Loading...
HomeMy WebLinkAbout34167-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33438 Date: 12/12/08 THIS CERTIFIES that the building ACCESSORY Location of Property: 450 CEMETERY RD EAST MARION (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 31 Block 10 Lot 8 Subdivision Filed Map No. Lot No_ conforms substantially to the Application for Building Permit heretofore filed in this office dated SEPTEMBER 16, 2008 pursuant to which Building Permit No. 34167-Z dated SEPTEMBER 18, 2008 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 SHED AS APPLIED FOR. The certificate is issued to JOSEPH VENTRANO (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A Au horized Signature Rev. 1/81 TOWN or FSOUTHOLD BUILDING DEPARTMENT P. Wo 10, TOWN HALL . &S-7 MAOoJ 765-1802 10 200,8,,, 3 APPLICATION FOR CERTIFICATE OF OCCUP Ki_DG-' 8EP­j­ WN F§ LITHOLo 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, 2- topographic features. streets, and unusual natural or 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. an Oof % lead. I I and similar buildings and installations,a certificate 5. Commercial building, industrial building, multiple residences than 2/1 of Code Compliance from architect or engineer responsible for the building..ilding. 6. Submit Planning Board Approval of completed site plan requirements. .B. For existing buildings(prior to April 9, 1957) riou-collfol-Illil g Accurate survey of property showing all property fill ' I uses, or buildings sand"pre'-existing-land uses: features. es,streets, building and unusual natural or topographic 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate Of denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Occupancy is fs_% Fees I.- Certificate of Occupancy- New dwelling$25-00, Additions to dwelling$25.00, Alterations to ti dwelling$25.00, Swinmling Pool $25-00, Accessory building$25.00. AddIi 2. Certificate of Occupancy oil Pre-existing Bu lolls to accessory building$25.00, Businesses$50.00. 3. Copy of Certificate of Occupancy-$.25 ilding- $100.00 4. Updated Certificate Of Occupancy- $50.00 5. Temporary Certificate'of occupancy-Residential $15.00, Conunercial$15.00 Date- New ConstruVion: Ol -------- d or Pre-existing Building: (check one) Location of Property: House No. CA57 filA k i o jJ Owner or Owners of Property: Hamlet, Street TAA A)o Suffolk County Tax Map No 1000, Section Block LotLot Filed Map. Lot: Permit No. q1t Date of Permit. Applicant: 4-N 7n Ago Health Dept. Approval: J\) -- -- Underwriters Approval: I Planning Board Approval: N Request for: Te pporary Certificate ------- Final CelliCIcate- (clieck one) Fee Submitted: $ Z:S;,,oC) A*, ,c Signature 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. 34167 Z Date SEPTEMBER 18, 2008 Permission is hereby granted to: JOSEPH VENTRANO P.O. BOX 105 CUTCHOGUE,NY 11935 for 10,E 1-9'Xi!e^' ACCESSORY SHED TO BE LOCATED IN REQUIRED REAR YARD AS APPLIED FOR. at premises located at 450 CEMETERY RD EAST MARION County Tax Map No. 473889 Section 031 Block 0010 Lot No. 008 pursuant to application dated SEPTEMBER 16, 2008 and approved by the Building Inspector to expire on MARCH 18, 2010 . Fee $ 100 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD y, BUILDING PERMIT APPLICATION CHECKLIST, BUILDING DEPARTMENT. Do you have or need the following,before applying?.'i TOWN HALL Board of,Health SOUTHOLD,NY 11971 4aets ofBuilding Plans ,li TEL: (631) 765-1802 Planning Board approval f� FAX: (631) 765-9502 Survey ;'' SoutholdTown.NorthFork.net PERMIT NO. h� Check Septic Form 11. Nx.S D.E.C. Trustee- "I: Flood Perinit Examined l�� 20 Storm-Water Assessment Form; ,I Contact: r. \l� 20 O� 1VIai1 to Approved Disapproved a/c M-660.� Phone: ''r M�... . OK Expiration ,20 ' 6 S 20 � 1I, Building Inspector APPLICATION FOR BUILDING PERMIT Date. �` 1 20 INSTRUCTIONS-,;' a.This application MUST be completely filled in by typewriter or in ink and submittedtq the Building Inspector withA 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 adjoinin 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.eyer,, lithe Building,Inspeetor;,,, �y issues a Certiffcate of Occupancy. _ f. Every building permit shall expire if the work authorized has not commenced within.l2:months affter•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;extensionof 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 applicEO''e Laws,Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition;as herein described.The 't( applicant agrees to comply with all applicable laws, ordinances,building code,housing code,and;ze lations, and to admit authorized inspectors on premises and in building for necessary inspections. (Siwtum of a plicant or name,if a corporation) (Mailing•address.,of applicant);,, State whether applicant is owner, lessee, agent, architect, engineer, general.contractor,electriciari,plumber.or builder " 9 Name of owner of premises ff� ` ' 1 , (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. r. 1. Location of land on which proposed work will be done: ,. House Number Street Hamlet County Tax Map No. 1000 _.Section Block IQ Lot ©� Subdivision Filed Map No. Lot Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing'use and occupancy. ILESIO&RA, b. Intended use and occupancy �l oSL sAE 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost �,0 p© • G"U 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 10 UJi b7N Rear 11 Lod Depth Height ��� �, Number of Stories1 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of`mire ryw construction: Front /0 w0f Rear Depth I L 40A Height la Number of Stories i"T L% 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 1.3..Will lot be re--graded?YES NO V1 Will excess fill be removed from premises? YES NO 14.'Names of Owner of premises �r> 6oN Iry Address �an 'fA�y �10. Phone No. Nam—e of Architect Address Phone No Nli ame of Contractor '' Address Phone No. 15 a. Is this property within,1100 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. 46. 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. 1 8.'Are;there,any covenants and restrictions with respect to this property? * YES NO- *IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: OUNTY OF 1i being duly sworn, deposes and says that(s)he is the applicant (Name 6f individual. contract) above named, -7 (S)He is the (contractor,Agent, Corporate Officer, etc.) �'f said owner or owners,axtd is..duly authorized to perform or have performed the said work and to make and file this application; that ail statements contained in.this.application are true to the best of his knowledge and belief, and that the work will be a� ,tv performed in the manner,se�` 6,Pinl;the application filed'therewith. NANCY A. PESTER `,, Ow Public, State of New York Sworn to before me this 098 w. 4945-Suffolk Coun day of C 206 Ex pires Aug. 1 N&Iry ($igi6ture of Applicant 1,; - SOUT,�°�o j 7; TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING [/] FINAL [ ] FIREPLACE & CHIMNEY �[ �] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: n J��.Op DATE r� g INSPECTOR COMNLENTS FIELD INS�ECTION REPORT DATE t FOUNDATION (IST) ------------------------ --------------- FOUNvi, ATION (2ND) z � O 3 ROUGH FRAMING& PII UMBING x . -- -- -- — xl INSULATION PER N. Y. STATE ENERGY CODE FINAL i ADDITIONAL COM30NTS � - NJ 0 p Z m V z x v b y i i I IL•L. 1 , Z C+� w. • N o, cc cc cc _LW 3�r21o7 QQw o : c� .Y.,;,:., i ` 1 10 P_k i�(` .'i bpi` f ,/\^/',y//t (i�C��...VVV lJ� �; �1�ti �� Y��rl� •S�L t ai 1 �1t{, �.. Y nl{�iy' i r }hr J� t`'f L ;•I.��. (.:Y :-•1 .' k� -',t trr�.i r ` ' A�r'q: l _ � .r �.r r •t�.z'� f�` t K.�F."-c•r r'�'A 4 .1;A' n "1r Y �d Y '``� � � 1� 1� .. t J s �r"fi*�{ ° �' ! ""a�.`S`����'`1 y,r� �niY t�Nt��` .�c�a„�, i���'ia�,} {�t�u7'��iN a.• •1'�'t,,.�1'�S( '"r i' •ac,• +nth,rcarr 1�.t` � _k � ZY 'C.-t�Y�`�'e t!�:ro'� a; �.f�.'� 2) t�.}iry,�• t;'nf,,`�rt?iiF,'�.�z'x t.�'`;�� �, 't x� y�i z,-it '�'�.: .• }u L ir s+h .,...Y- t { ! .,lL!T7 ?f §��?.'��$:• �j '3t 1 Gt' t t :t,1'6• :, ,.' r,• $: t`. - Lc{ t� `?C-�, 1'f Ff�f'v"'r': ,�� f �;n C�'F'•n. - tb! x•� 5' '`-':, " it3�,o^ s¢,•:.„ •�•� >���y: K {,�F' r�ri'Nq 4,1�)-�� x�'37:.t� '^'�ttiy .�����1.,�s:"t .iY{�,�'S� �:�a;. '¢>.h'�:'-� _ �r..n;. �'�;• 7isx ,r'r •., ` fca•, t :f �'r''�`c •iCP 5;F i a�'. lyt 1lr a ; = jZ:gi Ste' �`t�', t�i�"r '1f-tie " J<?y,..t}',5 A�, F q; - 4;�i;3t''`+ r c.. $d �Ir:"�(.•,is��4�,? r� �� 1 •e s�•f'�y p�'�✓iq'ti�.'�'.•s F�"}'.'��:. ��;��:��S' ������3•'?��;C'?.{{��,, t. �:^Sv' •^'t�rq.�,lk _i,i�,+�,,�..i��. f . ..� rrirc pp t,;: `f y. ri .. s�. ':b `• � in Y .r. itil.= 't C&+��4�:,.�:„,•§'�j!42 - .i�.t �.,Jtr, .t{,.�,;( 1�` � r rc k f•' h}+S.•},� �'S�� �4 �. P J' ..fir �?,}, t t r••�''.tit. .F } Ill" 4• I 9 SS ,1 Y•7r { •�4.. .$ S�P�� '� 4 x` ( it i• tY 1 G� t s ( q t.`� L i.�,�j1,,y c r:�d v,L Tt , ':ti, s .r s: w 1h y�:�- �tt Ali YY3 iT �y}�{y •pf ��.cl-t;L t•fy��.Y s'L3.'; J��j'' ,7�r .tht�;A7��,; ,'q _f ay •> q �I E'1.{�tt d j iw'��`f f+.➢•�rf-t.., t S �7u.}'4,r ':Y^ rs :.1x -AfGria-nx':4 '+�1 •F: ,aL d „ k t (r S 7 !. n r(kl ry r�,,, t rl i21 j "f `"a� 143's .j •trfl §. r..� tiN o:o.. !�rr`)` � �:. t4 t{•t� ,�, L { t� •)q,,'� y _.va, ss�.: `:'f .. :�'�.$:t 1 �� F.+��. 9"'>�'1�'�h � ig'7�,�•?`Y��1: :�.,}&t? jt.�6. �KdJ;.}k`r rr:�t�a. i � '���.. "��i• I t�{•{i�`�'jr�x� t:s 'G,- � f���..� • !`Sa T rrtl ,3 JF• .t�y.1� t..�rY•�' � ht✓i�`;+ s e y F I" �''t, t r ?..F r' =a+. ''t.rti%C^3w,.;=L-.� <.:i w'tS 1 S •r r Y t r 'l,t.�� t i .a f �i �r y 3� t . �i ��fct ��•" lsa �'., r { '� q 2 i �'r ...�"�i•��,7: � ,5,�6 `� �,.s�q �`� :.�"-•,•...1_.,' -_ ,. a•Z.2i.:�"�J :' (�:);' r7 i�t LL 1� 2.� S� ,.b' � v� 't@1'�1`{�t'�s�` j �!]��f c_ rs`art r.��5! �f� tt A,_. f +'.ti. n � ? y'bMt c( tt� a` S 2 'qt �' •� �� i ,.. .. ts7r 6�aq Aii�r4 � l-d`�"y� '� �,, SPV 1` i t ! n r /# �Y`s�• o- F r ��tu � V' 1r'Ch }�,5{C� � ���t 4[.i n• R �1��*Sss�V'a F���r �`P.'"�,��'yr?i�} C�•1,tt' ,x� �e�'} ,�.t.•:.,�. iiifrr�J'' Jr �'( ..�! tf k?y'a'� ,t �rat r Ii' .l: !; t+r� t' b '€� F i ,¢•�'��� f t �o r t�Z�,, :��p_,... �'�#,;,1,t�:t�. �,y tt''11 4 .,.� }(s ram"1j'i'y�.�'� �,)(j�i{�,J1F„�•'�`1¢c�+�t �'�{ "' ',..�• 1 r ;lY ,xt�"" � a"'c�`l- "�`'�4,ax"fe;�-'c'�� �1+.�"�•>�. �` ' '? t�Yiti �lTit`ir,r , t •r{ls h j- A��y�t. �€'l a#�.t4 r " Y �'•,* - ,,, .� `t.-�•�,� C.i. �2:?,C!`',�,`•��}�{�y��� � "•S}.� 4k lr�r'�y.'� t5 rjtd, z� f t x{7.r 1 r : ass., u �sn r ti tun f - �. Fe f_ Y-0 le �c�` `�� � � Z��• .Ff .cr 1" .f �S S �.a��`' �` c �z- •i-"�'r;,r�'fk,{ rs i ?•-:� q l r?c tiriAr( i.s 7 l y �. ri•. s '# n Y �{7 rw �f _ l u}L':� r ! r .{,.�yy. y:,ty.F•tliri (� t,�11t tff :r&:.�� �{ 7' ..1r 1'Y�,�''l�JS�t n.. r C• _ �rrr t �}i';y'��,} iz: is i° wr.p �}`•�1 F ? {- � tt' 'h,?�i tP ' J.. r,NS wT .1 '1 W'.', -1+n'`+'"r /8. �r'jjt' �s L.SyL�, .X � �w„ r.: 2`l .t i'•a��.;`s �'••; '^ t i :e,.�t_.r :flk?. 6 :-q ..f- A J t ., S}Y t F 1.� d^' •.9 'W Ll�3yr/k(f. e, •: ` A yI{Y e Ie{Nr'�.s�Z��?��...s� a7�`x+�L'�'�'. ..f;7';�tc,�kza h� q } 1 O'Z7o $ tr3} vt+ 1 U`O, — A 22 X -`• f !a��*"h`.t�1 Y j�a isry ti�'n !��i� � � .f � -t. e•�n '�'tr'� $''�'7 t�tV�(1 Pi,<'bY;3 T � .. � �� n .� b t'� n, •�'''l k +'T ,ofJ"41 •7` a � + nod«�.K�ti+��„ s��`t s w"'!rti7? rst s( L �,c� a 1st( y d?•'Sif' ( -t, i �''Sntti.Y r� �, J� 'Qii 3 )t•ai 3.p gF.tc'!Y rl I Ot.r. t [• ! Al t-?"'v ycJS��. S 7j i n�} }� .( y;art••-u.. t Yi. ry ' '•..+`i..,�=1:�._ - _ p i.:p. ,r t.. z�i;`ti'r •3'�rly»s~�o-+ �s'�itk�n.t t�z y�.✓���"'btt fj ;�'ttj qi' '3�i) 1 's s`( v 1r)^ 'U•rp •SL1 �l (_] c s 1 oy, y i.( i3 Fs5' 5 `i�i k �:�`;t •LrI F`, k ` { 4�• a�i}f '.'�-:: '-Sl' ,� �"'�`.:-�: � v -2 '� .�ta M •Vz{' t, (�.ty� �1K,sa 1� -( � �ts���4r1' �F:ki"'=�� ^�r�r7'•v�';�,V t,i( i ii�<f �v K.;". -.� -i �?'�'.� � �.� ,� .r�,' r C.rt3Yi y, r-14 ✓.,... M -� ��t i� t,s+ wyie S � k?�Y r . ^1,.7t2_�k i� � •LI`� ` ..Y.cr t� •� a� t `� �l� �f�;! � 7� wti�._�!c+7.'�C��£> o- ,,v L 7: ,a•. r•�.•.3�t' � � i�}+-Vf"1 .F�^v_r< i r-y�,r��••-� 7 '1 'r t -r�:t �. Y£bY�Yy�:�- �' r�s _ ?r�q 1,y..L .;....... <, VM 1r F, tC,y`�r '�;•�•* �• 5.r- :sL. .."+I `:,.ar Li:Ft d R s -..j` f? 'i`*' t {c r•,�.. r"�T '✓ (fi��"3�: :5, :r.,.. ui.;}' ,r�n.._4c i,/�,h54"7 ^f,R.: iEr'4,`k _t!- r'dt �k� ( 'f-.1 r.•.��i.S;.`�3.7t" drYi: ll hr_Aa �Y`SF+�{u,.,7.' `�rn•., v,, r q kf.: i � '�L h Y �l Acd �rtL�r% �t :u�i•� > \. t �` .+ [ i �) �h -�., T�" 1Y .j,,� '3'.14•sltl.�,c;•r"'Y'}{�.}<sti •7'•.' l''.�'Jd-e! l\ cJ t 'YCfZr e.I- y' � ?l2 i� 1-�,. ,tit{G �,a�"���=t"'�.•yr`�`g"t y' �1.t•s;'..�j�7'9r{tµ`�'�rY [y t rt { '{ t� �.( +1 r y 4, l,I..uT�?!, ¢,k.g�r-fir .a• 4 G' r� t• rt. -'� �rf�.F t�•t>''7 a r Z ' Y1 ` �•�ch�+ 'I1{ t�'*+-•¢!,;L �.. „ .x,r s yZ{ .may, S r 5 `t' 1 t�c r^ � -�t, t .:;i? i•,'� t� .J;,r.t��- tq �� t tt x1 .e ,+S J y= a =3t.,e+r ftM >-c 'i i- �._ i '. V•t4{�{{hh'yy':'�tr� L�r-r ,�w• v. t;n r-.��,Y '_. .x� .1k1 � y sT�. 7- e �� 3 w v,..r`�a't�tir �t��V•<i+2 `.'{. '.:-Y.iJ,>• •,' 'G' L Y ryl-"' � {QY ti r{} •+} �:, t �! f F•��'" .,.i � .A ';, ::i. :,Q. :�.' _ � �.Lt.l' i�:�;.: � � F':hi S,;ii;,., yt.r..f+n .. .. �,.^ ryc''t.i.xc u..'.-�>...���• _� m U) w � CD mwu- O (n w O tL LL w -� w cn O Z z w uj � ~ � z0 -1000 wU0 -cc z j � 'L s O Q U H U = W ^^ �� O� L7 F- 1_ Q C) Q F--• tY V O Z O V �� �`I 0 ; C) OC ti- 0 L_ F_ U F' 0 o0 00 0 LL t ate. U F- � 0 p —i w Q W . y r zzi� CC zF- C) coz0 �� � U o 0 0 0 U J U r , mac — O � tr_ � Q � ccZ �.uo _ L � «, U ¢ � t F Ua � ttt � [L - f— Z So CI, r °° Zp0 _ � pZw < O �-- � .f cn cn cn z QF- w0 =; OOoOC - LLCO � C� occn r Y f.� U W �-- 0 twi_ ZQ � L .- �i cr5 �t ¢ cWC 0 n� 0 U (/) Ly- v oc O �. 3 Luu cn i t r•,K'+gWr,(fah}f ��y�:p.7" i� h `�kJ(ti'C "�rJ 1 � ✓a�r�s-5a 1yL;}�('}•`iq pd•�J•1r'> '4 7 -,rl � �i��� ��'�si 3 J'ta J}� YF� �4pp,�.r ir�i t o r f !' H �.d7'uths ar6.�,.;a tFs'�Crt �Sai`'�`��` ye�09� �0� p s44 v'�A^�1rri�� �} L. ° ,� � 'r�lc. � +•�:. W.S�JWf'1 MWyids%Ado l n„ R <i }" #}rN'�1 n b EN'. . r+ap awn z^� -. �°... ..., y ; .i y� � �xA�ryJ'x`;y4 �`�.k'�f, ax - u'��i� 5 A}3. ''' _e c �y�, Y •P$x.f r,. way +£ r ,�.,.J� 3 xIj "�. ( ^^o �E'� -'°--wn-.._..e„�,x�•.y,s t 'fin IS rag - sy �'� � ♦f�-�1�K��` f�;dR'� j } 'a i' ��0n��! .�>! s-�°,,,�*.'�.,.�Yi'�-s _;,,�•h e» YL � tFif,it�il��•4`�,�� Y..����yy :� � a t V hY+ r cjF�. t . .mot �s� ti • NMI �p v 1 kn')!-�YSs+�7�i� g s { i• ry, r )7rxPY+S%/'it5•i''� St v�• I 3« NN re Lei'` {y r �,i� s4y�t�wyl' t 1 '�!f�3}�p ��i��•fa'z+••.. >, j:Y �+ � t, } � c�,t` 4 t s �+ :,r t'7'EX..o-w"%-'s,o-,z•a.���`p` �' i��5� " }�' � -CJtE�,��,�'..'ry.i .-Cr} M^`"�'"'}. �. v ti r r + +i 2h� LM1� :a7��:.''s vt l:r�,�'u�,r t.�r� � p .� k�y-, �`Yi�Y n�`r �dt � 5 1�i,',,r.., rY. �.� }� JF:. .y 1..{ r �{''rS+��+j•�s I�� .A_ ��i �<.+'. tJti4�U ! r 4y1 �.c�+"` y. `r,., f y'�,tTy����,) �,.t�'+t�1.� (�w�}' c"l.t� , ±( �S t)'t e! �' , �-rr.• £'u�i c.. if, { vt� r ,4 1 _n r 1, � "'', 4 ,r ./ { y.�( t •I t 1 � 7 u 4 F ,r+!- CMG' �''t r� ��T 1�t rGY#<;F<n r + 4p� ) ,t ��`� '�•�'p_.i�t'�t;L11'���4`' 1'f^'1,�j1�,.5�� rfx �..r <,` 5�� � � ` � t�f t ���1�{�ifl; sfi¢�} I�,i7�,,.�{{zc. 1F ����rl"•����F f. "} 'rr3A,�r (vi✓�,! T SF+ Y r .+ i r F t'r i� + � �+ -i "2 r'tifi+ '� •:a- ��rYyr;7'K S ?(,i 1!� ry'M1K. 'I l i T jI I +5.. p{ 7`IE,C•REM ty, l I/4- ..i F ,,,+ ! '{ r r ) ( r Y. i (�o±S�)�SrxZl ��to��;J � =n'nit�:}fi;.1�,;•I.r, rat .i + + t i }it '� �rr , � + � � (t l v.r;J{�, t ���i��q'� +• K7 i�brfnY i } L i r L s 1: �. W + t 7 ) }. S .✓t`>;a��'!Y ' I. i P sf rl5, ,-S + 1 fi rd4��'Yi)S 75 t _ t i (f 1 31 y r' + � r t r t . zl(( 1 4 t �.. r Siiu i S- ��r'3Lt+�a�°� r'•:C je + f t 11 1 lz �r f.rr ,,[ Y /n •kI '` tY ; •}5%3'� { zy v„1 4( i tt 1 i t -1 .,I S {{N r3'iy 3.[{inf•+ ttft..°i t?1 f Y. -., z; 1 }}��t 7x ,1,.. )S Ifi.. ., 1 Y i + 1 •, � I .- j 1 - c t i ,5{x4 � *. '{hT�S[1 tK 1N.+t,...t -.c.:'td!!;.'i;,� ,4 Y. r s. 'r r a ' 7: r r, , ''ffY i{:•k r t k`iu}h s'� +.c... MOO;i i s � � ' 4 4 t� c+ 2t (� yt r c r } e 1 ,x S i r. t t t + r i i y t!ry 7ir.fi �a.�¢� Y } ��4£!✓r h.} y am ( �-. S ti).1. `� t -f ! t I � i ✓ f s 1. v d�i G. �Z 7 +1 r-iv t ! .r + Sf E+ lfrtS• s ,~'� ^"s'M`w ftik2t !Y M.•ra!+oj Gte.,3:"°11{" '�= /{ ,S. '�h"f. {L• I�i�L �-' Hti+i��3 �v.,:„c1 f �"n �t t y�'(��rS,.�.�x�'y�� .p" ) t �l, �' a j.='r.,v " . zi ^��t - 5�,� �.., yS+r y�; sST 'p _Y�;.:,��r.S`'�'��''.i+py7y�{'�f f5 f.7a'{I"`�1�;5;. 'p��j`t}�'j-S�2"'�,{� l' yL 1+�` •���1'Ylri•r(�t .7� ' x """hhh::: � �S h, >�I •s�;.r.i..c+4�„F ���P*` i� 'it}�' <'JY,Jp ai'. � r w{ l�jrii - ''t''r tip•*".i + Y� � ¢� +}+t2.3>'y 1{�ll s��na! r,1 s.. �S.rL,t r a sl S i.P t i i ss: Ct,u � '. .F n..L(ti ) �r3yt i �I-•� /} > 4iy y �ii an 4 �' 4 ♦Y. Y .. 1 .,kr.v.t1.3.. :�( ;��� ;+ s'J. .. .,>.. t. ..': boS� � Town of Soufhold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT SSMENT FOAM PROPERTY LOCATION: S.c.T.M.q: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLANT Dis� trict Section a ock Loot — CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YOflK. Item N umber: (NOTE: A Check Mark(4)for each Question is Required for a Complete Application) Yes No Will this Project Retain All Storm-Water Run-Off Generated by a Two(2")Inch Rainfall on Site? �N (This item will include all run-off created by site clearing and/or construction activities as well as all Site — El Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location? ❑ This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow! 3 Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural ❑ Existing Grade Involving more than 260 Cubic Yards of Material within any Parcel? — 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ❑ Five Thousand(5,000)Square Feet of Ground Surface? — tj Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred(100')feet of a Wetland or Beach? — 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen(15)feet of Vertical Rise to F One Hundred (100')of Horizontal Distance? — 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Stone-Water Run-Off ❑ into and/or in the direction of a Town right-of-way? — 8 Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of ❑ any Item Within the Town Right-of-Way or Road Shoulder Area? — (This item will NOT include the Installation of Driveway Aprons.) 9 Will this Project Require Site Preparation within the One Hundred(100)Year Floodplain of any Watercourse? F-1 — NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water,Grading, Drainage&Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! --- ------------------------------------------------- EXEMPTION: Yes No Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question,a Storm-Water,Grading,Drainage&Erosion Control Plan is NOT Required( --- ------------------------------------------------- STATE OF NEVV YOPK, COUNTY OF....... ..lA� .�I�--SS That I, .. beuig duly sworn,deposes and says dial:he/she.is the applicant for Permit, Nz'mindividual signing DocumenO AndLhat lie/she is die ........................................................... ......... ........................................................................................... (Owner,Contractor,Agent,Corporate Officer,e(c.) Owner and/or representative of die Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and drat the work will be performed in die manner set forth in the application filed herewith. Sworn to before nie this; ................................. ...... .....Z14 of............. ,20..... NotaryPublic: .. ......�...................... .. .................... ........................... ................... . ... ........ ...................,.................... VICKI TOTF (SI elure of Applicant) FORM - 06107 No.01 619!)r. Qualified in Stif .=t Commission Fyhir: . (/ Q SURVEY OF PROPERTY AMAIN ROAD (S.R. 25) y A T EAST MARION b TOWN OF SO UTHOLD SUFFOLK COUNTY, MY N/0/F GALE CUNNINGHAM 1000-31 10-08 SCALE• V 30' N6013'00"E FE 210.58' FE APRIL 15, 2008 0.1 N STOpCAOE FENCE O/L W U71U7Y g PlP X— POLE W7H REBAR E (HIT) .£ . to O GUY WIRE M *� W O w w tv WA7ER o 0 co METER co cri � � _ q N/0/F RUTH HARLOW ��s � N A 422.49• _ _ — -r- V J\Vr- . — N5 770_20"E _ .— — — cn °1#EU 2 15' WIDE RIGHT OF WAY N y o - - - - A - - - - - A L *9 `d "' 200.00' 222.61' � �A ��y a N/0/F ESTEVES \ o ^+ 39.2' A/C.. CONC. 2 C UNIT C Z O � N ..Opp OD CER TIFIED TO. JOSEPH VENTRANO �P��of NEW yo SUFFOLK COUNTY NA TIONAL BANK FIRST AMERICAN TITLE INSURANCE COMPANY �., O��S•MEJ-�� Rai- ■=MONUMENT TI ccp =STAKE SET AREA=44,M 80. FT. - t¢ ANY AL7ERA77ON OR ADDI77ON TO THIS SURVEY IS A VIOLATION S. L/C. NO. 49618 205.39' OF SEC77ON 72090F 7HE NEW YORK STATE EDUCA77ON LAW. �- S56.46 30"W S, P.C. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CERTIFICA77ONS (631) 0 FAX (631) 765-1797 HEREON ARE VALID FOR 7HIS MAP AND COPIES 7HEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF 7HE SURVEYOR N/0/F JOANNA do JOSPEH CHERNUSHK 9 X 90 1230 TRA VELER STREET WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971 08-128