Loading...
HomeMy WebLinkAbout37514-Z "==- Town of Southold Annex 8/28/2013 FOiKco��� P.O.Box 1179 w 54375 Main Road o Southold,New York 11971 CERTIFICATE OF OCCUPANCY No: 36473 Date: 8/28/2013 THIS CERTIFIES that the building IN GROUND POOL Location of Property: 2700 Fairway Dr, Cutchogue, SCTM#: 473889 Sec/Block/Lot: 109.-5-14.13 Subdivision: Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 9/4/2012 pursuant to which Building Permit No. 37514 dated 9/13/2012 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 with fence to code as applied for. The certificate is issued to Paulick,Walter (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 37514 11/13/12 PLUMBERS CERTIFICATION DATED A o ' ed S'gnature t TOWN OF SOUTHOLD ��SUFFot,rc�. moo �y� 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#: 37514 Date: 9/13/2012 Permission is hereby granted to: Paulick, Walter 2700 Fairway Dr Cutchogue, NY 11935 To: construct an Inground Swimming Pool, fenced to code as applied for At premises located at: 2700 Fairway Dr, Cutchogue SCTM # 473889 Sec/Block/Lot# 109.-5-14.13 Pursuant to application dated 9/4/2012 and approved by the Building Inspector. To expire on 3/15/2014. Fees: SWIMMING POOLS -IN-GROUND WITH FENCE ENCLOSURE $250.00 CO - SWIMMING POOL $50.00 Total: $300.00 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). 1 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 IWlead. 5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate of Code Compliance from architect or engineer responsible for the building. 6: Submit Planning.Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses,or buildings and"pre-existing"land uses: 1. Accurate survey of property showing all property lines, streets,building-and.unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall.state the-reasons therefor in writing to the applicant. C. Fees l. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00, Swimming pool $50.00,Accessory building$50.00,Additions to accessory building$SO 00;Businesses$50.00, 2- Certificate of Occupancy on Pre-.existing Building- $1 00.00 3. Copy of Certificate of Occupancy-$.25 4. Updated Certificate of Occupancy- $50.00 5.- Temporary Certificate of Occupancy-Residential$15.00, Commercial$15.00 I Date. �129)1 z New Construction: Old or Pre-existing Building: (check one) Location of Property: 27M -V j ew. : 4.�(,{A vk,_%L je House No. Street Hamlet ...Owner or Owners of Property: Suffolk County Tax Map No 1000, Section Block Lot Al, �J Subdivision Filed Map. Lot::.. Permit NQ., 7 5 f.� Date of Permit. / / Applicant: -LSD lt9�,Q�S Poo Health Dept..Approval: Underwriters Approval: Planning Board Approval: Re oast for: Temporary Certificate t/ q P D' Final Certificate._ (check one); Pee Submitted: $ Applicant Signature f o��pF SOUTyoI Town Hall Annex ~ Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Q roger.richert(c)-town.southold.ny.us Southold,NY 11971-0959 'rOUNTI,� BUILDING DEPARTMENT TOWN OF SOUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Walter Paulick Address: 2700 Fairway Dr City: Cutchogue St: NY Zip: 11935 Building Permit#: 37514 Section: 109 Block: 5 Lot: 14.13 WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Elec-Tec Inc License No: 4814-me SITE DETAILS Office Use Only Residential X Indoor Basement Service Only Commerical Outdoor X 1st Floor Pool X New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures Service 3 ph Hot Water GFCI Recpt 1 Wall Fixtures Smoke Detectors Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps 2 Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks H Disconnect Switches Fi1Twist Lock Exit Fixtures TVSS Other Equipment: in ground swimming pool to include, bonding, 1-control panel, 2-GFCI circuit break 1-pool light, 1-heat pump Notes: Inspector Signature: Date: Nov 13 2012 81-Cert Electrical Compliance Form.xls OF SOpr�,O cOUNT'1, TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION . VEP/FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECT AL (FIN L) REMARKS: C&)�-u- DATE INSPECTOR ZIL OF SO(/r�o`o courm, ' 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) X ELECTRICAL (FINAL) REMARKS: DATE v INSPECTOR SOcou plyolo TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ' . . [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING/STRAPPING, XFINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT.CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL'(FINAL) REMARKS: - DATE °� 7 �� INSPECTOR �� SO(/ly� �o • �o TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH G. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING /STRAPPING [ - `FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS. i� - _ �l c f c T� v DATE l f,3 INSPECTOR �Of SOUjy l0 • aAir �yComm,� TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTIO [ ] FOUNDATION 1ST [ ] ROU PLEIG. [ ] FOUNDATION 2ND [ ] I ULATION [ ] FRAMING /STRAPPING [ FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: 17 DATE INSPECTOR �`' PLUMING INSMA- TION P.D11 N.Y. STATE ENERGY CODE \ t pr /.�..r: all 1V ► ..�, R OR MEMO 19 NOW i TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST .BUILDING DEPARTMENT Do you have or need the following,before applying? . TOWN HALL Board of Health SOUTHOL%NY 11971 % 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. '�az _ Clieck Septic Form N.Y.S.D.E.C. Trustees Examined / ,2012— Contact: Approved 13,20,,E 7, Mail to: J Disapproved a/c l Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date 422A-2 , 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 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 bekept onfhe.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 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, forthe:construction of buildings, additions, or alterations or for removal or demolition asherendescribed.The apphcant.agrees:to coxplywith all applicable laws, ordinances,;btulding code;housing code;.a ions to admit authorzed inspectors on premises and in building for necessary.inspections: ae6 ����E�Yn LID, ��� C)R (Signature of:apphcan naive;if a corporation) :ENCLOSE POOL TO CODE � «� 9P � � & , .��� x UPON COMPLETION ���:� r R .. ® �t P� Iles �I , BEFORE"WATER ing" a (Mail address of'applicant) State whether applicant is owner,lessee;;age I t,1arcfutec e gmeer general contractor;electrician,.plumber or builder � R N01, ame of owner of premises /J QULd C�ir✓ ��� �� P (as on the tax roll or 1 t deed �y V�_.. o 966FY BUILIjNG b£oNA��&frAT Tf applicant i a corporation, signature'of duly authorized officer ?(6,1802 5 ANI TC + ft'ULL®�NlNG INSPStd' 7 (Name and.title of corporate officer) 1 FOUNDATI®N T1N�I �E U4 eJ 7. FOR 1�OURED CONOWE 2: ROUGH-FRAMINO,' ' E Biulders" �cense No: STRAPPING, LEC"fR CA1 Ilf:l ' 1 K Plumbers L INSULATION FINAL:sN filNSEfiC:icense O MUST BE COMPLETE FOR C O:. Electricians License No. ALL CONSTRUCTION SFIALI AE*THE REQUIREMENTS OF THE'COOtt OF r )Ui Other Trade's License No. ®Pit SfiAT6, NOfi RR4PONRIRLE.FO% ' DESIGN OR CONSTRUOTION IRRORS Loca, ]omof land on whi. Lppro/p�o�sed�work will be done: se'Number Street Hamlet ' ae County Tax Map No. 1000 Section Brock a `Lot f� '�'1 ,'� '' ' Subdivision (Name) 2. State existing use and occupancy of pre es and intended use and occupancy of proposed construction: a. Existing use and occupancy kZ6iWjd& �w b. Intended use and occupancy �)( 3, Nature of work(check which applicable): New Building Addition Alter ion Repair Removal Demolition Other Work 6ijilfilhLIN KOL (Description) 4. Estimated Cost IjOt� 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 Rear_ Depth Height Number of Stories. Dimensions of same) structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front f Rear 1 Depth �z Height Number of Stories 9. Size of lot: Front Rear �0 Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated a�, 12. Does proposed construction violate any zoning law, ordinance or regulation: Ny 13. Will lot be re-graded kA 1 Q Will excess fill be removed from premises: YE NO n 2�0-R ac. 14. Names of Owner of premises N CAUL OL4'— Address e AAQ5✓C Phone No. —/,3y 2doL-E- Name of Architec i I Address 4&eL LA 6r•fnb,J Phone No `12-V-79SIS Name of Contractor N "os o Address t 2s7� Phone No. -74q-71 5 15. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE R QUIREDt a 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. STATE OF NEW YORK) SS: COUNTY OF being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) a6ov /� named, (S)He is the LK-, (Co fit ra�;Agent, C�rporate 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 forthiin,the;application filed therewith. Sworn to before me this r day of.=f° / 1SI- 2"0f/2 i Notary Public S ature of A iicant MARGARE7 A. KIDNEY Notary Public-State of New York No. 01 K16021111 Oualif led in Suffolk.County.. My Commission Expires March 8,2a� Town of Southold - Chapter,236 - Stormwater Management 1 SWPP.P -Storm Water Pollution Prevention Plan Assessment Form GENFRAT. INFORMATION: (All Requested Information is Required for a Complete Application) APPUCANr NAME: Owner-Agent-Consultant-Contractor or Other.(Cirde One) Property OWNER:'IH Different than Applicant) j Address: Address: i Z7 F W fl i i Telephone#: 31/, Fax# i `C Telephone#: Fax#: i E-Matte E-Mall; i ti i ! Property Address: �/�q �••�• 2-700 -EA� Dt° L't��L 0�il� Brief Description of;Gonsttnction Ac6vity�;I'ropasat stittch l BAft sot? i &M M.#: 0S )if. Stabalizddon BMP-%PsojeetScope aad/or Sequent a bf Construction Acffi* tmtrkt serilon tuocM Lot PovidaA&W.,riol Pali as'Needi Name of Contractor andlor Contact Person Responsible for Implementation of SWPPP. F.owaxos c 5 4 _ n,Ic. t/19Y11in/ WiTlt -- Address: /� -t--e--= 1-- `t20t & 2"A E•1111ee- c --- Tale Itone# /n Lf 4 P ?1- -718� Faxdk - / ���� ------------------ ) E E-Mal: Jt ---- vice- ---- -- -- - -- - ---- Name of Persons Responsible for Installation d Mtintenance of Erosion control Pracdce:. ---- _N _ -- Address: ---------------- - I - ---------------"-- r Telephone If. --- -- ---- -- Tele 1 l P - Fax ---•---- --------'-..------ —=--- to ------------------------- NAl1 —_------ ------Total Area of Land Clearing cels: and/or Ground DisNrbance: Fi (S.F.f Aces) i P►oject Duration: �•.� Start End - X (ZUdpated) �l• ' .Date: q ! Date: /® —"_______..._.._____..,___,,;_..--__.__.,-_______—_--- v J ----------------------_ Is ------- tNum�endar Days) _--_.-.______--________—'-_ • Will this Project Disturbe five(t)or More Acres at -- --�----------------------- -------- - Any OneTimeDuringythe Proposed Development T Y� _ ___________________________ If YES;Please ArSwiir;the.Followingl a Does the ApphcarA hal a Qualified Inspector On Staff To Coriduct th"e luired Inspections? Yes No b Does the SW0.PP Indicate How Frequently-the Site Q List lha.NAMES or description of all Potentially Impacted Waterbodie3 andlorWetlands: Inspections wdl Occwrand for What Period of Time? Yes No _ _ --------C. 'Does theSWPPPAdequatelyldentiryAliTemporary � (—� - ---------- I i andlor Permanents(iifShaWlZationMeasures? Yes No --'--- -`--------------------- -------- l d Does the SVI►PPP Adequately ldenfify a Complete Project Phasing Pfan 2 Yes No i e Does:the-SINPPP Indicate Additional Site Spettific Status of,Impacted revel leg 7MDL,303ii4l'lsted Impaired ) Practices that Will be Uhlized to Protect Water Quality? Yes No f Haicant Submitted a Completed DEC Notice '- sthe Appl Of Intent Type of Acceptance FDRn for Review �� L� Impaeted:Waterbody (eg Lake:Creek,.Bay Pond Sound Fre3hvratetWetland� I by the Town bf Southold? Yes No S7kA1'F OF IVih W YORK.. I . COU y OF 1�tat h. .. lJ-S • ••••••••-••••••••••••......being duly sworn,deposes and says that he/she is the applRca .. for Pem�it, (Name e<xxfivtdual signing Do=nenq I And that heJshe><s the .......................... 1 'l ? .................... 1 •. (Uwner Contractor Agent Corporate Officer etc) ' I f 4 :Owner and/or representative of the Owner O ;Owners;and Is dui authonzed to ,Y pedtitm or have perfo) cted the,satd`"work and:to I -make and file this,applcation'that all statements contained In Hits app)lcation`aTe nue to the bestof 1us ktowledgan - and that the-wor will be ormed in the manner set.forih m the!appltcatit n filed pert wttli. I i 'Sworn co beforeme III day of tip /2 .................................. ......................................... f All gnature.of.q t) i SYYRPP.As S�Ment FORM: 03-12 NIS Notary Public ,Stalte of NeW York No. of ki6,03 f 111. Qualified in Suffolk County My Commission Expires March 8,20 S °8 " T.O.S. "5{iVPPP" Preparation - Chapter 236 ForDepartn,entuseOnly. Storm Water Pollution Prevention S.C.T,M.#: 2700 N� enti�on Plan Property Address: Nz*440 Review Checklist Checklist i000 Zra see on - REQUIRED P1..AN INFORMATION AND IMPLEMENTATION DETAILS; Does tFie SWPPP Adequately Provide for and/or Indicate tfie FolloWfng:) i YES,' NO N.A. Explanation for NO or Nam. Plan Sheet 1. Gra na a cu a ons& tormwater BMPs Desl ned to costa n a Two Inch Rainfall On-Site. + ------------------- -------------------- -- it . --' + 2. Construction PhasingPlan Indlcatln �`- 17- _ _ ___$Sequence of P%posed Construction Actives. �'------- 3. GeneralLooatlonMa ---------------_-___.._�.___������r--_�---------- -------------------- - Location '9 4, Dralattge SIte:Plan Drawn to Scale at S 60' feet to the Inch or la er indicatin the followin ' a. Loc�UonaMfDasgrlptlonofPr a Boundaries ---" 9_____.__..9__+C7+ Ji L ------ - -_-__ - -_- -- °p t1Y i , b _SlteAcreage` - a -----________---_._-•_--- ,C7r=3,= __ ---- - ------- ---- - -- _. � j" c 911ExIstlnyNaturaFa -- - -- -----...______.___..._ _ -- '-- - -------------__.___ _ __ nd/or Man Made Features'on and within 50 of the Pro art Bounda + i - i - '-P Y__._ __ ______ d Test 1-iole DataslndlcaYtn�Soil Characteristics:&De th to Seasonal Hi h Water Table; - - ~ .- - -p-------- --g-- 0 "- e Contours lndicatfna'ProQerty EfeVatlotis Min+2'), - ---- --- -^--------------- ---- --- ---- _. _ { r __......_ _ . . f Spot Grade&Finish Floor El- Wfi-is fO F�dstfng and Proposed Structures --- - i i -----_--_- --------- 9 LoptTOn-o WoodedRreas lso�at9d feeswfth'aMinlmurnDirnensionof18"Diameter, ,0,�;�L -- _--_^---�--'- ^ ----------------------------- - -+ ' ------------------------------------ -_ -...._ . h So-il�onservatfonUTs�r a uirg ryt , y ,4, ----------------C�zj — .. _ 5 Background Information about the Scope,of the Protect,Location 8�De crlption of the Site, ;�;Q, Proposed Ghan�es to the Slte and Al!Ezlsti Develo went on the site Includln the Followin I �� f -��p- -� ^ - - -- a AUJutRtYLYsrD�r>g Ulclustl[�919o1eLI eRdJ (ahUa►1ccTsttal S$a 9r�a ____._ 1 i C����i��-- - - b Alf: Excavatton,Filling,S4fpping&GradingProposed and ldentified•astodepth,Volume -� '--- ------_ '--- '- '- -______ Nature`ofNtertalslnvolyee;----- -------------------_ -----...____iC]�l ]�[ i i� ------------ ---- ___c_ AIIAreasRgqulrtng_Clea�ingand/orGrubbingL,____ d. All Areas Where Topsoil Is to be Removed, and where Topsoil will ultimately be placedi �i- -------------- ------------------ e. All Tefiporer�r&Permanent Ve elation to be Placed on Slte; ------- --- ,o1r!= -- f.. AIi Temporar�r&Pemaanent Sto-rrri Water Runoff BMP Control Measures Pro oset) -- TheAritldated:--- ------ -- ----- --------- r -------------- __ Patt9mofSuhfaceDralnafgeD----Pori aiif-FeakRunoff f i--------------------------- h. The LOcatiOn ofa711foaa Drive-----` ------- -J�+ +_.. wags,Sidewalks,Paffos,Structures,Utilltles&Other---- , i ----------- -------`--` -- ' Improvements,fncr3GgfemporaryA'cress&�o`risiruc'tlonStagingAreas; C�.'�;� -----------------------•---- -•---.. - .. �----------_----------------------------- ._..._._. -rFgha-I ontburs ana o►Spo-tL"fe-va�tibns ofthi site--' --'0,0i��----------------- _ _ --------------------------------------------- _----- . ._ .. 6. A Schgtlule of:the Sequence for lire Installatlon'of All Planned Soll Erosion,Sedimentation , , , , - -- -' " &Sto[mwater Rtmoff Control Measures, i=,=" _ --- ------ --- - ---------------------- 7_ Descrl lion of Pollution Prevention Measures that wNl be Im lamented. '-- ---------- -- ----------- ---- - 8. A Descrl lion of the- p-----------•-----------a���i �. - ------------------ -- ,A _ Mlnlmum Erosion&Sediment Control Practices to be Installed and/or t i 01• ___Im�slerttented-for Each Construction Activ that will result in Soll Disturbance.------------ -------------------------...... ...i i + _9._Descdptionof_Gonstrttetlon&WastemateAalsExpectedtobeStoredOn-Site. r______________________________________ _ --------- ------- ------- ---------------------,O,CI 10, Temporary&.Perman8tit Soil Stabilization Plan that meets the Current Version of the + r +�i'- ------------ _ _New York State`Storm Water Desfeen Manual l'echnical Standard. -' " - _-._Y---____.---------------------------.----- � , .. 11. General Slte Plan and Construction Drawls sforthe Pro act. _ ,-= ----=---------------- _ 12._Dimenslons1Matedal Specifications&Installatlon©stalls forAl_Eroslon&Sediment Control Practices_ -------- --- ' 13. Temporary Pracxlces than will be Converted to Psmranerrt _ --- --------------------------- _Is '---'_"" - - __ _ control Measures. ______ _ JOi�id---- 14. ImplenientlonSehedole for Ste In Tem ore _Erosion Control Practice or B_'MP,' - ,,.�.,��__ ----------------------------------- on ~" ' 15.'MalrtenanceSc?tedulstoErisureContinuous& Ve0 a --- "- ---------"'�'�'ff ----------- ---- "Effectl -'- p ratlofErosio 8 , ,.______-_____ Sediment Control Practices. [� D i�I --- --•-_ 16. Names':of Potential Surface Waters of the State of New York and/or M84 that may be- - ' Im�actedbyDeVeloement _ iOi����"------------------------------------- ----.. . ---•- - 17._Delineation of Storm�ator Con-trol Plan ImelementaUon ReseonsibiliUes for�Each^art of the __� i i_1,`-- ----------' 1 _ProjectCottstruotlo - -- - - •� �+0+ � -------------------------------- T8. Allothe�Exlstln Data'tha -- - -- , ~-----__ -_-_-- --_- -- --------- TIT t Deserlbes Storm Water fiunoff and/or iJatural Dr_aln "-"-n ' �r1 1-- �l 19. Repalil atlon of/UI Cogtractor�s)%Sub-Contractors) Resporrslble.for installing,Canstructfitg,- Rapalrlri ,Re Iac1n Ins actin andMalntalnln the Erosion.&Sediment Control Practices. --- --"� - Storm Water Manageeaeht Control Plan Checklist#1 : 03.12 asu � DEC ""SWPPPV"• Preparation = . Chapter 23.6-19 For Department Use Only: ' Storm Water Pollution Prevention Plan s.a.T.M.#: PrdpeYtyAddress: �7 a,ozrat/ Review Checklist Checklist # 2 iaoo j0q 5 (Additional Items to be included-with Checklist#1 when Article_ Ill is trfgered:) pu+�et sececn 61cek - - - REQUiRED PLAN INFORMATION AND IMPLEMENTATiON DETAILS: I I i t Plan Sheet Does the SWPPP Ade'uatel Provide for and/or Indicate the Following:) 1 YES, NO I N.A.r Explanation for NO or N.A.Must be Approved by SMO Y 9) 1 .. 1 Location(Pg;#) 1. Does e Plan indicate an or Show a Items Requ re' fir-"Checklist---"_In this Pac et 7 -_-, , 1 _-- -- -------------------------- -------------------- -------------- 2. Does the Plan*Indicate and/or Show a Description of Each Post-Construction Stormwater - __.__ ment Practice 7 i i , Manage _- _____ -- ----- 3. Does the.S to Fisn/Construction Drawings)Indicate and/or Show the location&Size of -: - _ Each 1?dst Construction_Stcrmv rater Management Practice -- 4. Does 3ne Site Plan/ConsbucUon:[7rawing(s);Indicate:and/or Show Hydrologic&Hydraulic Analysis! - -For All Structural_Compbl ants of_the Stomiwater Management System for Applicable Storms_? I I1 I ---------------------------..:-------'_'--.___._........ 5. Does ilia Stte PIaNConsti trcdon 17rawing(s)IrYdicate and/or Provide a Comparison of Post- I O I O Devoto&nt:Stormwater Runoff Conditions w(th Pre=Development Conditions?___ __ - E --W __---- - I -r ova"- ----------------------- -- 6. Does the Site Plan%Construction Drawi�g�s)Indicate and/or Show All Dirnensfons,Material - I I 1 r--------- ----- Specineatlons:&Installation Details for Each Post-Construction Stormwater Practice? 7. Does the Site Plan/ConMmetlon Drawings)Indicate a Maintenance Schedule Provided by I I the Co tis tractcr(s)to Ensure Continuous&Effective Operation of Each Post-Construction Storrft t Mift ement Practice A I I I __ _ ------------------=--------------___ -----_- _� I I t----------------------------------- •___ 8. Does the Site Plan/Construction Drawings)Indicate and/or Show Maintenance Easements to Ensure:Access to Ail Stormwater Management Practices at the Site for the Purpose of inspection and Re air p.. 9. Does the Site Plan/Construction Drawings)Indicate and/or Show Inspection tennce and Maina Agreement(s) that are Binding-on Ali Subsequent Landowners 7 10. For Ali Activities meeting the Threshold 1n 236,1 g(B)(1),the SWPPP shall be Prepared&Signed By a Professlonal1n the Principlesand Practices of.Stormwater Management&Treatment Who LI�I01 ' Who Shall'.GertV thatt he Design Meets the Requirements of Chapter 236_ _ _ ____ •------- --- 'I ------------------------------- ---------- 11. Does the,Plan Indicate and/or Identify Ali Potential SouFces of Pollution which may affect the I � � � -` -"'`-- Quaiit�rofi,StormwaterDlschar�es7---------------------------------_--_-;�i�i 1 _ _ u. Does the Plan Provide Documentation Supporting the Determination of Approval with Regard 1 I ` -`-"`-`---"--` - '"`-` .1 to Historic Places cr Archeologleal Resources that Includes the Following______________.i�; i i --- I I r-------------------------------------------- .------- a. Infomt3Uon whether the stormwater discharge or land development activities would have 1 , , I an offect on a property that Is listed or eligiblefor listing or eligible for listing on the ;O;Imo;1SZ5{ - - _ §*t_ or_Natlonai Registerof Wlsforlc Places _1 I I�/' __ .Results of Historic ResourcesScraenin Determinations that have bee-----c---- iI��I�il3LJ1~ ---------------------------------------------- -The " -- - - - -- -- ---- - -- -� 1 I r-------------------------------------=------.-- c. Description of Measurers Necessary to Avoid or Minimize Adverse Impacts on Places Listed, orEti�ibl. orUstin$�ontheStateorNationaiResisterofHistorlcPlaces:and-___-____� i �___________ --------- ---------------------'=---------_ ___ _- d. Where Adverse.'Effects May Occur,Any Written Agreements in Place with the NYS Office of Parks,Recreation and Historic Places(OPRHP)or other Governmental Agency to D I [ MitIg�{ate Those Effects. ` I I I _.—___3--------------__--------------------__•..__—___......__--- r-------------------------------_ 13. A Description of the Soll(s)Present at the Site,InCludfig an Identification of the ,O,0,�, "'-"'-` -"' "'-- -"'-' H.YdraullcSollGroup_------------------- --------------- -- I 1 --- -----i i i L--------------- 14. Identification of Any Elements of the Design that are not in Conformance with.the• Design.in hual,,including Reasons for the Deviation or.Alternative Design and a Descripton ( ] of the Egulvalency with_technical Standards._ I I I I ______ -- ----- --------------------------------� I .. I r---------------- 15. A Hydfologlc and H draulicAnal Analysis for ll Structural Com .onents of the "`-"--`-----`-----' Y Y P StomiwaterMarianement_ControlSystem. ------------------------------_, i i��________-- --- ---- -------- ------ 16. A Detailed Summary,with Calculations,of the Sizing Criter[a that was Used to Design 1 `"""- '-'--- `-'-" All Post=Construction Sto rtwater_Mana�ement Practices. i 1 . ' i7. An Operations and Malrttenance Plan that)ncludes,'Inspection and Maintenance ; ; '� ;` - _ "'-"" Schedules and Action.ta Ensure Continuous and Effedtive Operation of Each i Q i Q I�I ' Post-Construction Storm Water.m>sn ement Practice..- I � 1 � Storm Water Management Control P1tan Checklist#2: 03-12 - or so�r�o Town Hall Annex TeleFpahzone(631)763-1802 54375 Main Road roQer.riChertpl (6M1)72&�.�1�Q • .Southo O.iVY 11971-0959 -� — OWn.SOUthOl5.ny.US . BUILDING DEPARTMENT TOWN OF SOITMOLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: �,Kl Date: Company Name: Name: License No.: M %'Y\E Address: .'f?�eev-�� ( ►� �1 `-�: C3 Phone No.: JOBSITE INFORMATION: (*Indicates.required information). *Name: \ *Address: Q0_7� �c, *Cross Street: *Phone No.: . Permit No.: Tax Map District: 1000 Section: ibq ` $lock: Lot: *BRIEF DESCRIPTION OF WORK(Please Print Clearly) a , (Please Circle All That APPIy) *Is-job ready for inspection: �YE'wy NO Rough In Fina *Do you need a Temp Certificate: YE NO Temp-information.(If needed} Service.Size: 1 Phase : 3Phase 100 150'. : 200 300 350 400 Other . *New Service: Re-connect. Underground Number of Meters -Change of Service Overhead Additional Information: PAYMENT DUE WITH APPLICATION a2-Request for inspection Form L r )' a Town Hall Annex 6 ' Telephone(631)765-1802 54375 Main.Road (631)765-g5Q P.O.Box 1179 G Q roger:nche.rt?,,Ro`1wn SOUthOI�.nV us Southold,NY 11971-6959 BUILDING DEPARTMENT TOWN OF SOUIMLD APPLICATION FOR ELECTRICAL INSPECTION REQUESTED BY: Date: Company.Name: v 5 ,`T. �I-em1C Name: �� l�C► License No.: 2 �e Address: 122 PULAS6 Qa �Ipj s o.Phone:;N : : .-. . .. .. JOSSITE:INF.ORI�/IATION: (Indicates. required information) *. Name:- f�t��iJ f�tlLiCl(, *Address: QO g9k/ � 0AW, Cross Stree4: w00,0 W *Phone'No.. Pemtrt No:: � r�1 • Tax "Di strict: 1000 Section: _ Bloch: 3' Lot: *BFtIEI=;DESCRIPTION OF WORK(Please Print,Clearly): OMW f N tidal nro �nc, Sr,/;mm l/ . ( lease >IrcI Alt That Apply) *ts tob ready for inspection: YE(/.N0 Rough In Final *[ o you need a Temp Certificate: YES / NO' TeF>�p Irk#c�rma#ion (If needed} *Service Size 1 Phase 3Phase 400 1 50 200 300 350 ': 400 Other *Nw Semce: Re-connect. Underground Number.o€Meyers Change offSrulce .Overhead . Addltrol•�at Information: 1 •. PAYMEN.T DUE 'lIyITH APPt_ICATtflN $2 Req bst for Inspection Form TOWN OF SOUTH OLD PROPERTY RECORD - CARD OWNER STREET f VILLAGE DIST. SUB. LOT j Ka* FQRMER OWNER N E ACR. . Eliz4 b n A: 4 /q S W TYPE OF BUILDING RES. , j) if SEAS. VL. 4 FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS "?m Ne, Ia rr Tell P 6D qq f bI 4 - 'a76 10 �� UJ - L 9� 1 y C.d 54: , .0 / () - 970-6 vja 1k,,v- 9, as I'.c l' Lyl5 Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD i -Meadowl.ond DEPTH House Plot BULKHEAD Total a r.x{L '+.s• t �rq"a. n ti 5'r x t q t y 1.\ ♦ r L\1drt, priS4ic > - r . k L 'T. 4 .-r X_.---•4 e^yk. R'..Y'r1'> D, tYs(1; . ■e■■■■■■■MEN■■■■■■■■■■■■■■e■ ANIMEMOMMIEN ■■■■■e■■■■e■rAa■■■■i■■■■■■■■■■■ ■■■■e■■■■ eI ■■ ■■��■ i■ ■■ ■■ ■■ ■■ ■ ■■■■■■■■■�i■i■■■■■■NI■■■■■■■■■ ■■■■ -�M■■■■■■■■■■■■i■■■■■■■■■■■ ■®■■ ■■S■ MMa■■■■■ e■■■■■■■■■■■ ■■e■�i■■■■MOMME■■■—■■■■■■■■■■■ ■■■■■■■■■O■■■INEVINIZEM■■■■■■■■■ ■■■■■Rw■■■■■■ ENOM■■■■■■■■■■■■ •- ■■■■■■�,■■■■e■e ■■■■■■■�■■■■■■ _■■■■■■■■■■■■■■■■■■■■■■■■■■■■ Ext. Walls Interior Finish Plac Fire e Rooms 1st Floor Rooms 2nd Floor �a --._ s • 'ARTHUR EDWARDS POOL & SPA CENTRE 929 ROUTE 25A MILLER PLACE, NY 11764. 516-744-7185 FAX-744-0174 APPLICATION FOR A SWIMMING POOL PERMIT: SOUTHOLD TOWN OF SOUTHOLD MAIN ROAD (P.O. BOX 1179) . SOUTHOLD, NY 11971 (631) 765-1802 PAPERS ENCLOSED: APPLICATION FOR OUTDOOR POOL PERMIT [1Q EROSION SEDIMENTATION &WATER RUN ASSESSMENT FORM [� CERTIFICATE OF WORKER'S COMPENSATION [ CERTIFICATE OF LIABILITY INSURANCE [kJ) SUFFOLK COUNTY LICENSE -[�'- SUFFOLK COUNTY PLUMBER LICENSE [}Q SUFFOLK COUNTY ELECTRICIAN LICENSE [ 4 SETS OF PLANS - (3 STAMPED) [� 3 SURVEYS APPLICATION FOR ELECTRICAL INSPECTION WITH $100 CHECK APPLICATION FOR CERTIFICATE OF OCCUPANCY I ] C.O. [ ] TAX BILL [ $300.00 CHECK FOR PERMIT FEE AREA-607sq.ft. PERIMETER— 110' YDS.CONC.— 12 REBAR— 17 FORM TIES— 156 H 1 L � E p .= p 2 F'A F S R6'-10' h R6' A-C 43'-7" R6' - 5 � B-D 43'-7" 1 2 5 A-E 29'-2" B-E 36'-9" E bj F. G RT-2j' A-F 19'-8" B-F 23'-11" A-G 17'-10" R6'-8j' B-G 22'-5" 20'-10' A-H 10'-2" \ N 14 6' 4 18'-5' B-H 26'-11". l3'-8' N b a QM A-J 14'-10' 0 / K B-J 13' R6' A-K 20' B-K 15'-1» 5 5 .9 A-L 32'-9" R6'-10• A-M 3 '4'-110" S 3 3 1 B-M 33'-3" R6'-i6' S A-N 33'-10" C2 20 B B-N 32'-9" L 38'-3' 8 A P161 A .. sldmnw. R.tvm. Atimtnum . .: ..:.rS;.:,:...... To FHb From Fntw h Pump . (p y W.0 OPW4 Rolled Wall F Plan A Piping.. Arrangement .� W.0 S-6. - - - . Vlrryl Lin - - µ Rebff 42" Section B—B 3=PSU Con—ts 1.0 ` - Section A—A T ical Wall . Section ` SIZE A B C D E F G H AREA CAP FEET FT. FT. FT. FT. FT. FT. FT. FT..SQ.FT. GALftmb S 16i32' 16' 32' 8' 14' 6' 4' 4' 8' 512 19'000 J�illf4ZG. ►VWi� `d PooL$t SPA '�CENTRE ' 185fi0' IB' 30' 12' 14' 6' 4' 4' B' 576 21600jF PERMACRET-E WALL :SYSTEM 18x38' 18' 38' .34' 14,. 8' 4, 5 8' 648 24,300 929 Route 25A Miller Place NY+ 11�764; � 20g40 _ 20' 40' 16' 14 8' 4 8' 8' 800 30,000 (831) :744 7f85 FAX,;(631) 744 Oi'7t4 24's44' 24' 44' 18' 14' 8' 4' 6' IV 798 30,000 „Suffolk.License #4436 HI 24'g48' 24' 48' 20' 16' 8' 4' 6' 16' 900 30000 Nasspu:. cense #HI74450000;" F ------ -- - — -- - ----- -- — - ---- — i .J'. Ld ' Young & Young jj > aP 400 Ostrander Avenue, Riverhead, 'New York 119*of, 63>-727-2303 0 Alden W. Young, P.E. & L.S. (1908-1994) Howard W, Young, Land Surveyor � p s }- r .1 Thomas' C Wolpert, Professional Engineer " Q 1 ,y �. Robert C. Tast, Architect .U: =k SANITARY MEASUREMENTS Q z E ------------ : -: _ r� .,, n_ 50.00' .� A N 88'38'20" W �� 8 S.T. 31' .24, " N 88'38'20" W 173.25' C.P. 1 33' 36.5' C.P. 2 46' 45' S . . ,WOOD' WAY C.P. 3 45' 35' rng"� co o 'j. 1 d' F P �si4� f x NOTE t AREA = 40,606 SQ. FT. � ILot 12 • SUBDIVISION MAP "FAIRWAY FARMS" FILED IN THE OFFICE OF ,THE ;. CLERK OF SUFFOLK COUNTY ON FEB. 15, 1974 AS FILE NO. 6066. Subdivision - "Fairway Forms , " zz FLOOD INSURANCE RATE MAP PANEL NO. 36103CO163 G `a I a w _ ' Q o LAST DATED MAY 4, 1998. ¢ ( 4 o z t L w O r s I O W � V • I wON 1 � w zW I m " O I w :no , n uz W03 1 0 r S 89'12 1 0 E CHAIN LINK FENCE 4 0 225.59' 1 v I i VE R S CCRTiF µ IC�iTI- N Q g I O Lot 13CO �; W 0 WE HEREBY CERTIFY TO KAR E N L. PAU LI CK, � I 0 Lv O c.P3 I O WALTEi R. PAUL ICK FIDELITY NATIONAL A.c I (j > TITLE INSURANCE COMPANY OF NEW YORK U uNIT Q S.T. I � �� ♦5.3' o =0 (�cP�s I .-�- ,(TITLE NO.�AQ-02-F-0854) THAT THIS SURVEY WAS � � � „��gQ L PREPARED IN ACCORDANCE WITH THE CODE OF PRACTICE FOR "N �' 9.0 w ^60 O I 0 LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION C 8 0' Un w m C.P.1 -, O O I30' p Q OF PROFESSIONAL LAND SURVEYORS. Y L _ t Q 3 9' 0 N _ 0.1` 0 84.0. < Y p 7.r ly Q I O a�f ENCLOSED z.o' = I W Q /� 1 r 6 P r 'sQ co 3 ; a' lli h: PORCH n Q 'wy ' ' 4 _ I O ' 57.7' a 2; ;t i Y► g, O 1 0 00 FIRM ZONE BOUNDARY AS SCALE FROM ; } yf 0: l a � W Z - HOWARD W. YOUNG, N.Y.S. L.S. NO. 45893 _ ;:A ; INJ - e I I _ THE FLOOD INSURANCE RATE M;,� PANEL NO. 36103CO16�3 G LAST :)ATED 0DOI. I MAY 4, 1998. ' O o- f ` Lr : 001 WELL Z ' I 5) OCADEE BOX 1 SURVEY FOR � N 89'12'10" 225.59' a KAR ` EN L PAUUCK & VIALIR R. PAU � A ' P�p�eQ >FCr�e2 Lot 14 � ; � I � � ��' ��' v/Z:� � LICK ' �^ I I „ LOT .13 "FAIRWAY FARMS" . "Iv o a ��tk Subdivision — "Fairway Forms" i t At Cutchogue, Town of Southoldz I x i X s Z z Suffolk County, New York v ; N r I - i County Tax MOP District 1000 Section 109 Black 05 Lot 4.13 ' I } o GREEN WAY FINAL SURVEY FEB. z, 2004 . 1 MAY 23, '2003 ; .IAN. 9, 2003 MAP PREPARED DEC. 9, 2002h r ;' -- JUNE 4, 2002 ka p � SCALE ,2 40` FJ � � MONUMENT SET SET ® a MONUMENT FOUND Q - STAKE SET A - STAKE FOUND Q. PIPE FOUND CE � CELLAR ENTRANCE RO =ROOF OVER JOB NO.,2002^0298 DWG. 2002-0298_final ' x •