HomeMy WebLinkAbout16855-z FOltM~ NO. fJ
TO~VN 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)
N°l (~5~ Z
Permission is hereby granted to:
o
...~.~...~.,....~ .................................................
· ] .
at premises located at .,/....,-~,. ~.J~.(~. ......... ~.~...~J~- .......... ~..f~/~- .liTe..........t~.- ~ .........
pursuont to opplication doted .,...'~.~'~.~ ..................... , 19..~...~.., c~nd opproved by the
Building Inspector.
Fee $ ............
Building Inspector
Rev. 6/30/80
FOUNDATION (2nd)
ROUGH FRAME &
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
LABS, INC.
7 0~.1;2 ~ 2 ~
LAB. NO.
Environmental Testing Laboratories ,'36A
575 Broad Hollow Road, Melville, New York 11747-5076 · (516) 694-3040 FIELD NO
Water/Waste Water Laboratory · Hazardous Waste Laboratory · Air Testing Laboratory TIME
Pdot Plant Studies and Other Analytical Services
COL BY C[JST,
Il III ::1 L11 iJ.¶l,1 F~I k'rd I-'lP I l!-~11] l] :! ::!.'~ I[,_11 :l.1 COLLECTED RECEIVED ANALYSIS
04/t0/97 04/:1,0/87
HARRY B~L. OMAN WATER ANALYSIS
I PREMISES 6F SAMPLING POINT I
MATN RD ' fiR. 5]CA~' GRTENT CAtJS~AY
E, MARION
MATTITUCK ~ NY lt022 POINT OF COLLECTiON:
DISTRIBUTION WELL OTHER (SPEC'i'FY) ROUTINE RE-SAMPLE SPECIAL COMPLAINT
Ill
APC/ml (<1) N~trates {mg/I N) (10.0) 0 ~ 0
Alkahmty (mg/J CaCO~)
Coliform Bacteria Chemlca~ Oxygen Total
Co~or (umts) Chlor,des (rog/I) ~ ~ ~ [ () ~ 0 O~ho
Total
Odor' HOt (3) pH ~ ~ Sultate
(mg/I SO,) (250) 0 5
~ Total Iron (rog/I) ~ 0 4 2 Total Amdgy
0
6
(0,3)
I
Sohds (rog/I) (mg/I CaCO3)
Manganese (rog/I} 0 0 ~ Specd~c 4 ~ ~ Sodium (rog/I) 1 0
(0.3) Cond ~mhos)
Free CO~ (rog/I) OeLergents (mg/~ ~s M~AS} ~l 0 0 4 Magnemum I 5
Nomograph ~ Tdrahon (rog/I)
Fluoride (rog/I) (2,0) Oxygen (rog/I)
Ammonia (mg/I N) ~ 0 O ~ 0
Aib. Calcium
Ammonia (mg/I N) Hardness (mg/I as CaCO3)
NdrHes (mg/I N) Temp
COPIES TO:
REMARKS: MR+ SICI311' E, MARION
I T£$TS MARKED ~ EXCEED N,Y,S, I.:~i'iTT,~ FOR POTA~I.E WATER
BUM OF IRON AHD HAN~ANE~[*: EXCEED~ 0~3 MG/L.
)-MaximumContainmentLevel(MCL) NY, State Samtary Code
LABORATORY DIRECTOR
DATE
REPORTED
Regulatory Affairs Uni~
Bldg, 40. S~--P,O~ 219
Stony Bruit, ~T 11794
(~1~)
n//oV
A revte~ has been made of your proposal to:
~ev ~ork ~t~te 9e~arCman~ o~ [nviro~en~al ~onse~a~ion has found ~ha
parc~l ~,~ proJec~ ~o be:
Greater than 300' from inventoried tidal wetlands.
Landward of a substantial man-~nade structure, ]"~/bc,"
greater than 1O0' in length constructed prior to September
__Land~ard of 10' contour elevation above-can sea level on · gradual,
n~tural slope.
Landward of topo~raphical crest of bluff, cliff or dune in excess
" of 10' in elevation above mean sea level.
Taerefore, no per-it under Article 25 (Tidal ~etlande of the Envtro~ental
Conse~ation LmO is required at this time since the current proposal ts
beyond State ~ndated Jurisd~ctton put.ant ~o this act, }l~ever, any
additional ~rk or modifications ~o the project ~y require a pe~it.
ts your responsibility to notify this office, in ~itiut, If such
addttto~l ~rk og ~difi~ti~us a~e cout~lated.
Al~er~te Pe~t Administrator
CI~tIDDRIeo~a
April 6, 1987
Mr. and Mrs. John Sica
1602 Clifton Street
Baldwin, New York 11510
Re: Health Dept. Covenants
Dear Mr. and Mrs. Sica:
Enclosed please find Covenants and Restrictions prepared by this
office at your request. With your approval, please sign on the third
page where indicated, before a notary public. The notary is to
complete the acknowledgment of your signatures following our pencilled
instrudtions. Use black ink only on this instrument.
Also enclosed is our statement for services. We would prefer a
separate check be made to Chicago Title Insurance Company for their
$135.00 charge (copy of their statement enclosed).
We enclose a self-addressed, stamped envelope for your convenience in
returning the signed Covenants and your payments.
Sincerely,
Encs.
SCHEDULE A
DESCRIPTION OF PROPERTY
DECLARANT JOHN T. SICA and LUCIA MARIA SICA, his wife
H.D. REF. NO. 86-SO-30
ALL that certain plot, piece or parcel of land, situate, lying and
being at East Marion, Town of Southold, Suffolk County, New York,
bounded and described as follows:
BEGINNING at a point on the southerly side of the Main State Road,
where the same is intersected by the westerly line of land of Miller,
running thence South 24 degrees 51 minutes 10 seconds East, along the
land of Miller, a distance of 235.00 feet to the shore line of Orient
Harbor; thence along the shore line of Orient Harbor, on a tie line of
South 35 degrees 40 minutes 00 seconds West a distance of 94.02 feet;
thence North 28 degrees 34 minutes 00 seconds West a distance of
280.00 feet to the said southerly side of the Main State Road; thence
easterly, along the southerly side of the Main State Road, North 64
degrees 05 minutes 80 seconds East a distance of 100.00 feet to the
point or place of BEGINNING.
DECLARATION OF COVENANTS AND RESTRICTIONS
THIS DECLARATION made this day of April~, 1987, by JOHN T.
SICA and LUCIA MARIA SICA, his wife, residing at 1602 Clifton Street,
Baldwin, New York 11510, hereinafter referred to as the DECLARANT, as
the owner of premises described in Schedule "A" annexed hereto
(hereinafter referred to as the PREMISES) desires to restrict the use
and enjoyment of said PREMISES and has for such purposes determined to
impose on said PREMISES covenants and restrictions and does hereby
declare that said PREMISES shall be held and shall be conveyed subject
to the following covenants and restrictions:
DECLARANT has made application to the Suffolk County
Department of Health Services (hereinafter referred to as
the DEPARTMENT) for a permit to construct, approval of plans
or approval of a sudivision or development on the PREMISES.
WHEREAS, the test wells sampled for the PREMISES indicated
groundwater supply that had contamination in excess of the
minimum drinking water standard and/or guidelines of the
State of New York and contained excess of the
following: ;
a
WHEREAS, the County of Suffolk Department ~f Health Services
has agreed to issue a permit only if the wellpoint is set at
least 20 feet below grade and a reverse osmosis treatment
unit acceptable to the department is installed to provide
potable water, also that a record covenant be filed stating
that the reverse osmosis unit was installed as required by
the department, it is DECLARED and COVENANTED by DECLARANTS,
their heirs or successors and assigns forever, that no
residence upon the above-described property will be occupied
prior to the installation of necessary water conditioning
equipment so that the water, when conditioned, meets the
said minimum quality standards.for drinking water of the
State of New York and evidence of the same is furnished to
the Suffolk County Department of Health Services for their
written approval.
The DECLARANT, its successor and/or assigns shall set forth
these covenants, agreements and declarations in any and all
leases to occupants, tenants and/or lessess of the
above-described property and shall, by their terms, subject
same to the covenants and restrictions contained herein.
Failure of the DECLARANT, its successors'and/or assigns to
so condition the leases shall not invalidate their automatic
subjugation to the covenants and restrictions.
Ail of the covenants and restrictions contained herein shall
be construed to be in addition to and not in derogation or
limitation upon any provisions of local, state, and federal
laws, ordinances, and/or regulations in effect at the time
of execution of this agreement, or at the time such laws,
ordinances and/or regulations may thereafter be revised,
amended, or promulgated.
This document is made subject to the provisions of all laws
required by law or by their provisions to be incorporated
herein and they are deemed to be incorporated herein and
made a part hereof, as though fully set forth.
The aforementioned Restrictive Covenants shall be
enforceable by the County of Suffolk, State of New York, by
injunctive relief or by any other remedy in equity or at
law. The failure of said agencies or the ~ounty of Suffolk
to enforce the same shall not be deemed to affect the
validity of this covenant nor to impose any liability
whatsoever upon the County of Suffolk or any officer or
employee thereof.
These covenants and restrictions shall run with the land and
shall be binding upon the DECLARANT, its successor and
assigns, and upon all persons or entities claiming under
them, and may be terminated, revoked or amended by the owner
of the premises only with the written consent of the
DEPARTMENT.
If any section, subsection, paragraph, clause, phrase or
provision of these covenants and restrictions shall, by a
Court of competent jurisdiction, be adjudged illegal,
unlawful, invalid, or held to be unconstitutional, the same
shall not affect the validity of these covenants as a whole,
or any other part or provision hereof other than the part so
adjudged to be illegal, unlawful, invalid ~or unconstitu-
tional.
STATE OF NEW YORK)
)
COUNTY OF ~)
Local Law #32-1980 - The DECLARANT represents and warrants
that he has not offered or given any gratuity to any
official, employee, or agent of Suffolk County, New York
State, or of any political party, with the purpose or intent
of securing favorable treatment with respect to the
performance of an agreement, and that such person has read
and is familiar with th~~~.~ Law #32-1980.
J~~.S~a /~-"(~¢~''
/
SS:
On the ~ day of April, 1987, before me personally came John T.
Sica and Lucia Maria Sica, his wife, to me known to be the individuals
described in and who executed the foregoing instrument and acknow-
ledged that they executed the same.
FRANK A. KUJAWSKI, JR., President
ALBERT J. KRUFSKI, JR., Vice-President
JOHN M. BREDEMEYER, III
JOHN L. BEDNOSKI, JR.
HENRY P. SMITH
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Town Hall, 53095 Main Road
P.O. Box 728
Southold, New York 11971
August 31, 1988
TELEPHONE
(516) 765-1892
Mr. & Mrs. John Sica
1602 Clifton Street
Baldwin, New York 11510
Re: 1000-031-14-9
Dear Mr. & Mrs. Sica:
Please be advised that after our conversation today, an on
site inspection was conducted for a determination on the need of
a wetland permit for the above property.
It was found that as proposed, your stakes are 58 feet to
the bulkhead, thus this project would be within the Trustees
jurisdiction.
We would like to advise you that you can submit an
application to this office and request a waiver from the Trustees
for approval of this project.
However, in addition to this office, please contact the
Building Department for a determination on any other permits
may be required for this project.
that
Should you wish to relocate your stakes 75 ft. back from the
bulkhead, we advise you to be careful when excavating so that no
disturbance occurs within the 75 ft. area.
If you have any questions, or need additional information,
please do not hesitate to contact me at 765-1932. The Trustees
will meet on September 29, 1988. Should you request a waiver and
the Board agrees, a determination will be rendered that evening.
Very truly yours,
Ilene Pfifferling, Clerk
ip
Attachment
cc: Bldg. Dept.
Board of Appeals
file
Board of Town Trustees
For Frank A. Kujawski,
President
Jr o
'FORM NO. 1
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
,~OUTtlOLD, N.Y. 11971
TEL.: 765-1803
)isapproved a/c .....................................
BLDG. DEPT.
TOWN OF, SOUTHOLD
Rece±ved ........... ,19...
(Building Inspector)
APPLICATION FOIl BUILDING PEIIMIT
2/$/88
Date ................... 19,.,
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in iuk and submitted to the Building Inspector, with 3
ets 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 streeL,
,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of tbis appli.
ation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon hpproval of this application, the Buildiug Inspector will issued a Building Permit to the applicant. Such permil
hall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in ~art for any purpose whatever until a Certificate of Occup,'mcy
flail have beeu granted by the Building Inspector.
APPLICATION IS ttEREBY MADE to the Bnilding Department for the issuance of a Building Permit pursuant to the
hdlding Zone Ordinance of t'he Town of Southold, Suffolk County, New York, aud other applicable Laws. Ordinances at
~egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, audtc
dmit authorized inspectors on premises and in building for vecessary inspections.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
3rate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
......................... ~:. :..:; . .- ..... ~lUi] d.c,~.~ ...............................................
qame of owner of prenfises ..... d c)hn. T,..&. Lugia. M('~.ia. ,%i¢ a ......................................
(as on the tax roll or latest deed)
if applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ......... ,].5.~ .............
Phlmber's License No ........ ?.?~. 6.p ...........
Electrician's Liceuse No .......................
Olber Trade's License No ......................
I. Location of land on which proposed work will be done...~'.:~?.~..5!a. 7.i?.n. ~.. !V.~. ............................
...................... ................................................
l lonse Number Street tlamlet
· ty T 1000 ti 9~3 .3.4 ~
Court ax Map No. Sec on ............... Block ... . .............................. Lot
Subdivision ..................................... Filed Map No ............... Lot ..............
(Name)
State existing use and occupancy of premises and inteuded use and occupancy of proposed construction:
a. Existing ,se and occupancy ........................... ... ........... ..:' ~. ~.: .......................
b. Intended use and occupancy ....... ,:-q.~g.].o. . ?am.zig..(~.vl~'~ lJ~g ................................
ii i, .[ ~., (Description}
4. Estin~a_ted~C #'~t/2qO.: ........................ Fee ....................................
~ I " (to be paid on filing this application)
5. If dwelling; number of ' ' . .....
dwel!mg umts ..... ]-. .. Nnmber of dwelling units m~ each floor ...............
If garage, number of cars . ~ ............ ~ ........................................................
6. If business, comm. ercial or mixed o. ccupancy, specify na_}t.t~% and extent of e~e of use ....... 5.._..?ia~/,,....
7. Dimensions of ex~sting structures, fishy: Front ..... ~ .... Rear .............. Deptll ~ .,.-7 ......
lleight . . ~ ........ Number nfStories ......................................................
I) me lslons of same stmctvre with alterations or additions: Front ................. Rear ..............
De th .
.,. P . , ... ...... ! .....Ile~ght ....... ;././., ........ Nmnbe,r.of Stones ...........
8. ,,,ens~onsg.o,~e.n}~renewc0nstruction: Front . .fi.K:.Rear ....q.~ / n.~,,. .~57/'/ ~ ....
I. ,--,,- ,,, ~u~<,uae ........ [ ..................... Name of Fornler Owner ...........................
Zone or use dislrict in whicll premises are situated AT.. ~ .IDa;'k
2 Does proposed constructiony~inte any zoning lawl ..... ' ............................
' ordinalce or regulation' . I~
3. Will lot be regraded :.ye~
..... ~ .................... Will excess fill be removed from premise~:
' [} Yes X N,
4. Name of Owner of premises . d ....... $:. J ~,Fj, ~Li.c a. Address . .3.
Name ofArchltect . .' . ; lressB/~.'l, .d¥~;L.n.
..... : ................... Adt ~ ........ Phone No ...............
Locate clearly and distinctlyl
roperty lines. Give street and bi,
Iterior or corner lot.
TATE OF NEW YORK,
OIJNTY OF ................
PLOT DIAGRAM
all buildings, whether e~isting or proposed, and. indicate all set-back dimensions fron
~ck number or description according to deed, and show street names and indicate whethc
S.S
.......................... ' ...................... being duly sworn deposes aud says that he is the applicant
(Name .... ;ning contract) '
of mdlwdual s~
[)eve nanled.
ie is the .................... ~ ................................
{ (Contractor, agent, corporate officer, etc.)
f said owner or ownels, and is duly ant ~orized to perform or bare performed the said work and to make and file this
pplicat~on; that all statements co' ' ·
fits ned m th s a ~ ~hcat on are trt, e to the best of his knowledge aud belief; and that the
fork will be performed in the man~er set forth in tho application filed therewith.
worn to before me this '
/.Z day bf ~ 19 ~'
' ~ ~ Counly
~olal~ Public .... .............
~EN K, DE ~E
_ N0, 4707878, S~lk ~un~ .............................
~ ~pir~ M~mh 30,1~ ~./ (Signature of applicant)
.io . . . ·
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