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HomeMy WebLinkAbout22984-z J � . I" FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23955 Date OCTOBER 17, 1995 THIS CERTIFIES that the building ADDITION Location of Property 2055 BAY SHORE RD. GREENPORT, NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 53 Block 4 Lot 12 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 18, 1995 pursuant to which Building Permit No. 22984-Z dated AUGUST 31, 1995 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 DECK ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR - Q AS PER ZBA #4324. The certificate is issued to RICHARD MAUTNER (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. H-365638 - OCTOBER 5, 1995 PLUMBERS CERTIFICATION DATED N/A a'�' a�' Building Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) QQ Date ......... `��..�........................................ 19../... N�� 2298 Z Permission is hereby granted to: D TA4.* �..1�/� / ?✓/. i, d 2r� G,!9lG ........... /J�/1 /1mn....eve4✓Qa...... zi✓f ele O w ✓ / , . .,., ....to �... ........./ ....... .......l! . . 1. .....-� e` .... .......... BiS....../9% ...... .. .. .:../( /99� �.. ........................ ......./ p Q! ��-�7,f .... M/!....#�r�/......1.....//�'!F�✓/ M F,!✓I..�.....{R .1..� ./..`�............... �f /.:•�i� ............................................................................... at premises located at.... ©SSS` ....................................................� `,✓fid ......................`./................................... ................. County Tax Map No. 1000 Section .....53.............. Block .... ........... Lot No. ....../ .............. pursuant to application dated ....J.!!)./LJ../....�a.. ........................ 19...E ... and approved by the Building Inspector. / Fee$,.,�................. ....................................... Building Inspector Rev. 6/30/80 f Form No. 6 T014N OF SOUTHOLD BUILDING DEPARTMENT T014N HALL 765-1802 APPLICATION FOP. CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: 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 used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "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 a 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 $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial 515.00 Date . . . � iYlhi �: .��. 1 l. . .. . . . . . . . New Construction. . . . . . Old Or Pre-existin Building. . . . _. . . . . . . . . . Location of Property. . . . . Al . . . . . . . . . . . . . . ��1 .. . . .yed ... . . . . . . . . . . . ... �. . . . House No. Street Hamlet Onwer or Owners of Property.. . .. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . County Tax Map No 100n0, Section. . . .S�. . . . . . .Block. . . V . . . . . . . . .Lot. . . 1 Z. . . . . . . . . . . . . . . Subdivision.iLCU)1!L.l� (. . F( ?. . . . . . . . . .Filed Map. . .�Io1.y. . . .Lot. . . .a-( . . . . . . . . . . . . . . ZZq� � ff3! Ij _ �lfTrt �� s 1 lit, � ul lc�eF Permit No. . . . . . . J . . . . . . .Date Of Permit. A' . . . . . . . . . . .Applicant.�. . . . . . . .<-. k -tet Jealth Dept. Approval. . . . . . . . .. . . . . . . . . . . . . . . . . .Underwriters Approval. . . . . . . . . . . . . . . . . . . . . . . . . 'lanning Board Approval. . . . . . . . . . . . . . . . . . . . . . . . tequest for: Temporary Certificate. . . . . . . . . . . Final Certicate. � . . . °ee Submitted: $. . ?� . . . . . . . . . . ... .. . . . . . CSR c s oaG y �.. . . .. .�;�`.'.. .. . . . . . . . . . . . . APPLICANT-- o��g�FFO[q-�,oG o� y� y � Town Hall, 53095 Main Road WO • Fax (516) 765-1823 e9y'110� � Telephone(516)765-1802 Southold, NewYork 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 15, 1995 John Bertani Builder Inc. 1380 Oakwood Drive Southold, NY 11971 Re: Mr. Richard Mautner - SCTM#1000-53-4-12 Prem: 2055 Bayshore Road, Greenport To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. The check is (outdated/not on file. ) ;25.00 No Health Department Approval on file. No final inspection has been made. No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984) . BUILDING PERMIT # 22984-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. G THE NEW- YORK V NIM-fMR-IT-ERs paw r a. 1001H71 _ 9WtEAU OF ELECTMCWY= (— 85 JOHN STREET. NEW YORK'.WEW YORK 10038 - - D.xe OCTOBER 05,1995 fppf3oetien.Mo onjtie- . 1£3315595445 N_ 36563f� THIS CERnFIE5 THXT swirtAe adocn�cel equipnterx ssdeerihrd bdwR cad iusa-odud�i b1.WsyfpGe+�xx�wrdaw.sie r6eoa auaL�riia tbe;+ewiaf�ej- r� RAY RfifiRTr RIZ. . l�tY,E'S&Y]R'F. -----------�__....�,..__.._ in the foUeriag location; :.At 8etement l:i FF. ❑ ind R. OtTS _ 5ec'tiori' Block Lot - +na exauwin6e,�da�n.,..�SEPTEFM 3.8,19r95 end foundto be In cempUamcs with the Notional MeetnLc. Code. -_ dtfltfl5 $YNTCFES RIITUCS VANGES tc p DEM I OVEM WASMERS EJDIA MTIO% rvC,WDESQNF %11oe[SCLwF atwE fMT- cW. , T- i tW. 1.nf- x.w- .an[. LW. SMT. 3 4RYEf.S -iti�iACE AiOTOfiS fUAW AfeM1 MKI REDM SiSCIALRECIMI TMCW City I M LL UM**Mi TM I MAD-WAFET I" prY�if f5,� 545T#M6= ult.. K.W. A.W.G. ]ni. � -Ai V- 1 uaT. - JMRS. T7IA[RS. s>♦T SaVAM DBCONNWT NROF S E R Y I - -C fSASM T. AW wm ;T.R'TV F{3'/, d3w 3J'.w aNdam- CF C[CONU wff.OF Ma '- MNO fa rtµS - OF AGlat ODM AMPA"IM a G & 5 CONTRACTOR LIC.#s?8Emown L!�` BOX 215 SOVTHOLD, YY, 11971 - _ Rl MA iillt' Thio osrlifi=" must not be Dilated in ow morwer;feawv for the office of M»$acrd if ismmea- kazpeeMts may-be id JW lbeir.tr dentiak. 1-IE11,f N plll3;GIION_RIIIOR'I UAIC. _ cOMHEV1; (FOUNDATION ( IST) C4 vr FOUNDATION (2ND) N ------ ------------ - -----� --__- ..._ --_ -__- - - --- - _ - ROUGH FRANI? — FT.IIMR i NGit _ II _ if INSM,ATION PP•R N. T . STATE ENRRGY GOUI: �I cc if VaF[NAL _ - 1�-- -- ------- ---- I - -------- ADDITIONAL. COMMENTS: t r-1 r-1 Fj 0 r' 5 APPEALS BOARD MEMBERS 1�gOfFO(� ¢io OGy Southold Town hall Gerard P. Goehringer,Chairman c :c 53095 Main Road Serge Doyen, Jr. y a P.O. Box 1179 James Dinizio, Jr. O • A Southold, New York 11971 Robert A. Villa y�OI *a0� )' Fax (516)765-1823 Lydia A. Tortora zFQ t00Telephone(516) 765-t809 BOARD OF APPEALS TOWN OF SOUT14OLD AUG 2 11985 ACTION OF THE BOARD OF APPEALS DATE OF ACTION: August 9, 1995 ADPL. #4324. APPLICANT: RICHARD MAUTNER. LOCATION OF PROPERTY: 2055 Bayshore Road, Greenport. NY. 1000-53-4-12. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector on July 18, 1995. "Proposed construction is less than 75 ft. from bulkhead . and will have insufficient side yard setback. . . ." PROVISIONS APPEALED FROM: Art. IIIA, Section 100-30A.3 and Article XXIV, Section 100-244B. RELIEF REQUESTED: Variance for addition for open deck with reduction in south (south/east) side yard setback from present 7.5 feet to a requested 3.5 feet, and reduction in setback from bulkhead from present 55 feel at the northeasterly corner to a requested 35 feet at its closest point. MOTION MADE BY: James Dinizio, Jr. , Member SECONDED BY: Gerard P. Goehringer, Chairman ACTION/RESOLUTION ADOPTED: Denied 3-1/2 ft. reduction in sideyard, and Granted setback from bulkhead provided deck is not wider than the existing width of the house and is not closer than 55 ft. to the bulkhead at the northeasterly corner at its closest point. REASONS/FACTS: The setback requested is similar to those existing along the waterfront in this area. The relief requested will not produce an adverse effect or impact on the physical or environmental conditions of (lie neighborhood as an "open" and "unenclosed, unroofed" deck addition. Grading and drainage is not to be toward the waterway or bulkhead area and shall be property retained. VOTE OF THE BOARD: Ayes: Serge J. Doyen, Member James Dinizio, Jr. , Member Robert A. Villa, Member Lydia A. Tortora, Member Gerard P. Goehringer, Chairman-Member This resolution was unanimously adopted. FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD,N.Y. NOTICE OF DISAPPROVAL Date . . O.GG . . . . . . . . . . . . . . . . . .. 19 5•� 71 PLEASE TAKE NOTICE that your appl'cation dated . .;! /. . . .. .. . . . . . . . . . . . . .. 19 ya for permit to Lt Locationof Property . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .S. . .t. . . .. . . . . . . . . . . . . . . . . . . . . . . . . . House No. heeHamlet County Tax Map No. 1000 Section . . . 3. . . . . . Block . . .� ' . . . . . . . . Lot . ./.2_ . . . . . . . Subdivision . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . . . Lot No. . . . . . . . . . . . . . . . is returned herewith and disapproved on the following grounds .Il�-fi�.. . 4C�4V. r, .. . . . . . . ares 21. s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� . ' � . . . . . . 'BuiX ing Inspector RV 1/80 3, LOT 33 U)L.GT 34a ,. Rik .Y .s}��' __ ._ _ _ i '`Y� ,`,'F�fiD '' Sy •Q�.. l�1 .1' 1 M .;Z. 5.45°4720`W, tios^1F122 340 t of mom ° As ; fY35 ,). SCHUfrSAGN it ^° wm4 Y4*sw slep m t G =aha +4aI 'hr "h MAP JFPROPERTY p°°" °'°h•�„ ° f OF Aft SURVEYE v �'c.iL `0 an `~4°•m'`" ( �.o\GK Vq� L� _ _ _ � 4,.t3�y-•ea b �M'+Cy�M j nil, TGF }J+ CP (jam �,� F`i 4S2562 E{ ; tAND SVP AQC-11.IAhs JMAQ(JE. / I -r.- F = `vTF��LC7 N.Y. / �CAk.t ^ _' Ct _ - �_ t49 :� A. AS �LtRVEYEt) JULY V �;? I.LVr NGS . REFEQ T 'AMENDED NEAP A PECONIC 610.Y tSTATEj',PILED it. THE t NO t ; 6'�'TgUFFU( Albert J. Krupski,President 0�� c�0 Town Hall John Holzapfel, Vice President Q4�� y1 53095 Main Road William G. Albertsony x P.O. Box 1179 Martin H. Carrell WO Southold, New York 11971 Peter Wenzel y't1p .��� Telephone (516) 765-1892 1 �/4 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD June 30 , 1995 Richard Mautner 2055 Bayshore Rd. Greenport, NY 11944 Re: SCTM #53-4-12 Dear Mr. Mautner, The following action was taken by the Board of Trustees at their regular meeting of June 29, 1995 : RESOLVED that the Southold Town Board of Trustees approve an Amendment to Permit #4193 to construct a 20 ' X 35 ' deck to an existing house as per revised survey dated May 15, 1995. If you have any questions, please call our office. Very truly yours, ' '- Albert J. Krupski, Jr. President, Board of Trustees AJK/djh CC. CAC Bldg. Dept. ate' oar New York State Department of Environmental Conservation �P �s Building 40 -SUNY, Stony Brook, New York 11790-2356 Phone (516) 444-0365 x �+ Fax # (516) 444-0373 e. Z 1PO:'.ClVTA1 Michael D. Zagata Commissioner July 10, 1995 Mr. Richard W. Mautner 60 Lenox Avenue Lynbrook, New York 11563 .' RE: 1-4738-00675/00004-0 Dear Mr. Mautner: 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. Ver truly yours, C ES T. HAMILTON P mit Administrator CTH/ls enclosure File NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER EFFECTIVE DATE 1-4738-00675/00004-0 July 6 1995 FACILITY/PROGRAM NUMSER(S) pE IT EXPIRATION DATE(S) Under the Environmental July 6, 1999 Conservation Law TYPE OF PERMIT ❑ New ❑ Renewal ❑ Modification 0 Permit to Construct ❑ Permit to Operate 0 Article 15, Title 5: Protection 0 6NYCRR 608: Water Quality ❑ Article 27, Title 7; 6NYCRR 360: of Waters Certification Solid Waste Management 0 Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPOES 0 Article 27, Title 9; 6NYCRR 373: Supply Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined Land ❑ Article 15, Title 15: Long Reclamation ❑ Article 36: Floodplain Island Wells Management 0 Article 24: Freshwater Wetlands 0 Article 15, Title 27: Wild, 0 Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control ❑ Other: PERMIT ISSUED TO TELEPHONE NUMBER W (212) 599-4700 Richard W. Mautner H (516) 599.2026 ADDRESS OF PERMITTEE 60 Lenox Avenue Lynbrook, New York 11563 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Linda Bertani 1380 Oakwood Drive Southold New York 11971 (516) 765-1594 NAME AND ADDRESS OF PROJECT/FACILITY LOCATION OF PROJECT/FACILITY 2055 Bayshore Road, Greenport New York 11944 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Pipes Cove DE9MIFTIM CF am-a3Iz® acrIVITY Construct a 20' x 351 deck addition to existing single family dwelling. All work shall be in accordance with NYSOEC approved plans. By acceptance 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 page 2) and any Special Conditions included as part of this permit. PERMIT ADMINISTRATOR: ADDRESS /Ceocit��(�avi s Bldg. 40, SUNY, Room 219, Stony Brook, NY 11790-2356 cl. S6 AUTHORIZED SIGNATURE DATE 1Jul-Y 7, 1995 Page 1 of 4 G6101AL CCMITICS Inspections 1 . The permitted site or facility, including relevant records, Is subject to In- spection at reasonable hours and intervals by an authorized representative of the Department of Envirorrentai Conservation (the Department) to determine vhhether the permittee is corplying with this permit and the ECL. Such represen- tative rray order the v�ork suspended pursuant to ECL 71-0301 and SADA 401 (3) . copy of this pe miit, including all referenced naps, drawings and special conditions, rrust be available for inspection by the Department at .all tins at the project site. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Penaneis 2. 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 regula- tions is found: b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) nenrnaterial information is discovered; or d) envirorrrental conditions, relevant technology, or applicable law or regulation have rraterially changed since the permit was issued. 3. The permittee rust submit a separate written application to the Department for renem 1 , modification or transfer of this permit. Such application mist include any form, fees or suppleTental information the Department requires. Any renem 1 , modification or transfer granted by the Department rust be in writing. 4. The permittee must submit a renem l application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SFDES) , Hazardous VlAste Nbnagemnt Facilities (Piff) , rrejor Air Pollution Control (APC) and Solid V16ste Nhnagerent Facilities (SMJF) ; and b) 30 days before expiration of all other permit types. 5. Unless expressly provided for by the Departrant, issuance of this permit does not modify, supersede or rescind any order or determination perviously issued by the Department or any of the toms, conditions or requirements contained in such order or determination. Other Legal Cbligaticns of Permittee 6. The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all dareges, direct or indirect, of v%hatever nature and by W-arever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State fran suits, actions, da-rages and costs of every name and description resulting frvn this project. 7. 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 irrpa i rrrent of any rights, titIe, or interest in real or personal property held or vested in a person not a party to the permit. S. The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-vAey that ray be required for this project. Page 2of4 95-20-6a(7/92)-25c Tidal WotlanJS ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34 and 6 NYCRR Part 608 ( ) 9 That if future operations by the State of New York require an al- other environmentally deleterious materials associated with the teration in the position of the structure or work herein authorized, or project, if, in the opinion of the Department of Environmental Conservation 13 Any material dredged in the prosecution of the work herein permitted it shall cause unreasonable obstruction to the free navigation of said shall be removed evenly,without leaving large refuse piles,ridges across waters or flood flows or endanger the health, safety or welfare of the bed of a waterway or floodplain or deep holes that may have a the people of the State, or cause loss or destruction of the natural tendency to cause damage to navigable channels or to the banks of resources of the State,the owner may be ordered by the Department to a waterway. remove or alter the structural work, obstructions, or hazards caused thereby without expense to the Stat[-, and if, upon the expiration or 14. There shall be no unreasonable interference with navigation by the work revocation of this permit, the structure, fill, excavation, or other herein authorized. modification of the watercourse hereby authorized shall not be com- 15. If upon the expiration or revocation of this permit,the project hereby pleted, the owners, shall, without expense to the State, and to such authorized has not been completed,the applicant shall,without expense extent and in such time and manner as the Department of Environmental to the State, and to such extent and in such time and manner as the Conservation may require,remove all or any portion of the uncompleted Department of Environmental Conservation may require,remove all or structure or fill and restore to its former condition the navigable any portion of the uncompleted structure or fill and restore the site and flood capacity of the watercourse.No claim shall be made against to its former condition. No claim shall be made against the State of the State of New York on account of any such removal or alteration. New York on account of any such removal or alteration. 10 That the State of New York shall in'no case be liable for any damage 16. If granted under 6 NYCRR Part 608, the NYS Department of Environ- or injury to the structure or work herein authorized which may be caused mental Conservation hereby certifies that the subject project will not by or result from future operations undertaken by the State for the contravene effluent limitations or other limitations or standards under conservation or improvement of navigation,or for other purposes,and Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 no claim or right to compensation shall accrue from any such damage. (PL 95-217) provided that all of the conditions listed herein are met. 11. ,Granting of this permit does not relieve the applicant of the responsi- 17. All activities authorized by this permit must be in strict conformance bility of obtaining any other permission, consent or approval from with the approved plans submitted by the applicant or his agent as part the U.S.Army Corps of Engineers, U.S. Coast Guard, New York State of the permit application. Office of General Services or local government which may be required, RC)deriCk Van T11V1 12. All necessary precautions shall be taken to preclude contamination Such approved plans were prepared by + of any wetland or waterway by suspended solids, sediments, fuels, last ceded date on JU[le 20, 1995 solvents,lubricants,epoxy coatings,paints,concrete, leachate or any 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. The storage of construction equipment and materials shall be confined to within the project work site and landward of bulkhead. Supplementary Special Conditions A thru F attached. DEC PERMIT NUMBER 1-4738-00675/00004-0 PROGRAMIFACILITY NUMBER Page 3 of 4 SUPPLEMENTARY SPECIAL CONDITIONS The following conditions apply to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenic, and Recreational Rivers Permits: A. A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. B. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page one or telephone (516) 444-0365. C. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. D. At least 48 hours 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 the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. E. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. F. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encroachment upon State-owned lands underwater. DEC Permit No. 1-4738-00675/0004-0 Page 4 of 4 9&20.1 (8187)-9d New York State Department of Environmental Conservation "'h NOTICE o 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 Administrator listed below. Please refer to the permit number shown when contacting the DEC. Regional Permit Administrator Permit Number '' 300 �•O ROBERT A. GREENE Expiration Date 77/t/99- NOTE: This notice is NOT a permit Not St. Charles F. Y tf d R I E, HOSPITAL 6 REHABILITATION CENTER 4 F C� T 200 SELLS TERRE ROAD,PORT JEFFERSON.N.Y.11777-1928 I I / 18/4,4 50 C /,I "S 731954 S1LT7N , u , LQIS , H .D . ADAPTIVE EQUIPMENT hC `P ,: AVE LY Nr ^t(1�^K , alY RECOMMENDATIONS FOR POST-DISCHARGE USE Please order only those specific items indicated below. 01, BATHROOM EQUIPMENT Suggested Manufacturer/Model # 1. Commode 2. Toilet Safety Frame =3. Raised Toilet Seat +-i l 1Q f rrl P 4. Transfer Tub Bench � 5. Shower Chair N4-1 2 J S r ll_1FL 5-6 (Lit Y" L)I') �P 1 S CLI /6. Grab Bars L4-2-1 1b ^ C Ly� r 7. Shower Hose 8. Other Ill ( I^ c� h I hn��"�I rr f' II. BEDROOM EQUIPMENT C re e"t-�CLCCJ ' 1. Hospital Bed: ( ) Manual ( ) Electric 2. Trapeze 4— 3. Bed Rails .-. r_ 4. Other III. WALKING DEVICES - Issued via P.T., unless noted here 1. IV. WHEELCHAIR &ACCESSORIES 1. Type: 2. Legrests 4. Accessories: Standard ✓ Footrests j Cushion Hemi-Height Seatbelt Tall 3.Armrests: Hemi Lap Tray Recliner Full Length /� Brake Extension Lightweight Desk Antitippers Wide Removable Other .1 r1r Narrow Other V. SEL HELP DEVICES " Reacher /2. Sock Aide 3. Extended Shoe Horn 4. Dressing Stick 5. Long Handled Bath Brush 6. Shoe Laces 7. Feeding Equipment 8. Transfer Belt ,.. / 9. Other pp , np Therapist's Name , . I l- -z.. l r CP C=c 1.k �r I L Date � ' f Department Phone#474-6259 Physician's Signature ti Date ' ,I 738:076/93 WHITE-CHART CANARY-PT/FAMILY PINK-EQUIP/CLINIC ADAPTIVE EQUIPMENT RECOMMENDATIONS FOR POST-DISCHARGE USE -- v5rl I AL and Rehabilitation Center Part Jefferson, New York INSTRUCTIONS TO PATIENT/OTHER ACTIVITY: I -Ve TREATMENT : MEDT TION : °1E + CIL A p III Ck'c1`I p- YVI S \)ascac-c �CLO�-h Ixc�ay�S � 1„ a. Sw,� — - - - — DIET : VtY,oU �� 3 Y,Fc r=ss4 r`` EQUIPMENT/APPLIANCES NEEDED : TEACHING PAMPHLET : FOLLOW-UP APPOINTMENT : Home Visit: Date Phone No. To Call M.D. Visit: Date � Phone No. To Call (7fC �l L Ou r�C nZ-110 I have received and understand the above: R. . Signature & Date Patient's/Other Signature & Date Witness, it other than R. N. above 6501742 Rev. 8/92 PATIENT COPY UFFO( APPEALS BOARD MEMBERS �pco �O p Southold Town Hall Gerard P. Goehringer.Chairman c ?<� 53095 Main Road Serge Doyen.Jr. W Qt P.O. Box 1179 James Dinizio, Jr. O Southold, New York 11971 Robert A. Villa *41, �a0� Fax (516) 765-1823 Lydia A.Tortora Telephone(516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD August 17, 1995 John Bertani Builder, Inc. AUG t 1380 Oakwood Drive Southold, NY 11971 Re: Appl. No. 4324 - Mautner Variance Determination Dear John and Linda: Please find attached a copy of the Board's findings and determination rendered at our August 9, 1995 Regular Meeting with reference to the above variance application. As indicated in the written determination, the Board of Appeals denied the sideyard reduction and therefore you will need to prepare a new drawing for the alternative granted, with reduction in size, for your building-permit application record. All projects which are located within 500 feet of a waterway or State or County road are required by the County Administrative Code to be reviewed by the Suffolk County Department of Planning. You may be contacted by their agency over the next few days. Very truly yours, Linda Kowalski Enclosure Copy of Decision to: Building Inspector's Office 4--� APPEALS BOARD MEMBERS �$UFFD(,� cOGy Southold Town Hall Gerard E Goehringer,Chairman c 53095 Main Road Serge Doyen, Jr. w x P.O. Box 1179 James Dinizio, Jr, o yc Southold. New York 11971 Robert A. Villa 41, �.aFax(516)765-1823 Lydia A. Tortora Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD OF APPEALS , $ 1p0� DATE OF ACTION: August 9, 1995 APPL. #4324. APPLICANT: RICHARD MAUTNER. LOCATION OF PROPERTY: 2055 Bayshore Road, Greenport. NY. 1000-53-4-12. BASIS OF APPEAL: Notice of Disapproval issued by the Building Inspector on July 18, 1995. "Proposed construction is less than 75 ft. from bulkhead . . . and will have insufficient side yard setback. . . ." PROVISIONS APPEALED FROM: Art. IIIA, Section 100-30A.3 and Article XXIV, Section 100-244B. RELIEF REQUESTED: Variance for addition for open deck with reduction in south (south/east) side yard setback from present 7.5 feet to a requested 3.5 feet, and reduction in setback from bulkhead from present 55 feet at the northeasterly corner to .a requested 35 feet at its closest point. MOTION MADE BY: James Dinizio, Jr. , Member SECONDED BY: Gerard P. Goehringer, Chairman ACTION/RESOLUTION ADOPTED: Denied 3-1/2 ft. reduction in sideyard, and Granted setback from bulkhead provided deck is not wider than the eidsting width of the house and is not closer than 55 ft. to the bulkhead at the northeasterly corner at its closest point. REASONS/FACTS: The setback requested is similar to those esdsting along the waterfront in this area. The relief requested will not produce an adverse effect or impact on the physical or environmental conditions of the neighborhood as an "open" and "unenclosed, unroofed" deck addition. Grading and drainage is not to be toward the waterway or bulkhead area and shall be property retained. VOTE OF THE BOARD: Ayes: Serge J. Doyen, Member James Dinizio, Jr. , Member Robert A. Villa., Member Lydia A. Tortora, Member Gerard P. Goehringer, Chairman-Member This resolution was unanimously adopted. � Z' 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [�NAL [ ] FIREPILACErHIMNEY REMARKS: �r lz�s — A o -- DATE INSPECTOR JUL 0 19A.5 BOARD OF APPEALS, TOWN OF 5OUTHOLD In the Matter or the Petition of ��o�tt � V3- ,mCLLJ44n NOTICE TO to the Board of Appeals of the Town of Southold ADJACENT TO: ]DLOn, ��� Y�rl1 PROPERTY OWNER YOU ARE HEREBY GIVEN NOTICE: t. That )t is he intention of the undersigned to petition the Board of Appeals of the Town of Southold to request a aria ) (Special Exception) (Special Permit) (Other) [circle choice] 2. That the property whi h is the subject of the Petition is located adjacent to your property and is des- cribed as follows: ` 0cc &1114 fhOU`�ov r l4n et 3. That the property which is the subject of such Petition is located in the following zoning district: -Ya 4 That by such Petition, the undersigned will request the following relief: 4S 1LYl. ("b L1111101� � Cl(� L�t1h w �i d � h1(re �� Cta�% In cutC PAt .ric�v rcwc'/ 5. That the provisions of the Southold Town Zoning Code applhtohe reght by the under signed are Article 100.7�4V6 QA� - 30a- I- [ ] Section 280-A, New York Town Law for approval of access over rights)-of-way. 6. That within five days from the date hereof, a written Petition requesting the relief specified above will be filed in the Southold Town Clerk's Office at Main Road Southold, New York and you may then and there examine the same during regular office hours. (516) 7�5-1809. 7. That before the relief sought may be granted, a public hearing must be held on the matter by the Board of Appeals; that a notice of such hearing must be published at least five days prior to the date of such hearing in the Suffolk Times and in the Long Island Traveler-Mattituck Watchman, newspapers published in the Town of Southold and designated for the publication of such notices; that you or your representative have the right to appear and be heard at such hearing. Dated:J ,l I1gr4j, Petitioner Owners ' Names :�� Post- , o{ Of�)cess e�s( _aLJnfpd, 10r' o (�J Tel No . M1 ) 7 J 1� [Copy of sketch or plan showing proposal to be attached for convenience purposes . ] PROOF OF MAILING OF NOTICE ATTACH CERTIFIED MAIL RECEIPTS NAME ADDRESS STATE OF NEW YORK ) ss.: COUNTY OF SUFFOLK) residing at being duly sworn, deposes and says that on the day of 19 deponent mailed a true copy of the Notice set forth on the re- verse side hereof, directed to each of the above-named persons at the addresses set opposite their respective names;that the addresses set opposite the names of said persons are the addresses of said persons as shown on the current assessment roll of the Town of Southold;that said Notices were mailed at the United States Post Of- fice at ;that said Notices were mailed to each of said persons by (certified) (registered) mail. Sworn to before me this day of 19 Notary Public (This side does not have to be completed on form transmitted to adjoining property owners . ) ry 1w BOARD OF HEALTH FORM NO. 1 3 SETS O�YPL,\NS . . . . . . . U. 8 TOWN OF SOUTHOLD SURVEY 1 BUILDING DEPARTMENT CIICCK=0 .. . . . . . _ . . . . . . . . TOWN HALL SEPTIC FORA . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t,OT I FY ; // p CALL .� Y: _ .�:5./,/ . . . Examined 1 MAIL TO : Approved . . .a/.31. . , 19/Q? Permit No. ?1 / 1 _ . . . . . . . . . . Disapproved a/c . � � � .� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Bu' di 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 sets rf plans, accurate plot plan to scale. Fee according to schedule. L't. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this app; cation. cc. 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 perm 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 whatever until a Certificate of Occupanc 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 th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describer The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) 1 aku)ttU . .f�(. .SI� u h . . . . (Mailing address of applicant) I Icy l State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder . . . . . . . . . . . . . . . . . . . . . . . . . es cr A. .Ccm. Cad-:AQM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . . . \'S �1G1( , A . . . , ! !. (a�A �c . . , . . (as on the tax roll or latest deed) If ap,p.�lic t is a corporation, signature of duly authorized officer. .,,6.e . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . l pqi , t � !p. A_ . . . . . . Plumber's License No. . . . . .�.. . . . . . . . . . . . . . . Electrician's License No. . . ... . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c 4 5 . . . .6.4Sh4!'0— .4 a.4:� . . . . . . . . . . . . . . . . . . . . . . . . . .Gzat.(.por t. . . . . . . . . . . . . . . . house Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . . . Block . . . . . . . . . . . . . . . . Lot . . . . . .. . . . . . . , . . Subdivision . &. . J. . . . . . . . . Filed Map No. �� rq. . .Y. . . . . . . . . Lot . . 3.7. . . . . . . . . (Line) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . .(. .e..Gf.L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition • • • • Alteration . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . Other . . . . . . . . . . , . Repair . . . . . . . . . _ > (Description: 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use .. . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . .. Number of Stories . . . . . . . . . . . . . ... . . . . . 8. Dimensions of entire new construction: Front . . .3 .. . . . , . . . . Rear . .3S. . . . . . . . . . . Depth . . . L G) . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . r . . . . . . . . . . . . . . . . . . . . . . . I :'. . . . . . . . . 9. Size of lot: Front . . . . . . . .j. ... . . . . . . . . . . Rear . . . . . . . . .r f . . . . . . . . . . . Depth . . . . y. . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . r . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . !\O. . . . . . . . . . . . . . . . . . . ... . . . 13. Will lot be regraded . . . . . . i).0. . ./.��. . . . . . . . . . . .Will excess fill be re oved fro }'s / Yes 14. Name of Owner of premises 1 Cvva4 .M(kl,A• . Address WA LRf (wy. .�C ' ne 1 0 . . . . . . . . . . . . . Name of Architect . . Address . . . . . . . . . . . . . o o. . . . . . . . . . . . . . . Name of Contractor . .AI % . r. . .IrJ.�� : . Address I�1 �I �I S�J�1�t . � Pho e llo. . . . . . . . . . . ". . . 15. Is this property within 300 feet of a tidal wetland? *yes. . ?{. . . . No. . . . . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back dimensions fro, property lines. Give street and block number or description according to deed, and show street names and indicate whenc.- interior or comer Iot. STATE OF NEN Y(�}3K, S S COUNTY CSF .du YT [ . {.`. ! 0 11C S_ . : l IfC'kv_'\. . . . . . . . . . . . . . . . . . . being duly sworn,deposes and says that he is the applican (Name of individual signing contract) above named. J J Heis the . . . . . . . . . . . . . .V. :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 thi, application; that all statements contained in this application are true to the best of his knowledge and belief;and that thi work will be performed in the manner set forth in the application filed therewith. Sworn to before me this q day of. . . . 19 . . . . . . . . . . . . . . Votary Public, . . . . . . . . County JOYCE M.WILKINS . . . . . . . . . . . . . . . Notary Public,State sof New York (Signature of applicant No.4952245,Suffolk County Term Expires June 12,19� mfei'" N1��4x1 ` PAM. r <<�ftti A 3w '� :•r ill ,x. s . A 9 JI I I y I J r il A r Il ; J II + 4,^ pn , , , 1 ell . .� s 1 J � t l IT ?I _ S'cY Tb Cr2h.C•Lc � � 1 121 I It - -I —_-9-- _ � ,,./frF-1 aIn.11sM t•M1+ocR:' r-i�.AT � j _T — ` 50(4" o5-fK �'x'GRr I3 7 _ ( � �� � T� S/y.><6� CSTR• etTYrv— cgt_e„��, 2;ae n.u,u>.x�r-• •:./ 'O �_— dd _ --- -- as L 4.ebnLx„ 4P A 6W �[ •,� - - - -n -_ 12 �� r-s c4.r �. it (212,<bnep�?k;: HAS Rsb n lL- 11C -m - - 4- - - r � T- -7' — (212.�r,-:f•=�W-I f ll NJl 1 �n - V_) I I Q o (sem scn ) u Di �i f ID � - 2Av CAP r ( 22 I i I , r CSlIgTrJC,� t=.lv,J(o f2,rt_aM ', _ I E�cISTlJ.1ta #-10..]SG' F�J,�IOd.T1 o,—I ' I it d I tr e.[I6TIh1-� KIT<-HEr.l S/y°+4wlr STt c.tOk'ii,. - �^ .; I _ 1 Yx" BgLTA ilk 17 1"� J s r it ,rh ; --- • t' I + I , � OCCUPANCY OR USE IS UNLAWFUL AF/ BASIN6TE0 i' I';,� T6: °�I ' .tMn WITHOUT CERTIFICATE OF OCCUPANCY No' NOTI YBUILDING'4EPANTMENy Al - 768-1802 8 AM TO 4 PM IFON`THE FOLLOWING INSPECTIONS;' ' r 7: FQUNDATION - TWO REGO]F�ED ' NJ FON POURED CONCPETE - 2. ROUGH RAO NG A PLUMBING , _I 3. INSULATION , 4: FINAL - CONSTRUCTION - BECOMPLET 106R,C.O. ALL CONSTRUCTION SMALL MEET THE REOUIREMENTS''OP,THE NY STATE CONSTRUCTION 6' ENERGY CODES: NOT RESPONSINLE. fSlf.1 r ' DESIGN OR COwETPUCTION ERAQNS iA- , I. , r r J 'r YI t E` 9,ji' � ,:�c�tl-Yr� lt�t3ti "w�; raM1 t1 [ + 1 � �H 1r 15 3� !- 1 (NI • - r l 4 !1 Y ( iA lt, 7t. R4,`,bi41}7,.1�t. .1S?;RAL,rK !At'.lyl-'S+T� k: y R v 7r Y6 a r•' r , ,_ h �+ el x� tai �la� ✓IGFAr^I� 1d1.'/YA.a ��, L r I t' I 6� ' �, E—� r �I r A J e C 4A'YC Arlt owe �xr f rtf tl Yra �. y 1 IIIA r r tx�7•IFer14 wr. pwvsrA�sbe© zAexe . . _ �, ' i o��.vl'../u"'S{':. i4Z�j�`x�"iv.:. 5"r .�u.3.,ra '"w Vta (f xl. GF ANC*1T99T5'�.T..NO APO FORM _ d v