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FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of. the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-17865 Date MARCH 21, 1984 THIS CERTIFIES that the building ONE FAMILY DWELLING Location of Property 1100 SEEBE DRIVE CUTCHOGUE NEW YORK House No. Street Hamlet County Tax Map No. 1000 Section 97 Block 7 Lot 10 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MAY 18, 1988 _pursuant to which Building Permit No. 17076-Z dated_ JUNE 8, 1988 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 ONE FAMILY DWELLING WITH ATTACHED GARAGE & ROOF DECK The certificate is issued to CHARLES S. LEVIEN (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 87-SO-150-MAR. 15, 1989 CERTIFICATE NO. N 060443-FEBRUARY 28, 1989 PLUMBERS CERTIFICATION DATED FEBRUARY 17 1989 - K&K PLUMBING & HEATING Inspector Rev. 1/81 IP'OB.M NO. A 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) N° 017076 Z Date ...tC:':..°...~...... ..., 19. Permissiro,n, ~is /h'ereby gronte to: //~y~ ~q/ /~/~j~//~+(~~J//~//} ~L V .~~::.1... ~V 7I. R.......-. ~..........:/..~... ~/ ~~ /L~ ta.~~~-..~..........~~...~~.-...~." ..'.......... at premises located at ......ll~.a.......ft"~~~-~&~`G.....d.~./.~tf/..'~ ....................................................... ........................................................... County Tax Map No. 1000 Section .........yn.~........... ........,7..~....... .................................................. . Block ..............7..... Lot No. ............................ ......,/...~........... pursuant to application doted ....... ...~~~ ..... .......................... 19G...fl/.., and approved by the 8uitding inspector. Fee $..J~..~.~f~.!. `~ ~- ~~..~.... ./••••/~: tzsyt•••• ..... Bu ng Inspector Rev. b/30/80 FORM N0.6 TOWN OF SOUTHOLD MAR 2`I i~~9 Building Department Town Hall FSLDO. OCPT. Southold, N.Y. 11971 70WN OF SOUTHC 765 - 1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted ~ e~~ to the Building In~ec- torwith the following; for new buildings 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 of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, acertificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" ~ land uses: 1. Accurate survey of pxnperty showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25.00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling $25.00, Accessory ~$ 10.00 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 50".00 3. Copy of certificate of occupancy $ 5 . 0 0 , over 5 years $ 10.0 0 4.Vacant Land C.O. $ 20.00 1, ~~~vil ~a~ S.Uodated C.O. $ 50.00 Date .. .../. 1....... ...... New Construction,,,,,,OldorPre-existing Building ............ Vacant Land -2,~~~ /~ ............. Location of Property ...................../.'".:`-.~ ~v.. ~~21 ~U....... ~~:~~~/~~.v~/ .. . House No. /~q,, /~j,~ //~~ ~ ~Q p.. Streer y Hamlet Owner or Owners of Property . ~Y l-~/4 i~'~7. l Y.. !!V 1.~".L ................................. . County Tax M~/a~p/~No. 1000 Section .. ~~ !........ Block .... ~ ........ Lot ... ~ v ......... . r ° ` (~~S-.~. ~(IL~~/' ......Filed Map No. ~J.7!i;/.Lot No. .~L.. ! Subdivision ........ ............... , , , , , . , , Permit No. p.f ~~.~.`t!~Date of Permit ~~~?~~~..Applicant~ur.~S~~ ~,!!i~l ~, !~; ~1G7"t,~?~, , , , Health Dept. Approval .r\~~~p:" S~.: ! .~~...l~.......Labor Dept. Approval . . ..................... . Underwriters Approval /~~..I{R ~ ~.~~ .~.~0 , , , , , ,planning Board Approval ... . .................. Request for Temporary Certificate .....................Final Certificate . ~................. . Fee Submitted $ .. ~~.~ .................. / Construction on above described building a mit meets al plicable codes and regulations. ApPlican~'~..~. ......................... neg. io-~oas ~'~.,``~~a ~ IS Co ~ 1~~65 THE NEW YORK BOARD OF FIRE UNDERWRITERS ''^~~` ~..IJOi)~1 CI `1, BUREAU OF ELECTRICITY 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~~i19(t.~~~~'nf ~u l~ id !)~(7L~(~$ @~4!it, hl iiiS)< IL It#, 2')i±`i . . APPBcatiort No. on file Date THIS CERTIFIES THAT only the electrical equipment as described 6ebty and introduced 6y the applicant named on the above application number in the premises of ^.df~skt?~r:S 6P~~3tT,'.a, i.l(1!) tIR;A1t111 IrcZ '.".fP4'i`.zfv'Gi,tt;;< 3'd<L`„ ~ /st F'(. ©2nd F'l. '~~~~'' Section BI«;k Lot in thefollou:ing location• ~~]]B tement ' <' P fti9 1;T.t~il,3KY a ~, E was exarnIned ore and found to be in eonxplianee with the reyuirentents of this Board. FIXTURES RANGES COOKING DKK$ OVENS DISH WASNERS EXHAUST FANS FIXTURE ECEPTAClES $WI7CHE5 OUTLETS INCANDESCENT RUORESCENT OTHER AMT, K W. AMT. K.W AMi K.W, AMT K.W. AMT. ~ N.P dtA T<( dk3 ~~! l t.:3,2 ! i. C. f` DRYERS WRNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL RFC'PT TIME CLOCKS EEtt UNIT HEATERS MULTI-OUTLET DIMMERS AMT. K. W. Oll H. P. OAS N. P. AMT. NO. A W. G. AMT. AMP. AMT, AMPS. TRANS. AMT. H P SYSTEMS NO.OF FEET pMT. WATia d~ h, ! i~ .; h1}t3 SERVICE DISCONNECT NO.OF $ E R V I C E AMT, AMP, TYPE METER EQUIP. I ~, 9W i A ~ ] A ~ 9A dW NO OF CC COND PER 9 A W. G. OF CC. COND. NO. Of HbtEG A, W, G' OF HbLEG NO OF NEUTPAIa A W, G' OF NEVTRAI OTHFR APPARATUS: 9/w '1't)Pv` rl'CI? f`t)i4(7"t'1"CUP! 1, 3 'i'DiV r l tt I:~N11J `t' Ct'P~- i +,.l;'.t'.1T 7 ~ Sk.C,VE'.Ti.71~F; ~;~ t>it~'('U t:7t:.#Li;tz@9F,; /~~ if7ti4Clt~", Y,RIVPI ~ 2 .1,, .. 43t"iX i'(1J GENERAL MANAGER ipk?<1 h;+~Krtlli'T`, YrY; El~~t+ 17. ran Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY F,OR BUILDING DEPARTMENT. THIS COPY OF CERYIFICATE. MUST NOT BE ALTERED IN ANY MANNER. ~~FF~[/1'~0~ ~zo ,~ ~ ~~, ~.~ rn ~ . ~ i, ~ ~.Y~l ~'ra Y~'~ TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 C E R T I F I C A T I O N TEL. 765-1802 Date ~, ,~ ~~~ Building Permit No. Owner ~ ~.JC.7~~ ~~.~(\ ~~ \/ (pleasep"r~in\t) ~~y~,i Plumber \`~- ~ ~ Y/ 1~CY~~llp~ G~~ b~~~d1~ (please print) \ ~:~~e~5~,~' ,~.'J~l - ~ I certify that the solder used in the water supply system contains less than 2/10 of 1g lead. (plumber's signature) Sworn $o before e this day of 19~. ~~ - Notary Public Notary Public, g~~u~(~ ~ N~o.62-S1'ieii00 w~ f~ali0ed (n Suffolk County .Tam ErpiresJen. 81,1880 __ r - ~ ~' M 7., / t -s ~. FOL'tJDATIO;J __. (1st) - - -- - ~ 2 FOUNDATIOiJ (2nd) 2. / ~ ROUGH FRAME & PLUMBING ' 3. IIJSULATIOCI PER N. Y, STATE ENERGY CODE 4. FINAL c V r I COMMENTS _v~c~ .L'6y m c= ~~~~' ~ _ ~, 9vL/ ~Z _ u,., it - ,7~ /~RG~ IMMENTS: (9~K.-~ --~---' ~~ Z -o Q my ~~ H .~ (~ C ~~~ ' c~~~ ~~~ m o~ O 0 H (~` m 37~, H x .- 3 ~C1""~"'~'~ ~ r ~. ~ ('~ 0 a z~C x u.,," , ,~ ~! x 'v H ~\ 9 H O °J z 1 ----~ ~~ x ~V rn ~ I r ~ y x d d m -~ H r .. ,• s•-.. p. ~. - ,~. .... y}M`Y x: ,. ~. ~.y Aye .$P~ s a.,.,~+wtk J N. z ~ ~ 116 fr ~% a eQ~~e Q W pp>,, h W F F O r Q r, 11~ a m _~ s `R C> ~ ~ ~ " a K F p U ~ LL 2 ~ W DV W ~I:~,~ In _ N '6i h ~tS ~~ ~ ~ ' d r Y m~ O O~ ~ ~ m~ O Y D -jiCAf ~s1~111~ ,t J '• '1 ; .~~. ~ w ~ °~ w V Z ° ~ a o ' c~.'U~ s ° 8 +w ~ ' nmR~ LL Q ~ ~ J J ~ K W ? 4 ~ W V r-. -~ ~ ~~~ ~I ,~+°~ j 3w ~ ~= 10.,E v~iw¢~ ju~iU w ,,111,,! ° N ~f.T ,~ . N i~07 >w0<~~ tea....; YI w ~ - FNUa aulu°Sa p 4 - ~ ~~ . ~` nro ~ ~ ~~~ ^ ~ ~ ~~ l 1 ~+1 ~ ^~ -i1_tM ~ " x„F. 1 L~" s ~r ' s ~s~~ ~:a1 1C ~j Gt1 .~ y ~ c ,q s .~c f~ { t ti i~~~,,~~(( /~" lhh .y"J~~y,~y ~. !r k d F F^kx} S~" ~~ !Y~., v~ G'"arS ~ - d t .~~?B1'~r3 ~a~a~C~ppZ QW~~. ~..'3 ttJ tJl]T.~~ ~ )x ~ Y'~4 t h'" ~_ .f y~~ 4 i al ..y t~~ Y Sr...~e.. 'l ~. ~14/ S J d ~1t'q ~~" r' C? ~ ', ~~ l'7+~ ~~ j y .. j Iz.~~ ~ ~~ ! ~ ~VY~~u ~ ~~~ t ~U Ca.. 'H~ ~ tc ' ~ N ~1f.41~oy'y~'? p '' ' F 111 _P J~ 4dL~e !w~ y~R/•'} T! "•~ i / i ~r `~, ~, ~ s ~ r (u ~ ~ y ~. ~, YI 51~.. \ ~~ ~ ..t J )~~ YYY ~`~~' fir",,~ 1 ,~ e 1 ~yk~ ~ , y ~ ~~~ - Elie ~ r~`~ ~, ~ r { YY~6 ~~~~.~ ~~ 4~~Ij.Sfl~ ~ ; % ` h ~ ~ Q ~ ~~ ~ ~ a ~ ~ ~ ;x~~Mi 4 / V YI t-. ~- ' W ~ - ~ q ~ of y 9 z ¢ M1. ~ Y. ~@ ~ s v ~aA ~ ~ ~pp -~~~~y~~-, ~ r a (~-" 4~y°I ., T£,~ ,iiy ~ :.~',4 of ti'- ~ -~ 'r •.. -, ,.k ~ ~' 3a. i ;~~. < ~~ ~.ti8~`l ,. x'> ~ `xa, '~, ~y ~$ 1 ~ _~ ~ GSI~k. C~.4s ~ y t a +~ y $ 4 i+ i s" 'Y.` ,t X ~~ 5~ ~., ~, .tG~~' r _ . ~ i, '~,~ _ , - _ ~ ~ v ~ 4 "~e - 7 ~3p M ~1~<r = vb t 7 } s~` ~ ~ I X t p {'\ 1 ` ~~~~.~ R rites ~ ^. ~ z ~~ ',' ~•~ ~ U.1\ ~~ 4. ~.'Y.k~`~+.('t J 11 a [`+ i ' --~ 3 a Y ~~ ~. ~~ i~ ~' if z ~~~~~ r ~ `~yor ~= rap,, T0~'rl (~I~ SOUTftOLi~ OPi'ICIi QE ESUILDhv`G INSPECTOR P.Q. UO`C 1179 TOWN 1lALL SO(JT'I1OLD, N.Y. i 1971 March 21, 1989 BURGER CONSTRUCTION 2515 PINE TREE ROAD CUTCHOGUE, NEW YORK 11935 TEL. 7C,5-1 IIO' RE: CHARLES S. LEVIEN To P7hom This May Concern, v7e arc unable r.o complete your Certificate of occupancy because ,of the following reasons. /~ An application for Certificate of Occupancy is not nn fil.c. (ENCLOSED) /J/ DIO Undera~ritcrs Certificate on file. /'~c^I 't'he checl; i_: (~S~X1C~7S3~d§~Xnot on file.) $25.00 /~( D:o flcal.th Dept. Approval on file. /_/ No final insl~~ect.ion hay bcett made. Plca:;r. contact: our office on t}tis matter. Thank you for your cooperation. l;uildir,g Perm.i_t-. II 1 7 0 7 6 Z 13uilc]inq Dupt. t*"/_/ tlo Plumber ;;older Cerl.ificate on file. ( a].1 per:aitc involv.i.ng plumbing bn_ing i.^.sucd aft.cr .1pri.l 1,1984 ) I ~0 7~ 765.1802 I / BUILDING DEPT. INSPECTION [/ FOUNDATION 1ST RO GH P ] [ ] U LBG. (]FOUNDATION 2ND [ ] INSULATIAN [ ]FRAMING REMARKS: [ ]FINAL DATE ~ ~-1 0 INSPECTOR .u ~~~026 ~ ~~~~-~ 765-1802 BUILDING DEPT. [ ] F MIND ,,,~ [ 1FnINAL ~~ ~ p_~~~~ REMARKS:~~'Iti(~ ~ C.YJD ~~ ~ 8 % CJ r ~ INSPECTION [ ]FOUNDATION 1ST [ ]ROUGH PLBG. [FOUNDATION 2ND [ ]INSULATION x~~. ~~ v~ s~ ~U~w~ s~,1~ ~G C~~$~~.C-~ 2 a v i 6~` DATE ~_~~ _INSPE~C'TOR ~~~~,¢,,; Q /~©~~ T65-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ~,}~RAMING [ ]FINAL ~ ~ A^A P / ~O ("~ DATE I ~'` d INSPECTOR L 1707 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ INSULATION [)FRAMING [)FINAL REMARKS: C.,~~B,tcJ(oc.~ ~'l2.-- DATE _,~[02 /~~INSPECTOR /~" I l ~ 0 7~ 765-1802 BuoLDING DEPT. INSPECTION [ ]FOUNDATION 1ST ( ] ROUGH PLBG. (] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [L-}-R11QAL ww.c~ ~ wvw _ DATE J ll2 INSPECTOR ~~~ ~ ~ ~.~ ~ ,~ 765-1802 BUILDING DEPT. ~/~~`""~ INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ULATION [ ] FRAMING / [ FINAL REMARKS: V ~~~~,-.~f` -"-~2~~ -~ ~~.~~ ~c~ ~~ DATE ~"I o" .~~~- ~ ~~~ ~ ~j ~:, 2~~ LECTOR ROBERT H _ WHEL_AN ~ P _ E _ P.O. BOX 590 BUNGALOW LANE MATTITUCK~ NEW YORK 11952 516-298-5940 August 4,1988 Town of Southold Building Department Main Road Southold, New York 11971 Att: Building Inspector Ref, Levien Residence Beebe Drive, Cutchogue Permit No. 017076-2 Dear Sir: During the construction phase of the above referenced project, a revision has been made to the original submittal, namely the installation of a b/0 sliding door in the basement wall, It is my opinion that the above referenced installation is in conformance with the general intent of the N,Y.S. Building Construction Code. Please include this letter with the original submittal for- this project. Thani< you for your cooperation on this matter. cc: Burger Construction _u~6 (9IB61-25c DEC PE Rn11T NUMBER 10-87-1938 FACILITY/PROGRAM NUMBERfs) N/A NEN'YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Article 15, Title 3; 6NYCRR 327, 328, 329: Aquatic Pesticides Article 15, Title 5: Protection of Water Article 15, Title 15: Water Supply Article 15, Title 15: Water Transport (-~ Artlcle 15, Tltie 15: l_~ Long Island Wells Article 15, Title 27: Wild, Scenic and Recreational Rivers ~Re r' .. PE MIT Under the Environmental Conservation Law 6NYCRR 608: Water Quality Certification Artlcle 17, Titles 7, 8: SPDES ArtiDle 19: Air Pollution Control' Article 23, Title 27: Mined Land Reclamation Article 24: Freshwater Wetlands N-New, R-Renewal, M-Modification, C-Construct ('only), 0-Operate ('only) DATE EXPIRATION DATE(s) 3/31/93 N Article 25: Tidal Wetlands Article 27, Title 7; 6NYCRR 360: Solid Waste Management' Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management Article 34: Coastal Erosion Management Article 36: Floodplain Managemont Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control PERMIT ISSUED TO John Levien ADDRESS OF PERMIT7EE Beebe Dr., Cutcho ue, NY 11935 AGENT FOR PERMITTEE/CONTACT PERSON TELEPHONE NUMBER Nalcaxxe~~x~~>SXLF3t~aam7cksPxti~+9t~4lLOCATION OF PROJECT: Beebe Dr.,Cutchogue f LOCATION OF PRO)ECTIFACILITY COUNTY TOWN/CATyJ}tlk¢(y¢E UTM COORDINATES Cutchogue Suffolk DESCRIPTION OF AUTHORIZED ACTIVITY Construct two story single Tamil dwellin terra d of 75' landward of tidal wetlands boundary and sanitary system a minimum of 100' landward of tidal wetland boundary. All work shall be in accordance with NYSDEC approved plan. GENERAL CONDITIONS By acceptance of this permit, the permittee agrees That the permit fs contingent upon strict compli• ante with the ECL, all applicable regulations and the conditions specified herein or attached hereto. 1 The permittee shaliflle in the office of the appropriate regional permit administrator orother office designated In the special conditions,a noticeof intention to commence work at least 48 hours In advance of the time of commencement and shall also notify him/her promptly in writing of the completion of the work. 2. The permitted work shall be subject to Inspection by an authorized representative of the Department of Environmental Conservation which may order the work suspended if the public Interest so requires pursuant to ECL §71-0301 and SAPA §401(3). 3. The permittee has accepted expressly, by the execution of the application,thefuil legal responsibility forall damages, direct orindirecL of whatevernature, and by whomever suffered, arising out of the project described herein and has agreed to indemnify and save harmless the State from suits, actions, damages and costs of every name and descrip~ tion resulting Irom the sail project. 4 The Department reserves the right to modify, suspend or revoke this permit at any time after due notice, and, if requested, hold a hearing when: a) the scope of the vrolect is exceeded or a violation of any condition of the permit or provisions of the ECL and pertinent regulations are found; or b) the Dermit was obtained by misre0resentation or failure to disclose relevent facts; or c) newly discovered Information or significant physical changes are discovered since the permit was Issued. 5. The permittee is responsible for keeping the permit active by submitting a renewal application, Including any farms, fees orsupplemental Information which may be required by the Department, no later than 30 days (180 days for SPDES or Solid or Hazarduous Waste Management permits) prior to the expiration date. b. This permit shall not be construed as conveying to the applicant any right to trespass upon the lands or interfere with the r~par(an rights of others in order to perform the permitted work or as authorizing 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. 7. The permittee Is responsible for obtaining any other permits, approvals, lands, easements and rightsaf-way which may be required for this project. e. Issuance of this permit by the Department does not, unless expressly provided for, modify, supersede or rescind an order on consent or determination by the Commissioner issued heretofore by the Department or any of the terms, conditions, or requirements contained in such order or determination. 9 Any modiflcatlon o/ this permit granted by the Department must be in wrltine ,nA ,es,.d r....... PERMIT ISSUANCE DATE 3/31/88 PER IT DMINI RA OR ADDRESS Bld ~ g.40,SIINY Rm. 219 r AUTHORIZED SIGNATURE ~'°~ 4 "' cc: H Page 1 of A. If any of the permit conditions are unclear the permittee shall con- tact the Division of Regulatory Affairs at the address and telephone noted below. r' B. A copy of this permit or approval and supplementary conditions shall be available at the project 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 from the weather and posted in a con- spicuous location at the work site until completion of authorized work. D. At least 48 hours prior to commencement of the project, the permittee shall complete and return the top portion of the enclosed receipt form certifying that he is fully aware of and understands all provisions and conditions of this permit. Within one week of completion of the permitted work, the bottom portion of that form shall also be com- pleted and returned. E. For projects involving activities more than one year, the permittee Administrator in writing at least of resumption of work each year. to be accomplished over a period of shall notify the Regional Permit 48 hours prior to the commencement F. If project design modifications take place after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modi- fications. The permittee is advised that substantial modification may require submission of a new application for permit. G. All necessary precautions shall be taken to preclude contamination of any wetlands or waterway by suspended solids, sediment, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project work. H. Any failure to comply precisely with all of the terms and conditions of this permit, unless authorized in writing, shall be treated as a violation of the Environmental Conservation Law. I. The permittee is advised to obtain any permits or approvals that may be required from the U.S. Department of Army Corps of Engineers, NY District, 26 Federal Plaza, New York, NY 10278, (Attention: Regulatory Functions Branch), prior to commencement of work authorized herein. J. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessary approval from the Division of Land Utilization, Office of General Services, Tower Building, Empire State Plaza, Albany, NY 12292, which may be required for any encroachment upon State-owned lands underwater Regional Permit Administrator NYS Dept. of Environmental Conservation Bldg. 40, SUNY-Room 219 Stony Brook, NY 11794 (516) 751-7900 DEC g 10-87-1938 Page 3 of 4 9940ba (tle6)-25c ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 Ritle S), 24, 25, 34, 36 and 6 NYCRR Part 608 f 10. That if future operations by the State of New York require an al- teration 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 natura{ resources of the State, the owner may be ordered by the Department to remove or alter the 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 com- pleted, the owners, shall, without expense to the State, and to such extent and In such time and manner az 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. That the State of New York shall in no case be liable for any damage ar injury to the structure orwork herein authorized which maybe 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. Granting of this permit does not relieve the applicant of the responsi- bility 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. 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. 14. • Any material dredged in the prosecution 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. 15. There shall be no unreasonable interference with navigation by the work herein authorized. 16. 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 (n such time and manner az 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. 17. If. granted under Article 36, this permit does not signify in any way that the project will be free from flooding. 18. If granted under 6 NYCRR Part 608, the NYS Department of Environ- mental Conservation hereby certifies that the subject project will not convavene 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. 19. All activities authorized by this permit must he in strict conformance with the,approved plans submitted by the applicant dr his agent az part of the permit app{ication. Such approved plans were prepared by Roderick VanT rv 2/2/87 last revision 3/10/88 on 11 12. 13 SPECIAL CONDITIONS A 50' natural vegetated buffer to remain from the landward edge of the tidal wetland boundary inland. 2. Roof runoff to be diverted to drywells. 3. Driveway to be constructed of pervious material Supplementary Special Conditions (A) through (J) attached. Additional Supplementary Special Condition (M) attached. DEC PERMIT NUMBER 10-87-1038 N/ARAMIfACILITY NUMBER ~• THE FOLLOWING K. R11 dredging shall be conducted so as to leave a uniform bottom elevation free of mounds or holes. L. All spoil material shall be disposed of either in the Atlantic Ocean or at an approved U.S. Government Dumping Ground, as directed by the District Engineer, U. S. Department of the Army, Corps of Engineers. Any spoil material not intended for such water disposal shall be removed from the site and disposed of at an approved upland site. ~ M. All fill and spoil material shall be suitably contained at the work site so as to prevent its eroding, leaching or otherwise entering into adjacent wetlands and waterways. _N. All peripheral rip-rap berms, cofferdams, rock revetments, gabions, bulkheads, etc. shall be completed prior to placement of any fill material behind such structures. O. All repairs to existing structures shall be confined to replace- ment of existing structural elements with no change in design, dimension, or materials, unless specifically authorized herein. REGIONAL PERMIT ADMINISTRATOR Division of Regulatory Affairs NYS Dept. of Environmental Conservation Hldg. 40, SONY-Room 219 Stony Brook, NY 11794 (516) 751-7900 DATE: 3j31j88 DEC # 10-87-1938 Page 4 of 9 1988 March 2, 1987 Mr. Henry E. Raynor, Jr. P. 0. Drawer A Jamesport, Mew York 11947 Re: Milton Sanders - Beebe Drive, Cutcho~ue Dear Mr. Raynor: Pursuant to your request for a determination on the need of a wetland permit for the above referenced, please be advised that the Trustees have conducted an on site inspection of the subject property and determined that no permit is required as long as all construction is done in accordance with the survey submitted by Roderick Van Tuy1, P.C. dated February 2, 1987. ' Please note that a 50 buffer from the edge of the wetland fringe back landward is to be maintained. Should you have any questions or concerns please do not hesitate to contact this office. Very truly yours, /` '6}y' `''~.a v Henry P. Smith, President Board of Town Trustees HPS:ip cc: Robert A. Greene, D.E.C., Stony Brook Commissioner Henry G. Williams, D.E.C., Albany Stephen Mars, Army Corps of Engineers Thomas Hart, Coastal Management Conservation Advisory Council Bldg. Dept. Board of Appeals File FORM NO. 1 TOWN OFSOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined f~~~l••••••••••.19~~ Approved . ~~ • • • • • • • • •, 19~Permit No. ~.~~7~0.~ Disapproved a/c ..................................... BOARD OF HEALTH Y ... .. .. ... 3 SETS OF PLANS ............ SURVEY ..................... CHECK ~:.IIg ................. SEPTIC FORM `.~ .............. NOTIFY CALL ..7.3.y-'.SdI7........ MAIL T0: , .:............ B{ uil~Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ',"aY 1g, 1988 Date ................... 19 .. . a. This application must be completely filled in by typewriter or in ink' and submitted to the Building 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. 8 ~, 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 the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Depaztment 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 inspections. (Signature of applicant, or name, if a corporation) 2515 Pine Tree Ro»d, Ciztchonue....._• ..................... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. GFneral_ Contx•aotor ................................................................................................ Name oi; owner of premises P~ . -:`..:. ti :. , . ~-.... ...~~41r~.'L.~..~,. ~f1J1 F!Y~ ........... . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. Ann Burger - Vice Prpsicient (Name and title of corporate officer) ......................... Builder's License No. 1' 1' ~ 1` ~•61iT Plumber's License No . ....................... . Electrician's License No . ..................... . Other Trade's License No . .................... . I. Location of land on which proposed work will be done Beebe Drive Cutchos;ue .........~~. O,~ ....................... ................................. House Number Street Hamlet County Tax Map No. 1000 Section ......~~7......... Block ......... ~ ....... Lot ..... 1.~ .......... . i~ioose Cove 32.30 21. Subdivision ..................................... Filed Map No. .............. Lot .............. . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ..... Vaea,n~t hand a. Existing use and occupancy ......... .................................................... ..... I3esidentS,a1 .....::', ................ b. Intended use and occupancy ........ •••••............ 3. Nature of work (check which applicable): New Building .....'.. X .Addition .......... Alteration ......... . e air P • • . • • ......... Removal ..... . ........ Demolition .............. Other Work .............. . hstima r (Description) 4: ted Cost .... ~G200 00'0 , 00 .................... Fee ..................................... . (to be paid on filing this application) 5. If dwelling, number of dwelling;units ..... , .1 i...... Number of dwelling units on each floor ............... . If garage, number of cars ... .................................................................. 6. If business, commercial or mixe{1 occupancy, specify nature and extent of each type of use .................... . 7. Dimensions of existing structures, if any: Front ............... Rear ............ Depth .............. . Height. ?. ,+.. ,'.. , J :..... Nutijber of Stories ....................................................... . I)imensib~fs? of same structure with alterations or additions: Front ................. Rear ................. . Depth; i~ , . ~,',.I~eight ...................... Numbe o Stories ...... . 8. Ihmen' ., , r ~~I r' ~d0 ly ~5f, ...,..~.9, ...... . • s~on5 of en ire new construction: Front ..... ~" Rear ............... Depth ..:........... . Height ' ~ ~~ liar of Stories . 22..... ,, .... .~~.~. . .................~~.5,.............. 9. Size ofslot: F4XQgQ :;. ;`: ' ...: Rear ...................... Depth ..................... . 10. Date of P~foliase• ....l~ o~mfTer ~ t3~E. , . • , , , , ,Name of Former Owner i 4 ham ....rI,I. ~ .................... 1. lone or use district in which pry 12. Does ro osed construction viol mises are situated ...Iles.i.de n:t.l.a.l..... • • • • • ' nTo~ • • ~ • • • • • • • ~ • ~ ~ • • • ~ ~ • ~ ' ' p p • ate any zoning law, ordinance or regulation : .......................... . . . .. . 14. Nameoof Owner of remises ... Al4 • ' ' ' • • • • Fill excess fill be removed from premises: Yes X No p • • • • • Sanders , >?,eviPnAddress .. . ................Phone No..... Bur ex...... .. ...... Name of Co tractor ......~'.. • • ~ • • • • • • ' ' ' ' ' ' • • Address ...................Phone No. • • ~•~!p_521'7 .. . • • • • • Consy ,. Ine•,• • ,Address ...................Phone No............... . __ PLOT DIAGRAM Locate cleazly and distinctly all' bulldings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block',number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NE YORK: • ~ S.S COUNTY OF , ....:. ~~ ° •' )L I ~`~ U 2 "I ~ . • .... being duly sworn, deposes and says that he is the applicant (Name of mdiv~dua si ning contract) above named. `, + He is the .......C(7`2'(~(~e ~T~....V ;i ~l.lJl.:`i'C. ~...~(~t~~(CIL; ~G 4~~!t 1^.....~~.~. (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 application; that all statements cont2ined 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 me this Not Pub: (/K C .~ 9 ..............day of ....~ may.........., 19 ~0. Ti ......... County ~ ........ l~-.~w..~G~Lii~ ..... . 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M~v ~~~~~~r, rJ'CT,2~,,i~87, rsot~r.~ r i,rf= r..:ar~ ~~,,~~. _ _ . 1 -. _• PRf+Ci_:G,'r~8; „UNCx__fts.t4~8y Jclrlfc?,7t~Y~ rat ~ -7.1 ta~g7.3'_t.~~?.15,1~. - ~-- -_._ _` ~~t.ALFr- au. iti "t': E Lt r.j ~ravrwe /pSl lNIIN _ ~. ~'E .`' :1 i.rr54Y G~ `T RL !". ~CJ ~ I~'~L,l~~ YAti~YL.~.~ C . - ~-' I LICE~iSED LAND SURVEYORS GREENPORT NEW YORK _~_ Y, ~~ SUFFOLK CO. HEALTH DiBPT. APP'RbY'Jl '~ H. s. No. ~, t~~ ~~ .~ STATEMENT OF INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK GO. DEPT. OF HEALTH SERVICES. (S) APPLICANT SUFFOLK COUNTY SERVICES -FOR CONSTRUCTION ONLY DATE: H. S. REF. NO. aPPROVEO: SiJFPOLK CO. TAX MAP DESIGNATION: DIE-T•~FF S//E~~,,~~CT BLOCK PCL. tCV t.1.lJ y`•d7 ~ iJ OWNERS ADDRESS ,~ DEED: L.F1;~A P. , - .;,:eJart k.aw. Ea M this s9rve'r men r10t ~M TCII?G,'.7':_ ..._. _. _ _ - {?.5 a :J sl.,n~evor S Inked seal R r.tw~„sa6 sssi she!: not ne o v s valid true u:OY• f ~-lINII run rem=.qs indlna+ad ha'~eon n m whom the survey v. a nn hm br-halt to the re f ano nrnen'al eBenq end wF~i 1. '~ wr i'ta i horson ed ~1'.t:V':: ~.. n ct:e "nY'inq instl- imt transFerahN r -, a e r-,(ro^s or suDeaquerrt WA'..:. s DEPT. OF HEALTH APPROVAL OF .'o*.,w ~4u. x~rti ~N s' ~ \V ~ ' f .,~ n5 ~ SEPTfG AI 1. i Z a y t! s i ~ R~•~~ `t~ ,~~,t` ~ t~/`h ~~ ~ [ti v t ~ ~ ~ ~d -SOUTH 5(Dts Sk'r7'ION-- Z5 r t~ Q VE1Z7'. SG.: 10' = l" ! ~~~~ TE:9T 1iOC.E i F1 8 ~ A 6~{p. ~_- to ~-------- - -- ._ #~--` ~(/Q~ ` S ' i ! l r Ft~ :' ~ U ~ • N. `~ ~ •FI:GX~ ,ir-4{µ)'-.,.,.... wLi ~ dit3 U \ ~ N N7E, 5020 ~. ~. ~~~__ li--- - __.._.. - ..._ _. [ ° ` ~ t, ~Tf ~ +~ ~/ ~-~ ;I lfl" y G3."~ (f~ROB03ED~. ~'~r /rPLAA7'lN~I LSQGIG~ ~+ tZ A F5 ~ I r ~;~~~GATW#LK ~~~ `4 I r 1~ /- v~/Gi~{?~D uP~,Al~k I . 1 _. t ' 4 jr ,~, __ _QOOCS ~ I ~7 .tl V ~'a''c'r' ~', , ~~o r _~ a Ft,'- _ urn ~tu~l.~ ~; _ -- PDDL WUMVf ~ V~^- .a L- t f ~ ~~ !' y" i. ;' ; ;, ~~7 "~ ti ~ ~ ~ ' ., , ,•" t ~'~ 1 ~ ~ • i r F ~~ ~ ~~ ~ ' ~ I 4pF---.....,~ . _°.. ... - ~ 3. ~ ~ y ~ ~:.. i _ .~~ r,_.. 1_-~ _ ,, - }..tG. r~ . x000 ~ _. ~~ ._ 4~r~ 1 ~~ SUFFOLK CO. HEALTH DEPT. MMJlOV,1~''^` ._ \_ H S. ~ NO ~ ~" ~ MAR I4 1:;,.; ~}. TKE WATER SUPPLY A'NOtSrEly '' `DlSPO4aAL SYSTEMS FOR TH1S REBID NEE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. DEPT. OF HEALTH SERVICES. (Sl APpItCANT r _ . ~, 1 ~ i~,:. 1 L-' ~~__ . _ ' ! SL iOLK CUUNTY Dt:r'ARTtr1z"lf Of HEt,LTH SE ~? .t _ - ~P~,LE F~ iILY D~N~L~R:G ONLY '- .'{ ~ nnT~AR 1.5 1q$ NS Acr ~~ ... .. _ T!1B £E142 [;F, GIST OS^i 8nr! Y~2=.'. •, c:Jn~!~ ';%C~~rt!?$ ~UC9tI0C FaJF t° ~. i^. ~ "t9ri l,`f t ~'Sifhflt Lh..f 2'%"_. SI.S njj ~~: Ifs rJ ~:_: gip, ~~~_. Chl~ efE;ureau "~~tz'r:.~r . ~ ~J'r-f^JEJ a _iZF_f- ~t~:. TrJ~MAF 7F i~1tx~S~..CG+V C~~ t tt_~ iJ IhJ 7}~k. ~L)FF. CCJ.Cl.twF"~.k'S QF`F'lt:r' _..-__._..._. __ .__....~_ _.._ _ .. _.._..._...,.--_.. _ __._._._.__,~..., , -_.,,.. ~_ u MAP 4~1C?. 3?~UU. 2 CC?hll'4[.3~5 i7~~E:C~_ `t'C? </! _ _, `1A2Y NtVF1 ~,. _ '#C2` __TiE Lti~i~ .rlar> I' ie ~~~ vw~,~,tY4. LtCEMS6D LANk~ >illRlFlrt'YC1R5 fiREENPORT NEW YORK ffi1FFOLK COUNtY DEPT.. OF MBM-~!'f SERVICES -FOR APPROVAL OF CONSTRUC710N ONLY DATE: H. 4. REF. NO.: $~_-'~O•kS£3 APPROVED: rJUFFOLK CO. TAX MAP DIISi~IATiORf> DI$T. SECT. 91.OC~C 1tEL. tCrOG cx~ r y rO ~nExa wuwcca~: Flo JCl_ ^HN~~t4~C/s~1~1 curs r~v,~~~~ tv.Y, rrg3a_ E ._?3+x:;2' ~~ ~ _ _ ~jL)I ~. ' -K, u .var o. .'.' 90l 64 COnP1lr>rk^ ~. 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