HomeMy WebLinkAbout36498-Z ' Town of Southold Annex 7/31/2011
r SOFO(,f`,
v � 54375 Main Road
5 cm
Southold,New York 11971
rh
. CERTIFICATE OF OCCUPANCY
No: 35058 Date: 7/29/2011
THIS CERTIFIES that the building AS BUILT ALTERATION
Location of Property: 750 GRETON COURT, MATTITUCK,N.Y. 11952,
SCTM#: 473889 Sec/Block/Lot: 107.-2-3.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
6/16/2011 pursuant to which Building Permit No. 36498 dated 6/21/2011
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
'As Built'Alteration to a Single Family Dwelling
Garage Conversion to Den with Bathroom, as applied for.
The certificate is issued to Lambrianides, Gus&Lambrianides, Otto
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 36498 7/18/11
PLUMBERS CERTIFICATION DATED 7/5/11 Hardy Plumbing&Heating
AuthAzed Signature
� svFF TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
or
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#: 36498 Date: 6/21/2011
Permission is hereby granted to:
GUS & OTTO LAMBRIANIDE
36-34 208 STREET
BAYSIDE, N.Y. 11361
To: 'As Built' Alteration to a Single Family Dwelling;
Garage Conversion to Den with Bathroom, as applied for
At premises located at:
750 GRETON COURT, MATTITUCK, N.Y. 11952
SCTM # 473889
Sec/Block/Lot# 107.-2-3.4
Pursuant to application dated 6/16/2011 and approved by the Building Inspector.
To expire on 12/19/2012.
Fees:
CO -ALTERATION TO DWELLING $50.00
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $832.80
Total: $882.80
aga
�la3
f
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. Swom statement from plumber certifying that the solder used in system contains less than 2110 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 G°pre-existing"land uses:
L ' Accurate survey of property showing all property lines,streets,building.and unusual natural or topographic
features.
2. A property 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$50.60, 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. l�1
New Construction: Old or Pre-existing Building: 1/ (check one)
Location of Property: �d �tJ t
House No. Street amlet
Owner or Owners of Property:
Suffolk County Tax Map No 1000, Section Block Lot ;✓.
Subdivision Filed Map. Lot:
Permit No. 3�e Date of Permit. Applicant:
Health Dept.Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate:_ (check one)
Fee Submitted: $ (1
Applicant Signature
®�*pF SO�j�ol
� o
Town Hall Annex Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 G Q
Southold,New York 11971-0959 ;41% roger.richerKb-town.southold.ny.us
' cou
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Nick Lambrianides
Address: 750 Greeton Ct City: Mattituck St: NY Zip: 11952
Building Permit#: 36498 Section: 107 Block: 2 Lot: 3.4
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service Only
Commerical Outdoor 1st Floor X Pool
New Renovation X 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt 5 Ceiling Fixtures 1 HID Fixtures
Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures 2 Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 8 Twist Lock Exit Fixtures TVSS
Other Equipment: 1-exhaust fan
Notes:
Inspector Signature: ,L, Date: July 18 2011
81-Cert Electrical Compliance Form
TEL. 765-1802
TOWN OF SOUTHOLD
ram;-i- • ". y
=^ �' OFFICE Or BUILDIN."i INSPECTOR
! P.O. 130" 128
TOWN I•::.LL
SOUTI-IOLD, N.Y. 11971
C E R T I F I C A T I O N
DatedQK
Building Permit No. 6.7
Owner: \� 1'+ , �\ \ -.1-11
(please print)
Plumber /4+;ZSy
(please print)
4
I certify that the so-Lder used :.n the water supply system
contains less than 2110 of 1% lead.
(p mber' s signature)
Savor to befor a this
i
dsy- of
17otary ublic
Nots_: Vlt,lic, Co unl.y EILEEN STRAND
NOTARY PUBLIC,State of New York
N6.01ST6001493
Qualified in Suffolk County
Commission Expires January 12,2U/�
SO//%O�
• �o
ol�cOUHI'1,�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1 ST [ ] ROUGH PLOG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [X FINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS:
DATE _INSPECTOR
OF SOti,yo�o
coulm,Nc�
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PL13G.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING / STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
DATE 1� INSPECTOR
i
Town of Southold
Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM �
PROPERT1 LOC ION: S.c.T.M.#. THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A
Oj j() 0 I I STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
6isVict '§ectctioon 4B.ZcW3_r0t_ CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK = PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels?
(Include Total Area of all Parcels located within Will this Project Retain All Storm Water Run-Off
the Scope of Work for Proposed Construction) Generated by a Two(2)Inch Rainfall on Site?
S.F.I Acres) ` (This.item will include all run-off created by site — ❑ i
b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all
and/or Ground Disturbance for the proposed Site Improvements and the permanent creation of
construction activity? 60,
(S.F./Acres) impervious surfaces.)
I j
2 Does the Site Plan and/or Survey Show All Proposed
PROVIDE BRIEF PROJECT DESCRIPTION (ProviaeAddteaalPages asNeeded) Drainage Structures Indicating Size&Location?This f
Item shall include all Proposed Grade Changes and — —
Slopes Controlling Surface Water Flow. fa�c
3 Does the Site Plan and/or Survey describe the em on
and sediment control practices that will be used to —
control site erosion and storm water discharges. This l
item must be maintained throughout the Entire II
Construction Period.
4 Will this Project Require any Land Filling,Grading or j
Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards —of Material within-any Parcel?
• i
5 Will this Application Require Land Disturbing Activities
Encompassing an Area in Excess of Five Thousand V/
(5,000 S.F.)Square Feet of Ground Surface? Li
—
6 Is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements or within One Hundred(100')feet of a Wetland or- —
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 .7 Will there be Site preparation on Existing Grade Slopes
are part of a larger common plan that will ultimately disturb one or more acres of land; i
which Exceed Fifteen(15)feet of Vertical Rise to
Including Construction activities involving soil disturbances of less than one(1)acre where One Hundred(100')of Horizontal Distance?
the DEC has determined that a SPDES permit is required for storn.water discharges.
(SWPPP's Shall meet the Minimum Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious i
for Storm Water Discharges from Construction activity-Permit No.GP.040-001.) Surfaces be Sloped to Direct Storm-Water Run-Off I j
1.The SWPPP shall be prepared prior to the submittal of the Not.The Not shall be into and/or in the direction of a Town right-of-way? I
submitted to the Department prior to the commencement of construction activity. I
2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material,
required,post-construction storm water management practices that will be used and/or Removal of Vegetation and/or the Construction of any ❑
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Right-of-Way or Road Shoulder
compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item vdll NOT Include the Installation of Driveway Aprons.)
Identify potential sources of pollution which may reasonably be expected to affect the
quality of storm water discharges. . NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark
3.All SWPPPs that require the post-construction storm water management practice 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 Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit
hat is knowledgeable in the principles and practices of Storm Water Managemen I i
(NOTE: A Check Mark(4)and/or Answer for each Question is Required for a Complete Application)
jl
1
STATE OF NEW YORK,
COUNTY OF...........................................SS ;
sl,
That Iln'r-' �. '........being duly sworn,deposes and says that he/she is the applicant for Permit,
I
t11 (Name of individual signing nt)
And that he/she is the ......................................... .. ............................................................
..... ......... . .... . .... .. ..
( rOwner,Contracto Agent Corporate Officer,eta)
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. I I
Sworn to before me this;
................••L�............ .day of...�.0 N.......................... .20.11
NotaryPublic: ............... .....�,. . V..... ........ ............................................. i
BARA H.TANDY (Signature of Applicant) i
FORM - 06/10 Notary Public,State Ot New York
No. 01 TA6086001
Qualified In Suffolk County
Commission Expires 01/13/20 L
TOWN OF SOUTHOLD PROPERTY RECORD CARD
OWNER STREET VILLAGE DIST. ' SUB. LOTY7�.
r s _._
'--arn by ► (L VI I� ! '%i'� ��,�'r' r % %s � '1 L � � ��'%J N .S � `- %
T;
FORMER OWNER N E ACR.
`
Qf),i rJr i G ;rJe� D r5 >
W TYPE OF BUILDING . p
RES. SEAS. VL. ;. FARM CONVN. CB. MICS. Mkt. Value
LAND IMP. TOTAL DATE REMARKS
Uc.)` /3� � .� 8 � : ` 13 Z i _ i LL4
I (000 00 6400 5 i3 q! �Oo2o 89- I p c'` -Zc�oS Pr. � c ` cif� Qn ��1'r.3��j `
7- II a " 13� �4, Ka�tere/a �.arnf�r�
I6-oo �l Zm 5�?00 , : 2Z -a30 4- 1-1 I sc7qo C 4V!° LrAm6ri'6in►de5 *ors. -f'v
/600 6300 7900 T c
600 .so.00 .pev 6600 z 6?0 3 - re ace EP4= 2 49
Tillable FRONTAGE ON WATER
Woodland FRONTAGE'ON ROAD
'.Aeadowk)nd DEPTH
House Plot BULKHEAD
-total
t
JyahSf� JI
s
�,��,j,
Lr' r
> �'i���x� }+� � �. ^v ? �'• ��A 'ns is, ;'tyufr L �,fRr � f
J"r
Wiz+ �.•->>. _
Interior Finish
Rooms I st Floor
Rooms 2nd Floor
Driveway
■■■■■■■e■a■e■■■■■e■e■ee■ee■ee
s.
�afsciry Fk71802
' [CE VE
Town Hall Annex Telephone(654375 Maio Road ' JUL -'8 2011
P.O.Box 1179 G Q ro errichert town s .us
Southold,NY 11971-0959 0
y�'aui�mt, BLDG.DEPT. �.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Ili ' (,,��iy✓I?—I.�tJ1 Date: j;g�� �s
Company Name:
Name:
License No.: 4 t d ohm 3 a I �
Address:
Phone No.: .
JOBSITE INFORMATION: (*Indicates required information)
*Name:
*Address: �, o _
*Cross Street: ,p _ - `� '� L9 15z'
*Phone No.:
Permit No.: (c4 Cj
Tax-Map District: 1000 Section: Block: Lot:
*BRIEF DESCRIPTION OF WORK(Please Print Clearly)
&
(Please Circle All That Apply)
*Is job ready for inspection:
t6NO Rough in Final
*Do-you need a Temp Certificate: O
Temp Information(if needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other t s.t ,
*'New Service: Re-connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
82=Request for Inspection Form
12G S( I
BUILDING PERMIT EXAMINER CHECKLIST Date Submitted: �- 8 Date Reviewed.
Applicant: Owner:
Architect/Engineer: Estimated Cost
SCTM# 10o0 — f.0 7 Subdivision: Zone: �' Conforming?
Property Address: ��� City: t Pre COs?
Building Permits (Open/Expired): BP -Z/C/o Z- ,Info: BP -Z/C/O Z- ,Info:
BP -Z/C/o Z- ,Info: - BP -Z/C/o Z- ,Info: . BP -Z/C/o Z- ,Info:
Single& Separate Search Required? Y or N Determination: STOPMAW*MAR_;R AM.Qj:�,F., V
REQ. Lot Size: ACT. Lot Size: REQ. Lot Cov. ACT: Lot'Gov.
REQ.Front ACT.Front REQ Side ACT. Side REQ. Rear PROP. Rear
REQ. Height. ACT. Height . . RE ct.A*TH SIDES A C T
Project Description:
Waterfront? Y or N?
If yes, water body: Panel# Flood Zone: Bulkhead/Bluff Distance:
ADDITIONAL APPROVALS REQUIREDLp N S(+f) SIGNED, SEs�Lt,D SURVEY nJe SITE PLAN
Suffolk County Health: Y or N- If yes, *Bed#: . *Date: _/_/ *.Permit#: Town Septic: Y-N
- If no, certification required: Y or N Received: Y or N By:
NYS DEC: PRE-DEC 9/1/75 Y or N - Date: —/—/ Permit#: or NJ Letter—Notes:
Southold Trustees: Y or N- Date: / / Permit#: or NJ Letter=Notes:
Southold ZBA: Y or N- Date: / / Permit#: —Notes:
Southold Planning: Y or N- Date: '/ /_ Permit#: —Notes:
Town Landmark C of A: Y or N DTE: /_/ *NYS CODE Compliance(page 2): Y or N
CoNTR croR t,lcE-Nst D150ILI1-Y LI!}BIt,ITy. . ...1�4/.oi2k�'f Ns- COMPeW.S4-rION_
Notes• a
Fee Structure: Calculation:
Foundation: SF X $
First Floor: SF +Initial Fee: $ 2`0 0 , v o
Second Floor: SF +Additional Fee L�): $
Other: SF SF X$ . =$
Total: SF +Initial Fee: $
+Additional Fee ( : $ �Cl
C of o FEE ��
AS 8 u I L r FEE TOTAL: $ K3 �� �
NEW YORK STATE CODE COMPLIANCE CHECKLIST
CLIMATIC/GEOGRAPHIC7DESIGN CRITERIA: "
Ground Snow Load:20 . Wind Speed: 120MPH Seismic Design Category:B
Weathering: Severe .-Frost Depth: 36". Termite: M-H Decay: S-M
Design Temp: 11 Iee Shield Underlay:YES Flood Hazards:
USE/OCCUPANCY CLASSIFICATION:
HEIGHT/FIRE AREA:
TYPE OF CONSTRUCTION:
DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE
FULL FRAMING DESIGN ELEMENTS: Y/N
READERS: Y/N WALL STUDS; Y/N GIRDERS: YIN
CEILING JOISTS: Y/N FLOOR JOISTS:Y/N ROOF RAFTERS: Y/N
LUMBER SPECIES AND GRADE:Y/N
WINDOW AND DOOR SCHEDULE:
-MISSLE TEST REQUIREMENTS: Y/N
EGRESS 5.7 S.F.: Y/N 4
LIGHT 8%: Y/N
TENT 4%: Y[N
NAILING/CONSTRUCTION SCHEDULE: YIN
MEANS OF EGRESS: Y/N
PLUMBING RISER DIAGRAM: Y/N
LOCATION OF DIRE PROTECTION EQUIPMENT: YIN
TRUSS DESIGN: Y/N
CERTIFICATION: YIN
ENERGY CALCS: Y/N (RES CREC K)
TOTAL COMPLIENCE? Y/N (RE,TURN TO PAGE ONE)
q SO�ryolo
Town Hall Annex 4 Telephone(631)765-1802
54375 Main Road N Fax(631)765-9502
P.O.Box 1179 G Q
Southold,New York 11971-0959 �� a
Cou�m,��'
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 1, 2011
Gus & Otto Lambrianides
36-34 208 Street
Bayside, NY 11361
Re: 750 Greton Ct, Mattituck, NY
TWO WHOM IT MAY CONCERN:
The Following Items Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
X3ectrical Underwriters Certificate. --- rl
A fee of 50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/ 4)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval.
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
BUILDING PERMIT : 39498 - Alteration
�D S�
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 f g . Survey
SoutholdTown.NorthFork.net PERMIT NO. (° Check
Septic Form
MY.S.D.E.C.
..— � Trustees
Flood Permit
Examined 20 I Single&Separate
Storm-Water Assessment Form
Contact:
Approved 120 Mail to:
isa
Phone:
Expiration � ,20_f4---
�n Building Inspector
C E v E PLICATION FOR BUILDING PERMIT
D
JUN 15 2011 Date �JN�� �'�✓ � , 20�_
INSTRUCTIONS
This applicWW P T be comp etely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of p ans, acc F 0 s-a e. 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 Pen-nit.
d. Upon approval of this application,the Building Inspector will issue a Building Pennit 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 pennit 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.
( ignature of applicant or In -ne, if a corporation)
(Mailing dress of app icant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises JA4�_jia�t�I -���
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Streel Haijlet
County Tax Map No. 1000 Section �/' Block_ Lot
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 1'��61;76-2 Fee
1.11 (To be paid on filing this application)
5. If dwelling, number of dwelling unit 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.
� o a
7. Dimensions of existing structures, if any: Front z Rear :�;J* Depth �o
Height ' Number of Stories ,
Dimensions of same structure with alterations or additions: Front Rear -
Depth ��v, Height Number of Stories
8. Dimensions of entire new construction: Front ��•� Rear e Depth -�'
Height I°� ' Number of Stories
I �•���
9. Size of lot: Front �.,'7 Rear Depth
�rZ
10. Date of Purchase 'yDol Name of Former Owner 4--)
11. Zone or use district in which premises are situated
12. Does proposed construction violate any z ring law, ordinance or regulation? YES NO_Z
p p
ed? YES NO Will excess fill be removed from remises? YES NO�
13. Will lot be re-grad P
�bI rrOOK-5. �_•'�I
14. Names of Owner of premises W V,s°�-t L064dress ® os�G' •Phone No. I
Name of Architect � -� Addressre fog j �^ ` ne No g, (_7�141- I I?o°I
Name of Contractor Address hone No.
15 a. Is this property within 100 feet of a tidal wetland orr-a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE QUIRED.
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.
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 )
Tay' being duly sworn, deposes and says that(s)he is the applicant
me of individual signin contract) above named,
(S)He is the .--
(C ractor, Agent, Cor orate O T
cer, 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 to before me this . 3
day of SU 20 It
144
State Of New York Signature of Applicant
No. 01TA6086001
Qualified In Suffolk County
Commission Expires 01/13/201
SURVEY OF PROPERTY
AT MATTITUCK N
TOWN OF SO UTHOLD
SUFFOLK COUNTY, N. Y. ss'y�,
1000-107-02-3.4 ,9 4' �ry�� i5U,�0 o
SCALE 1'=30.9 �JANUARY 20, 2011
N
�s
N t0
O
O_O '
CSl
LOT 6 210.T2 eoXTM
•41,00„E
N76U, POOL
EQUIP•
EL 20.0' o. B.S.
DECK
30.1 l 1 ASPHALT U)
37.9 1 POOL ` B.S. S y
N
C 1
1 0 � O
406
ZA.3 O
DECK CK m
a 37.T AROUND DE w m
(!) WOOD ONCE a a
= j 29.6 > r
m S M o LOT 8
n
z 2.2 O
EL. 18 Ok `° a
v > m N m 22 y
4b. �- o
O O ccn
CNr1 74.6'
� �W co
� m 26.3'
rWr► 0 A/C UN
C N
O �
O �
tom
Ty
rs 2.3'N 8 BOXES
FIE
E ER 215.51'
13.7' if,
76 4 X OO�W 0
F1'N T Aps . LOT 10
AREA=40 ' '0.2 so. FT.
LOT NUMBERS'REFER TO "MAP OF GRETON ESTATES"
FILED IN THE SUFFOLK COUNTY CLERK S OFFICE ON
SEPTEMBER 20, 1976 AS FILE NO. 6447. 'N0. 49618
\`fJ"
ANY ALTERA77ON OR ADDI77ON TO THIS SURVEY IS A WOLA77ON ECONIC UR EYORS`��:��z ��
OF SECTION 7209OF THE NEW YORK STATE EDUCA77ON LAW, (631) 765-5020 FAX (631) 765-1797
EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CERTIFICATIONS P.D. BOX 909
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 12JO TRAVELER STREET 110-2541
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971
NOTE:
CONTRACTOR TO NOTIFY THE ARCHITECT r rl rV
OF ANY AND ALL REVISIONS DUE TO FIELD w i�
CONDITIONS,CLIENT,AND OR GENERAL
CONTRACTOR WHICH DIFFER FROM THE u
CONSTRUCT. DRAWINGS/SPECIFICATIONS.
z
rl� � o
v
U
N
� " z
U
o
Z �
M
EXISTING GARAGE CONVERTED TO HEATED DEN r l
VFW � w
a,
V M N
o o6
ci
� U N
\\`
D '\ . T\'
JILJL
�/T
I
i
i
is
U
I
I
I
IE
2 ", 'o
/W �il'� �:�/�xi;
I L
I
11 1 1111 111111 1 1111 Hill l� 1111 11 11 1 11 111 11 l� i� l� 1� IF 11 1-11 1 1111 11 111 - 11
7 A— —
y Y—]�Iy—
— — -- --
EXIST. GARAGE DOOR WAS REMOVED W
& REPLACED WITH NEW 6-0" W. X 6-8"
H. SLIDING GLASS DOOR. NEW: Q Y
2 RISER X 6-0"W. CONCRETE STEPS. rr
NORTH ELEVATION EAST ELEVATION o — °
(EXISTING) (EXISTING) LEGEND Q cf) �
Ir � W
z
EXISTING EXTERIOR/INTERIOR WALL TO REMAIN. Ww
J NEW INTERIOR WALL ADDED. Q rr
- Ex EXISTING WINDOW/DOOR TO REMAIN. J W
O NEW WINDOW/DOOR ADDED. _
co ~ C/)
10
Q Q
EXISTING GARAGE CONVERTED TO HEATED DEN
' cn � Y
0 U
IZ D
0 Q �'
— — — — — — — — — — — — — — — rr
OEX
C;Ozv?PLY WITH i 1 nE L CODES OF
NEW YOM STATE E TOWN! CODES
DN. AS REQUIRED—MO-CONDMONS-OF
S�u'T D TG'�,!,'V ZF r
SGUTi�01
LA�PIA.,d"d'I'r'a BGAR�
O 2'-6"X 6-8„
EXIST. GARAGE DOOR WAS REMOVED
& REPLACED WITH NEW O H. SLIDING GLASS DOOR. NEW:
X 6'-8"
2 RISER X 6-0"W. CONCRETE STEPS.
APPROVED AS NOTED
15_M ✓ u � O�Cu ��,�,°�a.�e� OR DATE.
c' — — — — — — e— — — — — — — — — — '
— — — — — — — — — — — — — — — — — — — — — — — — — — 1�SS� I'a l-,1I 1!LA �`�I VL E BY
NEW BATH ADDED TO EXIST. GARAGE „� NOTIFY BUILDING DEPARTMENT AT
N SPACE ON TOP OF NEW' RAISED FLR. I "`- 1
�.`V. T-.I � I FI(� 765-1802 S AM TO 4 PM FOR THE
NEW FLOOR IS FLUSH WITH EXISTING FOLLOWING INSPECTIONS:FIRST FLOOR ADJACENlI ROOM. 0' O(C �U�O�iY��V ve 1. FOUNDATION-TWO REQUIRED 0
r FOR POUR
ED CONCRETE w
2 ROUGH•FRAMING„PLUMBING, D
STRAPPING,ELECTRICAL 6 CAULKING co
EXIST. GARAGE DOOR WAS REMOVED 3. INSULATION -
O j & REPLACED WITH NEW 6-0"W. X 6-8" d. FINAL-CONSTRUCTION 6 ELECTRICAL
H. SLIDING GLASS DOOR. NEW:
O 2'-4"x 6'-8" 2 RISER X 6-0"W. CONCRETE STEPS. MUST BE COMPLETE FOR C.O. t1
ALL CONSTRUCTION SMALL vEET THE ww
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR 0
DESIGN OR CONSTRUCTION ERRORS.
O ELECTRICAL w 0
z o
ISPECTIFtt�lRIf _ .
0w m .
0
cc11
i 4D oc D oc
���
EX EX V`) i 1�i!b'i.�, i t:0. 0at�✓S� C Y
(� COLLI T
— — — — — • — — — — — — — — — — — — — — — — — — — —E — — — — — — '»� -•,'U770 IN�11' 'A TER D co 0
EA
T- c�
EXCEED 21t 0 OF 1�;LEADe EXISTING 1 STORY HOUSE EXISTING GARAGE CONVERTED TO HEATED DEN SCALE:
1/4"11'0"
r
FIRST FLOOR PLAN OFFICE SET DWG. NAME:
(EXISTING) PL� �I � _ � 6.6. 1 1 COMPOSITE
"AS - B U I LT"
ALL PLLI'`!► 'V0 VIIIliM PLAN/ELEV.
&V ATI-A LI'n-Ct"
TESTI'<!G E mF 0• 6, r.' 3 DRAWINGS THESE ARE THE SOE PRO ERTY OF INSTRUMENTS
ARCHITECT.NO DWG. NO.:
REVISIONS,CHANGES,AND/OR MODIFICATIONS
SHALL BE ALLOWED W/O WRITTEN AUTHORIZATION
BY THE ARCHITECT. ANY REPRODUCTION IN PART A-
--A
1 OR WHOLE IS STRICTLY PROHIBITED BY LAW,