Loading...
HomeMy WebLinkAbout20490-z FORM NO. II TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N? 20490Z Permission is hereby granted to: .... ~....~.~_~..~ ....................... .../.....-~: .~...~.....~..,~, ~,~//~'~ .. at premises located at ~....~..~.~......~..~...~..~.~.......~ ........................................................... County Tax Map No. 1000 Section ..... ~ .......... Block ..... ~.. ............ Lot No ...... ~ ....... pursuant to appllcation dat~l ..... ~. ..................................... , 19.~..~.~, and opproved by the Building Inspector. Inspector Rev. 6/30/80 New York State Department of Environmental Conservation Building 40--SUNY, Stony Brook, New York 11790-2356 (516) 751-'1389 Thomas C. Jorllng Commissioner Edward Maidel 10 Koster Ct. Huntington Station, NY ]1746 November 21;a_~991 RE: Permit #1-4738-00377/00001-0 Dear Mr. Maidel: 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, Robert N. Thurber SR. Environmental Analyst RNT/rw enclosure TRUSTEES .John M. Bredemeyer, III, President Henry P. Sram. Vice President Albert J. Krupski, Ir. .John L. Bednoski, Jr. John B. Tuthill Telephone (516) 765-1892 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 10, 1991 Edward Maidel 10 Kester Court Huntington Station, NY 11746 SUPERVISOR SCO~IT L. HARRIS Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 'RE: Waiver request for Edward Maidel SCTM#1000-59.-6-25 Dear Mr. Maidel: The following action was taken by the Board of Town Trustees during its regular meeting held on September 5, 1991: RESOLVED that the Town Trustees approve the request for a waiver to construct a fence along the west and southerly property lines leading to and within 10' of Great Pond. Please note that permits from other agencies may be necessary, as the Trustees approval does not constitute approvals from other agencies. Very truly yours, John M. Bredemeyer, III President, Board of Tqwn Trustees JMB: jt ce: Bldg. Dept. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION .: . RECEIPT Location.,~ ~ Division For ~ C.,~ h [] Money Order Date Number '~'~C) '~ ? Title ~r ,~ '~ ?-/j -?/ ~-----] 6NYCRR 608: Water Quality Certification Solid Waste Management Nov. 21, 1991 Nov. 30, 1994 1 ~ 27, Title 9; 6NYCRR 373: 'dous Waste Management ~ 34: al Erosion Management ~ 36: plain Management es 1, 3, 17, 19, 27, 37; :RR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Edward Maidel ( ) ADDRLSS OF PLRMITTLE 10 Koster Ct., Huntington Station, NY 11746 CONTACT PERSON FOR PERMITTED WORK NAME AND ADDRESS OF PROJECT/FACILITY LOCATION OF PROIECT/FACII. ITY West of Kenney's Rd., 90' north of Sound View Ave. COUNTY I TOWN/CI~j~E wATerCOUrsE/wETLAND NO. ~YTM coorDINATES _Suffolk Southold N4 DESCRIPTION OF AUTHORIZED ACTIVITY Construct a 130' long split rail fence in an area adjacent to freshwater wetlands to within 5' of the freshw~erwetlands on Great Pond. Ail work shall be in accordance with the attached NYSDEC approved plan. 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 Reverse Side) and any Special Conditions included as part of this permit. AUT~O~Zf~SI~NATU~[~ ~~ DA~l/21/91 Page] of ~ GENERAL CONDITIONS Inspections 1. The permitted site or facility, including relevant records, is subject to inspection at reasonable hours and intervals by an abthorized 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 o'rder the work suspended pursuant to ECL 71-0301 and SAPA 40'~(3). A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all Hmes at the project site. Failure to produce a copy of the permit upon request by a D~partment representative is a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify, suspen~l 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 ofithe ECL and pertinent regulations is found; / b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material iniormation is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since !he permit was issued. 3. The permittee must s:ubmit a separate written application to the Department for renewal, modifica- tion or transfer of thi,S permit. Such application must include any forms, fees or supplemental infor- mation the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. 4. The permittee must submit a renewal application at least: a) 180 days before ~expiretion of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF) and b) 30 days before ~xpiration of all other permit types. 5. Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order br determination previously issued by the Department or any of the t~rms, con- ditions or requirements contained in such order or determination. Other Legal Obligations of Permittee 6. The permittee has ac?epted expressly, by' the execution of the application, the full legal responsiblli. ty for all damages, d~rect or indirect, of whatever nature and by whomever suffered, arising out of the project describedl n th s permit and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and description resulting from this project. 7. This permit does not ~onvey 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 impair. ment of any rights, ti1 to the permit. The permittee is rasp, of-way that may be le, or interest in real or personal property held or vested in a person not a party msible for obtaining any other permits, approvals, lands, easements and rights- .~quired for this project. Page 2 of :~P' 0 -I Ilot -rI 0 V o 3. Nature of work (check which aplSlicable): New Building .......... Addition .......... Alteration . . ..:..,_. .... Repair ..............//Rem°val .............. Demolition . . · Other Work. ~'~rt.d~ .. ...... (Description) 4. Estimated Cost ........ 7 ~. .......... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear ...... ........ Depth ............... Height ............... Number of Stories ................................... Dimensions of same structure with alterations or additions: Front ..................... ................. Rear .................. Depth ...................... Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front . .' ............. Rear ............... Depth ............... Height ............... Number of Stories ....... 9. Size of lot Front Z'/2. O! Rear //D ~ ............. ,t.' ' ,' .... ~:~%',; ............. ....... .x" · · 2.. · ..~ ............................ tJeptn ... :,.~./. ......... 10..Date of Purch..a!e. ]... q~..~/../}Y[~5 ............. z.~Name of~Former Owner . .'~.)~./Y...~',.../~.~/.~-~_~ .... 11. Lone or use msrnct in which premises are situated...©PH./?/qc~. ' ............ 12. Does proposed construction violate any zoning law, ordinance or re;~l'aiio'n'.' .... ,~,~ ........................ 13. Will lot be regraaed ....... ~3~.,~ · >...< ........ Will excess°fill be'~e..mo~0.zved from premises: Yes . No 14. Name of Owne. r of premises ...... ~. ?.,q:./4¥?:-.... Address ,'O./a:cV2~z er . Phone No Name of Architect ...................... Address ' Phone No ............ NameofContractor . .~/~.~...'.Z~../q/ ........... Address t~d./4/~...,~.~-d~ ..... PhoneNo. ~..2'--..~.///~. .... 15. Is this property within 300 feet of a t±dal wetland? *Yes.....~..'.' No ......... · If yes, Southold Town Trustees Permit may be required. /~L~45~ ,coT'g.' / P/,qc,~ ~ c~av~e'~ ~a',r,,./ ~ ha, PLOT DIAGRAM build' , ._ /~....~ ~*,~ De~o~'~2~,,~ ,,/~.. ,'~'o Locate clearly and distinctly all rags, wnemer ex~snng or proposea, aha. indicate all set-back dimensions from property lines. Give street and block nurfiber or descriptioh according to deed, and show street names and indicate whether interior or comer lot. APPROVED AS ~OT~D / NOTU:V ~U~L.mNG FOLLOWING INSPECTIONS: . ~, FOUNDATION - ~WO REQUIRED FOR POURED CONCRETE 2 ~OUGH ~ FRAMING ~ PLUMBING 3. INS~LATIOg~ 4, F~NAL CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY cou~v OF ....... ~[~kg. ~'~ ............ .... ............... d. y ,wo n. ana ,ys th. ap nc nt (Name of individual signing contract) ~bove named. leisthe ....................................... .~..~9.}.~....... ........... .. .. (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this · pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the york will be performed in the manner set forth in the application filed therewith. ;worn to before me this ................ · .~.~.day o,%f., fi ........ ~ ....... ,19... ' C'~',x ' ~f" '~':=~:':-~ ' ' ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .' Approved...~./. ~. ......... 19,~..2Permit No...~..~f Disapproved a/c .................................... APPLICATION FOR BUILDING PERMIT a. This application must be compl BOARD OF HEALTH ..... .... I 3 SETS oF Pt.. .s . CllEgK .................... SEPTIC FORH .............. CALL ...... ~TO: L~ '~ ~ // 7q- : -.D~te ......... : ......... 19... INSTRUCTIONS ~tely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ets, of plans, accurate plot plan to scal~ Fee according to schedule· b. Plot plan showing location of 1 )t and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed descripti' on of layout of,property must .be~ dYawn on the diagram which is part of this appli- :ati6n. c. The work covered by this apph0atlon 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 ~hall 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 ~hall have been granted by the Build~nglInspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Townlof 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. Fhe applicant agrees to comply with al/applicable laws, ordinances, building.o;ode, housing 'co'~ and reguiatiqgs~l to tdmit authorized inspectors on premise~ and in building for necessary insp. oc~l~fi~-.~ j .-; , //7 ' / ~.(.8~gnature of applicant, or name, if a c ,drporation) (Mailing address of applicant) State whether applicant is owner, lesiee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises.. .... .. ........................................... (as on the t,ax roll or latest deed) If applicant is a corporation, mgnature of duly authorized officer. ( ,N_ame and title or corporat! officer) Builders License No ..... /~.3~-~?...' '~ /~. Plumber's License No ........................ Electrician's License No ....... , ............... Other Trade's License No ...... Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax I~ap No. 1000 Section! ........ ; ..... Block ................. Lot ..... '~.~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Na ne) State existiug use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. b, Intended usaand occupancy ,.