Loading...
HomeMy WebLinkAbout16126-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z 17066 Date July 6, 1988 , THIS CERTIFIES that the building ...... 9.n.e...~.a.m.~.t.y..d?.e..1 .t.i.n.g: .................. Location of Property R.O.W. off Pvt. Rd. Fishers Island h3,;s'o 'do: ....................... 's't/~3i ....................... h3r;,iol County Tax Map No. 1000 Section .0.8~ ......... Block 0 1 .Lot 4 · 15 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated Dec. 4, 1986 pursuant to wkich Building Permit No. 16126Z dated .... June...............24,' 1987 ......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wlfich this certificate is issued is ......... One famil~ dwelling as per plans. The certificate is issued to ROBIIRT ,1. PIILLER ..................... ioh;,,'o;,i~'~&~ff~tli ..................... of the aforesaid building. Suffolk County Department of Health Approval ....... 8. 67 g.O.--. 2. .4 .6 ......................... UNDERWRITERS CERTIFICATE NO .... P.e..n.d i.n. g ..... PLUMBERS CERTIFICATION DATED: James Marshall 6/14/88 Building Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING D~:PARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No_ 16126 z Permission is hereby granted to: .......................... .~.~.,.....~:.....~..~.~2.~ .............. County Tax Map No. 1000 Section ...... ..C?.,~.. ........... Black .....C~...~ ........... Lot No ..... .,L~.,.',,/,.C ...... pursuant to application doted ...~~......~ ................. , 19.~....~.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted I~ to the Building Inmec- tot with the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, industrial buildings, Multiple Residences and similar buildings and installa- t/OhS, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- t/on requ ired to prepare a certificate. C. Fees: Additions $25.00 1. Certificateofoccupancy New Dwelling. S25.00, Accessory .$t0.00 Business $50.00 2. Certificate of-occupancy on pre-existing dwelling $ 50.00 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.woant .ando.o. 20.oo /.¢. 5.Updated C.C. $ 50.00 Date .,~..--~. ..'%. ........ NewConstruction ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property .---~,~,, ~,,, ~,..~.~.~., ~..~ ~ House No, ' ' Street' ' ' Nam/et Owner or Owners of Property .~.~..~.,.....~. ,~ ...................... County Tax Map No. 1000 Section . .~.~. ........ Block . .~..~. ......... Lot...~.~ .~. ~..'~.... Subdivision ................................. Filed Map No ........... Lot No .............. on pp .: .~ ........ Pla ing Board Approval ...................... Request for Temporary Certificate~ ..................... Final Certificate ..... ~ ............ Fee Submitted $ .~./~.~ .~..~. ................. Construction on above described building and permit meets all applicable c%des and re(~ations. FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765- 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in Wpewriter OR ink, and submitted ~m~ to the Building inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natu raj or topographic featu res. 2. Final approval of Health Dept. of water supply and sewerage disposal-iS-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of p~'operty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate, C. Fees: Additions $25.00 1. Certificate of occupancy New Dwe[[in§, $2.5.00, Accesso~y,.~ I0.00 ~us~ness ~50.00 2. Ce~ificate of occupancy on pre-existing dwelling ~ 50-. 00 3. Copy of cerdficate of occupancy $ 5.00, ove~ 5 ~ears ~]0.00 ~.Va~an8 Land C.O. $ 20.00 5.Updated C.O..// $ 50.00 Date . .~... ~ ........ NewC ohs tpuction ~ ,,, Old or Pre-existing Building ............ Vacant rand ......... Location of Property ...... ~ .,.~.~ .~~~.. .... ...... ....... Subdivision ................................. F~ed ~a~ ~o ........... kot ~o .............. Permit No. l~./~ate of ,,,~,~/~y~5,¢,,~nt ,eaJth Dept. ApprovaJ.. l~~~g' ~ r~ept. Approval., :~ '' Bequest for Tem~o[~w Certificate ~.~ .............. Final Certificate . *... I. ..................... Construction on above described building andpermit ~eets all applicable codes and regulations. A I cant ..~..~ ~f-'~... ~ ~ ~ pp ./,~A--..%.,-.y-..¢':. r;. ·., ...... z ..... '.~"-~.'..\; ................ Memorandum from.... BUILDING INSPECTORS OFFICE TOWN OF SOUTHOLD TOWN H^LL, SOUXHOLD, N. Y. 11971 765-1802 July I1, 1988 Dear Mr. Miller: Enclosed please find your C.O. I have also enclosed the extra copies of your final Board of Health approval. Yours truly, Secretary DAY, BERRY & HOWARD Starnfard, Harfford and Bostun One Canterb Start, ford Telephone (203) 97777300 Telex 99324 Robert J Miller 977-7327 Express Mail June 29, 1988 Mr. Curtis W. Horton Town of Southold Office of the Building Inspector P.O. Box 1179 Southold, NY 11971 Dear Curt: I understand that Tony Marshall has relocated the necessary portion of our septic system on Fishers Island, and I have asked the surveyor to have five copies of the survey of the system as installed and inspected delivered directly to you. If you have not received the surveys by the time you read this letter, please call me at (203) 977-7327. If you have received the maps, I would greatly appreciate it if you could deliver them to the person at the Health Department in charge of this matter, and if you would call to let me know either if the Health Department has provided you with a green-stamped copy of the survey indicating final approval, or if there are any further questions. Your cooperation and assistance are greatly appreciated. RJM/cmc cc: Mr. Anthony Marshall Sincerely yours, Robert J. UNDATION (1st) UNDATI ON ( 2nd ) UGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE FINAL ,J VICTOR LESSARD EXECUTIVE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York ! 1971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD June 15, ]988 TO WMOM IT MAY CONCERN A final Certificate of Occupancy will be issued as soon as the rails are installed on steps, a~d certificates rec- eived from Board of Health and final Underwriters Certificate CURTIS W. MORTON Senior Building Inspector FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N,Y. TEHPORARY Certificate O[ Occupancy No. Z16999 Date June 15, 198.8 THIS CERTIFIES that the building ....Op.e...f .a.m.i. 1. y..d.w.e..1.1.i.n, g ...................... Lc-mtion,~fPrnn~rtv R.O.W. OFF Pvt. Rd. Fishers Island House No. Street Hem/et County Tax Map No. 1000 Section 08 .Block 0 1 ..... Lot 4, 15 Subdivision MILLER .Filed Map No ....... Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated D e c. /4, 1986 pursuant to which Building Permit No. 16126 Z dated .... J une...............24; 1987 ........ . was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for wlfich this certificate is issued is ......... o.~. ~., .f.~.m..i .~ y..d.~.~.kl.i.~. ~.. ................... ' .............................. ' ... The certificate is issued to ROBERT J. HILLER ..................... ?oW.;;,';~~ ...................... of the aforesaid building. Suffolk County Department of Health Approval . . .P.e..n.d.i.n.g ...................... UNDERWRITERS CERTIFICATE NO. Pending sllp 6 / 14/88 PLUMBERS CERTIFICATION DATED: JAMES MARSHALL 6/14/88 Building Inspector VICTOR LESSARD EXECUTIYE ADMINISTRATOR (516) 765-1802 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 OFFICE OF BUILDING INSPECTOR TOWN OF SOUTHOLD June 15, 1988 TO WHOM IT MAY CONCERN A final Certificate of Occupancy will be issued as soon as the rails are installed on steps, a~d certificates rec- eived from Board of Health and final Underwriters Certificate CIIRTIS W. RORTON Senior Building Inspector DAY, BERRY & HOWARD STAMFORD, CONNECTICUT 06901 December 3, 1986 Mr. Lessard: Please find attached an Application For Building Permit that was omitted in the letter sent to you on November 14. Sincerely, Peggy Basa Secretary to Robert J. Miller, Esq. Mr. Tony Marshall Page 2 May 26, 1987 (4) TWO originals and one photocopy of site plan bearing red approval stamp of Suffolk County Department of Health Services. Please let me know if you need anything else to procure the building permit, and please communicate directly with Robbie concerning stamped plans for the structure. Best regards. Sincerely, Robert J. Miller RJM/pjb Enclosures cc: Carlotta Rice, Esq. Mr. Robert L. Marx DAY, BERRY & HOWARD Stamford, Hartford and Boston Three Landmark Square Stamford Conneetmut 0690t~2599 Telephone (203) 348~3840 Telex 99324 Robert J Miller December 28, 1986 Mr. Victor Lessard Building Inspector Town of Southold Building Department Town Clerks Office Southold, NY 11971 Re: Miller Application dated November 21, 1986 Dear Victor: Thank you for your Notice of Disapproval dated December 23, 1986 with respect to the above application. Having reviewed this matter further with our architect, we are exploring moving the proposed dwelling to the south of where it is shown on the site plan submitted with the application, so that no part of the construction would be within 75 feet of water or wetland. I understand that approval of the Town Board of Trustees or the Zoning Board of Appeals would not then be required. I would appreciate your holding our application in abeyance until we determine whether to amend it by relocating the proposed dwelling, or whether to proceed under the original site plan. Your attention and cooperation are greatly appreciated. Best regards for the holidays. Sincerely, Robert J. Miller RJM/p jb FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ · ~ .~7...~...~... ~...e4 ................. · ~....~.....~,... ~. t,. ~.~ ~ ..... PLEASE TAKE NOTICE that your application dated ...k)..~ ~..~ { ..... ,19 l~r pemfit to construct.. ~..~ ...................... at Lo~o~ of P~o~ ,.. ~.~..~.'~~ .... ~.~. ~~ ...... ....,.. ~ouse /vo. , Street County Tax Map No. 1000 Section ..-.. ~.~ ...... Block ... ~.~ ........ Lot 9.'~.Z 9:~5. Subdivision~r.J,.N~ Filed Map No. ~..~.~ P. ~.. Lot No.. ~ ............ is returned herewith and disapproved on the following grounds ~. ~..~.~ 7. ~~ .... ~ . . ., ........ ~.~.~.~3:5~,..~.~.... . .. ~.%~. x~~..~..~~. - , ....... Building Inspector RV 1/80 DAY, BERRY & HOWARD Counsel]ors at ]Jaw Stamford, Hartford and Boston Three Landmark Square Star-n ford Connecticut 06901-2599 Telephone (203) 348-3840 Telex 99324 May 26, 1987 EXPRESS MAIL Mr. Tony Marshall Bouton Services, Inc. P.O. Box 506 Fishers Island, NY 06390 Dear Tony: I hope we will finalize the figures for our proposed house this week, and look forward to hearing from you. Liza Rice, a real estate attorney in this office, is putting together a contract based upon the AIA form documents. You may hear from her, and should feel free to communicate directly with her. We would like to sign a contract the week of June 1. I think we are getting close enough to proceed with the building permit. As you know, we filed an Application last November when we planned to build within 75' of the wetland margin. That Application was disapproved because of the need (no longer present) to get Town approvals for activity within the 75' jurisdictional zone. I am not sure if we should complete and amend the original Application or start fresh. In any event, to assist you in procuring the building permit, I enclose the following: (1) Draft Amended Application showing information provided by me and Robbie Marx to be completed and filed by you. (2) Statement dated May 26, 1987 signed by me attaching a copy of the original Application and other materials and setting forth documentation that Town environmental approval is not required. (3) Original DEC permit and related materials, including original stamped site plan. DAY, BERRY One Cante~buW Green Stamford IConnect~cut 06901 Telephone (203) 977-7300 Telex 99324 1988 EXPRESS MAIL Mr. Curtis W. Horton Town of Southold Office of the Building Inspector Town Hall Southold, NY 11971 Dear Curt: As you suggested in our phone conversation of this morning, I enclose two copies of a site plan showing the exact location of our house and septic system on Fishers Island. The map differs from the one filed with the Health Department only with respect to some proposed final grading contours. As we discussed, it is necessary for me to procure a permanent Certificate of Occupancy as soon as possible. As an alternative to getting formal DEC approval of the septic system as constructed, which could take months, I would appreciate it if you could see if the Health Department would grant final approval now if the northernmost drywell is moved to a location approximately 120 feet from the wetland margin. The other drywell is about 100 feet from the wetland margin and therefore is in substantial compliance with the DEC permit. I have indicated on one copy of the map the possible relocation of the drywell. I assume that, since the septic tank is sealed, its location is not at issue. As you know, the property borders on a shrub swamp which is only seasonally damp, and no part of the septic system is within 100 feet of the surface water of Middle Farms Pond, which is several hundred yards away. Drainage is strongly away from the wetland. I have not yet been able to discuss this with Tony Marshall, and do not know whether soil conditions at the proposed location or other considerations might make moving the drywell impractical. However, because of the time constraints I wanted immediately to explore this as possibly the fastest way to the issuance of a permanent CO. DAY, BERRY & HOWARD Mr. Curtis W. June 16, 1988 Page 2 Horton This is to confirm my understanding that occupancy of the house now is permitted pursuant to the Temporary CO Number 216999 dated June 15, 1988. Thank you very much for your help. Sincerely, Robert J. Miller RJM/cmc cc w/encl.: Mr. Anthony Marshall 95-20 6 ¢~9/86) -- 25 c~ DEC PERMIT NUMBER ].n-86-1669 FACiLITY/PROGRAM NUMBER{z) N/~ NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental Conservation Law EFFECTIVE DATE 4/1/87 EXPIRATION DATE(s) 5/31/92 [~ Article 15, Title 3; 6NYORR 327, ~ 6NYCRR 608: 328, 329: Aquatic Pesticides I I Water 0uality Certification J~ Article 15, Title 5: J~J Article 17, Titles 7, 8: Protection et Water [ J SPDES ~--J Article 15, Title 15: J~ Article 19: Water Supply Air Pollution Control* ~ Article 15, Title 15: ~ Article 23, Title 27: Water Transport I ..J Mined Land Reclamation J~--1 Article 15, Title 15: ~ Article 24: N Long Island Wells I _ I Freshwater Wetlands ~ Article 15, Title 27: N--New, R--Renewal, M-Modification, Wild, Scenic and Recreational C-Construct (*only), O--Operate (*only) Rivers ~--~ Article 25: Tidal Wetlands J~--J Article 27, Title 7; 6NYCRR 360: Solid Waste Management* r--~ Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management ['~] Article 34: Coastal Erosion Management ~---~ Article 30: Floodplain Management ~-~ Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO Robert Miller 15 Farrell Rd., Weston, CT 06883 N/A NAME AND ADDRESS OF PROJECT/FACILITY (If d~fferent from Perm~tteeJ Fishers Island SCTM 1000-008-1-4.10 LOCATION OF PROJECT/FACILITY COUNTY TOWN/C~r~J~ J UTM COORDINATES Fishers Island Suffolk Southold I DESCRIPTION OF AUTHORIZED ACTIVITY Construct a single family dwelling and associated sanitary system 52' and 120' respectively to freshwater wetlands in accordance iwth the approved plans revised JanuaRy 13, 1987. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compli- ance with thc ECL, all applicable regulations and the conditions specified herein or attached hereto. The permittee shah file in the office of the appropriate regional permit administrator, or other office designated in the special conditions, a nohce of intention to commence work at least 48 hours in advance of the time of commencement and sha~l also notify him/her promptly In writing of the compJetion of the work The permitted work sha~l be subject to inspection by an authorrzed representative of the Department of Environmental Conservation which may order the work suspended if the public interest so requires pursuant to ECL §71-0301 and SAPA §40113} The perm~ttee has accepted expressly, by the execution of the applicauon, the full legal responsibility for ail damages, direct or indirect, of whatever nature, and by whomever suffered, arising out of the project described here~n and has agree~ to indemnify and save harm[ess the State from suRs, actions, damages and costs of every name and descrip- bon resulting from the sa~d project, The Department reserves the r~ght to modify, suspend or revoke this permit et any time after due notice, and, if requested, hold a hearing when: ......... '~ .... Bldg. 40, ~ 4/1/87 I AlfredT. Kellar SUNY, Rm. 2].9 Stony Brook, NY 1 794 cc: BEP 95-20-6a Iq/g61-- 25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34t 36 and 6 N¥CRR Part 608 ( 10 ~bat if future opeTatlons by t~e State of New York reqwre an al- teration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation 14 it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or we[fare 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 alter the structural work, obstructions, or hazards caused 15 thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other 16 modification of the watercourse hereby authorized shall not be com- pleted, the owners, shall, without expense to the State, and to such extent and in such t~me and manner as the Department of Enwronmental Conservation may require, remove all or any port~on 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. 17 11 That the State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized whmh may be caused 18 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 12 Granting of this permit does not relieve the applicant of the response- ) other environmentally deleterious materials associated with the project. Any mater~al dredged in the prosecution of the work herein permitted shall be removed evenly, w~thout 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 nawgable channels or to the banks of a waterway There shall be no unreasonable interference w~th navigation by the work herem authorized, If upon the expiration or revocation of this permit, the project hereby authonzed has not been completed, the apphcant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may reqmre, remove all or any portion of the uncompleted struct0re 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 If granted under Article 36, this permit does not sigmfy in any way tbat the project will he free from floodu~g. If granted under 6 NYCRR Part 608, the NYS Department of Environ mental Conservation hereby certtfles that the subject project will not contravene effluent bmitations at other hmttat~ons or standards under Sechons 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions hsted herein are met, All actiwtms authorized by this permit must be in stnct conformance with the approved plans submitted by the applicant or his agent as part of the permit application, Such approved plans were prepared by on SPECIAL CONDITIONS NOTE: This Department does not object to the permittee moving the structures further away from the freshwater wetlands. A silt fence is to be installed and maintained prior to the commencement of work at the project site. There is to be no clearing of vegetation from the existing footpath to the freshwater wetland line. Upon comnletion of the project the disturbed areas are to be stabilized with burlap sheetinq or hemp net,.~ng and plant with low maintenance quick growing ground cover to minimize the need for fertilizer and pesticide. Supplementary Special Conditions (A) through (J) attached, Additional Supplementary S~ecial Condition (M) attached. DEC PERMIT NUMBER 10-86-1669 PROGRAM/FACILITY NUMBER ~/^ Page 2 of 4 New York State Depa~ment of Environmental Conse~ation Regulatory Affairs Unit Bldg. 40,SUNY, Rm.-219 Stony Brook, NY 11794 (516) 751-7900 Henry G. Williams Commissioner Mr. Robert iMiller 15 Farrell Rd. Weston, CT ~06883 April 1, 1987 Re: Permit # 10-86-1669 Dear Mr. Miller In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Dennis W. Cole Senior Environmental Analyst enclosure ~' ' a~a~lable at the proJec~ site whenever authorized work is in progress. · ~ _~.~:..~-~i2.. '"-~ '/ .... '~ .............. of letter of approval ' ' C. The~'permit si%n enclosed with the permit er a copy . shall be protected from the weather and poeted itt a conspicinus location at 'the work site until completion of authorized work. D. At least 48 hours prior to co~cncement of the project, the pe~ittee shall complete and return the top portion of the enclosed receipt form certifying ' that he is fully aware of and understands all provisions and conditions of this pe~it. Within one week of completion of the pe~itted work, the bottom portion of thet fo~ sha%l also be completed and returned. E. For. projects involving activities to be accomplished aver a period ~r more than one year, the pe~ittee shall notify the Regional Pa~it Administrator in writing at least 48 hours to the co~encement of resumption of work each '~, design modifications tak~ place ~ b~i~[ t~" ~ppro 14~t changes for approval: ~y .the/ , 'p~l~dmini~tratov,' prt~r: ~0~. undertaking any such modific2~ions'" ~'~e 'is"~dvi's'ed thud~ s~bsd'~%ial~' modifica~io~'m~ '~eqa~? b-t? ,-,~,.. a. new~ application, for, pemiC.~:-:z-,- , · '; ~ "' ~"~:[~',,',-~:,["[ .. ~ :precautions~ sh~ll b~, t'aken ~'preclude tone.nation of any =' '"' ~ wkt'em%d~, byi' ~spend'~4 ~f{d~t~f 4'~diment~i< fuels';"solvents?.~:i? deteteriou~ mat~'ial'~'~s~'~iated-with~ the proJ act work*; ' ' faildraJt~ i~ply/preci~el~ithT'alz~ of the te~s and conditions of E~rb~encar. Conse~iOd': Li~;~::(~-'~'.5::':',-7 'f ,' :~:- -:: · '. ' - : ~' ::=' ¥' . ..':,4;--' ~'/ it ~ ~.. .. ~f ..;. :~i .St-fi~ ~'fS "--. ......... ' " :::.~ pe~ttee i~' 'advised to obtain auy pemits or approvals chat may be : 9:?~i~3:~:.~..~.?~,~ re~uire~', from:"th[~. U.S.i Department :of A~y CO~S ~f Engineers, ~ District, responsibility of obt~ini~8 ~ 6rant~ eas~ent, or other necessa~ approvaz fro~ th~ ~ivfsion of Land Uti!iz~tfon, Offi:a of General Semites, Tower Buildf:~, Empire State ~l~z~, ~bsny. h~ 12242, which :~y be required for 10-86-1669 Regional Pez-mit Administrator A~S Dept. of Enviror~ental Consa~cation Bldg. 40, SU~TY--Room 219 Stony Brook, ~NY 11794 (516) 751-7900 THE FOLLOI3t~IG CONDIi!OIIS SIL:~LL Z?PLY IF CHECIiED AS APPLICABLE THE REGIOIIAL PERi,IT AD~flUISTC~ATOit: Ail dredging shall be conducted so as to leave a uniform bottom elevation free of mounds or hole~o Ail spoil material shall be disposed of either in the Atlantic Ocean or at an approved U.S. Government Dumping Ground~ as directed by the District Engineer~ U~So Depart- ment of the Army~ Corps of Engineers° Any spoil matezl~l not intended for such water disposal shall be removed from the site and disposed of at an approved upland site° Ail fill and spoil material shall ~e suitably contained at the work site so as to prevent its eroding, leaching or other- wise entering into adjacent wetlands and waterways° Ail peripheral rip-rap berms, cofferdams, rock revetments, gabions, bulkheads, etc~ shall be completed prior to placement of any fill material behind such structures° Ail repairs to existing structures shall be confined to placement of existing structural elements with no change design, dimension, or materials, unless specifically authorized herein. DATE: DEC # 4/1/87 10-86-1669 REGIOgIAL PE~IT A~fINISTRATOR Division of Regulatory Affairs I~S Deft. of Environmental Conservation Bldg. 40, SUSa, Room 219 Stony Brook, l,Pf 11794 (516) 751-7900 Page 4 of 4 1987 DAY BERRY & HOWARD Stamford, Hartford and Boston Robert J. Miller Three Landmark Square Stamford Connecticut 06901-2599 Telephone (203) 348-3840 Telex 99324 ~OV 2 11986 November 14, 1996 Mr. Victor Lessard Executive Administrator Southold Town Building Department Town Hall Southold, Mew York 11971 Dear Victor: Pursuant to our phone conversation of November 12, I enclose my Application for a building permit for our proposed single- family vacation residence on Fishers Island. As we discussed, the Application is incomplete in certain respects, although an accurate plot plan plan is attached in triplicate. However, it is possible that we will require permits from the Board of Town Trustees and/or the Zoning Board of Appeals. I would appreciate it if you could entertain the Application as filed in order that I may begin those permitting processes if in fact permits are required. We will provide you with detailed plans and the other information needed to complete the Application in the near future. I was unsure about how to handle the fee, and therefore enclose a blank check payable to the Town of Southold. The final plans will not reflect habitable area exceeding 3,000 square feet including garage in any event, and I would be agreeable if you wish to fill in the check reflecting the fee on a 3,000 square foot bases. Please call me collect if there are any questions. Thanks very much for your assistance. Sincerely, e Robert J. Miller RJM:km Enclosure TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 CERTIFICATION Date Building Permit No. //~/~__~_ Owner ~ ~ · (please i. ) Plumber ~;r~ ~ (please print) I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. (plier' s/signature) Sworn to before me this /'q day of _~ , Notary Public,_~ County Notary Public HELEN K, DEVOE NOTARY PUBLIC, Sta!e.of ~ewYork . No, 47078/8 Su~o& County. s, ~erm Expres Ma~cfl 30,1~ Statement in Support of Building Application An Application dated November 20, 1986 was filed with respect to this project in order to commence, if necessary, the permitting processes for approval to construct in the vicinity of a fresh water wetland from the Board of Town Trustees and/or Zoning Board of Appeals. The site plan filed with the Application indicated that a portion of the proposed construction might be within 75' of a fresh water wetland. A copy of the Application and of the Notice of Disapproval issued with respect thereto on December 53, 1986 is attached. Since the issuance of the Notice of Disapproval, the margin of the fresh water wetland in question has been confirmed by the New York State Department of Environmental Conservation which duly issued permit #10-86-1669 effective 4/1/87. This permit specifically approves the construction of the proposed dwelling in its original proposed location or farther away from the wetland margin. The location of the proposed construction has been moved away from the wetland margin as confirmed by the DEC. No part of the proposed construction will be within 75' of the margin of the wetland in question, and Town approval is not required. This was confirmed by Mr. Henry P. Smith, President of the Board of Town Trustees, after physical inspection of the premises by Mr. Malinowski on behalf of the Board of Town Trustees (see letter of Mr. Smith dated April 20, 1987, attached). Dated: May 24, 1987 Robert~i ~1 e~ HENRY P. SMITH, President JOHN I~. BREDEMEYER, V/ce-Pres. P[41LLIP J. GOUBEABD ALBERT KRUPSKI, JR. ELLEN M. LARSEN BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Main Road P.O. Box 728 Southold, New York 11971 TELEPHONE (516) 765-1892 April 20, 1987 Mr. Robert J. M~ller 15 Farrell Road Weston, CT 06883 Re: Single family dwelling - Fishers Island, New York Pursuant to your request for a determination of jurisdiction for the above captioned work, please be advised that Mr. Steve Malinowski has conducted an on site inspection of your property and has determined that since no part of the proposed structure will be within 75 ft. of the wetland boundary (defined by both Ms. Sharp and NYS DEC), he recommends that a wetland permit from the Town Trustees is not required. The Town Trustees concur with Mr. Malinowskis determination in this matter. Should you have any questions or concerns, please do not hesitate to contact this office at the telephone number listed above. Very truly yours, Henry P. Smith, President Board of Town Trustees HPS:ip cc: Trustees file DAY, BERRY & HOWARD Counsellors a~ ~w Smmfo~. H~.Jord and Boston Three Landmark Square Stamford Connecticut 06903-2599 Telephone (203) 348-3840 Telex 99324 November 14, 1996 Mr. Victor Lessard Executive Administrator Southold Town Building Department Town Hall Southold, New York 11971 Dear Victors Pursuant to our phone conversation of November 12, ! enclose my Application for a building permit for our proposed single- family vacation residence on Fishers Island. As we discussed, the Application is Incomplete in certain respects, although an accurate plot plan plan is attached in triplicate. However, it is possible that we will require permits from the Board of Town Trustees and/or the Zoning Board of Appeals. I would appreciate it if you could entertain the Application as filed in order that I may begin those permitting processes if in fact perm/ts are required. We will provide you with detailed plans and the other information needed to complete the Application in the near future. I was unsure about how to handle the fee, and therefore enclose a blank check payable to the Town of Southold. The final plans will not reflect habitable area exceeding 3,000 square feet including garage in any event, and I would be agreeable if you wish to fill in the check reflecting the fee on a 3,000 square foot bases. Please ca1! me collect if there are any questions. Thanks very much for your assistance. Sincerely Robert J. Miller RJM~km Enclosure bcc: Robert: L. 14arx (w/encl.) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTItOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To .. : ............ . ~....,..~.... 0.,.,--~. PLEASE TAKE NOTICE that your application dated ...~..~..{P~.....~.{ ..... 19 .~..~.. for pemfit to construct.. O~-..~.t,.. ' .~~ ......................... at Locnt,onofProp rty .... County Tax Map No. 1000 Section ..'...O.g ...... Block ....~.3 ........ Lot .t,J...~...~ 9...t?.~.-..q., Subdivision.C~..~..?.~:..~.~FiledMapNo. ~ ~qol LotNo. is returned herewith and disapproved ,on the following grounds ~4.'..c.~.. ~...~%...,_:-;,x~....n.~.': .o...~,..~...~.. ~..~c~:~ .~. ~., Building Inspector RV 1/{I0 CI-UCRLES T., ~IYS DEC, Bureau of Marine l~abiitat Pro'::ect-ion Bldgo 40~ SU~Cf, Rmo 225 Stony Brook, N. Y. 11794 Re: Permit No. Icsued To. Contractor'S'Address. Contractor's Phone # Dear Sir: Contractor's Name Pursuant to General Condition No, I of the above referenced p~.rmit are hereby notified that the authorized activity shall comm~tce on This Notice is to be sent at least two days in vance of commencement of the project. The Permit sign will be po~ the site and copy of Permit will be available at site for in~pection~ Submitted by bATE: FAILURE TO NOTIFY OR POST SIGN ~[ILL LEAVE JECT TO APPLICABLE PENALTIES FOR NON-CO~PLIANCE-WITH' PERMIT CONDITIO~f~ Ct~AP&EE T. ILA/iILTO~ Chief, }iarine Regulatory Section I~S DEC, Bureau of ~rine Habitat Protection Bldg. 40, SUNY, Rm. 225 Stony Brook, N. Y. 11794 Dear Sir: Permit ~]o. Issued To. Contractor's Address. Contractor's Phone Contractor ~s Name. Pursuant to General Condition No. 1 of the above referenced Perm~,.~ you are hereby notified that the authorized activity was completed on Submitted by DATE: THIS NOTICE, WITH PHOTOS OF CO}~PLETED WOPX AND/OR COMPLETED SURVEY, )iS TO BE SEI~T TO ABOVE ADDRESS PRO~TLY UPON COMPLETION OF PROJECT. FAILU~ TO NOTIFY WILL LEAVE O%~ER Ahq)/OR CO~YfRACTOR SUBJECT TO APPLICABLE PENALTIES FOR ~qON-CO~'~LIA~]CE WITH PEP~IT CONDITIONS. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined...~../6fl'A'~.....~..~.., 19~.7. Approved · · ~ .... 19 ~.7. Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUiLDiNG PERMIT 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit snail 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. : APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Penni~ pursuant to the Building Zone Ordinance of tlae 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 ali applicable laws, ordinances, building code,,,h~ous, ing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe~j~ .,~./r.,/t ' .... ,, :. :. .,: ........ ; ....... :"', .... Robert Jo Miller ......... 15 Farrell Road, Weston, CT 06883 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or 1 . Robe~'t J. Miller Name of owner of premises ......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. to be provided to be provided Plumber's License No ......................... Electrician's License No. to be provided Other Trade's License No. to be provided Miller Subdivision (Approved by Southold l. Location of land on which proposed work will be done .................................................. Planning Board 10121/85) Fishers Island, Town of $outhold, Suffolk County, New York 06390 /louse Number Street _ Hamlet County Tax Map No. 1000 Section 8 Block 1 Lot .4...2.,..4. ..6.8. ,..4. .. 1.0. Southold Planning Board Subdivision..R.o.b.e.r.t..J....~J;1.1.e.r. ................... ~]l~ .~Luo.r..Rah- .... Lot...3. ........... (Name) div±s±on #401 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: vacant land - unoccupied a. Existing use and occupancy ......................................................... '. · · · ...... residential use of single-family for occupany by owner b. Intended use and occupancy ................................................. · ................... 3. Nat re ofwork (check which ~pphcable): New Building . .x. ..... Addition .......... Alteration Repair .............. Removal .............. Demolition .............. Other Work· .'... .......... ' (Description) 4 Estima' '- $200,000 [ · tea cost ........... ~ .......................... Fee .................................. i (to be paid on filing this application) 5. If dwelling, number of dwellini units..o.n.e. Number of dwelling units on each floor. ?./.A. ....... If garage, number of cars . .one ......................................................... · fly h typ 6. If business, commercial or mixed occupancy, spec nature and extent of eat e of use .................. 7 Dimensions ' ' ' if any: Front Rear Depth · of exmtmg structures, ............................... ............. Height ..... ~,. ..... Number of Stories ..................................................... · ' ~ ' ~e structure ~vith alterations or additions: Front Rear Dunensmns of. Depth Height Number of Stories 8. Dimensions of enhre new con~truction: Front 70 ..... Rear 7.0. ...... Depth 30. Height . Number of Stories two ........ · 9. Size of lot: Front .5.1.0..(.p.p.r,o.x.). ....... Rear 440 .(a.p.p.r. ox) perth 225 (varies-approx) 10. ~ Date of Purchase . A. qgqs.~ 9~ 1.9.7.9. ..... ~ame of~r~r'(~,~' Jo~en ~);~; '~: ......... l l. Zone or use district in which premises are situai;~ ~.4n.e. .A.~1. .A. ar.~...~.R.e.s. ('~'.':. 12. Does propo~ed construcfion violate any zoning iaw, ordinance or regulation: . .~. q ........................... 13. Will lot be regraded .N.q .... ~ .................... Will excess f'fll be removed from premises: ~ No 14 Name of Owner of premises iS. et B. elow Address Phone No Name of Architect .t~o..b.c..s. 9~l.~.e.d. ............ Address ................... Phone No ................ Name of Contractor to be SUpI~.ed ... Address ....... Phone No. 15. Is this property located withinl:00 feet of a tidal wetland? * Yes ..... No ..~.. · If yes, Southold Town T~ustees Permit may be required. ' PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloc number or description according to deed, and show street names and indicate whether /ntefior or comer lot. 14. Owner Robert J. Miller 15 Farrell Road We~ton, CT 06883 See plot plan attached. Tel.: Business: 203 -348-3840 Residence: 203 -226-1608 STATE OF ~~,e-~ ~ S S .......................'..'........../Aft. being duly sworn, deposes md savs t~a, h- is the applicant (N~e of individual si~ning een~ract) .... above named. He is the ................... efi~kk owner ez~, md is d~iy authorized to perfom or have perfo~ed the said work and to m~e and file t~s application; that al statements cofitfined ~ this application are tree to the best of his ~owledge and b~lief; and that the work wOl be perfo~ed in ~e mm~ t~r set forth ~ the application filed therewith. Sworn to before me this Not~ Public ..................... County (Signature of applic~t) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................. 19... Approved ................ , 19... Permit No ............ Disapproved a/c ..................................... ~EA~/)~2) (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... 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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. 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 issued a Building Permit to the applicant. Such permit ahall 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 whatever until ~ Certificate of Occupancy shall have been granted 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, 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 oiapplican~, or name, if a corporation) State whether applic.ant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ,uiiaer. Name of owner of premises, t~l't'/' ~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .................... : ..... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... .. ' ' 7 I. Location of land on which proposed work will be done. ~. ~.~.k.P. ' .Nd.. . .Sd.e/ ......... . . . 3. . r, . . A . . °. ......... House Number Street Hamlet County Tax Map No. 1000 Section f Block / Lot .q~.;~,L ~/:{t .~ .q.'./P... Subdivision t~0b't ~- ~, ~[/J,'t Filed Map No. qPJ. ........ Lot ...~. ........... (Name) 2. State existlng use and occupancy of premises and intended use and occupancy of proposed constructi°n: a. Existing use and occupancy b Intended use and occupancy .q'J~?/O[~. ~.j.e. ~y~ .$~k; ¢.~J/.~ .~?f( .~7..o.,n~r. ' 3: N~ture of work (check which applicable): New Building .. 9{ ...... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... (Description) 4. Estimated Cost ...................................... Fee ...................................... (to be paid on fding this application) 5. If dwelling, number of dwelling units.., q 0 f ......... Number of dwelling units on each floor...~..zYA ......... If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use o..~./.~... ?. 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 ,,C...;~. Rear ~,~ u~,,th qo Height ...~."~ .......... Number of Stories..'b¢~...~/~.t/~. fj~r..~.4e.~..e.,~[' ............................... 9. Sizeoflot:Front..C./a...~//O,z~ . Rear ~.~P. {','~,t, tll,~. " · . v , 'rr .......... taepm .~O. {.54./.../..v. .... ) .... 10. DateofPurchase .~.?~$~ .'/~ ./~.'/.~. .. NameofFonneroum~ 11. Zone or use dmrict ~n w~ch premmes are situated..~.~.e..~.-~./~$t:.)~..~.e4, ................................ 12. Does proposed eonsWaction violate any zoning law, ordinance or regulation: . ~.~.: ........................... 13. Will lot be regraded ...... ~.~.. ................... Will excess fall be removed from premises: ~ No 14. Name of Owner of premises $¢q..~e/~.. .......... Address ................... Phone No ................ Name of Architect ....... .S.~.e...~../..~o. · .......... Address ................... Phone No ................ Name of Contractor ...... .5.e.e...~./.~.o.: .........Address ................... Phone No ................ 15. Is this property located withinlO0 feet of a tidal wetland? * Yes .~Y... 1~o ..... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. ~)uTATE OF NEW YORK, NTY OF ................. S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the ......................................................................................... (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 fde 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 ........................ day of ..................... ,19 ... Notary Public ................. ................. County __ ........