The URL can be used to link to this page

Home My WebLink About31873-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32250 Date: 03/15/07 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 225 EAST (HOUSE NO.) County Tax Map No. 473889 Section 99 SIDE AVE (STREET) Block 1-- MATTITUCK (HAMLET) Lot 20 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated MARCH 6, 2005 pursuant to which Building Permit No. 31873-Z dated MARCH 30, 2006 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 ADDITIONS & ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to ERWIN S & LAURIE RODGER (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3008997 01/08/07 PLUMBERS CERTIFICATION DATED 03/12/07 GEORGE FREDRICKS ~#~ Authorized Signature Rev. 1/81 (\1\ t\ I Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 I . MARI5? APPLICATION FOR CERTIFICATE OF OCCUPANCY-- This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: I. 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 (8-9 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 2/1 0 of I % 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: I. 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 I. 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. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy. $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. :~ I q \ 01 Location of Property: :1.a5 F$""SIPeA.VE, House No. Street , Owner or Owners of Property: ERWIN f LALJR\'i: ROP6-f:F\ Suffolk County Tax Map No 1000, Section ~ B1ock:3 Lot 2.0 Subdivision OLD MILL. HAVf:N Filed Map.-BL--Lot: '3 Permit No. 3/873 z DateofPermit.~Applicant: ErW'IV'l +Lo...or~ "Rod3er Health Dept. Approval: Underwriters Approval: V MMm'Ud(.. (check one) New Construction: Old or Pre-existing Building: Hamlet Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ .:16".00 Final Certificate: ./ (check one) (j...Jz"7/ q 17 co %.32).50 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. 31873 Z Date MARCH 30, 2006 permission is hereby granted to: ERWIN S RODGER 225 EAST SIDE AVE MATTITUCK,NY 11952 for : ADDITIONS AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER DEC APPROVAL at premises located at 225 EAST SIDE AVE MATTI TUCK County Tax Map No. 473889 Section 099 Block 0003 Lot No. 020 pursuant to application dated MARCH 6, 2005 and approved by the Building Inspector to expire on SEPTEMBER 30, 2007. Fee $ 363.30 ... re ORIGINAL Rev. 5/8/02 @].@] I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ Cl/J, _ 2. -">A ~ @l CERTIFIES THAT 7 :J "-L/ fill ~ ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ TWIN FORK ELECTRIC ERWIN RODGER ~ ~ P.O. BOX 48 225 EASTSIDE AVE. ~ I JAMESTOWN, N.Y. 11947 MATTITUCK, NY 11952 I ~ Located at 225 EASTSIDE AVE. MATTITUCK, NY 11952 ~ ~ ~ ~ Application Number: 3008997 Certificate Number: 3008997 ~ ~ Section: Block: Lot: Building Permit: BDC: ns11 ~ ~ 3(613 ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ ~~ ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ II authority having jurisdiction, and found to be in compliance therewith on the 8th Day of January,2007, II ~ Name OIY Rate Ratinl! Circuit ~ ~ ~~~ ~ ~ 2nd fl addition ~ ~ Alarm and Emergency Equipment ~ ffiI Sensor I 0 Smoke ffiI ~~~~ ~ ~ Outlet 10 0 Fixture ~ ~ Fixture 10 0 Incandescent ~ ~ Outlet II 0 General Purpose ~ ~ Receptacle 6 0 General Purpose ~ ~ Switch 8 0 General Purpose ~ ~ Receptacle I 0 GFCI ~ ~ Paddle Fan I 0 ~ ~ ~ ~ ~ ~ seal ~ ~ ~ ~ I of I. ~ ~ ~ I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I @].@] Town Hall, 53095 Main Road P.O.. Box 1179 Southold, New Yark 11971-0959 Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD i'jAR 9 ?C:i CERTIFICATION Date: 3/12/07 Building Permit No. ,..fIt 7.s Owner: Plumber: (Please print) a eoY).f (Please print) , rr--eclr (qg I certify that the solder used in the water supply system contains less than lead. Sworn to before me this n -t ~ day of 111llvce, 20i:il , Notary Public, MELANIE OOROSKl NOTARY PUBLIC, State of New""" No. 01004634870 Qualified in Suffolk County 'll) D Convnission Expires September 30. d::;;. PAUL ROBERT ROUSSELLE, Architecture ') 0 " , AlA Interior Design Planning 3079 Elmore Mountain Road Morrisville, Vermont 05661 802.888.2961 October 17, 2006 Office of the Building Inspector Town of Southold P.O.Box 1179 53095 Main Road Southold, NY. 11971 Re: Alteration and Addition to existing Rodger Residence 225 EastSide Ave. Mattituck, NY. Dear Sir. I am writing to inform you of my site visit and observation of construction at the above referenced Project on September 28, and the subsequent findings. The Framing Modifications in field are as per plan modification as submitted Aug. 23, 2006, with slight adjustments due to existing condition discrepancies. The flush ceiling header (in question) has been re-review and is found to satisfy the structural design load of the existing attic floor section based on following criteria: design load values: LL= 30psf DL= lOpsf L/360 deflection Please contact my office with any/all comcems regarding this Project. Thank you. , ( 3/<i73Z TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING [)4 FINAL [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRAnON C~ - n - 'VK REMARKS: L~ ~ v<L , ~ f"- c >&-0 (t;LJO P Ike~ f~ ~ ~d ~ JWtr\cl , DATE 3 -/~ ~ 7 J INSPECTOR ~-~ 3/'1732 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND IXf INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: (~ Je_V~ ~ It) -I). r () b DATE f' INSPECTOR ~~ 3/173 L TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST )<i'ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION }<iFRAMI~~ I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION , t.:!-V~ ~ ~ tJf(. . DATE 1/ /1/bt INSPECTOR ~~ 3/113 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION ~ FRAMING I STRAPPING [ ] FINAL r'" - [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: .~~ , ;'- ~ } \.4.- ok r ~ ;)-.q.-~ ~ DATE I INSPECTOR ~ ~ 31~737 TOWN OF SOUTHOlD BUilDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PlBG. [ ] FOUNDATION 2ND [] INSULATION [(<l FRAMING I STRAPPIN_G [ ] FINAL . [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE f~')-"f-ct INSPECTOR ~~ 3/~73 TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 IN PECTION (flEes 1)4: FOUNDATI N 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~ j<LJ ;'/)4..- ~ OK,' DATE 7-}fJ -o~ ~ INSPECTOR ~, 31g73J-. TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 1'1'1 NSPECTION ~/~t -V [,)4 FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] INSULATION [ ] FRAMING I STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: ~~~ ~ ~ 07= "-a::- ~ ~/ / DATE 7 ~ 1;- - () h INSPECTOR ~~ JJ~73 Z- TOWN OF SOUTHOLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1 ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING I STRAPPING yxr FINAL A " [ ] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSlRUCTION [ ] FIRE RESISTANT PENETRAnON ~~~{ f~ 4~();kA REMARKS: DATE 3- 1-0 7 INSPECTOR ~r~ . .. FIELD INSPECTION REPORT FOUNDATION (1ST) DATE . COMMENTS lJJ 1- /2.AJIt. -r 7: ~ A 1wI.. ~ '..,1\ ~ aJ\R, ~K US -;;: , /J", ...._<? f"'I"~ -'" tfl-" '......- ;..r" '/I""!\. ~ ,I 'S ~ 1..~~job i' ,.-;.a- ., L ... -:>'.n '-;:~1R "g:JR ~ l;l~ 1/ FOUNDATION (2ND) ..\)"J:> r-~ J~ .. ./ { Z ~. ;vr -161JL .A>L='r . o.A ~ n .A. .0 /! 1'7;--.." .J ;;Y/ 'JCP. V ~ . 'f [J' V < --' =1, d,., M-r:: ~ "."'" /l i~('k v ' ..h'( '.1 · \ V \ '" .~ lrt./, - Lo fG. ' '-0. .~, J-lOA..ii ':-;'-+i>.+- ~0A1. ~ RO p~~G.&. \ (.JIll 0 1\..V . ~ -f-;....VjI,p V('~~(J-'n' ..II-U e,k. ~ ~ ~~ ('A ;;'"J J.FlrlrL LVL~ .J.- ~I'/I ;. t7;":"'+A (j, CAX~\l)~ ~.-L .~ Vifll' P~.-J.-J ~~ ~Pry A~-I ./. ~..../ '''' r.. r, ~ 'ff~ c..;t-Jt,jo~-f::i.-~L... \~~.P I ^ w-:;,vv-)~'/ '$ 11.. .....~ ---.J::!..; '- / 111\....I...f... 1 A U A- .;.: - --r~ L; r.; _'1, IJ .n./.AI ~" I~ i;:: I'" N'1I- (j . \fa V'd" fJ.1L iJ n ,h\ r/l',ltl- ~ 'I' ~I -po" t"' .-/ "'t--..t'l INSULATION PER N. y, ..l.J ~ STATE ENERGY CODE "- (1\ r>~^-p..../L~~ \ D A-i-\,f ~ II · - A M- ,./'9) dU hl<;..- ..:..._~ \. /"'4 L/ ' 'R~ _~dJ tL-t< n j,!c/ ~ I' ~ '.12./1' 3 W R- .." -1-07 -r.....- L1i, \ ,.l.. A ~ t' ~ I Q)I f(' A "" , 11 ...... II f'-. M, d '- ./?f~./ 10 FINAL ;.. 3-~1--zJ 11 c. -;;tJ /i...... I f.//~r-,:p / "1)'."- // ( f . ~...." - , . ADDITIONAL COMMENTS .b/_./ ~~ ~ /;/_ /' , J../ _~ ~ I < , [;>' ..-' d -i)~ , "" W'" o ~ .., o ... , 0 -JZ ::= i?~ =P~ t"l "':l :-'J OWNER STREET' .:" c:; '::'-~"" j VILLAGE DISTRICT SUB. LOT v // IOdo..., -3 -';;0 TOWN OF SOUTHOLD PROPERTY RECORD CARD .;~ , ,. ACREAGE V /l.- Ey /'~" , I " "-- : ,) II , t.~ J,"\, If \ II f-{(5J',G.. " .'-,'0""'1 ,...~ V"-", , N S M . TYPE OF BUILDING 1Jlo>'-1" -Iv~\ /r 004' I ~.."'" ,/ RES. ,J/o S S. LAND IMP. () 00 /66 /6 66 :.z (J 0 100:) 7000 VL. FARM COMM. I IND. CB. I MISe. tJ~ .tJ . TOTAL DATE REMARKS 2F ~C). (,2. 58 z"r:;~ '.' -1-0 ~1-IJ lJ~!I-/R, )Do. AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Farm Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable 3 Waadland Swampland Brushland House PI.- t- . Total ....- '2..['".... ; 7 ~~ I i I i ..J Foundation C, B, Bath 2 Basement f"l( , Floors ,W, Ext. Walls IIV", j' A, Interior Finish fA.tf~'K Fire Place ()/,-e Heat J'tfjA ".... /- '<() - )0 Y1'/ Porch Attic Porch Rooms 1 st Floor Patio Rooms 2nd Floor Driveway , L f/J.'\~L,+ , ~~.,.,.~ Z 110 ~rV' ~" \~'" f, , J y I '" . L\ , 5' .. ':; 0 ,~ r?,~~ ~B ,U~ : -If ( , , 7 I' 1 ~ 3/91 , , - f'{y - 't'i .)~ l-?-- (?M 2. J J?, ~ 1.-.'1 /'iX7 Extension Extension \0 I ': \0 ',I" ~~l.~,\W 21 X'2&,' Sl\1t> P6\"-( ~ ,SlJ 3Yi../D:;.,JYfJ /7b Breezeway Garage ).. 'i X Iq ;, 'f~'(' <far. 00 - O. B. fr 'V, t~ .~ '.;""/0. I I I",' . L(J " " I' ."/ III r - ) v- t~ ~ ; /", {J- r' e~ #/. - NEW YORK STATE DEPARTMENT OF ENVIRONMENTA~ CONSERVATION DEC PERMIT NUMB ,R 1-4738-02928/0000;t FACILlTY/PROGRA~ I I'UMBER(S) SAPP o PERMIT EFFECTIVE DATE Februa 2, 2006 EXPIRATION DATE(S) Under the Environmental Conservation Law Februa 1 2011 TYP, OF PERMIT . New D Renewal D Modification D Permit 10 Construct D Permit to Operate I D Article 15, Title 5: P "(tection of Wa- ters D 6NYCRR 608: Water Quality Certification D Article 27, Title 7; 6NYCRR 360: Solid Waste Management D Article 15, Title 15: Nater Suppiy D Article 17, Titles 7, 8: SPDES D Article 27, Title 9: 6NYCRR 373: Hazardous Waste Management D Article 15, Title 15: Nater Transport D Article 19: Air Pollution Control D Article 34: Coastal Erosion Management D Article 15, Title 15: _,,"g Island Wells D Article 23, Title 27: Mined Land Reclamation D Article 36: Floodplain Management D Article 24: Freshwater Wetlands D Article 15, Title 27: 'Nlld, Scenic and Recreati mal Rivers . Article 25: Tidal Wetlands D Articles 1, 3, 17, 19,27,37: 6NYCRR 380: Radiation Control PERMIT ISSUED TI Erwin and Laurie R( ADDRESS OF PER 225 East Side Aven CONTACT PERSOr Paul Robert Rousse NAME AND ADORE Rodoer Property, 2< LOCATION OF PRe, SCTM # 1000-99-3- COUNTY Suffolk Description of Authc Reconstruct the e:: covered porch, AI 1/18/06, and starn ) d er IAITTEE TELEPHONE NUMBER 631) 298-8055 !!', Mattituck NY 11952 I FOR PERMITTED WORK TELEPHONE NUMBER 802 888-2961 II", 3079 Elmore Mountain Road Morrisville VT 05661 SS OF PROJECT/FACILITY ~ East Side Avenue, Mattituck NY JECT/FACILlTY w TOWN Southold Mattituck Creek NYTM COORDINATES E:706,1 N:4543.2 WATERCOURSE rized Activity isting covered porch within the same footprint and construct a second story addition above the work shall be performed in accordance with the survey prepared by Paul Robert Rousselle on lIld NYSDEC approved on 2/2/06. By acceptance d this permit, the permittee agre at the permit Is ontingent upon strict compliance with the EeL, all applicable 2 ~ 4 and an S eela Conditions included as art of this ermlt. ADDRESS Bld9, #40, SUNY, Stony B ok. NY 11790-2356 DATE Page 1 of 4 Februa 2 2006 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. The storage of construction equipment and materials shall be confined to within the project work site and or upland area s greater than 75 linear feet from the tidal wetland boundary. 2. Necessary ~I'osion control measures i.e., haybales, silt fencing, etc. are to be placed on the downslope edge of any di! turbed area. This sediment barrier is to be put in place before any disturbance of the ground occurs and is lD be maintained in good condition until thick vegetative cover is established. 3. Disturbanc" to the natural vegetation or topography greater than 25 feet seaward of the approved structure is prc,hibited. 4. During con:;truction. concrete or leachate shall not escape or be discharged, nor shall washings from transit mix true ks, mixers, or other devices enter tidal wetlands and or protected buffer areas. 5. Roof runoff slall be directed to drywells a minimum of 75 feet landward of the tidal wetland boundary for immediate on-lite recharge. 6. No fill or bac krill is authorized by this permit without further written approval from the Department (permit or modification). 7. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or ~ norto permit expiration, whichever comes first. The approved methodologies are as follows: a. stabilizatioll of the entire disturbed area with appropriate vegetation (grasses, etc.). b. stabilized as per specifications identified on approved plans. c. temporarily ;Iabilized with straw or hay mulch or jute matting or other similar natural fiber matting within 1 week of fina 9rading. Temporary stabilization shall be maintained until a mature vegetative cover is established. 8. All disturbee areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained ty a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the !€award side between the fill and wetland or protected buffer area. Tarps are authorized to supplement thE,!;e approved methods. 9. This permit does not authorize any alteration, expansion or replacement of existing septic systems. 10. There sha I be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activ tl{. 11. Any debris or excess material from construction of this project shall be completely removed from the adjacent area (Jpland) and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands and c r protected buffer areas. DEe PERMIT NUMBER 1-4738-02928/0C 003 PAGE..L OF.J... f\'EW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permitt,,. Accepts Legal Responsibility and Agrees to Indemnification The permi~ e.,. excepting state or federal agencies, expressly agrees to inderrmify and hold harmless the Department of Enviromnental Com ervation of the State of New V ork, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damage" to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in conn< ction with, or operauon and maintenance of, the facility or facilities authorized by the permit whether in compliance or not ir compliance with the terms and conditions of the permit This indemnification does not extend to any claims, suits, actions, or dan wges to the extent attributable to DECs own negligent or intentional acts or omissions, or to any claims, suits, or actions nanling th:: DEe and arising lUlder A11icle 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision und or federal or state laws. Item B: Permittee' i Contractors to Comply with Permit The permit ee is responsible for infomting its independent contractors, employees, agents and assigns of their responsibility to con L~ Iy with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, md such persons shall be subject to the sarne sanctions for violations of the Enviromnental Conservation Law as illOse prescribed j 0" the pennittee. Item C: Permittee. ~.esponsible for Obtaining Other Required Permits The permit e" is responsible for obtaining any other pennits, approvals, lands, easements and rights-of-way that may be required to carry oul he activities that are authorized by this permit. Item D: No Right t ) Trespass or Interfere with Riparian Rights This permil Loes not Gonvey to the permittee any right to trespass upon the lands or interfere with the riparian rights of others 111 order to pe -[.}rm the pennitted work nor does it authorize the impailment of any rights, title, or interest in real or personal property held or veSl ed in a person not a party to the pennit. GENERAL CONDITIONS General Condition 1 . Facility Inspection by the Department The penni~ ed site or facility, inclnding relevant records, is subject to inspection at reasonable hours and intervals by an authorized representttive of the Dep~ent of Enviromnental Conservation (the Department) to detemune whether the permittee is complying with this ,ermit and the ECL. Such representative may order the work snspended pursuant to ECL 71-0301 and SAPA 401(3). The pennitl e(~ shall provide a person to accompany the Department's representative during an inspection to the permit area when requested by tI Le Department. A copy of t us pemut. including all referenced maps, drawings and special conditions, must be available for inspection by tile Department at al tin,es at the project site or facility. Failure to produce a copy of the pennit upon reqnest by a Department representative is a vi Jlation of this pennit. General Condition!: Relationship of this Permit to Other Department Orders and Determinations Unless expJe:;sly provided for by the Department, issuance of this pemut does not modify, supersede or rescind any order or determination pre liously issued by the Department or any of the terms, conditions or requirements contained in such order or detennination, General Condition I Applications for Permit Renewals or Modifications The pennitt ee must sublnit a separate written application to the Department for renewal, modification or transfer of this permit. Such applic'liOn must inclnde any fonDS or supplemental infonnation the Department reqnires. Any renewal, modification or tram fer granted by the Department must be in writing. The permitt ee must snbmit 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 pemrit renewal or modification are to be submitted to: N' 'SDEC Regional Pernut Administrator, Region I, SU1,rv Bldg #40, Stony Brook NY 11790-2356 Gl neral Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department res< rves the right to modify, suspend or revoke this pennit in accordance with 6 NYCRR Part 621. The grotUlds for mo( ification, suspension or revocation include: a) materially false or inaccurate statements in the permit application or supporting papers; b) failure by the pennittee to comply with any tetms or conditions of the permit; c) exceeding the scope of the project as described in the permit application; d) ne\l\,ly discovered material infommtion or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e) noncompliance with previously issued pel1nit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUIV fER p AGE---L OF -L 1-4738-02928/000il:i SAPP NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6 NYCRR PART 608 (TIDAL WETLANDS) 1, If future ope"ations by the State of New York require an alteration in the position of the structure or work herein authorized, 0 r if, in the opinion of the Department of Enviromnental Conservation it shall cause umeasonable obstruction t( the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, Jr cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department tJ remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, IIpon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercoUl se hereby anthorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in s lch time and manner as the Department of Enviromnental Conservation may require, remove all or any portion 0 ',he uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the waterCJurse, No claim shall be made against the State of New York on account of any such removal or alteration. 2. The State onr<,w 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. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fu els, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious m 11.erials associated with the project. 4. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piles, r, dges across or along the bed of a waterway or floodplain, deposits within any regulatory floodway, or deep holes thl It may have a tendency to cause damage to navigable channels or to the banks of a waterway. 5. There shall b< 110 unreasonable interference with navigation by the work herein authorized. 6, Ifupon the eXl,iration orrevocation of this permit, the project hereby authorized has not been completed, the applicant shall, withoUl expense to the State, and to such extent and in such time and manner as the Department of EllvironmentE I 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 all eration. 7. If granted und er 6NYCRR Part 608, the NYS Department of Enviromnental Conservation hereby certifies that the subject projec : will not contravene effluent limitations or other limitations or standards under Sections 30 1,302,303, 306 and 307 (f the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 8. At least 48 ho Irs 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 re1urned, along with photographs of the completed work and, if required, a survey. 9, All activities mthorized by this permit must be in strict conformance with the approved plans submitted by the applicant or h s agent as part of the permit application. Such approved plans were prepared by Paul Robert Rousselle on III 8/06. PAGE~OF~ DEe PERMIT NilllBER 1-4738-02928/00C03 SAPP 95-20-1 (11103)-9d New York State npn;:)rfmpnt nf I=n\lirnnm~nt~1 ~nnc:~n/~tinn ,;........ -r-.~-~~~-~-- -- -......-.....-...--. --..--. --...-.. .~ ~ ~ NOTICE ~ ~ ~ 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 the approved work and any Department conditions applied to the approval, contact the Regional Permit Administrator listed below. Please Urefer t he permit number ~ow when contactin~e DEC. -.., -O;'1~ it ~eg~n9p2it ;.rministrator ermit Number JOHN W. PAVACIC I Expiration Date NOTE: This notice is NOT a permit BUILDING PERMIT APPLICA nON CHECKLIST Do you have or need the following, before applying? Board of Health __ 4 sets of Building Plans ;./ Planning Bo~ approval Survey V;/ Check I(' Septic Fonn ./ N.Y.S.D.E.C. V Trustees Contact: TOWN OF SQUTHOLD BillLDI/G'DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/SouthoId/ f. MAR 24 I I PERMIT No.3 tf 73 ~ Examined 3f5D ,2ob ,20~ Approved Disapproved ale Expiration ,20~ Mail to: - d~C g - ce Phone:J3/" 0 - 0.5 J . APPLICATION FOR BillLDING PERMIT INSTRUCTIONS Date <3/s , 20tZh- 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 waterways. c. The work covered by this application may not be commenced before issuance of Building Pennit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six months. Thereafter, a new permit shall be required. APPLICA nON IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of South old, 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. ) ,;((25 Ef-tST (SIDE Au )vf It fr,a~nD ~r(~s oAttrtr q 5' L State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder DwtvE~ Name of owner of premises L AuRlb Ai\)D FRU)I N Ro \) tOt? ~ (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. 3 1..,,:>-' 7 - H Plumbers License No. ,-=<,S;;t () /\4 P Electricians License No. ?,'-\- 9i 8 - E Other Trade's License No. I. L,qcation of land e.n _w~i~ p;op'~~ work will be done: :rr 't1,;::? ~ ^~, House Number Street MA-~ Hamlet County Tax Map ~~. 1000 sectin 14 . Block 'J-:7 Subdivision ..?[,V KIU:...- A~ Filed Map No. (Name) Lot m-- Lot 1,P ~ 2. State existing use and occupancy of premises and intended use and occupancy of a. Existing use and occupancy b. Intended use and occupancy Addition Other Work Fee 4Jt7~ ~~ (To be paid on filing this apl?Ii.cation) Number of dwelling units on each floor ~ 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost-----!Ju~ t9tJl:? c:e' 5. If dwelling, number of dwelling units I If garage, number of cars t-.\A Alteration V (Description) 6. Ifbusiness, commercial or mixed occupancy, specifY nature and extent of each type of use. ----.b!~ 7 D. . ,f" 'f /A"",I /,,4-,1 h ...._...L1 /)( . ImenSlOns or eXlstmg structures, I any: Front U"/ Rear U"/ Dept '?'"T-LY Height ~ ~ Number of Stories Z I Dimensjsms,of sa~ structure with alterati~ns or additions: Front {p~ Depth~ - ~ Height 1:7tJ ~ Number of Stories 8. Dimensions of entire new construction: Front 30 I Rear 3&> I Height I (.., I Number of Stories r- 9. Size oflol: Front-.t6'b. r:;.~1 Rear~ . ~-,\-I IO. Date of Purchase 7/ /q ff 7 Name of Former Owner , Rear 7- 01 Depth 0 ~~' II. Zone or use district in which premises are situated Depth t,c;G . 7 I RDhM'l-JeaV] rSff'a V'JI)S f-'-4P 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO 1 13. Will lot be re-graded? YES_ NO~ Will excess fill be removed from premises? YES_ NO X fl'<.\'\')110 + Lf\U~IE ~ 14. Names of Owner of premises R.o C,/OE AddressJRS ~ t9" Phone No. 2CY ~ ??'O s-5:" Name of Architect Address~ f- Phone No t!JOZ.. ~8. Z~ Name of Contractor BC!" BRIELSO/\) LLe.Address PhoneNo.Go.3/72.? 15""3D IS a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? .YES l NO _ · IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED. b. Is this property within 300 feet of a tidal wetland? · YES ---X- NO _ · IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: CQ...UNTY OF Svfr::G 'trw~'\ e.f' Qod3er being duly sworn, deposes and says that (s)he is the applicant ed, (S)He is the dJuhJe-,eS (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 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 me thiS~. ~I'? ~. 20f!...f:2 Notary Public M'm ,..,. . . New llIrII A . . No. -4n154 . uualifled In Nassau / ~ Co~ /1 Commission Expiras I ~ / t;7 .' MTL RAFTER TIES 12 11-3J.4 SIMPSON HURRlCANETIE. SOLID BLK'G JST. AND RAFTER TO WALl PI... MODIFIED 1ST. AREA TO '1x6- SECTION ADD 2><6" 1ST. ICONT,) TO MODIFIED ST. MA5TER BEI:>ROOM SUITE. 120:21 e ROO F SECTION DETAIL seA L E: 3/8-"", I' _ On ~~~ ~ ~~I~ 01 -.j< ~ ..0 ~C~~J ~ ~.~~~~ ~~~gl' ~~ ..... ~~~.~~ ~~ 'I'~ C/) ~~~~.~ ~~~~~ ~ ]~ ~g . ~ ~z '- g ~ nlU; ~~nl!;~ . J~ I~ ...J IIII :;;; i .... .., '" Z 0 ;:: u .., ~ CIl ~ ... w 0 >j I 0 '" <l<l<l<l ~ .; U :> ~Z <. ..,>- ~~ ",Z UJ~ ~8 ....U CIl;:l 'QCfl <.... i O~ ..,- f .... "'.... I ~~ C\1< C\1::;; Lo.l <"_ -"0 ...J < 0 0 ..J ~, 0"- -0" Ul ~> ~ CIl O. ,om o-m ,;,::", ~::;: 0"" '" _0 w'" " ~_ VERIFY _ _ _ C) 2x4" COLLAR TIES SPACED 16" Ole. .--- I I +____l~ o SECTION D E seA L E: 18 = l' _ OB SECTION DETAIL seA L E: 1" = l' - o. ~--- I I I 1----- nl~ SECTION seA L E: 1 B '= l' - 0" "t~ w m~ ~ ~;;~ ~~~~~~~~~~ ~.<~~~ ~ ~.~~>~. ~i~~~i I~~~~i~j~i I~g ~. s~jil~!iU;i~ J ~ 3/4" T&G PL YWD. 5 ~U ~~F o<.~ SUBFLR. (ALIGN & LEVEL 'ifF. - i"o~~~~3.. I ~ 01 ,..., :;: E-< '" '" 2x10" JST. 13 MODIFIED TO 2x6 SECTION TO f::: ALIGN WI. EX'G ATTICjST. ~ ADD 2x6" jST. (CONT. SPAN) ~ '" FASTEN TOGETHER WI. 2 ROWS #IOd NAILS f~ SPACED 12" OIC (STAGGERED) ~ PROVIDE SOLID BLK'G. TO WALL PL T A I L ~ u ~Z ~~ '-'8 ~ ~UJ 1 O~ ! ~~ 2x10" jST. BEYOND MODIFIED T "C -.j< ..... rn ~ J~ i I1II ~ ~ jJ <l<l<l<l '" ;> <. ",>- "'z Ui~ E-<U "';:0 <E-< "'- I lQ~ I ",< ~ "'::. LiJ <-c_ -" " ..J <( 0 0 ~ E ,,"- -.~ :> ~ " . '000 0- ~ ~;<<l ~.: ~ o"~ E; ;;;, ~ Ul ~ Ul n n '" . '" . " n " n " " ... ... -; -; 0 0 -. Z '0 Z , -1-0 "'~ "'~> -0 , J:~ "'~> 0, 0'" ~- ~~O ~ ': 0- ~~O 0 O~ n-lO ~~ n-lO t:l U ~~ el~li: t:l mm~ !:l OZ '" --I " 1) '" --i~ jllO ~m "lg~ ... "'O~ ... 0 -1m "C) >- !: 0'" Q!!j::!l ~ >- 0'" Q!!j::!l C:;:; n::Lm '" li: nJ:m ~ 'tAm::D J: ~m'" t""' -1"'- ~ t""' '" ~::a- . ",-, >::i:n 5 >::i:n (;) m -...... 0 . .. :- J: C)_~ Z (5 C). m'" 0 ;Z ::a;lCl~ elO~ ~::i: "'- 'It ~ ~ (;; PAUL Ro B E R T ROUSSELLE AlA Elmore Mountain Road Morrlsvllle, Vermont 8028882961 ProJ-t '1'1.... --...... ROOF SECTION DETAIL RODGER RESIDENCE ..... VERIFY -- ..... -..... 225 EASTSIDE AVE. MATTITUCK NY. L:" L:" L:" L:" . I -0 ~ !:l 1) o ~ '" J: ~ J: Z o Non; 00 NOT SCALE DRAWINGS. llEVIEWANO "YUlFY ALL DIMENSIONS INAB..D ATAU. CONST1I.UCTION STAGES. REl'OII.T ANY DlSCAfPANCY TO NlCHITECT IlEFOllE MOCEDING 'MTH WOllK. THESE DOCl.lH9ffl;AND T1-IE ~T1~~~'if6AAE I~OFSEIIVlCEN<<> TO flEMAIN THE I'ROPElI.TY OF THE ~~:~~ WIVTTEN CONSeNT IY AIlOilTOCT ISlNDIkECT\'lOlATlON"WITH STAllANOFmERAl.STATUTE5. -- Q AUG.2J,2006 -.. -- PRR S1.4e