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 .,..