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Home My WebLink About28757-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-29212 Date: 01/23/03 THIS CERTIFIES that the building ADDITION Location of Property: 2350 DEEP HOLE DR MATTITUCK (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 123 Block 4 Lot 7 Subdivision Filed Map No. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 2002 pursuant to which Building Permit No. 28757-Z dated SEPTEMBER 19, 2002 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 REAR DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. Tg~e certificate is issued to H3kRLEY B ARNOLD (OWNER) of the aforesaid building. SUFFOLK COIR~TY DEPARTMEI~T OF ~LTH APPROV~kL ELEL-£RICAL CERTIFICA~]{ NO. PLUMBERS C~TIFICATION DA'r~3 N/A N/A N/A Signature Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28757 Z Date SEPTEMBER 19, 2002 Permission is hereby granted to: HARLEY B ARNOLD POMPANO BEACH FL, 33062 for : CONSTRUCTION OF A REAR DECK ADDITION WITH FLOOD PERMIT AS APPLIED FOR PER DEC AND TRUSTEE CONDITIONS at premises located at 2350 DEEP HOLE DR County Tax Map No. 473889 Section 123 Block 0004 pursuant to application dated SEPTEMBER 16, 2002 and approved by the Building Inspector to expire on MARCH Fee $ 250.00 MATTITUCK Lot No. 007 19, 2004 . COPY Rev. 5/8/02 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 Departtnent'~vith 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. Bo 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. Co Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of 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 New Construction: Location of Property: House No. Owner or Owners of Property: Old or Pre-existing Building: (check one) ~ Street Hamlet Block ¢ Lot '7 Filed Map. Lot: Applicant: Underwriters Approval: Suffolk County Tax Map No 1000, Section Subdivision Date of Permit. Permit No. o.~ ~ '~ ~- ? Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: (check one) Applicant Signature Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-1366 June 24,2002 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Harley Arnold 2350 Deep Hole Dr. Mattituck, NY 11952 RE: 2350 Deep Hole Dr., Mattituck SCTM#123-4-7 Dear Mr. Arnold: The Southold Town Board of Trustees reviewed the survey dated June 17, 1997 and based on the information provided, determined the construction of a deck to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code. However, any activity within 100' of a Wetland line would require further review from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. S i n ce re l y, ~ ~"~"~ '~'~'~:¥'¢ '~'~' Albert J. Krupski, Jr. President, Board of Trustees AJK:lms NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER ! EFFECTIVE DATE 738 o6o6 oooo3 I PERMiT / Au~lust 30,2002 FACILITY/PROGRAM NUMBER(S) EXPIRATION DATE(S) Under the Environmental August 30, 2007 Conservation Law TYPE OF PERMIT [] New [] Renewal [] Modification [] Permit to Construct [] Permit to Operate [] Article 15, Title 5: Protection of Waters [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transpod [] Article 15, Title 15: Long Island Wells [] Article 15, Title 27: Wild, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certification [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Reclamation [] Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Article 27, Title 7; 6NYCRR 360: Solid Waste Management [] Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management [] Article 34: Coastal Erosion Management [] Article 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO Harley B. Arnold ADDRESS OF PERMITTEE 2350 Deep Hole Drive, Mattituck, NY 11052-2615 TELEPHONE NUMBER (631) 298-4143 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT/FACILITY Arnold property, 2350 Deep Hole Drive, Mattituck, NY ' 11952-2615 COUNTY I TOWN [ WATERCOURSE Suffolk Southold Deep Hole Creek DESCRIPTION OF AUTHORIZED ACTIVITY: SCTM #1000-123-4-7 NYTM COORDINATES Construct a 12' x 22' deck to south side of existing single family dwelling. All work must be done in accordance with the attached plans stamped NYSDEC approved on 8/29/02. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit. I PERMIT ADMINISTRATOR: I ADDRESS I Region 1 Headquarters Mark C. Carrara (CKVV) Bldg. #40, SUNY, Stony Brook, NY 11790-2356 August 30, 2002 Page 1 of 4 DEEP HOLE DRIVE .~. ~o, ~ ~o ~ A · 54.24' · END FENC~ ~ FENCE' f'E ~02o0' NOII' S ~1', WO. 4' DI~ERSoN ' ~ I ~ORY ~_ ~I~G TOWN OF SOUTHOLD PROPERTY RECORD ,CARD OWNER STREET ~-~_~0 VILLAGE' DIST. SUB. ~f~ ~. ~. ~,~ co~. ~ND IMP, TOTAL DATE RE~RKS Z AGE BUILDING CONDITION FAro Acre Value Per Value J Tillable 2 Tillable 3 ' Woodland House Plot DE~H · - BULKH~D ~otel~ ~ ~ ~ M. Bldg. ~A~ ,~ O = ~ O;' . ]Foundation Bath ~ j _. Dine~e ~ension ~ension -- ... Fire Place ~ Heat ~ & /~. DR. - . ' Type Roof ~ ~J~ R~ms 1st Floor BR. ? P°r~e~ ?ffJ.~= ~/ ,~ ~> Recreation Roar Rooms 2nd FI~, FIN. ~. Porch " ~ Dormer :~ Breez~ Driveway Patio OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 2~, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under tl~e Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Developmen.t Permit Application" [FDP(93)], and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93)}. BLDG. D EF'T,. TOWN OFflO UT?O.L~, Southold Town Clerk August 25, 1993 APPLICATION PAGE I of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMFF APPLICATION This form is to be filled out in duplicate. SECTION I: GEN'E~ PROVISIONS (APPLICANT to mad and sign]: 1. No work may start until a permit is issued. 2. The permit may be revoked il' any false statements are made herein. 3. If revoked, all work mnst cease until permit is re-i.~sued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local, state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Adm;n;~trator or his/her representative to make ieasonable inspections required to verify compl;a-ce. 8. I, THE APPLICANT, CERTIFY THAT ALL STATEMENTS HEREIN AND I2q ATTACHMENTS TO . THIS APPLICATION ARE, TO THE BEST OF MY KNOWLEDGE, TRUE AN'D ACCURATE. (APPLICAN-~S SIGNATURE) ~ _ . /~7 DATE q - / q - O SECTIQN 2: PROPOSED DEVELOPMENT (To be completed bv APPLICANT) NAME ENGINEER PROJECT LOCATION: To avoid delay in pro,~_slng thc application, please provide enough information to easily identify thc project location. Provide the street addr~'-ss, lot number or legal description (attach) and, outside urban areas, the disttnce to the nearest intersecting road or wdl-known l~dmark. A sketch attached to ~hk application showing the project lomtion would be helpful. FDP(93) APPLICATION PAGE 2 OF ,~ DESCRIPTION OF WORK (Check all applicablc boxes): A STRUCTURAL DEVELOPMENT _A. CTIVITY [] New Structttrc [] Alteration [] Relocation [] DemOlition [3 Replacement ~MATED COST OF PROJECT T~.~T~ U CT U R E TYPE I~-Residential (14 Family) ~ Residential (More th~n 4 Family) [] Non-residential (FloodprooFmg7 [] Yes) [] Combined Use (R. exidcndal & Commcrnal) [] Manufactured (Mobile) Home (In Manu- factured Home Park? [] Yex) B. OTHER DEVELOPMENT Aka IVITIF_.S: Fl Fill 12] Minlng ' Fl Drilling F1 Grading .~ O Excavation (Except for Structural Development Checked Alive) ' -- · El Watercourse Alteration (Including Dredging and Channel Modifications) El Drainage Improvements (Including Culvert Work) El Road, Street or Bridge Construction El Subdivision (New or Expansion) [] Individual Water or Sewer System El Other (Please Specify) After completing SECTION 2, APPLICANT should submit form to Local Adminktrator for review. SECTION 3: FLOODPLAIN DETERMINATION (To be completed bv LOCAL ADI~-IINISTRATOR) The proposed development b located on FYRN{ Panel No. , Dated. The Proposed Development: [] h NOT located in a Special Flood H~Turd A~v~ ('NOtify the applir~-t that the application review b complete ~nd NO FLOODPLAIN DEVI=I OPMF-.lqT PER/vlTr IS REQUIRED). l'q Lm located in a Special Flood H~?~,,'d Aa-ea. PIRM zone de.qiguation i~ lO0-Year flood elevatiou at the site is: Ft. NG'V~) (MSL) [] UuavailaBle ~3 The proposed development is Ioca(ed in a floodway. 17BF'M Panel No. Dated [] See Section 4 for additional instruciions. SIGNED DATE BUILDING PERMIT EXAMINER CHECK LIST DATE SUBMITTED: SCTM# DISTRiCIL 1,000, SECTION I~-~ , BLOCK: zt , LOT: --~ STREET ~D~ESS:~75: " / PROJECT DES CR1PTION: ~16 ~V { W[O~ ~e~ W{ EST~ATED PROJECT COS~~ ~CHITECT/ENG~ER: ~/4 FAST T~CK?~ S~GLE & SEP~TE CERT~ICATION-~Q~D? ~a NOTES: - LOTS 40,000SF -I 00 24 ~ recognition.(C~ATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25 Mmger (A nonconforming at any time afle ZONING DISTINCT: ~-qO CONFORMING'? I ~Q. LOT S2E: q~,ooo ACT. LOT SIZE: qo,oq~ ~Q. LOT COV. ~ '~ ACT. LOT COV. ~Q. FRONT 1'o PROP. FRONT ;g,r: ~Q S~E ~ ~' ~O-- XCT. ~Q. ~ 4~ PROP. ~ ~ ~ ~J HEIG~ WAT~ F~ONr~, /( ~ V~CRWT~OS: ~2'4' '~ PA~L ~: ~ F LOODZO~:~' '-'~~ ~ A~ROV~S ~QUI~D S~FOLK CO~TY HE~TH DEPT: YES or ~BED ~):~ DTE: / / PE~IT ~:R10- TO= y mw YO~ STAT~ D~C: ~=:~,,,,,~o~ NO~[ SO~HOLDTO~TRUSTEES: ~rNO .~. ~q. [~ TO~ ZO~G BO~ ~PROV~: ~S or ~ ' ' - - ' TOWN PLAN. BOARD APPROVAL: YES or ~ TOWN HISTORICAL PRE (SPLIA): YES or }!tf) LIGHT (SQ. FT. x 8%). / NYS ENERGY: YES OR NO : ~ / EGRESS (18 H min.? 4 sq total) [--4~i VENT (SQ. FT. x 4%) BIJ[I,DING PERMITS OPEN/EXPIRED: BP -Z / C/0 Z- HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- NOTES: FEE STRUCTURE: FOUNDATION: ~_~' t/ SF FIRST FLOOR: SIr SECOND FLOOR: SF OTHER: SF TOTAL: SF 1. ( ~/(q SF)- ( SF): SF X $___ 2. ( SF)- ( SF)= SF X $ =$ =$ +$ +$ E'qlT FEE +$ +$ OTHER TOTAL FEE 765-1802 BUILDING DEPT. INSPECTION [ ;/~FOUNDATION 1ST [ [ ] FOUNDATION 2ND [ [ ,/ FF~MING [ ] ROUGH PLBG. ] INSULATION ] FINAL [ ] FIREPLACE & CHIMNEY DATE: //~//~ ~///(~ ~/'/" I N SPECTOR/. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ~ULATION [ f] FINAL [ ] FIREPLACE & CHIMNEY DATE INSPECTOR 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] ~TION [ ~]~FINAL [ ] FIREPLACE & CHIMNE/Y DATE INSPECTOR TOWN OF SOUTHOLD BUILDENG DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 Examined ,20 .. Approved q l[q' ,20 2.-. Disapproved a/c Expiration ~/lc! ,20 t~ BUILDING PERlVI1T~PLICATION CH]~CK!~l Bnilding !n~p~--~or APPLICATION FOR BUll,DING PERMIT Dat~ INSTRUCTIONS Co - (,, , 20.o.~_ a. Tkis application MUST be compl~ly fill~d ia by typewriter or in ink and ~ to the Building ln~ector with 3 sets of plans, accurate plot plan to ~.ale. F~ aoeorrli~g to sclledule. b. Plot plan showing location of lot and of builrlln~ onpremi~es, relationship to adjolnlngpremises or pubhc streets or area.s, and waterways. c. The wo*k covered by tl~ application m~y not be commenced befoi~ issuan~ of Building Permit. , d. Upon approval of this application, the Building ln_~e~tor will issue a Buildiag l~aro~t to the applicant. Such a perm/t shall be kept on the premises avaSlable for ia~p~fion throughout the work e. No building shall be oe~pied or used in whole or ia part for any purpose what ~o ~ ~ the Building lnnpector issues a Certificate of Occupancy. f. Every building permit shall ~a'pir~ if th~ work anthorized has not oomm~ed within 12 montl~ after the date of issuance or has not been completed w/thin 18 moatl~ from such dar,. If no zoning arn~nttrn~ntn or other reg~!a_~on~ affect~g the property have been enacted ia the ~; tl~ Bufldlng ~r may authoxiz~, ia wri~ tl~ ~l:lz~ion of the permit for an addition six months. Thereat,r, a ~ p~mit shall be ~ APPLICATION IS ]:rI~YMADE to the Building I)~aztm~ for the ~ ora Building p~mit pursuant to the Building Zone Ordinance of the Town of $outtlold, Suffo~ County, New York, and.otl~ applicable Laws, Ordinances or Regu/at/ons, for the construct/on o£building~, additions, or ~on~ or for removal or damolilion a~ herein d,scribed. The applicant agrees to comply with ail applicable law~, ordinan~, building cod~, housing c, od~ and mgn!atioag, and to admit authorized iaspectors on premi.q~ and in buildiag for ~ imp~tion~. ' ($ignaa~ of appli~at or n~me, if a corporation) State whethe~ apNicant i~.o"'~, l~see. ~ arc. hi.t. m~n.~r, gm.a'al coaUa~'t, or. el~-ra'ioian. Number or builder Name of owner of premises (As on ~e tax roll'°r lat~ d~l) If applicant is a corporation, (Name and title of corporate officer) Builders License No. ','~ OO ~7 O - ~ l Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Section [ Z :~ Subdivision Fil~tM~No.' v Lot ~' o 5~ If dwelling, number of dwelling ma$s If garage, number of cars State existing use and coXqJancy ofpremL~e~, and!nten~eql'us_ ejmd ocJzupancy of proposed conslruction: a. Existing use and oexatpancy. ~ ~ ..4~,-~ ' b. Intended use and occ-~pancy 5., · ~,~-- Nature of work (check which applicable): New Building Addition ~ ~ ,Alteration Repair . Removal ' Demolition. Other Work (Description) (To be paid on filing this application) N-tuber of dwelling units on each floor 6. Ifbusinessr commercial or m~xed occupancy, specify nature and extent of each type of use. 7. Dimensions 0fexisting s[~uetur~ if any:. Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height ~. Dimensions ~f ca_tire new comti~uction: Front. ~ Height ...l ~ '(9/~'r~v- Number of Stories 9. Size of lot: Front .Rear Number of Stories Rear 'Z~ I 10. Date of Purchase N~a~e of Former Owner 11. Zone or use district in which pmm{.~es are situated 12. Does proposed construction violate any zoni.g law, ordinance orregnlation? YES NO 13. Will lot be re-graded? Y~S NO Will excess fill be re.loved flom prern!se~t? YES NO 14. Names of Owner of premises Address Phone No. Name of Architect ... . ' , Address Phone No Nam.eofCo,,.-actor Joh Aa&~s 15 a_ Is thi.q property within 100 fe~t of a tidal wetlaud or a f~eshwat~r wetland? *YES v/ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMIrs MAY BE REQUIR.ED. b. Is this property wifhin 300 fo~ of a tidal wetland? * YES * IF YES, D.E.C. PERMITS MAY BE REQUIRED. o ? '/~7 ~?~ ;/a~: .'~), :-:7' 16. Provide survey, to scale, wiltt accurate foundation plan and distances to property lines. 17. If elevation at any point on pmpen'y is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY O~.~: /'/'~'~ ~-~hf Y~[~A/6>~ being duly sworn, deposes and says that (s)he is the applicant insure of indivi~h'~ si?i~g &rmract) above named, (S)He is the ~ ~ (C.~,~cto~, Age~ Corporat, Officer, etc.) of said owner or owners, and is daffy auth~ to perform ear have performed the said work and to make mad file th/s apphcation; that all statements contained in thi~ application are tree to the be~t ofhi~ knowledge and belief; and that the work will be performed in the manner set forth in the application flied th~Te~rith. Swol~JX~ before me thi~ ~, LYNDA M BOHN Term Expires March 8, 20 ~ Si~ature o£ Applicant