum of $250.00 paid by Thomas Cahill and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct an 18' x 36' in -ground pool; pool fence; pavers around pool (4' walk -around with 10' x 12' patio on narrow end of pool); slate walk from deck stairs to pool; and as depicted on the project plan prepared by Thomas Cahill, received on July 24, 2012 and stamped approved on August 22, 2012. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. I b Ghosio, Jr. — t TERMS AND CONDITIONS The Permittee Thomas Cahill residing at 570 Maple Lane Mattituck, New York 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 pursuant to this permit, and the said Permittee 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 complete exclusion of the Board of Trustees of the Town of Southold. 2. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. 4. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. 5. That there will be no unreasonable interference with navigation as a result of the work herein authorized. 6. 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. 7. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the 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 Town of Southold. 8. That the said Board will be notified by the Permittee of the completion of the work authorized. 9. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President '*4f so�ly Bob Ghosio, Jr., Vice -President �O 1�0 Dave Bergen 4 4 John Bredemeyer Michael J. Domino JIT BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 CERTIFICATE OF COMPLIANCE Telephone (631) 765-1892 Fax (631) 765-6641 # 0925C Date: November 1. 2013 THIS CERTIFIES that the construction of an 18'x36' in-Ugund pool; pool fence; Ravers around pool consisting of a 4' walk -around area with a i 0'x12' patio,• and slate walk from deck stairs to pool. At 570 Maple Lane, Mattituck. New York Suffolk County Tax Map # 107-3-3.1 Conforms to the application for a Trustees Permit heretofore filed in this office Dated July 24, 2012 pursuant to which Trustees Wetland Permit #7873 Dated Auggst 22, 2012 was issued and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for the construction of an 18'x36' in -ground pool• pool fence; pavers around pool consisting of a 4' walk -around area with a 10'x12' patio,• and slate walk from deck stairs to The certificate is issued to THOMAS CAHILL owner of the aforesaid property. j�ftm 04 Authorized Signature NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 PERMIT Under the Environmental Conservation Law ECL Permittee and Facility Information Permit Issued To: THOMAS CAHILL PO BOX 775 MATTITUCK, NY 11952-0775 SCOTT M EDGETT 330 E LEGION AVE MATTITUCK, NY 11952 Facility: CAHILL PROPERTY 570 MAPLE AVEJSCTMI000-107-3-3.1 MATTITUCK, NY 11952 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Mattituck Facility Principal Reference Point: NYTM-E: 707.037 NYTM-N: 4541.889 Latitude: 41°00'06.9" Longitude: 72°32'17.8" Project Location: 570 Maple Avenue - Watercourse - Long Creek Authorized Activity: Construct a new inground pool, patio, fence and dry well. All work must be in strict conformance with the attached survey by Nathan Taft Corwin III last revised 8/16/12 and stamped NYSDEC approved 8/24/12. (MAM) Tidal Wetlands - Under Article 25 Permit ID 1-4738-03562/00002 New Permit Permit Authorizations Effective Date: 8/24/2012 Expiration Date: 8/23/2017 NYSDEC Approval 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: SUSAN ACKERMAN, Deputy Regional Permit Administrator Address: NYSDEC REGION 1 HEADQUARTERS SUNY @ JrONY $ROOK[50 CIRCLE RD STONY BROOK. IMI1790 -3409 Authorized Signature: Date !a / LLJ / Zovl— Page 1 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 Habitat - TW MARY A MACKINNON Distribution List Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS 1. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by Nathan Taft Corwin III last revised 8/16/12 and stamped NYSDEC approved 8/24/12. 2. State Not Liable for Damage The State of New York shall in no case be liable for any damage or injury to the structure 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 from any such damage. 3. State May Order Removal or Alteration of Work If future operations by the State of New York require an alteration in the position of the structure 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 the State, or cause loss or destruction of the natural 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 permit, the structure, 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 manner as the Department 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 against the State of New York on account of any such removal or alteration. Page 2 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 4. State May Require Site Restoration If upon 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 lawfully 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 State of New York on account of any such removal or alteration. 5. 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, concrete, leachate or any other environmentally deleterious materials associated with the project. 6. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 7. 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. 8. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 9. Storage of Equipment, Materials The storage of construction equipment and materials shall be confined within the project work area and/or upland areas greater than 75' landward of the 25' contour line. 10. No Unauthorized Fill No fill or backfill is authorized by this permit without further written approval from the department (permit, modification, amendment). 11. Vegetate All Disturbed Areas The permittee shall revegetate all exposed faces and disturbed areas to prevent soil erosion prior to the project completion or expiration date of this permit, whichever comes first. 12. No Runoff down Bluff or onto Beach There shall be no discharge of runoff or other effluent on, in or down the bluff face or onto the beach. 13. Install and Maintain Erosion Controls Necessary erosion control measures, i.e., straw bales, silt fencing, etc., are to be placed at the 25 foot contour as shown on the approved plans. No fill or distrubance is permitted downslope of this barrier other than the installation of the fence. 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. 14. No Pool Discharges to Wetland There shall be no draining of swimming pool water directly or indirectly into wetlands or protected buffer areas. 15. No Drywells in or near Wetland Dry well for pool filter backwash shall be located a minimum of 10 linear feet above the 25' contour line. Page 3 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 16. Notice of Commencement At least 48 hours prior to commencement of the project, the permittee 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 permit. 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. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 1. Facility Inspection by The Department The permitted site or facility, including relevant reco-Fds�,,. is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71- 0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's 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 this Permit to Other Department Orders and Determinations 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 Transfers The permittee must submit a separate written application to the Department for permit renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires.:. Any renewal, modification or transfer granted by the Department must be in writing. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION I HEADQUARTERS SUNY @ STONY BROOK150 CIRCLE RD STONY BROOK, NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands. Page 4 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 5. Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to exercise all available authority 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 permittee 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; . 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 the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS 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 Department 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 permittee's acts or omissions in connection with the permittee'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 indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negli=gent 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 citizen 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 permit, including all special conditions while acting as the permittee's agent with respect 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 permittee. Page 5 of 6 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03562 Item C: Permittee Responsible for Obtaining Other Required Permits The permittee 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 riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. Page 6 of 6 Town Hall Annex Telephone (631) 765-1802 54375 Main Road ,ax �g Q2 P.O. Box 1179 GQ rOger.rlCllerttOW11 SO tnOltl nY US Southold, NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Company Name: 5 ,`T . EI -CC -1-n iC Name: r✓nC� - License No.: 2 r74j 146 Address: 122 Puiso ' Qo �w43 Qom, Phone No.: ol- ,*-OYDD JOBSITE INFORMATION: (*Indicates required information) *Name: r�ths C 0*41 L�. *Address: *Cross Street: *Phone No.: Permit. No.: Tax Map District: 7q4- JYM -7 5� f 1000 Section: —L(22— Block: Date: tQ31- Lot: 3, i *BRIEF DESCRIPTION OF WORK (Please Print Clearly) ,ORO L�ImrniN4 Am (Please Circle Ali That Apply) *Is job ready for inspection: YES I N Rough In Final Do you need a Temp Certificate: YES / NO Temp Information (If needed} *Service Size: 1 Phase 31Phase 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 Ri-Rewwu�ct fnr tncnnntinn G..— y Q4 Town of Southold Erosion, Sedimentation & Storm -Water Run-off ASSESSMENT FORM o PROPERTY LOCATION: s.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A Ol ` In 7 3 15.1 STORM -WATER, GRADING, DRAINAGE AND EROSION CONTROL PLAN s ctec3Tt on -ffo-k- -Tot CERTIFIED BY p DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. SCOPE OF WORK - PROPOSED CONSTRUCTION I ITEM # / WORK ASSESSMENT Yes No a. What is the Total Area of the Project Parcels? (Include Total Area of all Parcels located within 5'03 1 Will this Project Retain All Storrn-Water Run -Off jl� the Scope of Work for Proposed Construction) Generated by a Two (2") Inch Rainfall on Site? (S.F. /Acres) b. What is the Total Area of Land Clearing (This item will include all run-off created by site clearing and/or construction activities as well as all and/or Ground Disturbance for the proposed 5030 Site Improvements and the permanent creation of construction activity? (S.F. /Acres) impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This ✓ a Item shall include all Proposed Grade Changes and Slopes Controlling Surface Water Flow. 3 Does the Site Pian and/or Survey describe the erosion / and sediment control practices that will be used to J_ control site erosion and storm water discharges. This PROVIDE BRIEF PROJECT DESCRIPTION (Pro�laenaaoonal 'a'N6aded> �quAlo VihUC P r JfJi m Yh (N Q Pt�l Wi nt` 1'e�eQ /) (Q item must be maintained throughout the Entire Construction Period. 4 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural _/ Existing Grade Involving more than 200 Cubic YardsF 1 of Material within any Parcel? 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000 S.F.) Square Feet of Ground Surface? 6 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 General DEC SWPPP Requirements: Submission of a SWPPP is required for all Construction activities involving soil Beach? disturbances of one (1) or more acres; including -disturbances of less than one acre that are part of a larger common plan that will ultimately disturb one or more acres of land; 7 Will there be Site preparation on Existing Grade Slopes including Construction activities involving soil disturbances of less than one (1) acre where DEC which Exceed Fifteen (15) feet of Vertical Rise to / One Hundred (100') of Horizontal Distance? -�L the has determined that a SPDES permit Is required for storm water discharges. ( SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit for Storm Water Discharges from Construction activity - Permit No. GP -0-10-001.) 8 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm -Water Run -Off 1. The SWPPP shall be prepared prior to the submittal of the Not. The Not shall :be submitted to the Department prior to the commencement of constriction activity. into and/or in the direction Of a Town right-of-way? 2. The SWPPP shall describe the erosion and sediment control practices and where required, post -construction storm water management practices that will be used and/or 9 Will this Project Require the Placement of Material, / Removal of Vegetation and/or the Construction of any j—j constructed to reduce the pollutants In storm water discharges and to assure compliance with the terns and conditions of this permit. In addition, the SWPPP shall Item Within the Town Right -of -Way or Road Shoulder U identify potential sources of pollution which may reasonably be expected to affect the Area? finis Item will NOT Include the Iristallatlon ofthlyeway Aprons.) quality of storm Water discharges. 3. All SWPPPs that require the post -construction storm water management practice NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in a Box and the construction site disturbance is between 5,000 S.F. & 1 Acre In area, component shall be'prepared by a qualified Design Professional Licensed in New York a Storm -Water, Grading, Drainage & Erosion Control Plan is Required by the Town of that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building PermlL (NOTE: A Check Mark (4) and/or Answer for each Question Is Requirod for a Complete Appikadw) STATE OF NEW YORK, COUNTY OF ......... vafxx.............. SS 411f. That I .................................................................. .. �� ,........... being duly sworn, deposes and says that he/she is the applicant for Permit, (Name of Individual signing Document) And that he/she is the............................................[U:.... .... .... ... ................ .... . (Owner, Contractor, Agent, Corporate O(flcer, .et.c . J ........................................................... Owner and/or representative of the 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 herewith. Sworn to before Lne this; day of ....10- 20.9 7/+ Notary Public �� ............. �A. K NEIF............./_2.� .......................... ynature of A nt) ti^ntnww n�rwn . v r%nl - v vi I v No. 01 K16021111 i" Bt" C4" IN ol�atlNion EVIIIiIIo M90 8, K&C Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 October 15, 2013 BUILDING DEPARTMENT TOWN OF SOUTHOLD Thomas Cahill Q.0 .115 570 Maple Lane Mattituck, NY 11952 TO WHOM IT MAY CONCERN: Telephone (631) 765-1802 Fax (631) 765-9502 The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy: Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. (Contact your electrician) A fee of $50.00. Final Health Department Approval. 11Plumbers Solder Certificate. (All permits involving plumbing after 411/84) —0� Trustees Certificate of Compliance. (Town Trustees # 765-1892) Final Planning Board Approval. (Planning # 785-1938) Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Final inspection by Building Dept BUILDING PERMIT: 37581 — Swimming Pool .,s�7�ss.$�l�'Y�:1$�:..'1iF�F?i?R�=..r'�'rlk�Yv��Yk7t'ii.'�wn�7i'I:iV�.e`f€t�;i�y'��:�?s;:�y Yt::._iA'�r'i&?t'�q'„�c`il'1! S/u:'�!�-iiAl':.�n`T1'.l:Y'•M;`4t.',t�C�.�,.c �� Suffolk County Executive s Office of Consumer Affairs VETERAINS MEMORIAL HIGHWAY * HAUPPAUGE, NEW YORK 11788 DATL ISS1E-L-1 5/1/80 No. 2740 -ME SUFFOLK COUNTY Master Electrician License This is to certify that EDWARD S REIFF doing business as UNDERGROUND SPECIALTIES INC having given satisfactory evidence of competency, is hereby licensed as MASTER ELECTRICIAN in accordance with and subject to the provisions of applicable laws, rules and regulations of the County of Suffolk, State of New York. omw *A OL4 4cerlsed by ev, 'lownry Of Suftk SUFF6LK 00UN--t'QCPARTME4T FC AFFAmn ELECTRICIAN E10"WARD S REIFF ;JNt*ft5A0U*t" 5VFr'fAL �Iks C2'74hME 0" 204 4 A—dditiorial Businesses Diyect"-Jr PL,bo-�j oft 4z�C OT IOQ KNOW WW, - " 11d %C iL . iii • FT 14MOAAA.. VOWW8 VQAM4.09WlWeA ftupo W.vj . F f r Nit � �■ � � i fire --mov % �•� M� �i rte'"! iL��1� 6717 12 HE 1104 5*3 pop�y 140 4z�C OT IOQ KNOW WW, - " 11d %C iL . iii • FT 14MOAAA.. VOWW8 VQAM4.09WlWeA ftupo W.vj . F wt Lo --mov % 6717 12 HE 1104 5*3 140 6isig, eof e 4.'0. q' 100.0 12i'eA- X45 S'me 00 G-12 Mb ,�'•�' a^ E 1"2,-r 46 JW,,S 40 oto Co►.,icrMM , 4000 P,4a,I, @ Pkq 4ANS Dl4mff-m 5TH. ' 1 094-1 . „ q V-00) MMU AC TURID BY MU 26.9 - 5727 FAX ttbU269-2100 PELKOWSKI PRECAST. CORP. OLD NORTHPORT ROAD KINGS PARK, N.Y. 11 7C-4 5 DATE 000 �3 DWG 4 J. v= �4 :a .E ' 41 �►; ►��►®�. CC»t.1G12�7P.; .40= PSI, a AV 9"*b j C> MANUFACTURED BY y PCLKOWSKi PRECAST CORP. OLD NORTRPORT ROAD itSt 269 - 5727 KINGS PARK, N , Y. 11754 FAX163W 269 -2100 L eIED DATE JOB Flo z I DWG 42' Section B—B Section A—A SIZE A B C D E F G H AREA CAP. FEET FT. FT. FT. FT. FT. FT. FT. FT. SQJT. GAL. 16x32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19,000 cyr. a P,o,IP • To To Rohm (Dry Mol OP*4 Piping Arranpnt 3600 PSA C—r ft 10" Typical Wall Section 16'x36' 16' 36' 12' 14' 6' 4' 4' 8' 576 21,600 F� POOL & SPA Ce,= 18'x38' 18' 36' 12' 14' 6' 4' 5' 8' 648 24,300 PERMACRETE WALL SYSTEM 929 Route 25A Miller Place NY 11764 20'x36' 20' 38' 12' 14' 8' 4'_5' 8' 648 24,000 (631) 744-7185 FAX (631) 744-0174 24'144' 24' 44' 18' 14' 8' 4' 6' 10' 798 30,000 Suffolk License #4436—HI 2448' 24' 48' 20' 16' 8' 4' 6' 10' 900 30.000 Nassau License #H174450000 GAN D MON. v 165'2 o \ N (P J A N ' ' 5 Q p�VEMEN • • GRP- _ i �0_ � s \ ,� r; 7 5b6'68N ER _ I 1, V.�M� AP) CD, CN ° MON PRjVA ` OS O 0-75 `� � �`, ( A1C WATER � � �5• � � o� - • �f \ \ \ � � 2 b c -I Lr U? 11 it lo.P 5�• p w n �] cr - ��'>� • '" ER Wp00 P c �1 o L 11 , "r �c �y •. �,o ROOF �o.sin Ty ad h-. T5 AQ ,7io� • ' 3 SP," RGE 10R �IOVA g G , ... b � w. �,.5 p o•,as �� o � O Al. !� N C.)1<� 3 $ \ • 566 � �' o \ \ / / SURVEY OF PROPERTY -� SITUATED AT ' MATTITUCK _..�.. _ TOWN OF-SOUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-107-03-3.1 SCALE 1 "=30' OCTOBER 15, 1998 MAY 302000 SHOW NEW PROPERTY UNE AUGUST 21. 2000 ADDED PLOT PLAN . • "'FEBRUARY 14, -2005 REVISED 'PROPOSED HOUSE • • • • • • -' JUNE 1. 1, 2005 ADDED PUBLIC WATER -- - - - JANUARY -26, 2005 REVISED PROPOSED HOUSE OCTOBER 20, 2006 FINAL SURVEY AREA = 8079_6'" sq. 1t. - - i (TO TIE LINE) 1.85 ac. IMi SO CERTIFIED T0: THOMAS C. CAHILL MARY LOU CAHILL COMMONWEALTH LAND TITLE INSURANCE COMPANY , SUFFOLK FEDERAL CREDIT UNION NOTES: 1. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 36103CO143 G 70NE AE: BASE FLOOD ELEVATIONS DETERMINED ZONE X': AREAS OF 500—YEAR FLOOD; AREAS OF 100—YEAR FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100—YEAR FLOOD. ZONE X: AREAS DETERMINED TO BE OUTSIDE 500—YEAR FLOODPLAIN. PREPARED IN ACCORDANCE WITH THE MINIMUM STANDARDS FOR Trn F SURVEYS AS ESTABLISHED BY THE LI.A.L ro: AND APPROVED, AND ADOPTED FOR SUCH..VSE-'_Y VTHE NEW''Y STATE LAND TITLE i r X fra `•�-' i •1 N.Y.S. Lic. No. 49668 Joseph A. Ingegno Land Surveyor Title Surveys — Subdivisions — Site Plans — Construction Layout PHONE (631)727-2090 Fax (631)727-1727 OFFICES LOCATED AT MAILING ADDRESS 322 ROANOKE AVENUE P.O. Box 1931 RIVERHEAD. New York 11901 Riverhead, New York 11901-0965 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. CERTIFICATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION. CERTIFICATIONS ARE NOT TRANSFERABLE. THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OF RECORD, IF ANY. NOT SHOWN ARE NOT GUARANTEED. C__A Z r _ Z CO % N C2 %K VY -A %0% 1 ao cr. o� O� F �tk e, �G �O P � O Y ti 26-026B i I 3 z� I L rnfl Wit o to 10 / c0 • / •p �N bA7 %0% 1 ao cr. o� O� F �tk e, �G �O P � O Y ti 26-026B