HomeMy WebLinkAbout45256-Z std"
uFMir Town of Southold 2/20/2022
P.O.Box 1179 ,
o _ 53095 Main Rd
yea ao� Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42806 Date: 2/20/2022
TRIS CERTIFIES that the building ALTERATION
Location of Property: 9326 Main Bayview Rd, Southold
SCTM#: 473889 Sec/Block/Lot: 87.-5-25
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/21/2020 pursuant to which Building Permit No. 45256 dated 9/29/2020
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:
alterations to an existing single family dwelling as applied for.
The certificate is issued to Salice,Charles&Passaro,Camille
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 45256 12/20/2021
PLUMBERS CERTIFICATION DATED
u or e Signature
TOWN OF SOUTHOLD
�� Su¢Fot� BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
X.
�y • � � 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#: 45256 Date: 9/29/2020
Permission is hereby granted to:
Edson, Lisa
1800 N Bayshore Dr Unit 801
Miami, FL 33132
To: make alterations to an existing dwelling as applied for.
At premises located at:
9326 Main Bayview Rd, Southold
SCTM #473889
Sec/Block/Lot# 87.-5-25
Pursuant to application dated 9/21/2020 and approved by the Building Inspector.
To expire on 3/31/2022.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $302.40
CO-ALTERATION TO DWELLING $50.00
Total: $352.40
B g In ec or
Form No:6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings,property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder.* in system contains less than 2/10 of I%lead.
5. Commercial building,industrial building,multiple residences and similar buildings and installations,a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings(prior to April 9, 1957) non-conforming uses,or buildings and "pre-existing"land uses:
1. Accurate survey of property showing all property lines,streets,building 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
1. Certificate of Occupancy-New dwelling$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00,Businesses$50.00.
2. Certificate of Occupancy on Pre-existing Building- $100.00
3. Copy of Certificate of Occupancy-$.25
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy-Residential$15.0;0, Commercial$15.00
iDate. q� C 7 2,1, Z�
New Construction: Old or Pre-existing Building: (check one)
Location of Property: &&VII J
House No. Street Ham et
Owner or Owners of Property:
Suffolk County Tax Map No 1000, SectionBlock Lot
Subdivision / Filed Map. Lot:
Permit No. 2 J� Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $ �-�
Applican i natur
pF SOUT��I
0
Town Hall Annex Telephone(631)765-1802
54375 Main Road
P.O.Box 1179 �Q sean.devlina-town.southold.ny.us
Southold,NY 11971-0959 OIyCOU�e��
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICAL COMPLIANCE
SITE LOCATION
Issued To: Charles Salice
Address: 9326 Main Bayview Rd city:Southold st: NY zip: 11971
Building Permit#: 45256 Section: 87 Block: 5 Lot: 25
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: GJS Electric License No: 4839ME
SITE DETAILS
Office Use Only
Residential X Indoor X Basement Service
Commerical Outdoor 1st Floor Pool
New X Renovation X 2nd Floor X Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures Bath Exhaust Fan
Service 3 ph Hot Water GFCI Recpt Wall Fixtures Smoke Detectors 1
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO2 Detectors
Sub Panel A/C Blower Range Recpt Ceiling Fan 1 Combo Smoke/CO
Transformer UC Lights Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches 4'LED Exit Fixtures Pump
Other Equipment:
Notes: Raised Ceiling in Bedroom / Moved Fan and Smoke Up
Inspector Signature: Date:
December 20, 2021
S.Devlin-Cert Electrical Compliance Form
o��Of SOUTyo' q 03
# # TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION/CAULKING
[ ] FRAMING/STRAPPING [ ] FINAL
[ ]- FIREPLACE &`CHIMNEY [ ] -FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION [ .] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION ] PRE C/O
REMARKS:
" e s, r
1 J
o
en
V \/
Li
DATE INSPECTOR
�F SObTyol - --- - - —- ---- ---- —
TOWN OF SOUTHOLD BUILDING DEPT.
coorm, 765-1802
iNSPECTION
{ ] FOUNDATION 1ST - [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND: .- [ ] I SULATION/CAULKING
[ ] FRAMING /STRAPPING [ FINAL A145 '
[ ] FIREPLACE & CHIMNEY [' ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT.CONSTRUCTION: [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] PR C/O
REMARKS: C�
l
DATE �� g �l INSPECTOR
U LS
AUG 1 0 2021
N. J. Kk Z-2AFERRO, P.E.
PO Box 57, Greenport,N.Y. 11944 P 17 UXI
Phone- 516-457-5596 TO
Consulting Engineer
November 12,2020 Construction, EvYmqfigZ Labor Law
Page I of I
Town of Southold-Building Department
Southold Town Hall
53095 Main Road
PO Box 1179
Southold NY 11971
Re: Building Permit Number—4526
9326 Main Bayview Road
Southold,N.Y. 11971
District-1000, Section-87,Block-05, Lot-25
Inspection—Framing
On November 4, 2020, 1 inspected the construction at the noted location. The inspection
included the framing for the new residential structure. The areas inspected included the
attic and first and second floors of the existing house. The framing work included exterior
and interior walls, ceiling and roof framing. The inspection results are:
Items inspected included lumber type/grade, lumber size, dimensional spacing, framing
connections,header sizes, bearing, continuity strapping and integration with the existing
structure.
The framing work was done according to approved plans and in compliance with the
applicable sections of the IRC,NYS and Southold Town Building Codes. In particular
the applicable Sections of Chapter 5—Floors, Chapter 6—Wall Construction, and
Chapter 8 -Roof-Ceiling Construction of the 2018,ECC.
Result- The framing work, as verified by field inspection on April 23, 2020, is compliant
with all applicable codes.
Nicholas Ma=qferro
0
Nicholas J. Mazzaferro, P.E.
51
AR�FEssjo
AUG 1 0 2021
N. J. MAZZAFE",O, P.E.
r,I j T Ti JJ 3,1r,1111.G 7 1 F
PO Box 57, Greenport,N.Y. 11944 1 "
TO,
Phone- 516-457-5596
Consulting Engineer
November 12,2020 Construction, Estimating, Labor Law
Page I of 1
Town of Southold-Building I)Qpartme.nt
Southold Town Hall
53095 Main Road
PO Box 1179
Southold NY 11971
Re: Building Permit Number—45266
9326 Main Bayview Road
Southold,N.Y. 11971
District-1000, Section-87,Block-05, Lot-25
Inspection—Insulation
On November 4, 2020j inspected the insulation installed at the noted location. The
inspection covered the first and second floor alterations. The inspection results are:
1 —Walls—Insulation provided and installed by Delfino, Insulation Co. Inc. Insulation
provided rated as R-21. The insulation provided was done in compliance with the
applicable sections of the IRC, NYS and Southold Town Building Codes. In particular
Section R402.1 of the 2018 IECC.
2—Ceiling/Roof—Insulation provided and installed by Delfino Insulation Co. Inc.
Insulation,provided rated as,R-35. The insulation provided was done in compliance,with
the applicable sections of the IRC,NYS and Southold Town Building Codes. In
particular Section R402.1 of the 2018 IECC.
Result- The insulation and caulking installation as verified by the letter dated October
26, 2020 from Delfino Insulation Co. Inc., signed by Tammy Mazzara, is compliant with
all applicable codes and conforms with the design specifications. (Copy attached)
Nicholas Mazmferro
ois
Nicholas J.SlIazzaferro, P.E. A
T+ 14 s1+.5�* YS f
YYAA �N,41� x
Delfino Insulation Co., Inc..
*� 317 Burman Blvd,`Calverton,,NY 11933
CERTIFICATE OF INSULATION
JOB INFO: Diamond Builders DATE OF INSTALLATION: 10/26/20
9326 Main Bayview Road
Southold,NY 11971
2x4 Exterior Walls Closed Sloped Ceilings
INSULATION TYPE INCHES R-VALUE INSULATION TYPE INCHES R-VALUE
❑ OPEN CELL FOAM ❑ OPEN CELL FOAM
Q CLOSED CELL FOAM 3" R-21 CLOSED CELL FOAM 5" R-35
❑ FIBERGLASS FIBERGLASS
❑ CELLULOSE ❑ CELLULOSE
Gable Walls 2x6 Open Kneewalls
INSULATION TYPE INCHES R-VALUE INSULATION TYPE INCHES R-VALUE
❑ OPEN CELL FOAM ❑ OPEN CELL FOAM
[] CLOSED CELL FOAM 3" R-21 CLOSED CELL FOAM 3° R-21
❑ FIBERGLASS ❑ FIBERGLASS
❑ CELLULOSE ❑ CELLULOSE
INSULATION TYPE INCHES R-VALUE INSULATION TYPE INCHES R-VALUE
{] OPEN CELL FOAM ❑ OPEN CELL FOAM
❑ CLOSED CELL FOAM Q CLOSED CELL FOAM
❑ FIBERGLASS ® FIBERGLASS
❑ CELLULOSE ❑ CELLULOSE
Q FIRE CAULKED TO CODE DATE OF INSTALATION:
❑ FIRE BLOCKED TO CODE DATE OF INSTALATION:
[] AIR SEAL.SUBSTATE TO CODE DATE OF INSTALATION:
[� DC-315 IGNITION BARRIER TO CODE DATE OF INSTALATION:
[I DC-315 THERMAL BARRIER TO CODE R316.4 DATE OF INSTALATION:
I Tammy Mazzara certify that the residence referenced above was insulated
as per signed proposal by builder/homeowner,and the Installation was conducted in
conformance to applicable codes and standards and regulations.
6Ri IGNATURE
DATE FIELD INSPECTION REPORT G011NTS
FOUNDATION(1ST)
FOUNDATION(2ND) .
ROUGH FRAMING
PLUMBING
y
INSULATION.PER N..Y. y,
STATE ENERGY CODE
A thy
IL
I JR
FINAL
- �Dn: i!l�N:AL CC�1XI'ME`NTS: • •
0.
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 U ZSurvey
Southoldtownny.gov PERMIT NO. t Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined ,20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
OZ Contact:
Approved ,20 Mail to: Ural Talgat
Disapproved a/c 436 7`" Street, Greenport NY 11944
Phone: 631477 8963
Expiration �,20 -
nspector
1__,APPLICATION FOR BUILDING PERMIT
SEP Date September 17 2020
-�4, , INSTRUCTIONS
a.rTs`application' ST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 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 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 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.
(Signature of applicant or name,if a corporation)
436 7"' Street, Greenport NY 11944
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor,electrician,plumber or builder
Architect
Name of owner of premises CHARLES V. SALICE &CAMILLE PASSARO
(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:
9326 MAIN BAYVIEW RD Southold
House Number Street Hamlet
County Tax Map No. 1000 Section 87 A'�"Bl`ok�': 09J._,� Lot 25
o:lir..
V'84a..L��tit%`^,. .:Z:•:. feL":ir',:.t;i
s a
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 Single Family Residence
b. Intended use and occupancy Single Family Residence
3. Nature of work(check which applicable):New Building Addition Alteration X
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units 1 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 88' Rear 99' Depth 59'-2"
Height 38' Number of Stories—2
Dimensions of same structure with alterations or additions: Front 88' Rear 99'
Depth 59'-2" Height 38' Number of Stories 2
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 225.01' Rear 192.99' Depth 751.77'
10.Date of Purchase Name of Former Owner Lisa Edson
11.Zone or use district in which premises are situated AC
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO X
13. Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO X
Charles V. Salice 323-333-3404
14.Names of Owner of premises Camille Passaro Address Phone No.212-725-9086
Name of Architect Ural Talgat Address 436 7`h street Phone No 631-477-8963
Name of Contractor Diamond Builders Inc. Address 889 Harrison Ave Phone No. 631-727-5500
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X 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 X 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 X
* IF YES,PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF 5__rFFo(10
Ural Talgat being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the Architect
(Contractor,Agent,Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
I . day of r jFW 6L%,L 20 Z 0
y ublic LAUREN M.MCKIS Si ature pplicant
Hdary Public,State of No.OIM �Ya*
Qualified in Suffolk County
Commission Expires May 23.2024
Building Department Application
AUTHORIZATION
(Where the Applicant is not the Owner)
CHARLES V. SALICE &
I, CAMILLE PASSARO residing at Q Z� j"2 13.4Y vrew lel
(Print property owner's name) (Mailing Address) v v o L..cl �V
do hereby authorize URAL TALGAT
(Agent)
to apply on my behalf to the
Southold Building Department.
(Owner's Signature (Date)
(Print Owner's Name)
n- v- 1- O w vt e cC 57,
��rsohoAj� q.�e v-cel bEFom me
-phis 0 elm of sep�ern6q,r aaao.
�harles`I_ Salic¢ CAiMille �assnfe
VEL.frA` z.SCHWAMBOR\ f
NOTARY PUBLIC.SPATE OF NEW
Registration No.0IGA627.102h
Qualified in Suffolk Comet}
Commission Expires Dec.24.2U 0
CONSENT TO INSPECTION
CHARLES V. SALICE & CAMILLE PASSARO , the undersigned, do(es)hereby state:
Owner(s)Name(s)
That the undersigned (is) (are)the owner(s) of the premises in the Town of
Southold, located at 9326 MAIN BAYVIEW RD, SOUTHOLD, NY 11971 ,
which is shown and designated on the Suffolk County Tax Map as District 1000,
Section 87 ,Block 05 , Lot 25
That the undersigned (has) (have) filed, or cause to be filed, an application in the
Southold Town Building Inspector's Office for the following:
Interior renovations to the existing building
That the undersigned do(es) hereby give consent to the Building Inspectors of the
Town of Southold to enter upon the above described property, including any and all
buildings located thereon, to conduct such inspections as they may deem necessary with
respect to the aforesaid application, including inspections to determine that said premises
comply with all of the laws, ordinances, rules and regulations of the Town of Southold.
The undersigned, in consenting to such inspections, do(es) so with the knowledge
and understanding that any information obtained in the conduct of such inspections may
be used in subsequent prosecutions for violations of the laws, ordinances, rules or
regulations of the Town of Southold.
Dated: (?)Z 12-0
(Signature)
CHARLES V. SALICE
71a,
QrSe,rt P�
qppeare8 beVote me Alis (Signature)
5+d01 o -2aad, Cito,rlesV.SGllcsc CAMILLE PASSARO
pne� Li�1¢�CL55`�if° (Print Name)
EVE L.GATZ-SCHWAMBO�
NOTARY PUBLIC.STATE OF NEW YORK
Registration No.OIGA6274029
Qualified in Suffolk County
Commission Expires Dec.24,20�Q
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New York State Department of Environmental Conservation
Division of Environmental Permits, Region One
Building 40-SUNY,Stony Brook,New York 11790-2356
Phone:(631)444-0365 FAX:(631)444-0360
Erin M.Crotty
Commissioner
PERMIT RENEWAL_
March 18, 2004
Ms. Lisa Edson-
274 First Avenue, Apt. 11 G
New York, New York 10009
Re: Permit# 1-4738-02451100001
Edson Property-9326 Main Bayview Road, Southold
Dear Ms. Edson:
Your recent request to extend the.above permit has been reviewed pursuant to 6NYCRR
Part 621 (Uniform Procedures Regulations) and found to be approvable. Therefore, the
permit is hereby extended to May 9, 2006.
This letter is a modification to the original permit and, as such, shall be available at the
permitted site whenever authorized work is in progress.
All other terms and conditions remain as written in the original permit.
Sincerely,
r
George W. Hammarth
Permit Administrator
cc: Patricia Moore, Attorney at Law, 51020 Main Road, Southold, NY 11971
Bureau of Marine Habitat Protection, NYSDEC
File
DMG
FROM ENCONSULTANTS PHONE NO. ; 631 283 6136 Nov. 02 2001 01:44PM P8
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DEC•PERMIT NUMBER EFFECTIVE DATE
1-4738.02451/00001 May 9, 2001
FACILITY/PROGRAM NUMBER(S) PERMIT EXPIRATION DATE(5)
under the Environmental
Conservation Lau May 9, 2004
If TYPE OF PERMIT ■ New ❑ Renewal O Modification ❑ Permit to Construct ❑ Permit to Operate
❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Watef Quality ❑ Article 27, Title 7; 6NYCRR
of Waters certification 360: Solid Waste Manaaement
O Article 15, Title 15; Water ❑ Article 17, Titles 7, 8: SPDES O Article 27, Title 9; 6NYCRR
supply 373: Hazardous Waste Management
❑ Article 19: Air Pottution
❑ Article 15, Title 15: Water Control ❑ Article 34; Coastal Erosion
Transport Management
O Article 23, Title 27: Mined
❑ Article 15, Title 15: Long Land Reclamation O Article 36: FtoodpLain
Island Wells Management
0 Article 24: Freshwater Wetland_'*
0 Article 15, Title 27: Wild, O Articles 1, 3, 17, 19, 27, 37:
Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control
PERMIT ISSUED TO TELEPHONE NUMBER
Lisa Edson (212) 228-7105
ADDRESS OF PERMITTEE
274 First Avenue Apt. IIG New York NY 10009
CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER
Enconsultants Inc., 1329 North Sea Road, Southampton, NY 11968 (631) 283.6360
NAME AND ADDRESS OF PROJECT/FACILITY
Edson property, Main ea iew Road Southold
LOCATION OF PROJECT/FACILITY
SCTM 91000.87.05-25
COUNTY TOWN WATERCOURSE NYTM COORDINATES
Suffolk Southold Carey Creek
DESCRIPTION OF AUTHORIZED ACTIVITY;
Construct a two story single family dwelling,deck,pool,and a pervious driveway. Install a sanitary system with retaining wall and place
450 cubic yards of fill. Connect to public water. All work is to be done in accordance with the attached plans stamped NYSDEC
approved.
By aCCCptanee 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 pane 2 & 3) and arty Special conditions included as
part of this permit.
PERMIT ADMINISTRATOR: ADDRESS
George W. Hammerth (DMG) Sldg. #40 SUNY Stony Brook NY 11790-2356
ALIT H ZED SIGNATURE DATE
Ar/ May 10 2001 Page 1 of 4
PROM ENcoNSULTANTS PHONE NO. 631 283 .6136
Jul. iS 2002 12:07PM P2
1329 North See Roar!
Southampton,New York 119Fi8
631-288-6
-------- Fax:631-283-6136EN-CONSULTANTSi INC. E-mail; encon@peconic.net
ENVIRONMENTAL SERVICES www,enconsultants.com
March 1,2002
Albert Krupski,Chairman
Board of Trustees
Town of Southold
53095 Main Road
Southold,NY 11971
Re: Liss Edson Permit No. 5427
Dear Mr.Krupski,
As you no doubt recall, the captioned permit for construction of a one-family dwelling �, issued 26
October 2001 and included approval for a draiWe system to be installed in ly dwells s right-of-way i£way to
Main Bayview Road.
11)response to a request by the Suffolk County Department of Health Services, a very min r c
subsequently made to the inage syste,n,lt�that the ° �e was
are to be configured 1' rather in a c er. EncIosed is aeIls located beneath the driveway
this change, last d ed 6 December 2001. For our reference, copy of the site plan revised to reflect
both this plan and the I have also enclosed sectional copies of
and last October,highlighting the chance.
As this is such a minor and effectively non-substantive modificatior4 T
am unsure would typically be interested in receiving the additional paperwork. Because Patricia Moore mu]3oard
Present an application for setback variance to thst Still
e Zoning Board of Appeals, however, it would be proper
for us to request that the Trustees issue either an amended or a simple
acknowled&g receipt of the revised plan with notification that permit
permit modi{cation is
necessary. In either event,I,would appreciate your prompt response to my inquiry.
Also enclosed for your reference are copies of the Suffolk Co
approval and the DEC �Y Department of Health Services
Permit amendment which incorporates the drainage system that was requested by
the Trustees subsequent to the issuance of the original DEC permit, I thank you for your anticipated
cooperation:
Respect ly yours,
Robert
Coastal Management Specialist
Enclosures
cc:Lisa Edson
Patricia M000re,Esq.
"ROM ENCONSULTRNTS PHONE NO. : 631 283 6136
• Ju i. 15 2002 12:68PM P3
New York State Department of Environmental Conservation
Gullding 40-SUNY,Stony Brook.New York 11790-2356
Telephone(631)444-0365
Facsimile (631.)444-0360
, T i. rot
AMENnWNT TO vvw)%" Comtv
msloner
Date: February 21,2002
Lisa Edson Re: Permit No. &Location:
274 First Avenue,Apt. 11 G
New York,New York 10009 1-4738-02451/00001
Edson Pro e
a'n B iew lltoad Southol
CTM No. 1000-87-05- 5
Dear Ms.Edson:
Your recent request to modify the above permit has been reviewed pursuant to 6NYCRR,Part 621. It
has been determined that the proposed modifications will not substantially change the scope of the
permitted actions or the existing permit conditions. Therefore,the permit is amended to authorize the
construction o o story single family dwelling,porch,decks,pool,pervious driveway,and a
dra' a:Ia:jstra�X� 1316101,
oby Joseph A.Ingegno on
2' an stamped NYSDEC agFrov�d on 221102.
Special Condition No 8 is modified to read as follows:
8. hoof runoff shall be directed to drywells a minimum of 75 feet landward of the tidal wetland
boundary for immediate on-site recharge.
The follow'in S ecial Co ditio shall a l ;
14. Prior to excavation for installation of the drainage basins,a row of staked hay bales or
approvable erosion control devices shall be placed between the wetland boundary and the
project location_ This sediment barrier must remain in place and be maintained in good
condition until the project is completed and the disturbed area is stabilized with vegetation.
This letter is an amendment to the original permit and,as such,shall be available at the job site
whenever authorized work is in progress.
All other terms and conditions remain as written in the original permit.
Very truly yours,
cc: En-Consultants,Inc. permit Administrator
Bureau of Marine Habitat protection,NYSDEC
File
DMG
FROM :.ENCONSULTANTS PHONE NO. : 631 2B3 6136 Nov. 02 2001 01:44PM P9,
NEW YORK SIA 1 L UEFJAR I MLN I OF LN ViRUNMkN 1 AL I.UNSLRVA I JUN
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification
The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservaton
of the State of New York,its representatives,employees,agents,and assigns for all claims,suits,actions,damages,
and costs of every name and description,arising out of or resulting from the permittee's undertaking of activities or
operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with
the terms and conditions of the permit.
item B: Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors,employees,agents and assigns of their
responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with
respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the
Environmental Conservation Law as those prescribed for the permittee.
item C: Permittee Responsible for Obtaining Other Required Permits
The permittee Is responsible for obtaining any other permits,approvals,lands,easements and rlghts-of-way that
may be required to carry out the activities that are authorized by this permit.
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian
rights of others in order to perform the permitted work nor does it authorize the impairment of any rights,title, or
interest in real or personal property held or vested in a person not a party to the permit.
GENERAL CONDITIONS
General Condition 1: Facility Inspection by the Department
The permitted site orfacility,including relevant records,is subject to inspection at reasonable hours and intervals
by an authorized representative of the Department of Environmental Conservation (the Department)to determine
whether the permittee is complying with this permit and the ECL.Such representative may order the work suspended
pursuant to ECL 71-0301 and SAPA 401(3),
The permittee shall provide a person to accompany the Department's representative during an inspection to the
permit area when requested by the Department,
A copy of-this permit, including all referenced maps, drawings and special conditions, must be available for
inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon
request by a Department representative is a violation of this permit.
General Condition 2: Relationship of this Permit to Other Department Orders and Determinations
Unless expressly provided for by the Department,issuance of this permit does not modify,supersede or rescind
any order or determination previously issued by the Department or any of the terms, conditions or requirements
contained in such order or determination.
General Condition 3: Applications for Permit Renewals or Modifications
The permittee must submit a separate written application to the Department for renewal,modification ortransfer
of this permit Such application must include any forms or supplemental information the Department requires.Any
renewal, modification or transfer granted by the Department must be in writing.
The permittee must submit a renewal application at least:
a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES),
Hazardous Waste Management Facilities(HWMF),major Air Pollution Control(APC)and Solid Waste
Management Facilities(SWMF);and
b) 30 days before expiration of all other permit types.
Submission of applications for permit renewal or modification are to be submitted to:
NYSDEC Regional Permit Administrator,Region 1,SUNY Bldg#40,Stony Brook, NY 19790-2356
General Condition 4: Permit Modifications,Suspensions and Revocations by the Department
The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification,
suspension or revocation include:
a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions
of the ECL and pertinent regulations is found:
b) the permit was obtained by misrepresentation or failure to disclose relevant facts;
c) new material information is discovered;or
d) environmental conditions,relevant technology,or applicable law or regulation have materially
changed since the permitwas issued,
DEC PERMIT NUMBER PAGE 2 OF 4
1-4738-02451/00001
FROM : .ENCONSULTANTS PHONE NO. : 631 283 6136 Nov. 02 2001 01:45PM P10
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15(TITLE 5),24,25,34 AND 6NYCRR PART 608
(TIDAL WETLANDS)
I. if future operations by the State of New York require an alteration In the,position of the structure or work herein
authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable
obstruction to the free navigation of said waters or Rood flows or endanger the health, safety or welfare of the
people of the State,or cause loss or destruction of the natural resources of the State,the owner may be ordered
by the Department to remove or atter the structural work,obstructions,or hazards caused thereby withoutexpense
to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other
modification of the watercourse hereby authorized shall not be completed,the owners,shall,without expense to
the State,and to such extent and in such time and manneras the Department of Environmental Conservation may
require, remove all or any portion of the uncompleted structure or fill and restore to Its former condition the
navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on
account of any such removal or alteration.
2. The State of New York shall In no case be liable for any damage or injury to the structure or work herein
authorized which may be caused by or result from future operations undertaken by the State for the conservation
or improvement of navigation,or for other purposes,and no claim or right to compensation shall accrue from any
such damage.
3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission,
consent or approval from the U.S.Army Corps of Engineers,U.S.Coast Guard,New York State Office of General
Services or local government which may be required.
4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended
solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other
environmentally deleterious materials associated with the project_
5. Any material dredged in the conduct of the work herein permitted shall be removed evenly,without leaving large
refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause
damage to navigable channels or to the banks of a waterway.
6. There shall be no unreasonable interference with navigation by the work herein authorized.
7. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the
applicant shall,without expense to the State,and to such extent and In.such time and manner as the Department
of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and
restore the site to its former condition. No claim shall be made against the State of New York on account of any
such removal or alteration.
8. If granted under6NYCRR Part 608,the NYS Department of 1=nvironmental Conservation hereby certifies that the
subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302,
303,306 and 307 of the Clean Water Act of 1977(PL 96-217)provided that all of the conditions listed herein are
met.
9. At least 48 hour;prior to commencement of the project,the permittee and contractor shall sign and return the top
portion of the enclosed notification form certifying that they are fully aware of and understand all terms and
conditions of this permit, Within 30 days of completion of project,the bottom portion of the form must also be
signed and returned, along with photographs of the completed worts and,if required,a survey,
10. All activitles authorized by this permit must be in strict conformance with the approved plans submitted by the
applicant or his agent as part of the permit application.
Such approved plans were prepared by:Joseph A. Inaegno on 2/18/00 god lest revised 4/23/01,
OEC PERMIT NUMBER PAGE 3 OF 4
1-4738.02451/00001
FROM, : ,ENCONSULTANTS PHONE NO. : 631 283 6136 Nov. 02 2001 01:46PM P11
• NEW V RK STATED PARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix
Ftrucks, mixers,or other devices enter tidal wetlands and or protected buffer areas.
2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area
(upland) and removed to an approved upland area for disposal. No debris is permitted In tidal wetlands and or
protected buffer areas.
3. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted
activity.
4. The storage of construction equipment and materials shall be confined to within the project work site and or upland
areas greater than 75 linear feet from the tidal wetland boundary.
5. All fill shall consist of"clean"sand, gravel,or soil(not asphalt,flyash, broken concrete or demolition debris).
6. To protect the values of the tidal wetlands,a permanent vegetated buffer zone shall be established. There shall
be no disturbance to the natural vegetation or topography within an area extending 50 linear feet landward of the tidal
wetland boundary.
7. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer
area or 50 linear feet from the tidal wetland boundary,or as per NYSDEC approved plan, at commencement of
regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation.
8. Roof runoff shall be directed to drywelis a minimum of 80 feet landward of the tidal wetland boundary for Immediate
on-site recharge.
9. Dry wells for pool filter backwash shall be located a minimum of 80 feet landward of the tidal wetland boundary,
10.There shall be no draining of swimming pool water directly or indirectly Into tidal wetlands or protected buffer areas:
11. Driveways and parking areas shall be constructed of pervious material.
12. Sanitary system (bottom of tank and leaching pools) shall be located a minimum of 2' above seasonal high
groundwater.
13_The permittee shall incorporate the following language as a notice covenant to the deed:
"Regulated tidal wetlands associated with Corey Creek are located at Main Bayview Road,Southold,Suffolk County
Tax Map Number: District 1000, Section 87, Block 05, Lot 25,otherwise known as the properties of Lisa Edson and
her heirs, assigns, or successors. This property is subject to the provisions of New York State Environmental
Conservation Law(ECL)Article 25 or its successor,and the conduct of regulated activities may occur only pursuant
to ECL Article 25 if prior approval is given by the New York State Department of Environmental Conservation
(NYSDEC) or its successor. Regulated activities include, but are not limited to the erection of any structure(s);
excavation;dredging grading and filling;clearing of vegetation;and application of chemicals."
This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit.
A copy of the covenanted deed or other acceptable proof of record,along with the number assigned to this permit,
shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager, Bureau of
Habitat, SUNY Building 40,Stony Brook, New York 11790-2356.
DEC PERMIT NUMBER PAGE 4 OF 4
1-4738-02451/00001
O�*rjf SOUjy®l
Town Hall Annex ~ ® Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959 ® ��
l�C®UN�,�
BUILDING DEPARTMENT
January 24, 2022 TOWN OF SOUTHOLD
Salice, Charles
9326 Main Bayview Rd
Southold, NY 11971
RE :
TO WHOM IT MAY CONCERN:
The items marked below are required to obtain your Certificate of Occupancy
Application for Certificate of Occupancy. (Enclosed)
X Electrical Underwriters Certificate.
A fee of$50.00.
Final-Survey with Health Department Approval.
Plumbers Solder Certificate or Pex Affidavit
Trustees Certificate of Completion. (Town Trustees # 765-1892)
Final Planning Board Approval. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall. (631-765-1802)
Truss Construction Placard - VF.
Final Elevation Certificate required.
Final Trustees Certificate of Compliance.
Spray Foam Insulation certification from a NYS licensed architect or
Engineer
BUILDING PERMIT: 45256-Z Alterations
le e s saD?i°-F
00qT� v� SCTM # 1000-87-05-25
PROPERTY: 9326 MAIN BAYVIEW RD
w FFTJ �O ADDRESS SOUTHOLD NEW YORK 11971
w� �ww4 " FDG o�Ry� °�°• ? V.OWNER: CHARLES VSALIC
E
CAMILLE PASSARO
SITE: 148,418.19 SQ. FT. = 3.407 ACRES
ZONING: AC
SURVEYOR: Nathan Taft Corwin III
PO Box 16
1586 Main Road
Jamesport, New York 11947
• Y `� LICENSE # 50467
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DATED: AUGUST 9, 2020
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REY CREEK a,?91 (631)477-8963
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SOUTHOLD, NEW YORK
DATE: September 18, 2020
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436 7th STREET
GREENPORT, NEW YORK 11944
(631)477-8963
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NEW HEADER:
BOISE CASCADE VERSA-LAM LVL
PROVIDE FLASHING AS REQUIRED AT 2.1 E 5100 SIZE - 2 PLY
TOP AND SILL OF NEW DOOR6'-3"VERIFY 6'-3" VERIFY I J" (OR 5 �") x 11 J" HEADER
BEARING - 3 EACH END
EQUAL EQUAL NAIL PER NYS AND MANUFACTURERS SPEC
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OR
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NEW COLUMN NEW COLUMN
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SECOND FLOOR RIM JOIST AND (5) 2x6 SECOND FLOOR RIM JOIST AND (3) 2x6
POST AT FIRST FLOOR EXTERIOR WALL POST AT FIRST FLOOR EXTERIOR WALL
TO GIRDER AT PILES EXISTIN DECK TO GIRDER AT PILES
/ NEW 12 FT WIDE SLIDING
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/ ANDERSEN FWGD 1110611-4 0
EXISTING FIREPLACE TO BE
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OTHER LOCATION BY OWNER - EXISTIN
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TRIM TO MATCH EXISTING MASTER
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EXISTING I I EXISTING "�;1y""!NC. DINING AREA
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SOUTHOLD, NEW YORK
DATE: September 18, 2020
URAL. T LGAT
ARCHITECT
436 7th STREET
GREENPORT, NEW YORK 11944
(631)477-8963
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CEILING STRUCTURE OVER
EXISTING MASTER BEDROOM EXISTING ATTIC STAIRS TO BE
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ROOF RAFTER FROM PLATE ROOF RAFTER
CONNECTION TO OPPOSITE SIDE EXISTING ROOF
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PHONE 516 45-7 55Ci&
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SOUTHOLD, NEW YORK
DATE: September 18, 2020
URAL T LCAT
ARCHITECT '
436 7th STREET
GREENPORT, NEW YORK 11944
(631)477-8963
I
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EXISTING RIDGE
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EXISTING ROOF RAFTERS N FULL OVERLAP CEILING JOISTS
EXISTING ROOF RAFTERS EXISTING ROOF RAFTERS
REMAIN EXISTING ROOF RAFTERS TO ON "TRU55" TO BE
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NAILS EACH END AFTER "NEW"
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N. J. MAZZAEERRO, PE
P.O. E30X 5"7, CGREENPORT, NY I 1 cf44
PHONE 516 45-7 551f6
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436 7th STREET
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GREENPORT,.NEW YORK 11944
(631)477-8963
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