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HomeMy WebLinkAbout18390-z FORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No 219512 Date NOV. 16, 1990 THIS CERTIFIES that the building ONE FAMILY DWELLING AS APPLIED FOR Location of Property EAST END AVENUE FISHERS ISLAND House No. Street Hamlet County Tax Map No. 1000 Section 003 Block 002 Lot 006 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 31, 1989 pursuant to which Building Permit No. 183902 dated AUGUST 15, 1989 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 SEE BELOW **x The certificate is issued to SARAH TREMAINE/ARTHUR BULGER (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 89-SO-72 OCT. 22, 1990 UNDERWRITERS CERTIFICATE NO. N158486 OCTOBER 31, 1990 PLUMBERS CERTIFICATION DATED A. JOHN GADA OCTOBER 22, 1990 *xx PHASE I COMPLETED AS PER PLANS PHASE II OUTSIDE SHELL ONLY, WHEN FINISHED WILL NEED A NEW PERMIT PHASE III NOTHING DONE, WILL NEED A NEW PERMIT PLANS AMENDED TO INCLUDE DECK, FEE PAID. Building Inspe sosat xa s TOYVN OP 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) N 1 S 3 ~ ~ Z Date 19.~~ Permission i her by granted toy ° ~r~.....:~.. to .~<f.~~E4.:Fl.....~......~~1s4.~.. 0...........frJy'....... k~...... of premises located of ~.~r•.~ .........................................~-...~.~~~......~t~-~.::................................................................ .............................................................................................................`..~.y.............................................. County Tox Map No. 1000 Section ..~.y..~.-.~........... Block rte!..... Lot Na..:: %...~:z...... pursuant to application doted .........f.,1.~-~ 19.d~ and approved by the Building Icnspector. ~ Fee s: ~.~o Build g I for Rev. 6/30/80 TOWN OF SOUTHOLD ~°'~°~~°"""fiz ° p _ BUILDTOWNDHALLTMENT ~~E t~?, l~,.y~ ~V~, LS~~ SOUTHOLD, NEW YORK 11971 Qli7 i ~ 1)~ ~ bo_,l APPLICATION FOR CERTIFICATE OF OCCU ~ r~r- ~`~~?"FIf?~£p ~ DATE.....10/5/90........... NEW CONSTRUCTION..X..OLD OR PRE-EXISTING STRUCTURE.....VACANT LAND...... Location of Property...Private Drive off East End Ave.....Fishers Island HOUSE NO. STREET HAMLET Owner or Owners of Property...Sarah Tremaine/Arthur Bulger County Tax Map No. 1000 Section..003..B1ock..19,.Lot..7...... Subdivision ...................Filed Map..........Lot.. ,Permit No..18390Z.......Date of'"P,ermit..8/15/89...Applicant A.J. Gada.... Health Dept. Approval ................Underwiters Approval • I~ / SST ~ta Planning Board Approval Request for Temporary Certificate........Final Certificate.....X.......... Fee Submitted....$25.00............ Applicant. A. John Gada General Contracting, Inc..... ~ yo~y~-- ~ o z, ys/ THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1075012 BUREAU OF ELECTRICITY _ BS JOHN STREET. NEW YORK, NEW YORK ]0038 pate DCTOdER 31,1440 AppficationNo.onfTle 6HD3639[I/90 N 15$iiH4> THIS CERTIFIES THAT only the ehsctriw/ equipment a deeeribed tislotD end introduced by the oppficant named on thea6ow application wutn6er in the prowsieae of 3.TRENAINE/ARTHURBIIL.GE..R, FAST END AVER, FISHERS ISLAND, N. Y. in thefdbmtnp locettonq ®Basetnent ® fat Fl. ®Ynd F1. pUT SerNon Biock Lot ~ ales exomined on OC TOILER 23,1990 snd oared to 6e in com fiance with the f pl requirements of this Board. ta1TISE RxruR~ RANOes CpOKINO 6EClts oven DISH wASNERE EzNAUSr FANS ~TI?RS AOR6 SWITCXEf INGNDESCENT Hud1ESCENi OTHER AMT. K. W. AMT. K. W. AMT.. K.W. AMT. K. W. AMT. N, r. 55 5 SO 55 4 F" - DRYERS RNNACE MOTORS lUTUtl ARLANCE 1~ER5 SRIgALIRC'eT TIMItAOCIIE ~L UNITNGTNS MUL1601iilET DIMMERS AMT, K. W. dl H. r. GAS N. r. AMT. NO. A. W. G. AMT. AAV. AML AMTS. TRANS. AMT. N. r. NO. «W ~T AMT. WATTS 3 P 2 SERVICE DIfCONNICT NO.OE S E R V 1 C E ~r~~ AMT. AMr. ItRE 1 X tW 1 X tW S X SW 3 X AW ~~CeCGND. d' C CG~ D. ~ N4N:G OI ND. Of NFUTRAni Oi NEUTRAL r 20o cs 1 x ~ sla 1 i/~ ~ oTS1ER AeMRATUS PANEI.HOARDS:1-31 CIR. 200 f,.p,C.I:-tr TRAt;K LIGHTING,:-31:1 DADA CONTRACTOR L.IC.N29bE ~~~%`G URAUER - H - EISHERS ISLAND, NY, 06340 OENIEAI MANAOM 11 Pa - This cartifica» must not be altered, in any manner; return to tM ofiiea of the Board ifinwrred. I t M idrrnllEied Ngir±credentioh. - CO A S , THE MEW YORK BOARD OF FIRE .UNDERWRITERS I'n(" ' Inraola - BUREAU OF ELECTRICITY r. 85 JOHN STREET. NEW YORK. NEW YORK 10038 fi APKI1.. 1(I,199U APPlicationNo.onJik G2C12'J?f34/R9 N i'l;4?3y ~ THIS CERTIFIES THAT only the elecerlcd equipwssnt a dscrthed 6elors and introduced 6y the opplicant named on cha ahooe oppiicatiaa nuaaksr in the promise of SAKAtI 1KIiMAIN[JAKI HOIILIiF, C:A'il LiND AVIi., PISFiiiKS C'.iI,.ANI), N.Y. in the o(buin l1Ma 1 nt 0(I l J y F~ ? Ixt FI. ? Ynd Fl. Sectian Block Lot A~nK l; tt S, 19~ uw examined an and found to 6e in compliance with the reyuirementx of this Board. _ RXTURE ACIK fYgTMlS RXTURlS RANGES CtIORINO ElCKS OVENS OKN~w T FANS WTEETS INCANOEECEM ilUGI1ESCENT OTHER AMT. K. W. AMI. R. W. AMT. R.W. AMT. K. W. AMT. M. P. DRYHS RIRNACE MOTORS RJTUM AMIIAIICE RRIEBlS fMGAI RECf`i TIME C10CKf ENl UNIT IMATElS eMNTE.WTERT DIkIMERS AMT. K. w. at P4 v. GAS N. R AMT. NO. A W. G. MIT. AAV. IJAT. MVS. TRANS. AMT. N. P. NQ O! TMT AMr. wxm SERVICE DISCOPN!!CT NO.OE S E R V 1 C E AMT. AMP. Trv! 1 w xvI I / xW 1 / xW ] / .w RM;COND. OP CC Cp+D. NG.OP NbtEG ~ NO. W NENxA15 a •~~t i 100 <:H C k 1 'I i '1 OTHER AKMRATUS•. - - ftihp Si::NVICE FQft H11I4_DCNG C'I1KP1)$I":-1 ~i .^i ~ kiAOA Ct1NIKALCOR L.Ii:.S29h-I'; DKAWE:K - B _ fI9F11':KS CtiLAND, NY, ClG:S7U pMALAlANAOM 1! Per ~ Thirdrtificaq mutt not be aherad in any manner; return q EM office of Ilw Board if incorrect. impettors "'~heir_cndea/igh. _ F, COPY FOR BUILDING DEPARTM@IT. TFRS COPY OF CERTIFICATE AN18T N01''t! • , ~ r TEL. ?65-1802 pS~~Fp~~pl TOWN OF SO~JT~O~.pJ ~ OFFICE OF BUILDING INSPECTOR o° ~ P.O. BOX 728 u'' ~ TOWN HALL "O ~ ' `r SOUTHULD, N.Y. 11971 C E R T I F I C A T I O N - Date October 22, 1990 Building Permit No. 183902 Owner Sarah Tremaine/Arthur Bulger (please print) Plumber A. John Gada General Contracting (please print) I certify that the solder used in the water supply system contains less than 2/10 of to lead. G-~. A. John Gada Jr. (plumber's signature) Sworn~_et_o_ before me this ZZ day of ~ '~-e~-Q-~ ~ ,t~ l Notary Public Notary public, County ~fbY Public, Stafe of N.w yoy No. 5 2-9 50418 5 Qualified in Suffolk Gounly pp twro Expires ~l 30. 19~-I c1... - ~i - - ~1 - - - - ~ ~V ,~~A O - - - - C~ i - ~~~J~ ~ C/ - - i - - - ~ i ;f1.~ _ l~' ~ _ - i' /~ld~i114' j - - ~ - - ~ ~?~K<~ _ _ _ ii i~ _ i ~ r1~LD Ii:SPEC;lUN IIDni COMMGNT° ro m ~/a 1 • H `yd~' ^OUI7DATION (1st) ~ ~ m~~ FOUNDATI011 (2nd) - ~ - 2. o P,OUGH FRAME & .PLUMBING ti H 3. ~ rn H I1dSULATI0P1 PER N. Y, ~ STATE ENERGY CODE ~ f 3 ` l.' ~ .-----1 y 4. ~ ~j F I i1 A L ~ •L-=-- `y ~ ~~a i~ a yv ~ ADDITIONAL COMMENTS: i ~ R . . ~ H 9 ' H H r • x a • r ~ - ~ P/1 d d • m r-.) H V ~ . ~ ~ E ~ ~ ~ V ^ ~4 ~ 1 ~ ~ ~ ° ~ ~ ~ ~ Q W II. 1.. ~ ~ ~ ~ ~ ~ d cn ~ ~u w ~.`.~...V....,».. CARPENTRY ELECIRICAI WORK PLUMBING ~ ELECTRICALAND PAINING GAS APPLIANCES REFRIGERATION A. JOHN GADA ROADS AND GROUNDS ' General Contracting, Inc. Member Connecticut Society of Civil Engineers Licensed Home Improvement Contractor Drawer B • Fishers Island, NY 06390 TELEPHONE (516) 788-7231 • FAX (516) 788-7955 June 23, 1990 New York State Department of Environmental Conservation Division of Regulatory Affairs SUNY Campus, Building 40 Stony Brook, NY 11790 TO WHOM IT MAY CONCERN: The Tremaines are requesting a deck as so emphasized on the enclosed drawing. , Due to the cost of fill on the island, we are also requesting permission to construct a stone wall also shown on the drawing. The biggest reason for the stone wall is that the amount of rocks and boulders that were accumulated in the process of digging the foundation and scratching in a rough road. This will serve in 1) getting rid of the rocks, 2) using some of the smaller ones as fill on the inside of the wall. After the wall is built, bank run gravel will be used as a subgrade. The final will be topsoil and then seeded with future shubbery plantings. Please note the sketch on the back of the drawing showing more detail. Also emphasized is the proposed future deck and garage. I hope to hear from you in the near future in regards to this matter. Sincerely yours, A. AL CONTRACTING, INC. of E. Cook Superintendent HEC/ddp Enclosure T~s CARPENTRY ELECTRICAL WORK PLUMBING ELECTRICAL AND PAINTING GAS APPLIANCES REFRIGERATION ROADS AND GROUNDS A. JOHN DADA General Contracting, Inc. ri Member Conneckicuk Socieky of Civil Engineers Drawer B Fishers Island N. Y. 06390 TELEPHONE (516) 7BB-7231 Licensed Home Improvement Contractor .Fax No. (516) 788-7955 July 21, 1989 _ D (I~ f ~ Cy l - iy 1 , '~9 I BLDG. DLPT. TOWN OF SOUTHOLD Building Department Town of Southold 53095 Main Road Peconic, NY 11958 Gentlemen: Enclosed is the start of the paper work for the Sarah Tremaine house. I have sent for the additional copies so that I can forward them on to you. Please let me know what the building permit fee will be for this structure. Sincerely yours, A. JOHN GADA GENERAL CONTRACTING, INC. • ~ Harold E. Cook «j°J Superintendent HEC/ddp , - Enclosures ~p Tiruc~/cr~ue ' I DL( APPLICA]ION NUAABEf~ I ' ' 95-19-3 (glg9)-Ye ' s NEW YORK STATE UIiPAkI'MF NI' OF FNVIRONMI'N YAI COHSE RVATION I ~ ~ f t I~ k ; _ _ ' r bll S ARMY CORPS O~ ~NC}INL'ERS A4P41CATION NO(. rsl-~- t'; J(?fN1' A4~1`~L4~~~,'1"ibPJ Fl>bi PEt~nitl'T [ , _.~.......~.;...1 1 r . ' ~ II`1_rase rrvtd Att lnstnicthuts on b uP htdorr completing tins apphr noon F'leasa ly4e or print [lenrly jn tnk. AfQneh aC~rh'tidryel inforrp>aYtoo a5 tlaedod L_~AIITICIE 9, YITLE 1, AR'I'If.l l; d{ 6N YCldfi 6A6 (LAKR CI'OR(~-E3 RPCREA LICJN %ONF) i ~ `'~I ~~i. ' ~ ~ ~ 1 ~ ~ L~ARTiCLE 15, 111 LE3(AQl1A,71C I'FS LICIUCS CON7li(JIJ LJ4NY(:RR 327 (ACjl1AlIC VCGF7A710N) ?6r~yCkR 3G0 [FISH) Ls6~1'C7kR~S29f~WSECTS7 ?ARYICLE 75, 71TLE 5 6NYCRI2 I,OB (PR(j LEC'NON OF WATY P,S) ~ ,P ~ ".i + t li,' r~-7t - • s . , A LJ FOr the <nnslructinn, reranstNrtioh, or repair of a 17AM of other irnpnun[ImenL stmrl ure T ?EOr the disturbance of a SCRCAM REU OR BANKS or rxravalion in of 611 of MASRCABLC N+ATP RS ' ' I_:IAOf WATER QUALITE' CERTI4ICAYIl7k" .,r i { .p, E ~ggT!([LE 15, TITLE 15 - C~6n'VCR R'601 (WATER SUF'1'l Y) ~_~GNYCItR 602 (IONC ISIAND WELL}~ ,1 ~gRTI(ILE 55, 'f1TlP 27 6NY1'Rlt 666 (WILD, SCCNIC ANU RLt'It IiA7'ICINAL RIV[RSI ~ ~ I - " s ` ~SI;' ' ss--33 tJ ~ tlrP IJ~I qq Tl('LE Z4 6NYCRR 662, 663 II Rh511WA1 ER WE I LANDS) IAI ARTICLE 15 6NYCRR 661 (11UA1 WI YLAND$) L_~AR'FICII' 34 6NYGRR 'i0S (COASTAL ERtlSION)'~ ~ ~ ~ ~ ~.t p k RIIFICtAtICiN: J SPC110N 10 (RIVER ANI) I IAR BUR ~A('1 OF 1899) for 5l niranes and work in nevi ;abhF waters of the U 5 Y,+IJ Ct}ASTAC;CONSISTENCY CL'y{ I»_..i E f-T ~ ~ .i. ~ JJ SECTION 401 (('LEAN WA1 PJt ACY UF, 1977) for Alsposal of dredged or fill era tori:d in walrrs bf tF~e U,S. ~,a 7 - ...i ~~S[C110N 70:1 (MARINI Pltr)ICC LION, IiESEn RC31 ANU SANCTl1ARIE5 ACI) Inr the Iransportatlnn of dredgedrmaterials for duhipin&~into oCearL~~'~p~q~s~~ ; ~,1{-L~~I~~SrrT~~yNyyR~nEyyV{{~~IOyyUyyS PyI }R~~MryITIyAgfc~PryhlA(ANpUfN,yN`l1MByEyR~$~AgNC),rO*.~A}/I S pf „yyy)/~ry'~ ttX p ,2~ ~ x, r}~L'yn i 4. ~ ~ ~ ' ''''WiR.1111'1, [~RIA/~ .1)1114 l'FM1L'11fT ~B, h0.?~ AWP'"+JS+d'1,`I V/,~,4 ~ 1i4Rd " CdifA[ 4'~E~ A:;T+&TV ~ 2 AI'PI ICANT 15 AIAN.--~ rr~~3 ~~II y _ ~ C Owner LJ Operator I.J lessee. r.I NUnicip, alrty/Governmental AgCncy"; (Check A4 many as app(y)`~ 3 NAM,a~ExtanO,•I"t~yAl',JrP~pL~~IrC~~ALLN''T (yyUy~s~~,e11lFulgql Hansel upvfN t~ttyy ~Iwa1' - ~ ~ , ' .,',__SBRIIaJ.'!_,iRTYG~.Li1ttIi:.A'k _J~:3.116rA-.4WSA+ilxxnrpi_._ MAIL/INFO A„D~~D~R~StSyy sy ~TtiLEPFIONt (Where can bo"ranched d11r'Gtg day) F'O~51yO+IyPgI'eiCE 1 ~g~(~ pp ~ 51"ATE ~ . -71P rCSUF". I .n..w0.i41bY3twLY6H.L"4..'it~[rt,L.. ~4 tJAME'UI' Iy~ppyOy~~w~~ner yy~~,prp(~~fAfgo~n~yytlppC~~yyOggnf~act~P/eWrson (Chpe~pc~k one) ~•y~-~ .~~.-w ~ ~ .L r4: ~_~._...~I-..- ~.~t~w--- ii ~~-I~Y_.+.LLAW.II.~!I+r~6 1:JWW L3FA43~-3.73 ~~E ! ~t r'~~AAtArI~L~IN~Cgi~¦A~gbNpE 55 ~TI(E~Y+P~N,gO~N6 (Where c9n be reath~ r}4gYrig daY7 f'C)ST OFI'ICI ~ ~ ~ t ~ yM STATE ~ ZIP CODE ~+p~g~s~s }~T} yt`y p~.y i. C~RiwlYiNlYll-.4Y~A~h •tr4al#~4rW'' 5 1'kO1EGTlFACILI7 LOCATION (Mark Ibtation on map, see Number 1a on' reverse side) y~., y 9 t i,"'.: ~ ' .t County ~yr I Town or uty_ ya11 I Village # i - S7REEY ADDRESS (If tllffentnt from applirml) ~ ~ t ~~~~wY1 s~gr we~w'ay~s I u : s( t~> [ 1w1AA~iw,~-~-J6s.GwE#V~~_. 1!i_ fY ~ r ' E'bST,OFI'ICG - ~ STATE t` 21P` GSISE I;' I~xr~(v'*~y~ ~.~yp ~y~¦q ,p- a ~1 t ~ e -l r..IG{1R1i'nYN7-.1.iM+AJyAI+_.._....__~_ ~ ' , 6 'IJAME bF STRI'AM OR BODY ht WATER ~ ~ ~ I t ' ° r _ 7 7, ry1 ' 7.'HAS}}WC)R1C OtGUN ON PI2(?)E t'1+ li VI S attach explanahen ar starting work wrthour, prrrni4 IntlUde darns ~ 'gy' WILI•PRO)ECT-+UTIL12'[ STAKE71,AfJbi JVCS } 11„ ~ Show work an map endfor AiuwhrOS C'~ties ~ ~ No ? ~'9 lPF;OPOSfb IJ51' ~ prrvalc 117. PROPOSED 97 AItTINGtDATb. 1I. APPItOXIMAIE COMPLETION DATE: 11. FEE OE(NYS parnl7t Only) U Puhllc ~ omhtrk:~al ~ ' ' - $ ~ I En<;I `ysed a . _ _ _ ....i.i.-~wi~...._ T' 13.' PR07E<;Y bE'SCR.14TIUN: t'~ gtiam Iv and type of matarlal by be &x~agatpd dredged of used fen fill tit rip rap,{Ineat~nh of disposal tltnsi'tYpe of s ~ xt 5buetUre to be hsstallyd, hn gM o! dam, cl8n of lmpoundent,, rapadpev of Propnud wat[n seurces extent pf distdbbtlon system etc) i t d i' ~ 'I t I w i~ ~ ~ s ~ tI t , ,q s 'il ~ t I r ~ r i} 11 ~ t ~ ~ A Mi~ ~ nai ~ ~ ' ~ ~1}~ li t i t it ~ I y 11~~ f ~"'.+r..r"~~' I ~~+~11~~N,~'.>!".~~.it. _ i _ tti r c ~ i a , ~~E~iiWILI~7kI1S PRO1E4Y REjjl11R(-NSDI7-IONAt~PEbF,'I2A451AL[ nNDIOR`LOCAI_fIERMITk7 Ye9"-`~I ~yoft '~'.I#~AS ptda'se lists at Ira `UI~ o ~ s!J"II 1 ' .4'_ ~ ~ ~ ~ t t i I,. ~ ita ' h~. 1,7' ?t t ' ' 'i~ s~ i Y 6 S )i' Iw~i..~, ..n z~:,r y~'f.Egylrl,nrioN ! ~ I i . r 4 !f , 'I her'dhj'laffirm that tinder tram lily of perpuy that informatmn prvyhled on thJS finer and ell attachments sulimRtBd herewith is'ttue t0 the b~si oP hA71itSb4{'leB~e ''end bdlfhf.'Falsn stalCmenfs grade herein are punish,{IEIe as a C:I'ess A-'ipi}demhanor pursuant hs Sertion 111f,%IS "a4~tf]e Pehal'Law. - ~ t ' furthAY, the appllCant aen•pla full fespnnslbillty for all,damegr, ~diret E on iddirect, of whatever nature, arfd liy'whnfheVet Suffered, arislhg out'of the [irbja~.t ' rlmGnlS'pd hereto and agrees w i~,drmpi(y anti nave hannl4ss the State, flan "suRS, actions, drainages and eosts of avdr9' name and desr,tip0on resulCing fro18 Bald project.In additidn, Federal Inm, 10 IJ 4 C Sectlou 10(11 provides for a fhie of not mere then 510,000 or impdsonrr(ettt For not mars than=flue years, 00 jso{h, i,' ,k where An appliedgE Wwwingly and willfully fe lsifies, Conceals, or [ oveh dp n materiel fart, rir Imowingly makes ai nid9 a 141~sc, ftctitoo5 or frauduledt s(atilmm{[.-"~ I~1 hereby 9ufhdrize the ngeM na ~n¢d in Numhrx 4 abm~e to sstbnnt rtes ahpla anon nrl my behalf. ti ' _1 ~ _'L _.L-.._ _ Ise [ ~ ~ - ` SI(NAII RE +s fI jIE~~ "`v ~ ~ PIEASE READ All. INSTRIIC 7"lC)NS ON REVERSE SIDI ~ wr.~ _.~.....,~..I..~..... I~j Pe"°~. • • 'i' ~ ~ . 'd ~ ' bF( APML[fI~Y IQN YIUMUER t 1 ' E Itl ~~I r 35-~9 7 (8184)-7e I i, if ~ NEW YORk'STA1 E'DFP.IR FMF.NT'UF ENVIRONME NFAL COIJSERVATION~ l E ~y ~ ~ ~ 1, dl $ AIiMY'C"(7,~(7$ C'1P EfSGIfJI`7_RS APPLIBiCT`IDN NOS I z • ~ ' t t ~ ~ll~~ 1 /R~I'f^~.~I,a P~ 1 ~QI? T"6/~ ~ k ~ i'i 2 t ? s E f ~ ~ i A . u,r~„~,,,yl.~ ~ ~ ar _..-..+~-.~+~..._:....-.--..._.u., .._....._..u~- ~ r n- -'~'uW+~ •4 ~ Y,-tl t4. ' F f`{Palo rAad ALL iltstructlons of btck beloro umyflebnp, fhls aPPhcauon Please typ6 br print dry¢rIV ~n ihk AitHoh @4ldhibi~'nl ,mf¢pi~bkf? A~ rYedSl~t~ i 4{'-" ; ~ z c I~At!`fl(aLE 9, TITLE t, AR,FIC LF d1 fiNY'CP.R 6A6 (LAKE L1EOR(E RPCHEATION XONG)~ ~ 3 ~ Y 9 E ' >`9IP Y 1~ yld ` ! e r i. I i ~ i 1 I ~I - ''~~ApTit[LE 18~TiTlE 3(AQUA71('. PES IICIDf5 CON71tOL) ~~fiNYf RR 329 (4QUAl jC VEGLIATIOM ~~BNY~RR,}26 LFISH) LJG~yGRR ~~4~~W~~~'~$) r ' I~~ARTICLEdSr'FI7LE 56NYCRI26(~B (PI1pTEC'FION OF WA7ER5),' Ill (1f II~l t' 3~~~~1~1{It t T -y I i ~I. ! ~ l t, i rt ht ~ i1~ ~J FDr [he nm9fructioh, mcooslrucUon, nr repair of a DAM oI other imrynun<Lm°nt slruolure ~ s 1 ' ;I rr~--~9 I ~ - ~Ebi'dHe~~dlbturbancbl nhI a $IRL'AM BIiU OR BANKS or'ekcavation In a fill of NAVIGAti~E WA7~RS I WABi ~A?l:R QUALM ~I~uEkYt~Ql~ K.~CN t T ~ry+~ 'IL3JARYICLE 15~ YITLE 1R '1 '~~t;NV4`RRCIit51 (WATER SUPpLVI (~'~TiNVC'RR ti0'J. (I,ONC ISLAND WELLP~ I I ' t i ~ tls Ir t11 y ~ .illlt ~ Is'~ I' ARTICLE Y6„TITLE Z7 6NYClN2 66G (WILD. SGENIC AND RI f.RG/aTIONAL RIVL RSA .I ~ I t rT gill ~ ` _ ~Ap'[ICLE 74 61JYCRN fib2, 1,63 (I RISt114ATF R WE ELANDS) ; ' L' ~ ' ~i~ ~ d III = ~ ` ~'I 1 A ~ ~ cr I ~ApTICLE ZS 61JYCRft 661 (TIDAL WETLANLIS) ~1J AItTICLY 'iA 6NV(Rft i05 (COA59 AL EROSION] ~ '11 t "f' i S'µµ--,~ .a r c.. .rl• .~.r vrl f 1 1i ~ ~ 414F~1( N ~ IJ SECTION 10 (RIVER ANb EIAIt&JR AC1 OE ig94) for stn¢41rerand Work m nemgnbfe~waters of the U 5. dCtJASTAI CON4f$TENCY PERT IPIC'ATstOH b @ ~~5f~TION 4pA (CLEAN, WA'[FR AC7 Olt 147Y),for disposal of dr~di~ed of (i71 nigton7l n) waters of the _U S. t ~ ~ 1 i 1nl i~=sI ~tJ SCCTION 70:1 (MAINE PRO LPC PION, RESEARCH AN[7 SANCIIIARIEs A(.q or the eransportatlom of dredge Imat vials ~4rr dumping;iptq bdedd. ~ofi - ' Y, 'q%j~,LI~3Tµµf'REVIO,U&F'FfLMI7lA1'RI I~.AI ION NUMBE R5 ANU DATCS (if any)~~~ •~~~•~~~~I . } ~ -h I 1 ' i Il 1 I$ ji (At' ~i l1 ' ~ Iy,..Ib~.SCA~~~~lhNil'~F ~~i `~pp~ Y'~i~u ~~'~+"~d'~1~~~ '"*'I~iY~ls~~~ kdl~~ ~i J'~'i!~~~ - ~N a I I ( ~ ji 1~. i 2. APPL1CAsNT Ib ALAN ~.]J)w_~ery LJOperator~ ~~Jlass~e,~__.,, palltyl~oveFNment~l ~h@e%cy~'~~tfihock 'ds mahy',a,46ppIY)r t£,. tfMV ~ ~Munlci '3. NAME~UI' ANPLIC:AYyN,~rr7f~ (==Uttts.~P fulppl Nnym~y¢~I gl,~yy~~p k'f, ~ , t J t r , ~%J ~ . " t :1•u.i~~:A7L1illMILY~]a.,gK. J7.W.Ad0.Ym-+~Fi14__._:..._.~_.:_._~._ .._.._.1 i~=r.J-'~~w-~. ' MA-ILIrN~G ADURESS ; TI LEPEIONE (Where can br'~'eacAatl~difl~ng dbY) .i tttl ~~sj,,+Pt`S5T Of LICE', . ~ I ~ ~ , ~ _ STATE ' $ip~ 15E1 I d I ~'~EB~S.Wr7-~t~3fh„_.Sl~_ - 4~fdAMt {11 ;'r T 1 .1 (Swner t ~ ~ .`'"'r"`""i'... r I ~ t r P°*' ~~..J AgenU(onlact Person ,(Check one) i s t F e, ~ 1'~t r t w s v p~ l i ~ l i ! {E. :I t rlL~ ~ 51:~14>~~.i~~Lli.$1,LA~JM .Lk ~WV".w,.-~.4'F~W~-`--+---j.-r-,-.-~-" _ I MAILINO ADDRESS ~ I I, , ~ _ ~tfG~~'IjpNB,tWhard ?an b~,rgdch~~ d ~ny day) ,,~i~JWBl~17i~4T...~~... a - --._,t...~. _ i( ~ : t . ' i . ,E'4)57 OI'I ICC ~ ~ I ~ ' ' ~ Y. ~ ~ ~ ~ +ri ~ ~ 'r i~ I r { I, a 9l{rATE'I ZIQ ,t,'{E t - - a.__._.... _ ~ a ' S l'[{OlE(T,'EACIL1~V,LOCA710N (A6trk Ibc VR>m on mep;'see Nwnher TU pn'reverse side) i ' F t I ~tJ i?;`t r I " i Count ~ Town or ut ~ Villa o ? t ~ ` Y.,=l25VJCaLrYrWB_..._._... y__9SAf~~l3Alt _8~6~-~' ,l.T'~'L r STREET ADDRESS (If different hum applicant) ~ ~ ~ a 1'r fl~~ ~ ~ I ~ ~ ~ 6TA78 ~ i~ll~ii} ~~at~ POST, PrICG '+IC I'1 " I I' ~ e ~E4s ,.I~ ilYl 1a~3 r;t s, ~~74yM~~- v f R~NAME O~'~STRPA~j1~O~R 9,O~DV OI WATER .t ti ~ t P:"IP ll ~9"'+ °}/I' ' _,_a.:_,a._..,:i .l, _ ~ ~ I ~I . ~ . _ _ } 4 ~ ~ r '~--~-,TT °„t„ B i ~ T`.',I~AS WOYtK B~CUN ON PRbllf T+ II YES, attacFY axplanatias at starting work wrthouY permit include dato5 = I '~.1 WILL PRCIj1ECT tLTiLIZE+5119 ~~LANE/1 ' I t Show worKorV wary -fndlor drawings ' ~ t i ' I Yes " Nbj 11 rz , ~Ya¢, ~No x I I l~q,~l'I OP05TC1+~19E ptiJii' I 16 PROPOSEy 4T }INTINCtDATI ti nPPRp%IMATE COMPIE'!It'JN DgTE T2 PEE OP; (fJY$MePMIE IC}nlySlx ~3 (y ) ~ ~~s III.` i ~ 3 I~ s f I "a ~k'~l Iah;~ ' L5 Public ~LC m serssal ~ II I I, h 1 ~ t it . - ' r S;~El1i i 4 i ~ I ' 13 iRO1H E DLSCRIpTION~ e I quantity and typt of mbtnrlaf to by~'E kca ated dfPdgad or used fPr till dr xip ryp locak~b{t of disposal s+ttsy`type of l{l ..~p ~+di T{LL i ' ~ sfruLlTQre`IO Beilnstlall~J;'•fi`~I~ oi;darrll slAm bf impoundenrl eepac~((gsi of ptoposY+d waW.rtspurcn3 dxt'Anp ~ ~3tr~utid~t fystgm etc`} ) Ir a q; 4. > ~id,I .)i 11 ~ I,Y~' .I '~>'~~I Mi 1~{4i~';Irf~ F tl'6il ~ ~ ¦ q y~ ` 4It~ rY I -,r ~ i:YR~ ~F~~p9~'41'at~'I~~O~tk I%` 4s ~I t:'j4{rT Y ~i l~ ~ L~ ~ ~ i{ lS~ft~ `'~~L{tit ''r'wtt litr f rfF p~~.~ x+l--yy~~ yy -ti+....-.-.r...+..~.~.~+-k.t.li y r It, {33~~I (91LL ~IPII$ PROTECT. RhQI)IRI ~AOUI LIO~A rILJQRAL, SLATE ANUIOR LOCAL PIRMlFSt ~ Yo1 I NoT°s lf't es pbeaye list. " it ll Ilil 3 In fi[Lrf , I~S 1 tr ~ i I r S.y1 t ~i~~4~I a qy~ r..,':. 'ml'~ df1IS° ~ nyc In p~ptx ~ ds v ea i sl I ' o ' ~ ~Itd~jl) ~ ryh~ Is ~f1~~`~t~~~P'~~ ~ saw6~ttil(fa f;'= ~ I 1 ~ i I ' I I ~ rl i!~tt'~~i17!('r a5~ ~ ~ Fazr #1 ~t{srt )j3 ~(cystti ~tSf ~ , I 'II L.+w....~11 I ~ Ef +..wu+~S n 1,...~._„~~ ~ I ~ 7 ~~rP I i ~ ~~Ih 's I~`PR71C IkrAYIQN~~~, .L.y..u~,. I _ ,~`1'.,'w~' 3 I F' I { -+t e yr 9 I 1 It.. ~s{ I i, . ) 1, { ~'herekll"al~iftn That~udder{1t b~iiil•~df pequry lhaL informadun prpvi~}cd un thi5.form and all attachlnCnC§4sulSmittad hp9Awjth 19tr4o t6 the b85tr~np tsye}~d 'rr t~i' and bnjlef.~ Pa1se 3ta11imnMs'tltadltl he3cld are piulishable qs d Cl~ss'~,A°nu9d`•r~69nor pursuant to SectitlA i~6~'Ab B~NYb Penbl,LgW - i t ` + Ic'11,. ' furtho4 ihn appliteht aL'Gepls full frr{~nnslNllity'Pdeall damage, dl~af(ot indirect, of~ whburver naturpt bnd 8y wBdrPtaVey sutfered, arrsin~ ddE 4f IBg ~jt5~a{1h S . , rig;crll(od herein and agrees tb I~rdeQthlfy anA Savo harmless the 51 nit from, suits, at tion,a, damages end co1t9 crf eyeSf• [tame and desctip(Iao'tetpltNg fl'oH1 9`gid ! ' ' ~ rynljec['~Irv additidn, Fatlernl I bN', Y6 ll S C Sectiolt 11H11 providrs fof a fine of not more then hitt,tltN) or impli9onmonY For not [Wore ihamflvo yPnl5 0 .bdthy ' 4rhere bdappllcant Knowingly[ and wdlhdly £alsif ns, conceals, or dove rs up a maternal far'h d[ knowingly 9paKes oY, CIbeS a false, IISTIYObis 6r li¢udulenUsUat~iA~,t!'K 1 t , ~1 hambY authorize,the agdnl~dzrndd In NLmbrr 4. above to submit this erypllcation nri my behalL' ~ # e t j $riJ I ~ i sI 7 n ~ i, a ~ ' S1~C 111 URI J A ~ I 1 ._uG,.,.7 d'a. 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S nS'y~f ~ r Y ~L ~~~U ~ ~ F ~ I i5 ft~ ~?.~,t+§r k itt ~ ~r 4~~x y~'le q`~ g ~.a r ' ~ ,t ~ . s, ~ - - ~ t ~r i t;- r r,j~a b T~ 7 " ~x ~xx ~ x~ .xlx n CARPENTRY ELECTRICAL WORK PLUMBING ELECTRICAL AND PAINTING GAS APPLIANCES REFRIGERATION ROADS AND GROUNDS A. JOHN DADA General Contracting, Inc. Member Conneckicuk Society of Civil Engineers Drawer B Fishers Island, N. Y. 06390 TELEPHONE (516) 7807231 Licensed Home Improvement Contractor Fax No. (516) 788-7955 July 21, 1989 III n9,r~.~~.~j lltr_ k1LOG.0EP TOWN OF SOt1TNOLD Building Department Town of Southold 53095 Main Road Peconic, NY 11958 Gentlemen: Enclosed is the start of the paper work for i;he Sarah Tremaine house. I have sent for the additional copies so that I can for°ward them on to you. Please let me know what the building permit fee will be for this structure. Sincerely yours, A. JOHN GADA GENERAL CONTRACTING, INC. Harold E. Cook ~G~.J Superintendent HEC/ddp Enclosures Tiruc'7/a~ice ~~4; ,Ir 9~,~ New York State Deparimen1 of Eravironmentaf Conservation Regulatory Affairs Unit ' Bldg. 40, SUNY, Rm. 219 SCony Brook, NY 11794 Thomas C.Jorling Commissfoner (516) 751-7900 ' ~rv, May 8, 1989 Sarah C. Tremaine (°"TM~ ~ Su II~ ~ cfo Drawer B ~ •U~~m~~ ~ (5 ~ Fishers Island, NY 06390 11~~ JU1. 3 11989 ~ FsLCIG. DEP"f. TOWN OF SOt17NOLD ' Re: Permit No. 10-89-005 llear Ms. Tremaine: 1n 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 1, above address.', Also enclosed is a permit sign which is to be conspicuously posted at the pxo,lect site and protected from Che weather. Very truly yours, Susan Ackerman Seniox Environmental Analyst 1' SA• rw enclosure ~i; i NfN IORK STATE Df PARTMENT O(lNVIRONMENTAL CONSERVATION .iH nL~miBLR ~ EFFECTIVE DATE x 0'89-0705 ~ May 8, 1989 Int nu,•PROCenM Numet RLT PERM{1' ExvrunnoN DATEt z1 N/A Under the Environmental Conservation Law May 31, 1992 328c1329~ Aquat c Pecticides327 ~ WaterROua~ y Cerllflcation ~ T dal Wetlands Article 15, Title 5: Article 17, Titles 7, 8: ~ Article 27, TTtle 7; 6NYCRR 360: rr~~ Protection of Water ~_j SPDES Sohd Waste Management` u Water Supply le 15' ~ Airl Polluton Control' ~ Hazardous Walste ~Managemeni 3 Article 15, Title 15: ~ Article 23, Title 27: ~ Article 34: Water Transport Mined Land Reclamation Coastal Erosion Management Article 15, Tdle 15'. Arllcle 24: Article 36: C~ Long Island Wells ~ Freshwater Wetlands ~ Flootlplain Management Artieie 15, Title 27: N-New, R-Renewal, M-Modification, ~ Articles 1, 3, 17, 19, 27, 37; ~J Wild, Scenic and Recreational C-Construct (`only), 0-Operate (`only) 6NYCRR 380: Radiatitln Control Rivers PE Ratli ISSUCD 10 Sarah C. Tremaine I nnuRLS, ul PERMill1 L c/o Drawer B., Fishers Island, NY 06390 nGEn7 FOR PCRMITICE/CONTACT PF RSON TELEPHONE NUMBER Mr. Glenn G. Just, J.M.O. Consulting 516 929--5775 NAME ANU ADDRESS OF PROTECT/FACILITY III ddferent from Permittee) Fishers Island LOCATION OF PROJECT/FACILITY COUNTY TOW N/$G474MEg6~R$$ UTM COORDINATES I Chocomount Cove Suffolk Southold DESCRIPTION OP AUTHORIZED ACTT\'ITY The applicant proposes the consCruction of one single Tamil residence with se tic ~ system, porch, deck and driveway as per NYSD$C approved plans attached. A 75 foot I buffer of undisturbed natural vegetation will remain between the development and the i I wetlands. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees that fhe permit is contingent upon strict compli- ance with the ECL, nil applicable regulations and the conditions specified herein or attached hereto. t 7hr permitter shall fJemthe o(I¢e of the appropriate regional permit administrator, or other office desiRnaled mthe speual conditions.anonce of intention to commence wort, al leaq 4A hours m adva nee of the time of commencement and shall also no Ufy himlher promptly m writing of the completion of the work _ Thn prrmmed wod shall b•• subtrct to mspenrnn by an authoraed repretentabve of the Department of Environmental Conservation which may order the work suspenged r! ' me putiuc interest so requires pursuant m ECL 4r1-0301 and SAPA 4401(37 J Ihr permnlee has ac<rpu•d expressly, by the eaecubon of the apphcabon, the lull IeRai responvbibty for all damages durct or mdrtect. of whatever nature and by whomever sobered, arising out of the protect described herein and has agreed to indemndy and save harmless the Slate Irom snits, aprons, damages and costs of every name and descnp- tton resulting from the said protect 4 The Depzrtment reserves the right to mgdrfy, suspend or revoke this permit at any time after due nonce, and, i( requested, hold a hearing when al the scope of the protect is exceeded or a violation of any condition of the permit or proviswns of the ECL and pertinent regulations are found, or b) the vermu was obtained by misrepresentation or failure to disclose relevent facts; or c7 newly discovered m(ormalion or stgmhcant phYSical changes are dacovered since the permst was issued. 5 The permittee is responsible for keeping the permit active by submitting a renewal appl¢ation, including any forms, fees or supplemenai information which maybe regwred by the Department, no later than 30 days D80 days for SPDES or Solid or Hazarduous Waste Management permnsj poor m the expvatmn date b Thn primp shall not he conslmed as convevmg to fhe appbcant any right to trespass upon the lands or interfere with the riparian rights of others m order to perform the permitted work or as authorizing the impairment of any rights, title or interest m real or personal property held or vested m a person not a pam~ to the perms: l The permittee is responsible for obtmmng any other permits, approvals, lands, easements and rightsof-way which may be repmred for this Droject 8 Issuance of this perms by the Department does not, unless expressly provided for, muddy, zgpersede or rescind an order on consent or determination tit the Commissioner issued heretofore by the Department or any of the terms, conduions, or requirements contained in such order or determination 9 App mode ¢a non of this perms gram d by the De ailment miss be rn writing and attached hereto I P R T UANCE DATE I PERMIT A MINIS RAT OR ADDRESS B1dg.40, SUNY,Rm. 219 ~ Christine J. Costopoulos Stony Brook NY 11794 { I AUTHORIZED SIGNATURE 1 i 1..~Gvw~C.,,,~ l.~ .Oiv~~'^~ 4 Page} of I cc: BMIIP ' ez m-6a (11ae1-zs~ Tidal WEtlands A'DDITIOt1AL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5), 24, 25, 34, 36 and 6 NYCRR Part 608 10 That rf future operations by the State of New York regmre an al- other environmentally deleterious materials assoaated with the teration in the position of the structure or work herein authorized, or protect if, m the opinion of the Department of Environmental Conservation 14 Any ma[enal dredged in [he prosecu UOn of [he work herein permitted rt sbal 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 [he bed of a waterway or floodplam or deep holes that may have a the people of the State, or cause loss or destnicUOn 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 15 there shall be no unreasonable interference with navigation by the work thereby without expense to the State, and if, upon the expiration or herein au[honzed revocation of this permit, the structure, fill, excavation, or other 16 If upon the expiration or revocation of this permit, the protect hereby modificaUOn of the watercourse hereby authorized steal{ not be coin- authorized has not been completed, the applicant shall, wnhout expense pleted, the owners, shall, without expense to the Slate, and to such to the State, and to such extent and in such time and manner as the extent and in such time and manner as the Department of Environmental Department of Environmental Conservation may require, remove all or Conservation may require, remove all or any portion of the uncompleted any portion of the uncompleted structure or fill and restore the site structure or fill and restore to rts former condmon the navigable to its former condition. No claim shall be made against the Stale of and flood capacity of the watercourse. No claim shall be made against New York on account of any such removal or alteration the State of New York on account of any such removal or alteration 17 If granted under Article 36, this permit does not signify In any way 11 That the State of New York shall m no case be liable for any damage that the protect will be free from flooding. or injury to the structure or work herein authorized which may be caused }8 If granted under 6 NYCRR Part 608, the NYS Department off nvnon- by or result from future operations undertaken by the State for the mental Conservation hereby certifies that the subtect project will not conservation or improvement of navigation, or for other purposes, and contravene effluent limKatia~s or other hmKations or standards under no claim or right to compensation shall accrue from any such damage Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977 12 Granting of this permit does not relieve the applicant of the responsr (PL 95-217J provided that all of the conditions listed herein are met bi6ty of obtaining any other permission, consent or approval from 19 All activities authorized by [his permit must be m strict conformance the U 5 Army Corps of Engineers, U 5 Coast Guard, New York State with the approved plans submRted by the applicant or his agent as part Office of General Services or local government which may be regwred. of the permit application 13 All necessary precautions shall be taken to prelude contamination Such approved plans were prepared by Ri Chard StrOUSO of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any on April 11 , 1959 SPECIAL CONDITIONS 1. No fill may be brought to the project site Without further approval from this office. 2. No disturbance to existing vegetation or topography shall occur a minimum of 75 feet landward of the tidal wetland boundary. 3. A snow fence must be installed prior to the start of construction at the landward edge of. the 75 foot wide buffer area. The purpose of this fence is to prevent distLtrbatlce of this buffer area during construction. The fence must remain in place until all construction is complete. 4. The sanitary system must be installed a minimum of 2 feet above seasonal ground water level. 5. All driveways and parking areas muse be constructed of pervious material (gravel, crushed stone, etc.). Supplementary Special Conditions (A) through (J) attached. UEC PERMIT NUMaER 10-89-070.5 PRgGRAMIfAULITV NUMI3CR NQA Page Z of _Z_ CHARLES T. 1AMILTON Chief, Marine Regulatory Section NYSDEC, Bureau of Marine Habitat Protection Bldg. 40, SUNY, Room 225 Stony Brook, N. Y. 11794 RE: Permit No. Issued To: Contractor's Name _ Contractor's Address Contractor's Phone No. Dear Sir: Pursuant to General Condition Number 1 of the above referenced permit you are hereby notified that the authorized activity shall commence on This notice is to be sent at least two days in advance of commencement of the project. The permit sign will be posted at the site and copy of permit will be available at site for inspection. Submitted by Failure to notify or post sign will leave owner andJor contractor subject to applicable penalties for non-compliance with permit conditions. CHARLES T. HAMILTON Chief, Marine Regulatory Section NYSDEC, Bureau of Marine Habitat Protection Bldg. 40, SUNY, Room 225 Stony Brook, N. Y. 11794 RE: Permit No. Issued to Contractor's Name Contractor's Address Contractor's Phone No. Dear Sir: Pursuant to General Condition lvumber 1 of the above referenced permit you are hereby notified that the authorized activity was completed on Submitted by This notice, with photos of completed work and or completed survey, is to be sent to above address promptly upon completion of project. Failure to notify will leave owner and/or contractor subject to applicable penalties for non-compliance with permit conditions. /Y~y h^'~ L ('y w~ ~J C. • as ~J.°-~ ~ 'c ~ ~ o o ~ ~ - ~ ~ v CG a> ~ p~~¢ ~ D~~, O rs~ p- ~ ~ C.~ O N C Q IUI.1 o s"~.. ~ N W t4 ~ O ~ ~ r O Q ~ N 'C3 ~ Q~ O C Y Q ~ N ~ C7 U.l C C mot" C O c4 ~ C Q Q cc5 U G U O ~ ~ G ~~N ~ O C ~ ~ ~ t~A ~ N c6 N ~ C7 ~ cd ~ ~ ~ ~ ~ ~ ~ L'3~ N 'U -G Z o_ ~ ~ Q,,... E 0 W O- b m m m N T ,i I' ~ , , ~ SUPPLI:MEN'1'P.12Y SPECIAL CC~NUI`1'ION5 ~ - ; I ~ ~I~ ~ ~ The lollow~ing conditions apply to old permits: A. lf_ anyjoP t_he permit conditions are unclear, the pecrnittee sha.rl con- tact the Division oP Regulatory APtairs at the address and te.('ephone it noted k~elow. B. A copy of this permit with supplementary conditions and approved plans shall be ava.iLable at the prolact site whenever authorized work is in progress. C. The permit sign enclosed with the permit or a copy of letter of approval shall be protected Prom the weather and posted in a con- spicuous location at the work site until completion of authorized work. D. t1l least •IZt hours prior tom, commencement of the project, the permittee shall complete and return the t.op portion of the enclosed receipt Form c•ertiEvinq that he is Pu11y aware of and understands all provisions and c•undil.r~.~ne; this permit. Within ~~ne week of completion of the permit!.~~d •~orl:, Lhe bottom port.~on rE that Eorm shall also be com- p!e~ed and returned. E. Por pro~ect_s tnvulvi~~g ar'~_.vitiez; t,~ he accomplished ovec a period of more than _,ne ','ear, the peunit:tee :=.haL1 notify the Regional Permit AJministr~,tor In wasting at least 45 hours prior to the commencement cf res.rmpt ion of ,~orl; each year . P. l~ p~~~jr~ri ~~~•:s~ran ;audit ic'a~ r;,ns lak~• place after permit isc>uancC, the permiLl~~° -hall subuut the apprvpri~,te plan changes f.or approval by the !2eg~~,nai Peru!iC Administrator prior to undertaking any such modi- trcalion~;. The pe rmiLteu is advi Sed that, substantial modification way n>qurie subwission vP a new application For permit. G. ALI i~ecesdaiy precauPiuns sha71 be taken to preclude contamination of ,,ny wettandc; ur waterway by suspended solids, sediment, Euels, solvents, !irLricanLs, epoxy coatingr„ paints, concrete, leachate or any ether environmentally de1_eterious materials associated with the proiect ~.~~'rl:. tl. Any laiiu!e comply prer.iseLy wit~~ all of Che terms and conditions or this permit, unless auChor~zed .in writing, shall be treated as a violation of the Environmental Conservation Law. i i. The uerwittee is advised to obtain any permits or approvals that may be required Crom the C).S. Department of Army Corps of Engineers, NY Drstricl, 26 (Federal. Plaza, New Y~,ih, N1 102')8, ZAttention: Regulatory h'unct.ions Branch), prior. to commencement of ~.,ork authorized herein. %i Ali J. The granting of this permit does not relieve the permitCee oEithe responsibility o1= obtaining a grant, easement, or other neces~ary approrai from the Division of Land Otilization, Office of General I'~ 5~`rvrc~-:s, 'l'ower Building, Empire State Plaza, Albany, NY 1229 y', which I~ r;~.-ry be required Por any encroachment upon State-owned lands underwater. Itegrorial Pernu~ Administrator i 'j NY5 Dept. of Environmental Consfievation Bl,ig. 90, S[7NY--Room 219 ire Stony Brock, N`1 1:799 'I~ (516; 751-7900 ~iP ~ i,' 10-& 0705 DGC - - i' ~ page S oi' f3 ~i ti ~ ~ ~ ~ ~ Y. / / O 'J - / _ --""'1.'..._ to ...1,,,, ~ . / i Si*it>cees / ~ IO.GJ ~ IO p \ ~ ~t"^'sp• .•7(j'?!A~;~"r„"';""+'-ir, p,n +~~}{4 P IOS ____OO s .....+~,..""'_t „wwt{1~y'N.b1>'. „n.y., s.~ 4Ntil> 1 ~ C,~J.-des -r~cs~- Ho~.e , p f t o s ~ r'- pd',~ ~ . ' `K ~ 6~ ~'s` i„ 8Ch1G1{ M4PX. ,~+pPd~~J' ~ ~ 6; ~ ~i'~'ff{ e~; , ham' ~ ~3-~ ~o , ToP ar Wv0 4'r ~ ~~rt~' Ci.fN b 9.9t uw _ dye i • . ` Y~ ~4, A.~..~ ~ ~ / . i ~ c.`~ ~ r dG ,g ~ td~ ~ ~ t ~ ( F , e3Ldr..~ ~ ~ .r w \ ~ ~ ~ G ~ r I.Y ~ ~ ~ tia~~~ i ~~ar~ ~r_. vt, ~ ~ xu~~( t / l ~k Fk lJ+rf h l \ ~ P a' n 1 41~~4d~~u~'. !l+ x1 , .l i ~ ~ 4Y ~~~k~ X s 4 ~ h t 1 1€i, , t ~ t„ 7 i 1q 'F1 r~'fYA'H~ri S ~ •/,y - ~ l \ .~la i ti t of bi~ ~~~r', sx tT~R yv^~~ ~nk~, u Y ~ A bJ p3 / .~y{i 7 t7r ppr V 'w i ~ ;^5 Y p ~ ',f C? 4 ~(+v + ~5 1 t ~4,,~'~~? ,W(t 4' in~4~, 3~i~+u(l,~,Ewy s",' ; e~"~~,u~,I•J ~~,k~ dr~W.titi{.df J *l~ ~~tT~~t S°~r~t~y. ,}P~ ~ l~n ~~s ;~/h~$~~~yy,~~ i 5~'~ q~.,~ ~~tl!t ~1~%~'y ~~~t~Y. r~'. L,<, $a.fi~^ i .~t.~t~ 7y.., ~ u{ ran .1n¢ r ~N„ ~ / l _ _..-fir"_" ~ \ +7.7 ~ - ~ / ~ ` \..~.i N ~ / ~ OiA~'9.. ~ i-s n 4 a~ ba • ~U ~ l~(~N6 p~~~~u1" ~ bb p u,r., F,apv,a IV.zJ/O ~ .y i.~t~r°:M. BOARD OF HE.\LTH 3 SETS OF PL.1NS . I-A-=~....... - FORM NO, 1 SURVEY - ~ • • . . TOWN OF SOUTHOLD CHECK . •1~a-4~.• . BUILDING DEPARTMENT sEPTIC roar[ TOWN HALL EOUTHOLD, N. Y. 11D71 NOTIFY TEL.:765-13D2 CALL Examined 19~ MAIL T0 . s Approved ....(L/..~~......., 19~ Permit No.~~~.~U _ t_j. f~ l1 Disapproved a/c . ~ Tf2 ..n._~ ~ , 4 JUL 3'4 49~ . A~~ 70WN OF SOOTHOLD ildi Snspector) APPLICATION OR BUILDING PERMIT ,p ' Date 15~: INSTIZUCTIONS a, Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildin ;Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on rite premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bui]ding Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicatr'fe laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa inspe lions - ' (ign~ture of applicant, of name, if a corpor~fton)~ y.. j • (Mailing address of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................~c-~,~.~~~ .~~..-..1.................................. 'vame of owner of premises ~•.~~-l'???e~° . (as on the tax roll or latest deed) [C applicant is a corporation, signature of duly authorized officer. . . ~:~-,1 . (Name and title of corporate officer) Builder's License No. ......~f~~/~: . Plumber's License No. ~f~•d_ Electrician's License No. Other Trade's License No. `9~.~~.~.J....... . Location of land on which proposed work will be done. ~~?~'f~-~t~ House Number Street ~ Hamlet County Tax ~\lap No. 1000 Section ~~Q~: ~©3" : , IIlock , , , , , , , Lot . . ~ , , , , Subdivision Filed ltap No. Lot . ..(Name) ~ _ State existing use and occupancy of pre~~mises and intended use and occupancy of proposed constructioh: a. Existing use and occupancy ....../,t;?;~.'~'.- . b, Intended use and occupancy •-•'~'~•~r'~~~~J'~~~~'~~'-'',,,,, 3. Nature oCwork (check which' applicable): New Building , . Addition .Uteratirn" . Repair Removal Dcmohtion , , , , Other \Vark . (Dcscnptton) 4. Estimated Cost , ~~.O„P.oo . Fee , . (to be paid an tiling this application) 5. If dwelling, number of dwelli g units . , . , Number of dwelling units on each floor . . . n If Sara, c, number of cars . ~ . . 6. If business, conunercial or mi~cd occupancy, specify nature and extent of each type of use 7. Dimensions of existing stmctares, if any: Front . , , , , , , , , , ,Rcar Depth . , .~A... , , . , . . ,,,„,p~,eight r::,, . Ntiniber of Stories . . . . r'"Y $ Di'mcnsions of same stru lure (with alterations or additions: Front Rear . l ;Depth . . . } Ilcight , , .....Number of Stories . ; Qitnensio,~ts.,of cntirc~t conStnic[ion: Front , ~`P... , Rcar ~O.......... Depth ~A......... . :Hei~4'r i , . Nutnbcr of Stories . ( . . E9. Size of lot: Front . . . : Rear Depth , , . lfiA. Date of Purchase , . . . . . . .Name of Former Owner . , . lsl.. Zone oi• use district in 5vi'iich p'rcmises are situated . . . . . . . . 12. Does proposed construction viplate any zoning law, ordinance or regulation : . 13. 1Vi11 lot be regraded Will exc s G ] remo cd from premises: Yes 14. Name of Owner of preJ~ices ~GtrL,rly,~',J?/~i•~?a~yr~ddress ~~,.~r~. Phone No. ~~:~x: Name of Architect 4C~F~??' e ..:,yr~~c, ~ Address 4~~~.~"'¢ .Phone No.`~18;~9: `~IC Name of Contractor ~~~G.~~:":~: ~1L~fddress~rD 4~~4~:y~1~. Phone No. u'`~~:~'7s?~/.. . 15.Is this property looted wiChin X00 feet of a tidal 'wetland? *YES.'?..NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAb1 Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fror.• property lines. Give street and blocl4 number or description according to deed, and show street names and indicate whethc: interior or corner lot. l ~ ' t I i i STATE OF tiE1V YORI' S,~r S•$ ~OUNTY OF r Q , , , ~ . . being duly sworn, deposes and says that he is the applicant Name of individual si~nhig contract) ~bovrr named. 1 3c isthc .......................!-~I!~l~ (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly',authorizcd to perform or have performed the said work and to make and fflc this aplication; that all statements contained in this application arc true to the best ofltis knowledge and belief; and that the ork will be perfonncd in the manner set forth in the application Yi1cd ttteretvith. .vom to betorc mu Iris ~ ~ 19 ayof nary' Public; S-'[~:^T...... a`~"~~ ~:unty / /J EILEEN 6.` WALL yam.. ~ _ , . y , >~qy~y Vubllc, SIaYe of NrW YctY l . , , , , , ! . No. 52-9509185 - ' Qualified In $u}folk County t~ ~ ($lgnatUre Of appllCanL) Grin ExolrAS IpIM~ 3D. l4~-. m