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HomeMy WebLinkAbout31515-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY NO: Z 33304 Date: 09/26/08 THIS CERTIFIES that the building ADDITION Location of Property: 3121 OAKLAWN AVE SOUTHOLD (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 70 Block 6 Lot 10 Subdivision Filed Map NO. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated OCTOBER 14, 2005 pursuant to which Building Permit NO. 31515-Z dated OCTOBER 14, 2005 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 BATHROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to HOWARD & CAROL SAFIR ( OWNER ) of the aforesaid building. S~I~3LKC~)L~I~fDBPAR~NTOF}~ALTHA~PRO~KAL N/A BL~L-£~ICAL CERTIFIC-A~ NO. 3013612 11/09/06 PLLRWBt~S C~RTIFICa%TION DA'r~ 04/03/00 THOMAS J BALL ~zed~ Rev. 1/81 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 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: 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. Conunercial 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 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. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy- $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. ¢7/~ ~/t~{5~ Old or Pre-existing Building: New Construction: Location of Property: .~ ? oD / House No. Street Owner or Owners of Property: ~/~'7._ Suffolk County Tax Map No 1000, Section "-) ~ Block (check one) Hamlet Subdivision Filed Map. Permit No. 3 [ ~1~ [ ~ Date of Permit. Applicant: Lot: Health Dept. Approval: Underwriters Approval: Planning Board Approval: Request for: Temporary Certificate Fee Sub,mitted' $ ,c~ ~ Final Certificate: (check one) Town HalL, 53095 Main Road P. O. Box 1179 Southok;i, New Yod~ 11971 Fax (516) 765-1823 Telephone (516) 765-1802 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD cERTIFICATION Owner: /(~Vl~ s e -~pr int) (please print) I certify that the contains less than 2/10 of 1% lead. solder used in the water supply system (Plu~er~/~ure) Sworn to before me this Notary. Public, ~ HELENE D. HORNE NoteW Public, State of New York No. 4951364 Qualified in Suffolk Cour, t~ County Sep 26 08 07:52a carol safir 4102806121 p.1 r BY THIS'i'CERTIFICATE.OF COMPLIANCE THE- NEW YORK BOARD OF FIRE .UNDERWRITERS BUREAU OF ELECTRICITY 40 FI. JLTON STREw! - NEW YORK. NY 10038 unon the application pf CERTIFIES THAT upon orem~ses owned by:,. CAROL & HOWARD SAFIR 215 EAST 68TH ST. APT 30E NEWYORK, NY 10021 CAROL & HOWARD SAFIR 215 EAST 68TH ST. ,~,PT 30E NEW YORK, NY 10021 Located at 3121 OAKLAWN AVE. SOUTHOLD, NY 11971 Application Number: 3613612 Certificate Number: Section: Block: Lot: Builc;n8 Permit 31515-Z ~DC 30~,3612 ns11 Described as a occupancy wherein the bromines electrical system consisting of electrical devices and wiring, described below located in/o~ the 13rem~ses at: First Floor, A visual inspection of the D[emises electrical system, ira]ted to electrica devices and wren8 tc the extent detaded hereto, was conducted n accordance ,#tn t~e requrements o1 the applicable code aaa'or standard promulgated by the' State of New York, Department of State Code Enforcement ane Admimstratmn, or ether authority having jurisdichon; and found to be in comp iance t~erewith on the 9th Day of November, 2.006. Name QTY Rate P~ting Circuit Type Mi~ellaneous AS BUILT '~001 BATFIROOM ALTEI~ATION Wiring and Devices Fixture 2 0 Incandescent Switcl~ · - t 0 General Purpose Receptacle 1 0 OFCI An ~s built inspection, 0f the d=lincatcd cl~cui,~l installation, determined thai an ebvioas h~zard is not present and. thc installation ks believed lo be m comformance with the applicable reference standard for thc eslimaied period of construction of d~c premises wiring system. 1 of 1 T~is certificate may not be altered in any way and is va{idated only by the presence of a raised seal at the Iccatio~ indicated. ; :¥' i /"Y ,,- ~.-.- -- . ~ it, ..; ~ · /7 !v. . iii I TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION [ ] FRAMING / STRAPPING [~X~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING / STRAPPING ~FINAL ~ [ ] FIREPLACE & CHIM,EY [ ] FIRE SAFETY INSPECTION REMARKS: ~~ ~ ~ ~~ DATE ///'"" 7-- ~ ~ __ INSPECTOR 765.t802 BUILDING DEPT. oSPECTION N 1ST [ ] ROUGH PLBG. [ ] FOUNDATION2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE_ & CHIMNEY REMARKS. ,~ ~ '-~ INSPE~~ 765-1802 BUILDING DEPT. INSPECTI [ ] FOUNDATION 1ST [ ,/J' ROUGH PLBG. [ ] FOUNDATION2ND [ ]INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~ ,~~~ BUILDING DEPT. INSPE(:TIO [ ] FOUNDATION 1ST [ ,~ ROUGH PLBG. [[ ]] ~OR~UNMiDNA~'ON2ND [[ ]] 'F~NSAU~ATION [ ] FIREPLACE & CHIMNEY~ REMARKS: ~-~¢~c'/:~-- [ i ~~~i 765-1802 UILDING DEPT. NSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY ~REMARKS:--~/ - ~ DATE INI 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. 31515 Z Date OCTOBER 14, 2005 Permission is hereby granted to: HOWARD & CAROL SAFIR 215 EAST 68TH ST APT 30E NEW YORK,NY 10021 for : CONSTRUCT AN ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT REPLACES BP 24276. at premises located at County Tax Map No. 473889 Section 070 pursuant to application dated OCTOBER Building Inspector to expire on APRIL 3121 OAKLAWN AVE SOUTHOLD Block 0006 Lot No. 010 14, 2005 and approved by the Fee $ 150.00 hori S re' Rev. 5/8/02 ORIGINAL FORUM NO. ~ TOWN OF SOUTHOLD BUILDING DEPAI~TMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 24276 Z Do,e ..................... .~./Z[...~...~ .................. , ,,..~..,7 Permission is hereby granted to: ........... ~..../.~......~..........~.~......~ ........................ ,~ ~.~...~...~...:~.,./.~.z.~.. ....................... . ~o../z.~. ~,,.~.,.,.~.~..~...../._~......././~;~.~. 'o.~ ....... ~ ...... ~.....~.~.~.~ ...~.~..~.~.~. .......... ~.~, ........... z~.~..//..-.~e ......... ..~....~.......~-~..~/~-3.....:....~.. ......................................... a..~.~......~.~ .o~ ..................................................................... County Tax Map No. 1000 Section ..... ./~..~.. ............ Block ..... ~.~. ........Lot No ........ .,~'.~.. ......... pursuant to application dated ................ ~./~.~? .......................... , 19..,..?..7., and approved by the Building Inspector. Rev. 6/30/80 21:39 September 20, 2000 TO: Southoid Building Depafb,~ent FROM: Carol Safir P.01 It is my understanding that the breezeway pefn~it is a part of the ~Amendment to Pe.r, it~ dated August 12, 1997. [t is item #4, ~6~Nide breezeway in a 11~(15' 'L" design in accordance with N.Y.S.D.E.C. approved plan Howard/Carol Safir dated 3uly 30,1997. We have applied for an extension on this permit and have now submitted the requested engineer's report to finalize the work on the ]uly 97 perrnit. Because of the complex angles of the existing rooflines of the garage and the house, we need to frame the breezeway before submitting a final drawing. I am also sending on to you an "Amendment to Pe.~it" dated February 17, 2000 extending the original permit to July 31, 200~ This amendment addresses the issue of dredging, which was the only part denied by the Trustees. All other parts of the pe..it were extended to complete work, including the breezeway. Please reach me today after you have read the following documents, ! can be reached at 212-535-1106. ! would like to clear this up as soon as possible so that the work can begin. Sincerely, Carol Safir NEW YORK STATE OEPARTMENT OF ENVIRONMENTAL coNSERVAT[O~ DEC PERMIT NUMBER 1-~7~8-01~9/00001 FACILiTY/PROGRAM NUMBER(S) PERMIT Under the Environmental Conservation Law lEFFECTIVE DATE July 25r 1997 EXPIRATION DATE(g) July 31, 2000 ! )'TYPE OF PERMIT · New CI Renewal ~, Modification [] Permit to Construct [] Permit to Operate J r [] Article 15, Title 5: Protection of Waters 0 Article 15, Title 15: Water Supply [] Article 15, Title 15: Water Transport 0 Article 15, Title 15: Long Island Wells [] Article 15, Tit(e 27: Wi[d, Scenic and Recreational Rivers [] 6NYCRR 608: Water Quality Certification Article 17, Titles 7, 8: SPOES Article 19: Air Pollution Control Article 23, Title 27: Mined LaDd Recla~tion ~ Article 24: Freshwater Wetlar~s · 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 Article 36: Floodplain [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Control Other: PERMIT ISSUED TO TELEPHONE NUMBER Howard and Carol Safir (212) 535-11D6 ADDRESS OF PERMITTEE 215 E. Nth Street, Apt. 3OE New York, NY 10021 CONTACT PERSON FOR PERMITTED WORK NAME AND ADDRESS OF PROJECT/FACILITY Safir Property 303 Private Road #3 TELEPHONE NUMBER LO~TION DF PROJECT/FACILITY East side of Oaklawn Avenue Southold COUNTY I TO~N WATERCOURSE I MYTH C~RDINATES Suffolk Southold Jockey Creek DESCRIPTION OF AUTHORIZED ACTIVITY Construct a 3~ x 9' additia~ to existing single family dwelling. ALL work shall be in accordance with attaohod NYSOEC approved plans. By acceptance of thispermit, thepemittee agrees that thepermit is contingent upon strict c~liance with the ECL, all applicable regulations, the General Cooditions soecifiod Csee page 2) and amy Special Conditions fncl~ as part of this permit. PERMIT ADMINISTRATOR: j AOORESS Charles T. Hamilton J Bldg. 40, SUNY, 2o~ 219, Stony Brook, NY 11~0-~56 AUTHORIZED SIGNATURE Page ! of 4 SEP-~9-2000 2~:40 P.02 New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, New York 1 'i790-2356 Telephone (516) 444-0365 Facsimile (516) ~.~; 0373 AMENDMENT TO PERMIT John P. Cehill Commissioner Dear W~e., ~.0,'e.. &~'=" ~'~ ~'~ ~ ~ur feint mqu~t to e~nd the above pe~A has D~n reviewed pumuant to 6NYCRR, PaA621, The expiration date is ~ded to 3~1~ ~ur recent request to modify the above permit has been reviewed pumuant to 6NYCRR, Part 621. It has been determined that the proposed modificaUons will not substantially change the scope of the permitted actions or the existing permit conditions. Therefore. the permit is amended to authorize:'~,~,r~) e .~,,'/-3,,t~w.~,+o $1 kael~,~ i' This e~er ~s an amendment to the onglflal perm t and, as such, shall ~ avada~e at the o~ job site whenever author~ed wo~ is in progress. ~ ~L~ [[~j,~ All other te~s and conditions remain as wri~n in the original ~it. Very truly yours, ~ [ ~.a~. Permit Administrator SEP-19-2000 21:40 P.03 New York State Department of Environmental Conservation --. your recent- request ~.o extend ~.e above ~er~.i.= ha._s?=4e.~ reviewea pursuant to 6~C~, Par~ 621. TBe expxracxon ma~e x ~"~¥0ur recen= request ~o modify =he above permi= ha; ~een reviewed p~suan= =~ 6~, Par~ ~e pro~s~ m~ifioa~i~s will ~ s~m~an~ia%lV Therefore. ~e p~it is ~ended to a~oriz%: This let=er .~.I an amendment: to ~l~e original paral= and, es suc~, Sh&X1 be ava~l~bl~ ~ ~e ~b sl~e whenever au~riz~ w~r~ ~..1. Very ~.ru.i.y yours, Permit Adminisl;ra~or TOTAL P.03 Albert J. Krupski, President John Holzapfel, Vice President Jim King Mm'tin H. Garrell Peter Wenczel /.%x'v~ Town Hail 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-1892 Fax (516) 765-1823 June ~0, 1997 Carol Safir ~!5 East 68th Street ~t. 30E New York, NY 10021 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD ~E~ SCTM ~70-6-10 Dear Ms. Safir, The following actio~was taken at the Southold Town Board of Trustees Regular Meeting on June 25, 1997: RESOLVED, that the application of CAROL SA~IR, requesting a Transfer of Permit 42072 from Janet A, Maddams to Carol Safir for a 45' X 4' dock with a 6' X 20' and a 6' X 3' ramp, and a Waiver for a 3' X 9' addition to existing house. This approval does not constitute approvals from any other agency. If you have any questions, please feel free to contact our office at 765-1892. Sincerely, Albert J. Krupski, Jr. President, Board of Trustees AJK/djh cc. Bldg. Dept. TOWN OF SOUTHOLD PROPERTY RECORD CARD 7o OWNER STREET ,~ I~f' VILLAGE LOT 17/- / FORMER OWNER .'_,,:: ../!, W DISTRICT SUB. j- .... /,!: ~ ,/25' TYPE OF BUILDING LAND j IMP TOTAL (, ,~ - '_~_o ..... - -_ ..... AGE NEW Form Tillable Tillable 2 Tillable 3 FARM DATE Acre i Value Per Acre Woodland Swo mp lt~rrd~-~ Ih ushland ABOVE Value House Plot Total REMARKS ' Foundahon' M. Bldg. ~'" ~ ' -'? ~ 2 ,~ ~0 ~<~,~ , ¢'- Extension /.?' ~/ .~' ,_~ -~ /, tJ 0 ? ~ Basement Extension [ E . II Extension Fire Place Porch it : Interior Finish "' ,,) . ~ ~ Heo.t Attic Porch Rooms 1st Floor Breezewo Patio Rooms 2nd Floor Driveway 83 Dorchester Road Rockville Centre, NY (516) 766-4160 George V. Germano, P.E Engineering/Consulting Property Management Home/Building Inspections Damage Assessments Root Cause Analysis Energy Management Mrs. Carol Safir 215 East 68th Street Apartment 30E New York, NY 10021 August 10, 2000 Mrs. Safir: As you requested, I have inspected the bathroom addition to your property located at 3121 Oaklawn Avenue in Southhold, New York to determine if several aspects of the new bathroom meet certain building code requirements. My investigation of the foundation and insulation systems has determined that the foundation is a minimum of 36" below grade, walls are insulated to R19 and the ceiling is insulated to R30. Please feel free to call me if you have any questions regarding this matter. AlSo, keep in mind that We have a staff of engineers, technicians, energy and environmental professionals who can assist you with all your technical needs. George V. Germano, P.E. A__p~lication for Buildinq Permit Howard and Carol Safir Private Road 3 (off Oaklawn) PLAN: 1. Remove existing living room window and replace with 8' sliding glass door. 2. Remove existing bedroom window and replace with window removed from living room. 3. "Square off" southeast corner of existing structure with an addition of approximately 3' by 9'. Existing roof line of structure followed. 4. Electric outlet to be installed at end of dock (marine outlet). Ail work to be done to code. Property is located in flood zone "C". r-edo / ~ c e-~ . SEP-29-1997 10:43 P.O1 September 30, 1997 TO: GARY FISH FROM: CAROL SAFIR RE: BUILDING PERMIT Dear Mr. Fish: The shell of our 3'x 9' addition is near completion. We have discovered that by installing a pocke~ door the space can house a bath area to include a toilet, small sink and stall shower. Therefore, we would like to clarify and ammend our permit for the installation of the fixtures. The plumber/electrician is Thomas ~. Ball of Southold at 765-1412. Please advise us if you need further information. Mr. Ball intends to begin the rough work by the end of this week. He is licensed as both a plumber and electrician. Thank YOU Carol Safir 212-535-1106 212-535-1630 (FAX) Property in Southold is 303 Private Road ~3. TOTAL P. 01 M~R-~O-1997 Bi:OB P.O1 TO: GARY FISM FROM: CAROL SAFIR MARCH 20, 1997 Dear Garyl When we spoke yesterday I had not heard back from the insurance agency which handles the flood policy on our house. They called this morning, returning my call and ~ asked them if they could provide me with verification of the flood zone. They faxed me the following letter and copy of the previous owner's premium notice for verification. Mf husband and I ~Qok over the existing policy and we have not yet r~ce~Ved our copy of the policy. If this ks sufficient for your records, it '~is easier than sending off a copy of the entire appraisal, we are trying to go out of town for a week or so in hopes of easing my husbnnd's recuperation from his recent surgery,. If the l~tter and premium notice suffice and you can go forward with the permit, ! w~11 put the paperwo~'k together and see you~ the first week in April. If you need something else, please let me know. I'll gladly bring in whatever when I come in. · ~ Thanks for youz help- I can be reached by phone a~ 212-535-1106 Or by FAX a~ 212..535-1630... F.~X may be best as I have ~he phone off when my husbau4 is n~pping. ', ~ Best regards, MAR-~O-1997 01:05 P.O1 ROLLINS 1.15 B~edfoKl Reed, [~oo~h, Ncw't'~'k 10536 * 914 -Z3Z'~I00 * F~*: 914-Z3Z-SU0~ March 20, 1997 Howard & Caro~ Safir 215 East 6$th SC. Apt New York, NY 10021 Re: Flood Insurance for: OaklawnAvenU~, Southold, NY 11971 Dear Mr. & Mrs. Saflr: Attached is a copy of the flood insurance coverage for the above proper=¥. The endorsement correcting t~e flamed inaured to you hae been issued and you will be receiving it ehortly. 'x~nis letter ~ill confirm tha= =he property is located in Flood Zone C. If you have any questions, please ~eel ~ree to call me. Pere0nal Risk Manager LDA/16872~ Andres-Forbes lasunmcc The Rollins Agenc~ Inc.. Katonah. NY · Ligbd~ou~ Point, FL · 'li~ckahoe. NY Ltd. TOTAL P. 81 MAR-20-199? ~l:~a P.02 - ' ' - IMPORTANT - YOUR FLOOD }~URAN~CY W~ EXPIRE SEE REVERSE F~NSTRUCTI~~,~ f'~ . . ~ --~'., X~PORTANT-- DO NOT PAY--- THIS ZS NOT A BXLL~ AGENT COPY ONLY BU~I. OIN~I mvm,~e ~,de. MAXIMUM INSURAN~ AV~LABLE - ~D;~: ~'~'HE ROLLINS AGENCY INC kS MAIN ST ~' kEVER~ NDE -]~A~ST A MADDAHS* --1 ~q-9 HERITAGE 'I.~LCS~,, SOMERS ''NY iTUCKAHOE NY ~0707 .. , ~ PREMIUM INCLUDES THE FEDERAL POLICY $ERVICE'F~E OOS~OkOeflG~ ~S?3~&qqo9 0o &o0oaosq00.ooa u, moooqo oo '~' O~ACHH~ Iq-OOD INIURANCERENEWAL PRF.~IbM NO~'JC8 ,).i ,~ · o~.~-'Y.: 1.-S?3E-a'q, 0-0 ~: REGULAR c°""uarr~.]3ka,Sl, 3O0?~k.ge C '~ O~-O;].qk ~,':: ~ SE-' ~lt~t/rm'~t $;o~ POR INSTaUCTtONS TOTAL PREMIUM DUE ONE V~ O~ r, TH~ Y~R O~ ~HE~ BOX AT, ~ B~, ~ ~ F~ Aetna ,-c~ ~s E~cr PqEM;U~ 5MOWN FOR ~ A~O ~C~Y: ~ TO MM ~ ZMPOqTANT-- DO NOT PAY-- THX5 IS NOT A BILL-- AGENT COPY ONLY OosEabo~qbE ~s?3eBqqOO 00laOODDO3qOODOO~aMOOO0qD~OO · Jew~York State Department of Environmental Conservation D~vision of Environmental Permits Building 40 - SUNY, Stony Brook, NY 11790-2356 Phone (516) ~. ~. ~0365 Fax # (516) ~.~/.~0360 Commissioner July 25, 1997 Howard and Carol Safir 215 E. 68th Street, Apt. New York, NY 10021 30E RE: 1-4738-01659/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions .carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit Sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, Charles T. Hamilton Permit Administrator CTH:cg enclosure GENERAL CONDITIONS Inspectipns The permitted site or facility, including relevant records, is subject to in- spection 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 represen- tative may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). 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. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. Permit Changes and Renewals 2. The Department reserves the right to modify, suspend or revoke this permit when: 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 regula- tions 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. 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, fees or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. ~ne permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Elimination System (SPDES). Hazardous Waste Management (HWMF), major Air Pollution Control (APC) and Solid Waste Facilities (SWMF): and b) 30 days before expiration of all other permit types. Discharge Facilities Management Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination perviously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. Other 6. Legal Obligations of Permittee The permittee has accepted expressly, by the execution of the application, the full legal responsibility for all damages, direct or indirect, of whatever nature and by whomever suffered, arising out of the project described in this permit and has agreed to indemnify and save harmless the State from suits actions, damages and costs of every name and description resulting from this project. This permit does not convey to the permiitee 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. " The mermittee is responsible for oDtalning any other permits, approvals, lands. eas~ents and rights-of-way that may be required for this project. Page 2 of 4 ,7 ?HU ~:27 ?~ ROLLINS AGE}ICY FAX NO. S14 232 5069 R LLINS 135 Bedford Road, Katooah, New York 10536 ',' 914-232-7100 ~' Fax: 914-232-5069 P. 2 March 20, 1997 Howard & Carol Safir 215 East 68th St. Apt New York, NY 10021 30E Re: Flood Insurance for: Oaklawn Avenue, Southold, NY 11971 Dear Mr. & Mrs. Safir: Attached is a copy of the flood insurance coverage for the above property. The endorsement correcting the named insured to you has been issued and you will be receiving it shortly. This letter will confirm that the property is located in Flood Zone C. If you have any questions, please feel free to call me. Lpea'~srcanDa~ RATsh~rManager LDA/168728 Andrcs-F0rbcs Insurance The Rollins Agency, Inc. Katonah, NY * Lighthouse Point, FL * Tuckahoe, NY Robert W. Sundenna~n Ltd. FLOOD INSURANCE RENEWAL PREMIUM NOTIC[~9 C]4/18/96 POLICY FL: 1-5732-8940-0 JANET A MAD~AM$ OFF .0AKLAWN AVE SOUTHHOLD NY IMPORTANT- YOUR FLOOD Ifl~URAN~CICY WILL EXPIRE SEE REVERSE FOR INSTRUCTIONS B BUILDING CONTENTS 56~40[ Ihe incme, sinO vsl~.~ of your ~rop~. If ~his amount still revere gido. CONTENTS TOTAL PREMIUM DUE At YEA. 180 · 00 A3 V~-AR 390.00 TOTAL PREMIUM DUE m YEAR 184 · 00 B3 YEAR 401o00 MAXIMUM INSURANCE AVAILABLE- BUILDING: 25 [19 00~ONTENTS; 1 000 9 0 000 SEE # 4 REVERSE SIDE J-~HE ROLLINS AGENCY INC IJ'ANET A MADDAr'Is 65 MAIN ST 614-B HERITAGE HILLS SOMERS NY 100589 ,TUCKAHOE NY 10797 ~ ....... .?. *~* .. L_ .... ..,.,.,....,....... ..... .....,-.. E , Ao ~{.- ~'(;ENT' =~= PART A PAYOR COPy - RETAIN FOR YOUR RECORD5 ~ ~= PRE~IUI4 INCLUDES THE FEDERAL POLICY SERVICE FEE =.~ 09520692962 1573289400 0018000003900000184000040100 DETACH HERE FLOOD INSURANCE RENEWAL PREMIUM NOTICE 'OLICY FL; 1-5732-8940-0 ,GENT'S NAME: DETACH HERE pLAN: REGULAR COMMUNITY: 3608130078E ZONE: C EFFECTIVE DATE 05/23/96 A1 06-02-96 ONE YEAR OPTION [] 180.00 B1 [] 184.00 r~ANET A MADDAM$ A-Y TOTAL PREMIUM DUE THREE VEAR OPTION A3 [] 390.000 B3 ~l 401.000 -1 614-B HERITAGE HILLS SOMERS NY 10589 3. MAIL BY TO AVOID DELAY: MAIL TO Aetna Flood Insurance program, P,O. Box 70302, Charlotte, NC 28272-0303 INSURED NAME & MAILING ADDRESS IMPORTANT-- DO NOT PAY-- THIS IS NOT A BILL-- AGENT 00520602962 ~ AFP-25 (5-94) ROPY ONLY 15732894000 0018000003900000184000040100 ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (Title 5}, 24, 25, 34 and 6 NYCRR Part 608 ( v~,ltefs or flood flows or endanger the health, safety or welfare of Ihe peo01e of the Stale. or cause loss or destruction of the natural revocation of this permit, the structure, flU, excavation, or other modificauon of the watercourse hereby authorized shall not be com- 15 Dieted. the owners, shall, without expense to the State, and to such Conservation may require, remove all or any portion pi the uncompleted structure or fill and restore to ~ts former condition the navigable and flood capacity of the watercourse No claim shail be made against the State of New York on account o~ any such removal or alteration. l0 That the State of New York shah in'no case be liable for any damage 16 or miurv to the structure or work herein authorized which may be caused bv or result trom future operations undertaken by the State for the 11 Granting of this permit does not relieve the applicant of the responsi- 17 ~he US ~,rmy CorDs of Engineers. US Coast Guard, New York State Tidal Wetland other environmentally deleterious materials associated with the prolect 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 hanks o~ a waterway There shall be no unreasonable inted:erence with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the proiect 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 £nvironmental Conservation may require, remove ail 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 If granted under 6 NYCRR Part 608, the NYS Department of I~nviron- mental Conservation hereby certifies that the subject proiect wi[[ not contravene effluent limitations or other limitations or standards under Sections 301. 302. 303, 306 and 307 of the Clean Water Act of 1.977 (PL 95-217) provided that all of the conditions listed herein are met. 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 H.C. Safiir on June 20, 19 SPECIAL CONDITIONS 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. 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. Supplementary Special Conditions (A) through (F) Attached 1-4738-01659/00001 Page 3 of 4 SUPPLEMENTARY SPECIAL CONDITIONS Th~ following conditions apply to all Tidal Wetlands; Freshwater Wetlands; Coastal Erosion Management; and Wild, Scenic, and Recreational Rivers Permits: ao Bo A copy of this permit, including all conditions and approved plans, shall be available at the project site whenever authorized work is in progress. The permit sign enclosed with the permit shall be protected from the weather and posted in a conspicuous location at the work site until all authorized work has been completed. The permittee shall require that any contractor, project engineer, or other person responsible for the overall supervision of this project reads, understands, and complies with this permit and all its general, special, and supplementary special conditions. 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. If any of the permit conditions are unclear, the permittee shall contact the Division of Regulatory Affairs at the address on page one or telephone (516) 444-0365. If project design modifications become necessary after permit issuance, the permittee shall submit the appropriate plan changes for approval by the Regional Permit Administrator prior to undertaking any such modifications. The permittee is advised that substantial modification may require submission of a new application for permit. 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 the permitted work, the bottom portion of that form shall also be signed and returned, along with photographs of the completed work and, if required, a survey. For projects involving activities to be undertaken in phases over a period of more than one year, the permittee shall notify the Regional Permit Administrator in writing at least 48 hours prior to recommencing work in subsequent years. The granting of this permit does not relieve the permittee of the responsibility of obtaining a grant, easement, or other necessa~t approval from the Division of Land Utilization, Office of General Services, Tower Building, ~pire State Plaza, Albany, NY 12242 (516) 474-2195, which may be required for any encr~ac.~ment upon State-owned lands underwater. DEC Permit No. 1-4738-01659/00001 Page 4 of 4 95 201 (8187)--9d New York State Department of Environmental Conservation 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 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. Permit Number Expiration Date Regional Permit Administrator NOTF: T~is noH¢~ is ~OT a FORN NO. I TOI, TN OF SOU~IOLU BUILDING DEPARTHENT TOWN llAl,l. SOUTIIOLD, N.Y. 11971 TEl,: 765-1802 BOAllll OF llEALlll ............... '3 SETS OF PLANS ............... $11RVE¥ .,.;.:~ ........... ~ ..... CIIECK ........ ~ ................ SEPTIC FOEN ................... INSTRUCTIONS a. 'lids applicatlon mast be conpletely filled in lry ~yp~*riter or in ink ~ ~ittM to O~ ~dlding Ink.tar with 3 ~ts of plus, acetate plot pl~ to scale. F~ acco~li~ to b. Plot plan M~i~ l<atlm of lot ~ of ~dldi~a ~ w~i~s, ~lati~shlp to Mjolni~ struts or areas, ~ 81vi~ a {btallM ~mrlpti~ of l~t-o[ ~r~ mst be dram d. U~ al~,t~al of this a~llcati~, tbe ~ildi~ InSerat will is~ a ~ildi~ ~{t to the ~li~nt. ~h ~mlt ~mll Im kept ~ tl~ pl~,[~s ~ilable for ins~ti~ th~t the ~rk. e. ~ildl~ ~mll be <~iM ~ uM inO~le ~ in ~rt for ~ ~mdmt~r tmtll A~.IC~'FI{~ 1S I~ ~E to tl~ Mildi~ ~prmnt for tbe ismmme of a ~dldi~ Pemlt ~rm, nt to the ~dldi,~ 7~ ~lism~<e of ttw ~ of ~tl~ld, ~[[olk ~L% ~ Fork, aal otl~r ~Ilcsble I~, ~lis~es or ~datlms, .for tbe ~st~tlm of I~dldi~s, a~ltlms or ~lter*tlms, ~ fe ~,wal or ~lltlm, ss I~reln ~b<ril~l. ]lw *~l. lc~t a~s to ~ly with stl ~llcsble I~, ~i~es, Mildi~ re~latlms, ~1 to ahlt m~tlmrlr~l in--tore m ~i~s md in ~dldi~ for ~essa~ IJNDBNVR~RS CERTIRCATE REQUIRED (Signature of applicant, or nane, if a corporatirm) ...215..E... fi 8.th..S.t.. N ..~.12 ...N.. ~.. 1.0 Q2 l.. (l~ailln8 a<klress of applicant) State wl~etber applicant is ¢r~er, les.~ee, agent, arch{tect, ehglneer, ~ral c~tractor, el~trleian, plier or In~ihler. ........... qxo r ....................................................................... .......... ~a---E----r o[ ~tm. Howard and Carol Saflr ~~~1~ ,~: ~, ~,~ - I, .............................................................. =~'~'~;~'--'~"~*/~JZ .... (as ~ tbe t~ roll ~ latest d~) ~R:" {,fi- ~ '/ /~"' N~ l~ ~ ~ If nH)licit is a ~rati~, si~tt~ of {hlly m]tl~riz~l officer. 768-1~ I ~ ~ 4 ~ ~ ~ USE IS UNLAWFUL ........ WITHOUT CERTIFICATE. .... OF'OCCUPANCY El ect r J c},'m.q License .................. Dlber 'l'rr~le'a l,lcen~e No...'-J'.~ ~ ............ FO~ ~ ~ FOUNOmlON - lWO IBQUIIIIO FO. 3. INSUI.ATIO~ 4. FINAL o CON~'RI~ION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION {HAU. THE REOUIREMENT$ OF THE N.Y. ~TATE CON~TflUCT~ON CODES. NOT RESPONSffiLE FOR 1. t~catlc, of lm~J on ~hlch Imopo,,~] work will be (off Oaklawn Ave) Southold lk~ ~r St~t l~et C~,ty T.x mp ~. I~ ~tlm ..... ~ ...... ,l~ ..... ~. ........ ~t ...l.P .......... ~lMivisim ...................................... FiI~ ~*p a~ ................ lot ............... (~) 2. State exiski~ um a~ ~ of ~i~s a~ inte~ a. Exlsti~ urm ~ ~a~ ........... ~¢~¢~..~¢~ ................................................. b. ~.t~ um ~ mo~ ........... 5¢~FZ~9~9~O..gP¢~ ..................................... ............................. I~ldh .............. I(). I~lle ()f I~lt'i:hn~ .... 12/31/96 ~.~. ()f F()l.er ~r . Ha~dams 5167659125 1~ I,(YI' I) TACllAH hx:~lle cie.dy flfxl (I. ist:inct:ly alt I.lil(li[~s, ~ltetl~er existin8 or proix~se*l, taxi i~xHcflte ~11 set-h~.:k cJi.'~mi(.m ~.~,elh(!l i.t(:J i()r c)r ~:()II~Z~I' ]lOt:.I It,! i. Il.; ..................... .~...~O..Ip~..~J ................................................................... Ih;Il the .,k .ill t~ le[l:Ofll~l lit II1~ II~lUieF ~et forth i, Ihe ,pl~l i(:~ll:[(), filed Ilierc~iLIi. ....... ~..: ........ ,,,,~ .~/~...~.~. NYSOEC / APPROVE[I ..~o .,..