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Home My WebLink About27606-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-28070 Date: 11/15/01 THIS CERTIFIES that the building ADDITION Location of Property: 3915 STILLWATER AVE CUTCHOGUE (HOUSE NO. ) (STREET) (HAMLET) County Tax Map No. 473889 Section 137 Block 1 Lot 5.1 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 19, 2000 pursuant to which Building Permit No. 27606-Z dated SEPTEMBER 10, 2001 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 FOUNDATION UNDER AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to VICTORIA M URY (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELEC.'TRICAL CERTIFICATE NO. N/A PLUMBERS CERTIFICATION DATED N/A ho zed Signature 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) PERMIT NO. 27606 Z Date SEPTEMBER 10, 2001 Permission is hereby granted to: VICTORIA M URY CUTCHOGUE,NY 11935 for CONSTRUCTION OF A NEW FOUNDATION UNDER AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR WITH TOWN TRUSTEE ' S AND NY DEC CONDITIONS at premises located at 3915 STILLWATER AVE CUTCHOGUE County Tax Map No. 473889 Section 137 Block 0001 Lot No. 005 . 001 pursuant to application dated DECEMBER 19, 2000 and approved by the Building Inspector. Fee $ 75 . 00 Authorized Signature ORIGINAL Rev. 2/19/98 Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT O TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY BLDG.DEPT. q4i F 5 TMOL.D This application must be filled in by typewriter or ink and submitted to the Building Department e o owing: A. 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. Photocopy of Certificate of Occupancy-$0.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy- Residential $15.00, Commercial$15.000 Date. New Construction: Old or Pre-existing Building: (check one) Location of Property: 3 fz�- a.. T ck-tck2o__�f House No. Street Hamlet Owner or Owners of Property: Suffolk County Tax Map No 1000, Section 3 Block Lot Subdivision Filed Map. Lot: / Permit No. D--N,0 Date of Permit. I ' O Applicant: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Final Certificate: '� (check one) Fee Submitted: $ r Applicant Signatufe `� TON ' OF SOUTHOLD PROPERTY RECORD. CARD � - � iI� ° Q - OWNER STREET : % = VILLAGE DISTRICT SUB. LOT "# l i 71-1 CUfc 014a IV FORMER OWN N E ACREAGE 0.7 S W TYPE OF BUILDING RES,,9 SEAS. VL. FARM COMM. I IND. CB. I MISC. ( Est. Mkt. Value LAND IMP. TOTAL DATE REMARKSV Q QQQ / //J4 �'� % na e re �, ovPd /iY zee(y, o D _ L o 11 UG tR � (,iL ti / GO _. /O 0 ✓ 1 oo Ooa J,/ a 0 �// I 04/90-L 15 7pM 7- .p (er r, 40 D2 r U C;� -� � a a- i I l q� tea_ o �iY �- AGE BUILDING CONDITION �, 9 — tp�'"'�% Y �e % —f NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD I Tillable 1 BULKHEAD 1 Tillable 2 DOCK ' Tillable 3 7 Woodland -/p r) - Swamplond Brushland r� 1� House Plot ��' Total i I i ' I i 7 `a i Foundation Bath J M. Bldg. i y X z --- �9 Basement�,.r Extension s X Z - 3• !_ ( Floors Extension Ext. Walls I S - Interior Finish - ec Fire Place I Heat =�� ------ Ext nsion _ ;52 - - -- ------- Porch Roof Type n Porch Rooms 1st Floor -5merewaY Patio Rooms 2nd Floor —_ Garage Driveway -- Dormer__ -- — O. B. I i I ��'ee3t.�YY'Qy YOTIO - Garage Driveway Dormer O. B. 3n LoL7 OWNER STREET VILLAGE DISTRICT SUB. LOT ,. FORMER OWNER N E ACREAGE 3�S S W TYPE OF BUILDING RES. 312— SEAS. VL. FARM COMM. I IND. I CB. C. I Est. Mkt. Value LAND IMP. TOTAL DATE REMARKS �� , .23 '� N� f f!,e �� Y all / O U U / l3—UQ �} / -�/ G!; a 173 13 LD �'�,P L'78S f�u ,LD nrEw G'R,eA9� L.^_ �r� eo a. D U O / O O AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FRONTAGE ON WATER Farm Acre Value Per Acre Value FRONTAGE ON ROAD Tillable 1 BULKHEAD Tillable 2 DOCK Tillable 3 Woodland Swampland Brushland House Plot • r' ...wry M. Bldg. ' Foundation Bath I Extension Basement Floors Extension I Ext. Walls _— Interior Finish Extension Fire Place Heat — —�-- — — — Porch Roof Type Porch Rooms 1st Floor —t-- Patio — Rooms 2nd Floor Breezeway I Garage Driveway Dormer O. B. I I `vr 765-1802 BUILDING DEPT. INSPECTION [ X11 FOUND ATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REM#RKS• DATE � � � I INSPECTOR �-�/� C) B Tii DEPT. INSPECTION [ ] FOUNDATION IST [ J ROUG BG. [ ] FOUNDATION 2ND [ ] 1 ULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CRIMNEY REMARKS• , �'��Sil��_N� � C� DATE l` �� 0r INSPECTOR FIELD INSPECTION REPORT ' GATE - � COMMENTS � aasaaaaaassaass=s----sa- - =a=tea== -�_�s- aaasa-�'�' arsz =aas+---aaaa 1 l FOUNDATION ( 1ST) b FOUNDATION (2ND) �J ROUGH FRAM & S PLUMBING r INSULATION PER N. Y. STATE ENERGY CODE C FINAL C' ADDITIONAL COWOWS: C • �q O p w • a 0 ' �FORM `NO. 1 3 SETS OF PLANS . . . . TOWN OF SOUTHOLD SURVEY � � •� BUILDING DEPARTMENTCtiECR . . . . . . • • . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . ;�► SOUTHOLD, N.Y. 11971 E TEL: 765-1802 TRUSTEES . . . . . . . . . . . . . .. . . . . . . . NOTIFY:, ��.'� 3�•. •. / CALL 11 MAIL TO: . . . . . . . Approved.....1�./l�........ Cb/ . . . . . . . . . . . .... Permit No.•�?6Q6.�.... ................................ Disapproved a/c ..................... �� ,..TM .• cin,.�..'................ . i (Building'Inspector) i 9 2000 APPLICATION FOR BUILDING PERMIT `.0 Date.BUgUS t. . .2 . . . . 20.0.0. INSTRUCTIONS a. This application must be campletely filled in by typewriter or in ink and submitted to the Building Inspector 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 m yst be drawn on the diagram which is part c this application. 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 issue a Building Permit to the applicant. Suc permit 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 uhatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATIm IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws,, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary ryinspections. ...: �.. . . ....1.:??.. (Signature of•a licant or ame,i a........... Pp name, if a corporation) 31O'.%AvAP, �jt/e,Cu7c{�o�ue ............................... ...�... (Mailing address of applicant) ....... State whether applicant is owner lessee , agent, architect, engineer, general contractor, electrician, plumber or buil ................................................ Name of owner of premises ......Victoria M. U r y .............................................. (as on the tax roll or latest deed) .......................... .. .... If applicant is a corporation, signature of duly authorized officer. • •••..•.• (Name and title of corporateofficer) •�• Builders License No. ............... Plumbers License No. ................... Electricians License No. Other Trade's License No. .................... 1. Location of land on which proposed work will be done......... 351.5............ J..hAtftV...Ayenue Cutchogue ....N. • Y. House Number Street .................................. �et........ ................ County Tax Map No. 1000 Section ...J. .7.:X.- Map of 5. .1 Block ................ Lot ................ Subdivision ..Rroparty..ot...M.S....ia.nd... Filed Map.No. ...730........ I.ot ..1.`�.. &_ 16• (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...?gpA0.gnce _of. Victoria .M:_ Ury................................ b. Intended use and occupancy .... Same _a s_. a )W.Y 1 3. Miture of work (check Which applicable): New Building .......... Addition .......... Alteration ...X..... Ite-pair. ............ Removal ..e' ......... Demolition ............ Other Work • ........................... (Description) 4. Cstiiroted Cost J.5 F p O e t............. fee .............................................. (to be paid on filing this application) 5. If &elling, mm er of dwelling units ..On e..... Nurrt>er of dwelling units on each floor ................ Ifgarage, number of cars............4......................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if any: Front..2 8.'.......... Rear .....2 8......... Depth .40 .............. Heiglht ..1 4:................... Number of Stories ....One.............. Dimensions of same structure with alterations or additions: Dont .SAMP........ Rear ..'�ajue....... Depth .Sajae............. Height ....dale.......... Rmiher of Stories .SAMA......... B. Dimensions of entire new construction: Front No change.. .i ar p exterior-diir}De t ions ,,gWar. excavation... S.�iiite' � r 6 cries 9. Size of lot: Front ... 0............... Rear .. 1.0 1.;2.5.1........ Depth .. 3 6 0............. 10. hate of Purchase ....1.2.-.1998....... Nam of Former Owner ..49thur .G;„� Madlyn A. Ury. ........ ........ 11. Zone or use district in which premises are situated ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....N o................. 13. Will lot be regraded .................... Will excess fill be removed from premises: YES X NO 14. Names of Owner of premises Y.kq.tgXi;a.M; Ury,.... dress 3915, Stillwater Ave. P1one X734-6195 ... .. Name of Architect .................................... Address .............................. Phone. No. ....... .. .. Name of Contractor ................................... Address ...............................Phone No. ........... 15. Is this property within 300 feet of a tidal wetland? * YES ...X...... NO .......... *If YES, SOUI11('A.D MV ZRDSIIIi.S PERMIT MAY BE MWIRM. PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block nurber or description according to deed, and show street names and indicate whether interior or corner lot. St vu-. Our N:w Y(W, S.S COM1Y OF . SUFFOLK........... ... ... ....V.�y..........being duly sworn, deposes and says thatshe is the applicant (Name of individual signing contract) above rkTrLd, Ileis die ....................... .................................. ... . (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 this appl.icatioii; that all statements contained in this application are true to the best of his knowledge and belief.; and that the work Will be performed in the manner set forth in the application filed therewith. Sworn to before we this (L ........:.:-7..... ay f .. .....:?9.aa... :........ W . Notary Public .. .. :.... � AMURGURY,A .•Si• aLure•of•Applicant) . •'. Notary Public,State of New York ( P�Th` No. 02UR4058150 00" 6n: - ELEVATION CERTIFICAI .._. O.M.B. No. 3067-0077 ' FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement.This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances,to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR).You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION FOR INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUMBER V IGTa91 ,4 u 4 N __ STREET ADDRESS(Including Apt.,Unit,Suite and/or Bldg.Number)OR P.O.ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 39/6- ST/c1.w,orL-Z RV&AJa OTHER DESCRIPT B. umbers,etc.) off- B. CITY Aj U E!^� �`;•,'} STATE ZIP CODE �0• I3 4 * ON B FLOOD INSURANCE RATE MAP(FIRM)INFORMATION • Provide the it ry it t�p ape IRM (See Instructions): 1.COMMUNn1�' -5y 2.PA EL NUMBER 3.SUFFIX 4.DATE OF FIRM INDEX 5.FIRM ZONE 6.BASE FLOOD ELEVATION �•.^ at (in AO Zones,use depth) 016 -3 G NIA X 1 9 )c�c��,e c3fL1 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations(BFE);KNGVD'29 ❑Other(describe on back) 8. For Zones A or V,where no BFE is provided on the FIRM,and the community has established a BFE for this building site, indicate the community's BFE:�� .❑feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level f d' 2 2(a). FIRM Zones Al-A30,AE,AH,and A(with BFE). The top of the reference level floor from the selected diagram is at an elevation of i s:�feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1-V30, VE,and V(with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of LL I I I .❑feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A(without BFE). The floor used as the reference level from the selected diagram is i.❑feet above L_I or below❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is ❑I.❑feet above❑ or below L](check one)the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor(reference level)elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations:K NGVD'29 ❑ Other(describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes &No (See Instructions on Page 4) 5.The reference level elevation is based on: % actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post-construction Elevation Certificate will be required once construction is complete.) / / . 3 6.The elevation of the lowest grade immediately adjacent to the building is: 1 .161 feet NGVD(or other FIRM datum-see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the"lowest floor"as defined in the community's floodplain management ordinance,the elevation of the building's"lowest floor"as defined by the ordinance is: I I I I I .❑ feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31,MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE,AH, A(with 13FE),V1—V30,VE, and V(with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6, 7 and 8- Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s),then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. 1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Sectio 01. ND� CERTIFIER'S NAME � LICENSE NUMBER(or Affix Sea _jos4ph X • /N �g wv S -- 4U63 8 _ A TITLE COMPANY NAME / ADDRESS _oSCITYt ! ;c0, LAk 4O K P9 3 ! ST ZIP SIGNATURE DATE p Copies should be me his Certificate for: 1)community official,2) insurance agent/company,and 3)building owner. COMMENTS: /S 4 ,r11�7t__ /S i v �rLo�-- /�v Zo;zeg __ A ALSO rwv _4p41ses o•v y� .eo e' A Z,P 71y B/>yayiov 7Fawn• . ON WITH ON PILES, SLAB BASEMENT PIERS,OR COLUMNS A v A A v ZONES ZONES ZONES ZONES ZONES REFERENCE REFERENCE LEVEL BASE LEVEL REFERENCE FLOOD LEVEL ELETATION BASE BASE FLOOD ADJACENT REFERENCE FLOOD ELEVATION REFERENCE ADJACENT GRADE LEVEL ELEVATION LEVEL GRADE 4. ADJACENT:.. �7 GRADE The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 02-C"PERMIT NUMBER EFFECTIVE DATE 1-4738-02770/00001 0 December 1 2000 FACILITY/PROGRAM NUMBER(S) P E RM I T EXPIRATION DATE(S) Under the Environmental Conservation Law December 1 2010 I� TYPE OF PERMIT ■ New ❑ Renewal ❑ Modification ❑ Permit to Construct ❑ Permit to Operate ❑ Article 15, Title 5: Protection ❑ 6NYCRR 608: Water Duality ❑ Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management ❑ Article 15, Title 15: Water ❑ Article 17, Titles 7, 8: SPDES ❑ Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management ❑ Article 19: Air Pollution ❑ Article 15, Title 15: Water Control ❑ Article 34: Coastal Erosion Transport Management ❑ Article 23, Title 27: Mined ❑ Article 15, Title 15: tong Land Reclamation ❑ Article 36: Floodplain Island Wells Management ❑ Article 24: Freshwater Wetlands ❑ Article 15, Title 27: Wild, ❑ Articles 1, 3, 17, 19, 27, 37; Scenic and Recreational Rivers ■ Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Victoria M. Ur (631) 734-5308 ADDRESS OF PERMITTEE 3915 Stillwater Avenue, Cutchogue NY 11935 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT/FACILITY Ury property, 3915 Stillwater Avenue LOCATION OF PROJECT/FACILITY Cutchogue NY 11935 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold Eugene Creek E:712.7 N:4543.4 DESCRIPTION OF AUTHORIZED ACTIVITY: Excavate to expand the basement and create a basement entrance. Project shall be in accordance with the attached plans stamped NYSDEC approved on 12/01/00. 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 8 3) and any Special Conditions included as part of this permit. PERMIT AZST ATOR: ADDRESS Jo ie Bldg. #40 SUNY,)'Stony Brook NY 11790-2356 A TNO SIGNATURE DATE Page 1 of 4 December 4 2000 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees,agents, and assigns for all claims,suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits,approvals, lands,easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others in order to perform the permitted work nor does it authorize the impairment of any rights, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility,including relevant records,is subject to inspection at reasonable hours and intervals by an authorized representative of the Department of Environmental Conservation (the Department) to determine whether the permittee is complying with this permit and the ECL. Such representative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by the Department. A copy of this permit, including all referenced maps, drawings and special conditions, must be available for inspection by the Department at all times at the project site or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify,supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications The permittee must submit a separate written application to the Department for renewal, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration 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 expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg#40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications,Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. DEC PERMIT NUMBER PAGE 2 OF 4 1-4738-02770/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION 'ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15(TITLE 5), 24, 25,34 AND 6NYCRR PART 608 (TIDAL WETLANDS) 1. If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State,the owner may be ordered by the Departmentto remove or alterthe structural work,obstructions,or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed,the owners, shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State of New York shall in no case be liable for any damage or injury to the structure or work herein authorized which may be caused by or result from future operations undertaken by the State for the conservation or improvement of navigation,or for other purposes,and no claim or right to compensation shall accrue from any such damage. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S.Army Corps of Engineers, U.S.Coast Guard, New York State Office of General Services or local government which may be required. 4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly,without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall,without expense to the State,and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. 8. If granted under 6NYCRR Part 608,the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301, 302, 303, 306 and 307 of the Clean Water Act of 1977(PL 95-217)provided that all of the conditions listed herein are met. 9. At least 48 hours prior to commencement of the project,the permittee and contractor shall sign and 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 project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or his agent as part of the permit application. Such approved plans were prepared by: �� DEC PERMIT NUMBER PAGE 3 OF 4 1-4738-02770/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. During construction, concrete or leachate shall not escape or be discharged, nor shall washings from transit mix trucks, mixers, or other devices enter tidal wetlands and or protected buffer areas. 2. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (upland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and or protected buffer areas. 3. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 75 linear feet from the tidal wetland boundary. 4. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. D 1-4738-02770/00001 EC PERMIT NUMBER PAGE 4 OF 4 95.20-1 (Wn-9d New York State Department of Environmental Conservation Am Am vNOTICE v 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 -7 A 111A Permit Number - 3�- oZ1q"o1 JOHN W PAVACIC Expiration Date a- 11RO10 NOTE: This notice is NOT a permit Albert J. Krupski, President � ,OFFOlIr Town Hall James King,Vice-President .rte �lj 53095 Route 25 Henry Smith � P.O. Box 1179 o y Artie Foster a = Southold, New York 11971-0959 Ken Poliwoda Oy Telephone (631) 765-1892 Fax(631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD September 22 , 2000 Ms . Victoria M. Ury 3750 Stillwater Avenue Cutchogue, NY 11935 RE: SCTM#137-1-5 . 1 Dear Ms . Ury: The following action was taken by the Southold Town Board of Trustees at their Regular Meeting held on Wednesday, September 20, 2000 . RESOLVED, that the Southold Town Board of Trustees grant the request for a Waiver to VICTORIA M. URY to excavate that portion of the basement which has not been excavated and create a new entrance to the basement at the front of the house, hay bales must be placed along seaward side of project. This approval does not constitute approvals from any other agency. If you have any questions, please call our office at 765-1892 . Sincerely, _ 0 . ♦ ° A Albert Jr Krupski, Jr. President, Board of Trustees AJK: cjc cc: DEC Building Department Ld I LL~ _ J Z — crl 1 I1ALE I OV 6iDE V ) V LL LL F - . •"�_ F c-aD L Sys' T�; -. 17-- t, a E oc l`"X 16" Pi ER CoE UMN oil x 1-0" ' �. �.: "�`^�6" 07 PIER ;t w ,j LL BASEMENT VI-c -Fo K I'A 0) , TAW 0 wN� Vi � . y'. OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE OF OCCUPANCY UNDERWRITERS CERTIFICATE REQUIRED ASN00 oA FES BUILDING DEPAR MEN T NOT T65-1802 9 AM TO ; PM FOR HE FOLLOWI 'INSPECTIWO'REQUIRED 1 .FOUN DATION - FOR POURED CONCRETE 2. ROUGH - FRAMING 8L PLUMBING a INSULATION 4, FINAL - CONSTRUCYION MUST BE COMPLETE FOR C-0- ALL CONSTRUC�NS OF THE N.Y. ALL MEET THE REQUIREMT STATE CONSTRUCTION NOTTRRE TPONSIBLEEFOR CODES. 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