The URL can be used to link to this page

Home My WebLink About25714-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-26699 Date: 09/22/99 THIS CERTIFIES that the building ADDITION Location of Property: 8800 NASSAU POINT RD CUTCHOGUE (HOUSE NO.) (STREET) (HAMLET) County Tax Map No. 473889 Section 118 Block 6 Lot 3.2 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 26~ 1999 pursuant to which Building Permit No. 25714-Z dated MAY 10~ 1999 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 5' X 7' DECX ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR · The certificate is issued to HARRY HOHN & WF. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED N/A N/A N/A Rev. 1/81 FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25714 Z Date MAY 10g 1999 Permission is hereby granted to: HARRY HOHN & WF. 200 EAST 66TH STREET NEW YORK~NY 10021 for : CONSTRUCTION OF A 6' X 6' DECK ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR AND TO CONDITIONS OF THE DEC. at premises located at County Tax Map No. 473889 Section 118 Block pursuant to application dated MARCH 26 1999 Building Inspector. 8800 NASSAU POINT RD CUTCHOGUE 0006 Lot No. 003.002 and approved by the Fee $ 75.00 Rev. 2/19/98 ORIGINAL TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY be filled in by typewriter OR ink and submitted to the buildi inspector with the following: for new building or new use: 1. Final survey of .property with accurate location of all buildings, property line 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 used in system contains less than 2/10 of 1% lead. 5. Commercial bnilding, industrial building, multiple residences and similar build 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. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings Vpre-existimg" 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 a consent to inspect signed by the applica 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swarm, lng pool $25.00, Accessory building $25.00 Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Oc~upa~cy on Pre-existing Bulldin~ - $100.00 3. Copy of Certificate of Occupancy - 4. Updated Certificate of Occupancy - $50.00 · 5. Temporary Certificate of Occupancy - Residential $1~OOf, Commercial $15.00 , Date ..... ~/. ~. ~-~- ...................... New Construction. ~ ....... Old Or Pre-existin~ B,utiding ........... /~ .... oeatiom of Property. .g:. .... ............ Subdivision .................................... Filed Map ............ Lot .............. . . Permit No .............. Date Of Permit ..... Applicant ....................... Health Dept Approval . . ...~. ...... Underwriters Approval /-- · Planning Board Approval .......... ........ Fina ertic Request for: Temporary Certificate.. . · Fe~ Submitted: $ ...... .~. ~..'. ............ .......... 765-1802 BUILDING DEPT. iNSPECTION [ ] FOUNDATIONlST [ ] FOUNDATION 2ND [ ] FRAMING [ ] ROUGHP~LB~: [ ] ~UI~ATION [ ~FINAL [ ] FIREPI~ACE & CHIMNEY REMARKS: DATE INSPECTOR / /1.C PERHiT NUMBER /+738-01963/00001 //IFADILITY/PROBRAM NUMBER(S) TYPE OF PERMIT · New NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION PERMIT Under the Environmental EFFECTIVE DATE October 8f 1998 EXPIRATION DATE(S) October 31, 2001 [] Renewal [] Modification [] Permit to construct [] Permit to Operate [] Article 15, Title 5: Protection of Waters [] 6NYCRR 608: Water Quality Certification D Article 27, Title 7; 6NYCRR 360: Solid Waste Managen~nt [] Article 15, Title 15: Water Supply [] Article 15, Title 15: Water [] Article 17, Titles 7, 8: SPDES [] Article 19: Air Pollution Control [] Article 23, Title 27: Mined Land Recla~tien [] Article Z/+: Freshwater Wetlands · Article 25: Tidal ~etiands [] Article 27, Title 9; 6NYCRR Hazardous Waste Management [] Article 34: Coastal Erosion Management D Article 36: Floodplain Management Articles 1, 3, 17, ~9, 27, 37; 6NYCRR 380: Radiation Cc~ltro[ Other: PERMIT ISSUED TO J TELEPHONE NUMBER Mart,/ and Janet Rohn J C516) 758-2557 ADDRESS OF PERMITTEE 200 Emst ~th Street~ Apt. C 1203t New Yorkr NY 1001~ CONTACT PERSON FOR PERMITTED WORK LOCATION OF PROJECT/FACILiTY suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: 11968 WATERCOURSE Little Peconic Bay TELEPHONE NUMBER (516) 283-6360 NYTM COORDINATES Construct 61 x 6~ platform with steps underneath rear door of house. Ail work shall be done in accordance to plans stabbed HYSDEC approved. By acceptance of th~s permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable re~atio~the General Conditions s~cifi~ (see ~ge 2 & 3) a~ any Special Co~itions i~l~ as ~rt of thi. y ~rmit./ ~ r T~ [ding 40, SUNY, Stony Brook, NY 11~0-2~56 J a~ ) ~ Alber~ J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Po]iwoda Town Hall ¼ 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 22, 1998 En-Consultants Inc. Rob Herrmann 1329 North Sea Road Southampton NY 11968 RE: HARRY ~ JANET HOHN ..... SCTM #118-6-3.2 ............... Dear Rob, The following action was taken at the Southold Tow~ Board of Trustees meeting on October 21, 1998: RESOLVED, that the Southold Town Board of Trustees grant the request to rescind the Waiver granted May 29, 1998 for a deck and grants a new Waiver to construct a 6' X 6' platform and stairs underneath the rear door of the house. However, this does not constitute approval from any other agencies.' If you have any questions, please call our office at 765-1892. Sincerely, Albert J. Krupski, Jr. ?resident, Board of Trustees 3K/dJh · Bldg. Dept. PLANNING BOARD 1VIEMBEtLS BEt~NETT ORLOWSKI, JR. Chairman WILLIAM J. CREMER$ KENNETH L. EDWARDS GEORGE RITCHIE LATIL~I, JR. RICt-IARD G. WARD Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD December 15, 1998 Robert E. Herrmann Coastal Management Specialist En-Consultants, Inc. 1329 North Sea Rd. Southampton, NY 11968 Re: Minor subdivision of Harry & Janet Hohn SCTM# 1000-118-6-1, 3.1 Dear Mr. Herrmann: The following took place at a meeting of the Southold Town Planning Board which was held on Monday, December 14, 1998: The public hearing which was held in regard to allowing the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house to occur outside of the building envelope designated for Lot Number 2, as shown on the site plan dated September 30, 1998, was closed. The following resolution was adopted: WHEREAS, the Planning Board required a Declaration and Covenants and Restrictions as a condition of subdivision approval for the Minor Subdivision of Harry and Janet Hohn; and WHEREAS, a Declaration was filed in the County Clerk's Office in Liber 11343 page 237; and WHEREAS, Condition Number 3 of the Declaration states that "Houses and their accessory uses, structures, and facilities, including, but not limited to the access driveways for the subdivision lots, shall be sited and constructed only within the Page 2 Minor subdMsion for Harry & Janet Hohn December 15, 1998 building envelopes and driveway areas shown on the subdivision map."; and WHEREAS, the owners of Lot Number 2 in the Hohn subdivision have asked the Planning Board to allow the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house as shown on the September 30, 1998 site plan for Lot Number 2; and WHEREAS, the proposed construction is outside of the building envelope for Lot Number 2; and WHEREAS, the applicant received a waiver for the proposed construction from the Town Trustees on October 21, 1998; and WHEREAS, the applicant received a permit for the proposed construction from the NYSDEC on October 13, 1998; and WHEREAS, the Declaration requires that any modification to the Declaration be approved by a majority plus one of the Planning Board after a public hearing; and WHEREAS, the Planning Board, pursuant to Chapter 58, Notice of Public Hearing, has received affidavits that the applicant has complied with the public hearing notification provisions; and WHEREAS, the public hearing to allowing the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house to occur outside of the building envelope designated for Lot Number 2, as shown on the site plan dated September 30, 1998, was held on December 14, 1998, and closed on the same day; be it therefore RESOLVED that the Planning Board approve the request to construct the 6' by 6' platform and stairs underneath the rear door of the existing house outside of the building envelope as shown on the September 30, 1998 site plan for Lot Number 2. Please contact this office if you have any questions regarding the above. Sincerely, Bennett Orlowski, Jr. ~ Chairman cc: Building Department OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY APPROVED AS NOTED NOTIFY BUILDING DEPAI:g',MEIqT~,~I~T 765-1802 9 AM TO 4 PM FOR THE ~NG INSPE~ONS: I FOUNOATION - ~0 REQUIRED ~R ~URED CONCR~E 2. ROUGH. F~ING & PLUMSING ~. I~U~ON 4. FINAL - CONSTRUCTION MUSf BE COMPL~E FOR ALL CONSTRUCTfON SHALL MEET THE REQUIREMENTS OF THE ~ATE CONSTRUCTION & E~,ERGY CODES. NOT RESPON~;~r ~OR DESIGN OR CONSTRUC~t~ =RNORS 54°4~.'00'E t43.03' cdr ;6 PARr OFl£or 93 I R,,,45.00 L~45. O~ L 34.08 'P~OPOSED SUBOIVISION NAP O~ ~'~4-Om ~ ' 0~ 'SUBDIVISION POND 0~'~/'~ ~.oo' CONSTRUCTION, INC. March 25, 1999 To,am of Southold Building Department Main Rd. Southold, NY 11971 Re: 118-6-3.2 HohnProperty Gentlemen: Enclosed find application and necessary documents to secure permit for deck above referenced. Very truly yours, BURGER CONSTRUCTION, INC. Eugene Burger P,O. Box 934 * Cutchogue, New York 11935 + Tel: (516) 734-5217 * Fax: (516) 734-5249 [KiD IllSPI~CTION RI~PORT DATE CO,fliNTS OU]~I],AT~ON 01]I~IDATION OUGH FRAME & (~s~) ! ~ (21{D) I~SULATIOlt ~ STATE EI~RGY CODE Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Pol~woda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 29, 1998 En-Consultants Inc. Roy Haje 1329 North Sea Road Southampton NY 11968 RE: HARRY & JANET HOHN SCTM #118-6-3.2 Dear Mr. HaJe, The following action was taken at the Southold Town Board of Trustees meeting on May 28, 1998: RESOLVED, that the Southold Town Board of Trustees approve the request for a Waiver to construct a 10' X 35' deck onto northwest corner of existing 1 1/2 story dwelling. However, this does not constitute approval from any other agencies. If you have any questions, please call our office at 765-1892. Sincerely, Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/dJh cc. Bldg. Dept. Albert J. Krupski, President James King, Vice-President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18~]2 Fe~x (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 22, 1998 En-Consultants Inc. Rob Herrmann 1329 North Sea Road Southampton NY 11968 RE: HARRY ~ JANET HOHN ..... .... SCTM ~118-6-3.2 Dear Rob, The following action was taken at the Southold Tow~ Board of Trustees meeting on October 21, 1998: RESOLVED, that the Southold Town Board of Trustees grant the request to--the Waiver granted May 29, 1998 for a deck and grants a pew Waiver to construct a 6' X 6' platform and stairs underneath the rear door of the house. However, this does not constitute approval from any other agencies.' If you have any questions, please call our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/dJh cc. Bldg. Dept. PLANNING BOARD MEMBERS BENNETT ORLOWSKI, JR. Chairman WILLIAM J. CREMERS I~ENNETYI L. EDWARDS GEORGE RITCHIE LATHANI, RICIL&RD G. WARD Town ttall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 Fax (516) 765-3136 Telephone (516) 765-1938 PLANNING BOARD OFFICE TOWN OF SOUTHOLD December 15, 1998 Robert E. Herrmann Coastal Management Specialist En-Consultants, Inc. 1329 North Sea Rd. Southampton, NY 11968 Re: Minor subdivision of Harry & Janet Hohn SCTM# 1000-118-6-1, 3.1 Dear Mr. Herrmann: The following took place at a meeting of the Southold Town Planning Board which was held on Monday, December 14, 1998: The public hearing which was held in regard to allowing the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house to occur outside of the building envelope designated for Lot Number 2, as shown on the site plan dated September 30, 1998, was closed. The following resolution was adopted: WHEREAS, the Planning Board required a Declaration and Covenants and Restrictions as a condition of subdivision approval for the Minor Subdivision of Harry and Janet Hohn; and WHEREAS, a Declaration was filed in the County Clerk's Office in Liber 11343 page 237; and WHEREAS, Condition Number 3 of the Declaration states that "Houses and their accessory uses, structures, and facilities, including, but not limited to the access driveways for the subdivision lots, shall be sited and constructed only within the Page 2 Minor subdivision for Harry & Janet Hohn December 15, 1998 building envelopes and driveway areas shown on the subdivision map."; and WHEREAS, the owners of Lot Number 2 in the Hohn subdivision have asked the Planning Board to allow the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house as shown on the September 30, 1998 site plan for Lot Number 2; and WHEREAS, the proposed construction is outside of the building envelope for Lot Number 2; and WHEREAS, the applicant received a waiver for the proposed construction from the Town Trustees on October 21, 1998; and WHEREAS, the applicant received a permit for the proposed construction from the NYSDEC on October 13, 1998; and WHEREAS, the Declaration requires that any modification to the Declaration be approved by a majority plus one of the Planning Board after a public hearing; and WHEREAS, the Planning Board, pursuant to Chapter 58, Notice of Public Hearing, has received affidavits that the applicant has complied with the public hearing notification provisions; and WHEREAS, the public hearing to allowing the construction of a 6' by 6' platform and stairs underneath the rear door of the existing house to occur outside of the building envelope designated for Lot Number 2, as shown on the site plan dated September 30, 1998, was held on December 14, 1998, and closed on the same day; be it therefore RESOLVED that the Planning Board approve the request to construct the 6' by 6' platform and stairs underneath the rear door of the existing house outside of the building envelope as shown on the September 30, 1998 site plan for Lot Number 2. Please contact this office if you have any questions regarding the above. Sincerely, 7 Bennett Orlowski, Jr. ,/ Chairman cc: Building Department New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile [516) 444-0360 John P. Cahi[I Commissioner October 13, 1998 Harry and Janet Hohn 200 E. 66th St., Apt. C1203 New York, ATY 10011 RE: 1-4738-01963/00001 Dear Permittee: In conformance with the requirements of the State Unifor~ Procedures Act (Article 70, ECL) and its implementing re~latio~s (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are u~able to comply with any conditions, please contact us at the ~ove address. Also enclosed is a pe~it si~ which ~spicuously posted at the project site and )rotec~d ~ ~ ~ather. ~ ~. Wiela=d Pe~it Adm{~istrator JAW/ls DEC PERMIT NUMBER 1-4T58-01963/00001 FACiLITY/PROGRAJ~ NUMBER(S) TYPE OF PERMIT · Hew L-] Renewal PERMIT Under the Environmental Conservation Law EFFECTIVE DATE October 8t 1908 EXPIRATION DATE(S) October 31, 2001 [] Modification [] Permit to Construct [] Permit to Operate Article 15, lille 5: Protection of Waters Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport Article 15, Title 15: Long Island Wells Article 15, Title 27: Wild, Scenic and Recreational Rivers other: 6NYCRR 608: Water Quality Certification Article 17, Titles 7, 8: SPDBS [] Article 19: Air Pollution Control 0 Article 23, Title 27: Mined ~] Article 27, Title 7; 6NYCRR 360: Solid Waste Management ~ Article 27, Title 9; 6NYCRR PERMIT ISSUED TO TELEPHONE NUMBER Harry and Janet Hohn (516) 758-2557 ADDRESS OF PERMITTER 200 East ~th Streetf Apt. C 1203~ Hew Yorkt NY 10011 CONTACT PERSON FOR PERMITTED WORK EnConsultants~ [nc.~ 1329 North Sea Roadf Southampton~ NY NAME AND ADDRESS OF PROJECT/FACILITY ~ohq propert¥~ 8800 Nassau Point Road~ Cutchogue 11968 TELEPHONE NUMBER (516) 283-6360 suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: WATERCOURSE Little Peconic Bay NYTM COORDINATES Construct 61 x 6' platform with steps underneath rear door of house. All work shall be done in accordance to plans stamped NYSDEC approved. By acceptance of this permit, the permtttee agrees that the permit is contingent upon strict compliance with the ECL, all applicable re--the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of ,th~.s permit./ ~,~ ........ J~lm%wlqtand ) ~ i ~ lding 40, SUNY, Stony Brook, NY 11790-2~56 AU R D SIGH E ) DATE NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages and costs, direct or indirect, of whatever nature and by whomever suffered, for liability it incurs resulting from activity conducted pursuant to this permit or in noncompliance with this permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from such activity. Item B: Permittee to Require it's Contractors to Comply with Permit The permittee shall require its independent contractors, employees, agents and assigns to read, understand and comply with this permit, including all special conditions, and such persons shall be subject to the same sanctions for violations of this permit 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, [ands, easements and rights-of~way that may be required for this project. 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 or facility, 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-O301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when written or verbal notification is provided by the Depad. ment at least 24 hours prior to such inspect[on. A copy of this permit, including ali referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site. 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 If project design changes become necessary, the permittee shall submit the appropriate plan changes for approval by the regional Permit Administrator prior to undertaking any such modifications. Be advised that substantial modification may require submission of a new permit. The perm[ttee must submit a separate written application to the Department for renewal, modification or transfer 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) 1BO days before expiretion of permits for State Pottutent 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 B[dg #40 SUN, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit when: 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) environmentat conditions, relevant technotogy, or applicable [aw or regulation have materially changed since the permit was issued. I DEC PERMITNUMBER I PAGE ;~ OF 4 -4738-01963/00001 I NEW YORK STATE DEPARI~ENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 ( ._TIDAL WETLANDS_ ) 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 flood 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 alter the structural work, obstructions, or hazards caused thereby without expense 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 manner as 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 capacify of the watercou'rse. No claim shall be made.against the State of New York on account of any such removal or alteration. 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. · · 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. Ail 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. ~ . Any matedal dredged in the prosecution 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. 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. If granted under 6NYCRR Part 608, the NYS Department of Environmental 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 95-217) provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and returo 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 work and, if required, a survey. 10. All activities 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__ DEC PERMIT NU~I~ER 1-4738-01963/00001 PAGE ,3 OF 4 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, 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. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or prior to permit expiration, whichever comes first. The approved methodologies are as follows: a. Stabilization of the entire disturbed area with appropriate vegetation (grasses, etc.). 5. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 50 Linear feet from the tidal wetland boundary. 6. If seeding is impracticable due to the time of year, a t~porary mulch must be applied and final seeding performed at the earliest opportunity when weather conditions favor'germination and growth, but not more than six months after project completion. 7. A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area or 20 linear feet from the tidal wetland boundary, or as per NYSD~=C approved plan, at commencement of regulated activities and remain in place until project is completed ahd all disturbed areas stabilized with vegetation. DEC PERMIT NUMBER PAGE 4 OF._4__ 1-4738-01963/00001 New York State Department of Environmental Conservation NOTICE The Department of Environmental Conservation (DEC) has issued permit(s) pursuant to the Environmental Conservation Law for work being conducted at this site. For further information regarding the nature and extent of work approved and any Departmental conditions on it, contact the Regional Permit Administraior listed below. Please refer to the permit number shown when contacting the DEC. Permit Number Expiration Date Regional Permit Administrator JOHN W. PAVACIC NOTE: This notice is NOT a permit IIE'I'URN Tills FORM TO: Ileglonnl Mnnnger Bureau of Mariue Ilahll~t Pr~flecflnn New York State I)epnr{ment of Euvlronmen[al Cmlservaflon Bldg. 40 - SlOIly Brook, NY 11790-2356 / CONTRACTOR NAME: Jnhn P, Cai:ill ADDRESS: TELEPHONE: Dear Sir: Pursuant to Supplementary Special Condition D of the referenced permit, you are hereby notified Ihat tile authorized activity si:all commence on . We certify that we have read the referenced peru:it and approved plans, aud fully understand the authorized project and all permit conditions. We have inspected Ihe pmjecl site and can cmnplele lite project aS described in the pemfit and depicted GU the approved plans in full compliance with all plan notes aud permit conditions. Tiler Permit sigh, permit, and approved plans will be available at the site for inspection in accordal,ce with General Condition No. I. PERMITTEE DATE CONTRACTOR DATE Tills NOTICE MUST BE SENT TO TIlE A BO VEA I)DRESS A T LEAST TWO DA YS IN ADVANCE OF COMMENCEMENT OF TIlE FAILURE TO RETURN Tills NOTICE~ POST TIlE PERMIT SIGN, OR IIA VE TIlE PERMIT A~tD APPROVED PLANS A VAILARLE AJ~4E W¢)~K SITE MA r SUBJECT TIlE PERMIITEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENALTIES FOR N~ COMPLIANCE WITII PERMIT CONDII'IONS. Cut along this line ..................................................................... ~' ......... NOTICE OF COMPLETION OF CONSTRUCTION RETURN TIIIS FORM TO: Regional Manager Bureau of Marlite Ilabltat Protection New York Stale Deparhuent or Envlronnlental Conservation Bldg. 40 - SUN¥~ Room 223 Stony Brook, NY 11790-23S6 CONIRAClOR NAME: ISSUED TO: ADDRESS: TELEPHONE: Dear Sir: Pursuant to Snpplementary Special Ce~:dition D of the referenced permit, you are hereby notified that the authorized activity was completed on We have fully complied with the terms and conditions of thor permit and approved plans. PERMIT'fEE DATE CONTRACTOR DATE Tills NOTICE, WITIi PIIOTOGRAPIIS OF COMPLETED WORE AND/OR A COMPLETED SURVEY *, AS APPROPRIATE, MUST BE SENT TO TIlE AROVE ADDRESS WITIIIN JO DA YS OF COMPLETION OF THE PROSECT. FAILURE TO DO SO WILL RESULT IN A COMPLIANCE INSPECTION BY N¥SDEC STAFF. ITT BLDG OWN OF §OUT~OLD FORH NO. I TOWN OF SOUTIIOLD EU1 ti)lNG DE PAR'It4ENT TOWN IIALI, ,~OIH'IIOLD, N.Y. 1197 ! TEl,: 765- lB02 BOARD OF HEALTII ............... 3 SETS OF PLANS ............... SURVEY ........................ CIIECK ......................... SEPTIC FORH ................... NOTIFY: c^,.., ...... L7 HAIl. TO: .................... APPI,ICATION FOR I~tI[LI)ING PERHIT INSTRUCTIONS February ,99 a. 'lhls application must be conpletely filled in by typc~riter or in ink and red,miLLed to the l~Hhling hmpector 3 rets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan si~in~ location o1~ lot and of buildings on premises, relationship to adjoining premises or Ixd~lic streets or areas, nnd giving a detailed deecripticu of layont of property mint be drawn on the dlagra, d~lch Is part of this application. c. 'Ilia ~)rk covered IT this al~lJcation may not be com,enced before issuance o[ Px~ildtag Permit. d. Upon approval of thls applicatlon, tie lluildiag Inspector wtl]~ issue a Iluildlng Permit to the applicant. permit shall be,kept on O~e p,,~dsea available gar hmpectton thrc,~out tim work. e. No buildln~ slmll be occupied or used in dtole or tn part for any purpore dmtever troth e Certificate of Occupancy shall have been granted by U,e I~dldlng Inspector. APPLICA'rI~ 15 I£1~nY MNJE to ~tlm Itu|lding Department for the Issuance of a Building Permit purmmnt to the l~J}ldlng Zone Ordinance of the 3~ of Sc, lthold, Suffolk Ccxmty, Ne~ York, and other applicable Laws, Ordhu~ces or Regulatlona, for the constroctton oE I~dtdlnga, additions or atteratlons, or for t,~,~,al or der~olitlon, as herein descrll~d, ll~e applicant agrees to cc.ply with all applicable la~s, ordlnaaces, building code, I~using code, and regulations, tm~1 to admit anthorlsed inspectors on p~'o,dses and in building for recessary Inspections. (Sigtmture o[ applicant, or naue, if a corlx)ration) · EQ..~.o.x.. 33A..~.q ~.qb.q g.q .e..FX....L! .o.3.5. .... (Mailt~g address of applicant) State ~d~etl~er applicant ls c~mer, lessee, agent, architect, engleeer,'~enera[ contractor, electrician, phrnber or bulhle B.u LLcLe r ............................. off o~rer of premises [~rJ~¥..G.,.~O. hll ......................................................................... (as on tl~ tax roll or latest deed) If applicant is a corporation, aigrmt~,re of duly antl~>rlz~-~l officer. (Narc and title of corporate officer) Plud)ers License No .......................... Electricians l.icerme No ...................... Other Trade*s License No ..................... t~_ ~ Nassau Point I. l~caticu of land on ~ic]) prc~x~! ~ork will . ~x~ .............................................................. Ilouse D~iSe r Street IL~mlet Co, ntT Tax H~p No. I000 Sectlo~ ..].l.~ .......... Block ...~ ............ lot .~.s~. .......... 2. State existing use and occupartcT o[ [r~emises and intemled tree taxi occ~pase7 of proposed ccxmtn~ct|cm: Residence w/6' X 6' deck ' a. Existing ~me and occulmr, c¥ ............................................................................. b. Intended are and occup.~ncy ........................................... ]. t~mu,e of ~ck (eMck ~deh al~Pticahh): ~ I~ildio~ .......... &~tti~ .......... Alteration .......... I~lmir ............ ~al ............. I~t~l Itl~ ............ Otl~er ~rlpti~) Is. Est i.~t~l ~st ' f~ .............................................. (to ~ I~id ~s~ filthR this al~licatt~) 6. If Im~i,~as~ ~tercial or miwi'~z[~, s~c1~ t~t,UFQ al~ I~i~,t ........................ Ka~imr of Stories Ili.ensl~m of ~m stn~ra ~Jth alteratl{m$ or ~MJttons: Fr~t ............... ~ar ............... I~pth ..................... l~t~,t .................... ~=fl~r oE Btorle$ ............... 1~i~t ......................... K~i~r o~ atodea ..................... ~. ai~ of lot: *t~t .................... ~aT .................... ~pth ....... ~9. c9~. sq. f~. II. ~ or u~ diaedct tn ~dd~ pr~i~a are ait~t~l .............................................................. 12. ~a pro{~l ~mt~tt~ violate an~ ~lng I~. ordi[~e or regularly: ............ Il. 9tll lot Im r~r~ .................... ~ill ~eaa fill Im la this p~rty ~lthln ~ feat. of a tt~l t~tl~? n W3 ..~ ...... ~ .......... *IF~, ~flIIDI~a~I~I'I'~Y~II~.- Waiver dated 0ct.22, 1998 H.OT IHAGRA~- fr~n prolmrty lt~a. G[~ atmt a,~l hl~ m~tlmr or t~serlpti~ ~cordlng to ~. a~ d~ strut ~ma ami i~licaCe t~tetber i.tertor or corr~r lot. lie i. the thnL the ~rk ~ill Im ~rfon~l In tl~e .~ntmr ~t forth i~ the nppllcnti(m fil~l ~)m Lo I~fore ~ this (Si fi,re:ute of~