The URL can be used to link to this page

Home My WebLink About33887-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-33551 Rte: 02/18/09 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 805 BAY SHORE RD GREENPORT (HOUSE NO.) (STREET) (HAMLET) County Tax Map NO. 473889 Section 53 Block 3 Lot 10 Subdivision FiledMap No. __ LOt NO. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated APRIL 29, 2008 pursua/lt to which Building Petit No. 33887-Z dated mY 12, 2008 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 ALTERATIONS AND ADDITIONS, INCLUDING DECK, UNHEATED SUNROOM AND ATTACHED TWO CAR GARAGE AS APPLIED FOR. The certificate is issued to WILLIAM & CHRISTINE EISENREICH (OWNER) of the aforesaid building. SUFFOLK COliCkY DBP~T~T OF }~ALTH~PPRO~-AL N/A E~.RC~RICAL C~ERTIFICATH NO. 4008061 12/02/08 CERTIFICATION DA'r~ 02/14/09 CUTCHOGUE EAST PLUMBING uth~ized Signature Rev. 1/81 Form No. 6 TOWN OF SOUTItOLD BUILDING DEPARTMENT TOWN HALL 765-1802 CATION FOR CERTIF'ICATE OF OCCUPANCY 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 Appwval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fi.om 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. Commercial building, industrial building, multiple residences end similar buildings and installations, a certificate of Code Compliance from architect or en~neer responsible for the building. 6. Submit planning Board Approval of completed site plan r~quirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" laud uses: 1. Accurate survey of property showing all property tine% streets, building and unnsual natural or topograplxic features. 2. A properly completed application and consent to inspect signed by the applicant. If a CeRificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees t. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25~!~0, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing B)~ilding - $100.00 3. Copy of Certificate of Occupancy - $.25/" 4. Updated Certificate of Occupancy - $5G.00 5~~ Temporary Certificate of Occupancy -q, esidential $15.00, Commercial $15.00 New Construction: Location of Property: Old or Pre-existing Building: (check one) House No. Street Owner or Owners o f Property.'~'~__ ~ L..I ~ Suffolk County Tax Map No 1000, Section ~ ~-~ Subdivision Permit No. ~ Date of Permit. '~ -<~ --~ Hamlet Block OZ Lot Filed Map. Lot: Applicant: '-~-~n,o~.~5 ['-~. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Suh tted:, Underwriters Approval: Final Certificate: J (check one) Y Apphcant Signature [] BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by SJ OCONNOR ELEC. CONT. CHRIS EISENREICH 1195 SHIPS DRIVE 805 BAY SHORE RD $OUTHOLD, NY 11971 GREENPORT, NY 11944 Located at 805 BAY SHORE RD GREENPORT, NY 11944 Application Number: 4008061 Certificate Number: 4008061 Section: Block: Lot: Building Permit: . BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Attached Garage, Outside, 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 authority having jurisdiction, and found to be in compliance therewith on the 2.d Day of December, 2008. Name OTY Rate Rating ~ircuit~ TYPg Alarm and emergency equipment Sensor I 0 0 Carbon Monoxide Sensor 3 0 0 Smoke Appliances and Accessories Electrical Heat Baseboard 1 0 .25 ~ Furnace I 0 Oil ..-1 Panels ~ 1 100 16 Wiring And Devices Fixture 9 0 Fluorescent Fixture 20 0 Incandescent Outlet 29 0 Fixture Outlet 57 0 Gen, Purpose Paddle Fan 1 0 Receptacle 1 0 20a-ac Appliance Receptacle I 0 20a-laundry Appliance Receptacle 1 0 30a Dryer Receptacle 4 0 GFCI seal Continued on Next Page I of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. BY THIS CERTIFICATE OF COMPLIANCE THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY 40 FULTON STREET ~ NEW YORK, NY 10038 CERTIFIES THAT Upon the application of upon premises owned by Sj OCONNOR ELEC. CONT. CHRIS EISENREICH 1195 SHIPS DRIVE 805 BAY SHORE RD SOUTHOLD, NY 11971 GREENPORT, NY 11944 Located at 805 BAY SHORE RD GREENPORT, NY 11944 Application Number: 4008061 Certificate Number: 400806,1 Section: Block: Lot: Building Permit: . BDC: ns11 Described as a Residential occupancy, wherein the premises electrical system consisting of electrical devices and wiring, described below, located in/on the premises at: First Floor, Second Floor, Attached Garage, Outside, 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 authority having jurisdiction, and found to be in compliance therewith on the 2nd Day of December, 2008. Name OTY Rate Rating Circuits Twe Receptacle 30 0 Gen, Purpose Switch 30 0 C-eh, Purpose seal 2 of 2 This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. Fax (5'16) 7§5-iI~23 ie~ephone (516) 765-1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOLITHOLD CER~ I F i C AT I 0 N ' I (please print) (please print) i certify that the solder used in the water supply aystem contains less than 2/10 of 1% lead. Sworn to before ___IL/¥ Notary Public~ ers Sfgnature) Notar~ PulPit, Sta~ of New York No. 01.¥A6185177 Cemm~alh'ied in Suffolk Coant/ ission Expires April 28, 2014 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE # 0398C Date January 30, 2009 THIS CERTIFIES that the two-stor~ addition and greenhouse addition to the existing single- family dwelling, reconfit, uration of the driveway, and roof drainage system At 805 Bay Shore Rd., Greenport Suffolk County Tax Map #53-3-10 Conforms to the application for a Trustees Permit heretofore ~ed in this office Dated 8/17/07 pursuant to which Trustees Wetland Permit #6744 Dated 10/17/07 was issued, and conforms to all of the requirements and conditions of the applicable provisions of law. The project for which this certificate is being issued is for a two-story addition and greenhouse addition to the existing single-family dwelling, reconfiguration of the driveway, and roof drainage system. The certificate is issued to WILLIAM & CHRISTINE EISENREICH owner of the aforesaid property. Authorized Signature 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. 33887 Z Date MAY 12, 2008 Permission is hereby granted to: WILLIAM L EISENREICH 9 OREGON DRIVE HUNTINGTON STA,NY 11746 for : ADDITIONS/ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR PER TRUSTEES, DEC NJ, WITH FLOOD PERMIT AS APPLIED FOR at premises located at 805 BAY SHORE RD GREENPORT County Tax Map No. 473889 Section 053 Block 0003 Lot No. 010 pursuant to application dated APRIL 29, 2008 and approved by the Building Inspector to expire on NOVEMBER ~Lr-,20CD.-~-.._~ ~ Fee S 659.20 ~~/~_ ~rizedSig ature~ut ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ]FOUNDATION 2ND [ ] IN~J~ATION [ ]FRAMING/STRAPPING [/,/]'FINAL [ ]FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ]FIRE RESISTANT CONS'II~UCTION [ ] FIRE RESISTANT PENETRATION REMARKSj,~ ~ -- DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [~]~INSULATION []FRAMING/STRAPPING []FINAL []FIREPLACE&CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~~ DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION FOUNDATION 1ST [/,,']~ROUGH PLBG. ] F/OUNDATI ON~2ND-..~ [ ]INSULATION FRAMIN~ [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARK :~~~[ ]FIRERESI.~S~CONSTRUCTION~,~[ ] FIRE RESISTANT PENETRATION DATE TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST ~'ROUGH PLBG. [ ]FOUNDATION 2ND [ ]INSULATION ~FRAMING S~RA~I~-~ [ ]FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRATION TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION ] F~DATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ]FRAMING / STRAPPING [ ]FINAL [ ]FIREPLACE & CHIMNEY [ ]FIRE SAFETY INSPECTION [ ]FIRE RESI~I'AN~NS~UC~ I~ON,_ ~,/] FIRE~ANT PENETRATION REMARKS. ~--~~~ DATE ~/(~'~ ~/(~)~ INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-t 802 , INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. ] FOUNDATION 2ND ] FRAMING / STRAPPING ] FIREPLACE & CHIMNEY [ ] INSULATION [ ] FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: ~/~-~r ~-~q~--~ ~ ~ DATE I~, ~ '/' r'~ ,~- ~.-~. ~'~J ...................................... ' ~S~ATIO: PER N. Y. STATE RN[RGY CODE x ~ , ~o~ Co~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Approved ,20 Disapproved a/c Expiration ,20__ PERMIT NO. Building Inspector BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey( Check Septic Form N.Y.S.D.E.C. Trustees Storm-Water Assessment Form Contact: Mail to: ~'~ Phone: APPLICATION FOR BUILDING PERMIT Date~--- INSTRUCTIONS ,200 8 a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 Permit. 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 Cei~ificate 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. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,.'"'7 ~' /Q (S~mre of applicant or name, if ~ corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises <,,0' ~t..l,o,~.,,, ~15 (°.JA~IB~-I ~ t~_.t~l~dl~--lr~l-[ (As on the tax roll oi- latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. ~i- ?--~-~ci' -' H Plumbers License No. Electricians License No. Other Trade's License No. Location of land.._9,n which_proposed work.&vill be done: House Number ~ Street County Tax Map No. 1000 Section Subdivision (Name) Hamlet -~'~ B}ock -~ O~ Lot ~'" Filed Map No. . -. i Lot State existing use and occupancy of premises and intended'use an~l occupancy of proposed construction: a. Existing use and occupancy ?2,_l~C~ ~" "~r~t..,,( ~-.~"S ~fS~-v'~C~-~ b. Intended use and occupancy ,~_ ~ ~,L 3. Nature of work (check which applicable): New Building_ Repair Removal Demolition 4. Estimated Cost ~,~'] ~ OtZ)O Fee 5. If dwelling, number of dwelling units [f garage, number of cars Addition Other Work Alteration (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. ! 7. Dimensions el>existing structures, if any: Front ~ I · '~ Bear ~ {' ~ Depth Height. '~ ' Number of Stories ~ . ~ 44,5' Dimensions of same structure with alterations 8. Dimensions of en_Lil;e new construction: Front Height ~' Number of Stories 9. Size ofiot:Front J(~t Rear l additions: Front '-~ l, 5 Rear Number of Stories 1. ~ Depth J 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO~/ - / 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES NO 14. NamesofOwnerofpremises~lSe~og~,)C~X Addrcas ~r,~*~ ~, 'O*~ho,~eNo. (.-/3- 4416 NameofArchitect ~-i~o,o ~'l.~'t_. Address ,Iml~ NameofContractor-T~,~ ~.~o~wo.~ Address los t~c-, 15 a. Is this property within 100 feet ora tidal wetland or a freshwate[/wetland? *YES~ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMIT~yfvlAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES b/ 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. 18. Are there any covenants and restrictions with respect to this property? * YES __ NO / · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) '"T--~L~FF~J~.~ ~, [~_x.j~ ~ being duly sworn, deposes and says that (s)he is the applicant ' (Name of individual signing contract) above named, (S)He is the (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 [t~ dayof (~ ~Q~l~i I 20 O~ I~RSARA H. TANDY Signature of Applicant Notary Public, State Of New Yo~ No, 01TA6086001 Qualified In Suffolk Cou~ ~ ~ Commission Expires 01/13/'20 ~ Permit Number Checked By/Date REScheck Compliance Certificate New York State Energy Conservation Construction Code REScheckSofiware Version 3.5 Release 1 Data filename: C:~Program FilesSCheck\REScheck'~Eisenreich Residence.rck TITLE: EtSENREICH RESIDENCE COUNTY: Suttblk STATE: New York HDD: 5750 CONSTRUCTION TYPE: Detached I or 2 Family HEATING TYPE: Non-Electric DATE: 11/20/07 DATE OF PLANS: November 20, 2007 COMPANY INFORMATION: Donald G. Feller - Architect COMPLIANCE: Passes Maximum UA = 242 Your Home UA = 190 21.5% Better Than Code (UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor JlA Ceiling 1: Flat Ceiling or Scissor Truss 903 30.0 0.0 Wall 1: Wood Frame, 16" o.c. 1453 21.0 0.0 Window 1: Wood Frame:Double Pane with Low-E 173 Door I: Solid 20 Floor 1: Ail-Wood Joist/Truss:Over Unconditioned Space 277 21 0 0.0 Floor 2: Ail-Wood Joist/Tress:Over Outside Air 576 38.0 0.0 0.320 0.190 32 72 55 4 12 15 COMPLL~qCE STATEMENT: The proposed building represented in this document is consistent with the building plans, specifications, and other calctflations submitted with this permit application. The proposed systems have been designed to meet the New York State Energy Conservation Construction Code requirements. When a Registered Design Profkssional has starlUx.and signed this page, t]~y are attesting that to the best of his&er-- --kn°wledge' belief: and B uild~erfDesign~~professional jug plan eati are in compliance with thiSDateCOde__/~/~) James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 October 17, 2007 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. & Mrs. William Eisenreich 9 Oregon Drive Huntington Station, NY 11746 RE: 805 BAY SHORE ROAD, GREENPORT SCTM# 53-3-10 Dear Mr. & Mrs. Eisenreich: The Board of Town Trustees took the following action during its regular meeting held on Wednesday, October 17, 2007 regarding the above matter: WHEREAS, WILLIAM & CHRISTING EISENREICH applied to the Southold Town Trustees for a permit under the provisions of Chapter 275 of the Southold Town Code, the Wetland Ordinance of the Town of Southold, application dated August 17, 2007, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council and to the Local Waterfront Revitalization Program Coordinator for their findings and recommendations, and, WHEREAS, the LWRP Coordinator recommended that the proposed application be found Inconsistent with the LWRP, and, WHEREAS, the Board of Trustees has furthered Policy 5 & 6 of the Local Waterfront Revitalization Program to the greatest extent possible through the imposition of the following Best Management Practice requirements: the installation of gutters and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code- Storm Water Runoff, a line of staked hay bales to be installed prior to construction along the 9' contour line, and WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on October 17, 2007, at which time all interested persons were given an opportunity to be heard, and, WHEREAS, the Board members have personally viewed and are familiar with the premises in question and the surrounding area, and, WHEREAS, the Board has considered all the testimony and documentation submitted concerning this application, and, WHEREAS, the structure complies with the standards set forth in Chapter 275 of the Southold Town Code, WHEREAS, the Board has determined that the project as proposed will not affect the health, safety and general welfare of the people of the town, NOW THEREFORE BE IT, RESOLVED, that for the mitigating factors and based upon the Best Management Practice requirement imposed above, the Board of Trustees deems the action to be Consistent with the Local Waterfront Revitalization Program pursuant to Chapter 268-5 of the Southold Town Code, and, RESOLVED, that the Board of Trustees approve the application of WILLIAI~I & CHRISTINE EISENREICH to construct a two-stow addition and greenhouse addition to the existing single-family dwelling, and re-configure the existing driveway, with the condition of the installation of gutters and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, a line of staked hay bales to be installed prior to construction along the 9' contour line, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated November 11,2007, and received on November 20, 2007. Permit to construct and complete project will expire two years from the date the permit is signed. Fees must be paid, if applicable, and permit issued within six months of the date of this notification. Inspections are required at a fee of $50.00 per inspection. (See attached schedule.) Fees: $100.00 Very truly yours, James F. King President, Board of Trustees JFK/eac BOARD OF SOUTHOLD TOWN TRUSTEES SOUTHOLD, NEW YORK PERMIT NO. 6744 DATE: OCTOBER 17~ 2007 ISSUED TO: WILLIAM & CHRISTINE EISENREICH PROPERTY ADDRESS: 805 BAY SHORE ROAD~ GREENPORT SCTM# 53-3-10 AUTHORIZATION Pursuant to the provisions of Chapter 275 and/or Chapter 111 of the Town Code of the Town of Southold and in accordance with the Resolution of the Board of Trustees adopted at the meeting held on October 17, 2007, and in consideration of application fee in the sum of $250.00 paid by William & Christine Eisenreich and subject to the Terms and Conditions as stated in the Resolution, the Southold Town Board of Trustees authorizes and permits the following: Wetland Permit to construct a two-story addition and greenhouse addition to the existing single-family dwelling, and re-configure the existing driveway, with the condition of the installation of gutters and drywells to contain roof runoff and in accordance with Chapter 236 of the Town Code-Storm Water Runoff, a line of staked hay bales to be installed prior to construction along the 9' contour line, and as depicted on the survey prepared by Nathan Taft Corwin III, last dated November 11, 2007, and received on November 20, 2007. IN WITNESS WHEREOF, the said Board of Trustees hereby causes its Corporate Seal to be affixed, and these presents to be subscribed by a majority of the said Board as of this date. TERMS AND CONDITIONS The Permittee William & Christine Eisenreich, 805 Bay Shore Road, Greenport, New York, as part of the consideration for the issuance of the Permit does understand and prescribe to the following: That the said Board of Trustees and the Town of Southold are released from any and all damages, or claims for damages, of suits arising directly or indirectly as a result of any operation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and all such suits initiated by third parties, and the said Permittee assumes full liability with respect thereto, to the complete exclusion of the Board of Trustees of the Town of Southold. That this Permit is valid for a period of 24 months, which is considered to be the estimated time required to complete the work involved, but should circumstances warrant, request for an extension may be made to the Board at a later date. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maintain the structure or project involved, to provide evidence to anyone concerned that authorization was originally obtained. That the work involved will be subject to the inspection and approval of the Board or its agents, and non-compliance with the provisions of the originating application may be cause for revocation of this Permit by resolution of the said Board. That there will be no unreasonable interference with navigation as a result of the work herein authorized. That there shall be no interference with the right of the public to pass and repass along the beach between high and low water marks. That if future operations of the Town of Southold require the removal and/or alterations in the location of the work herein authorized, or if, in the opinion of the Board of Trustees, the work shall cause unreasonable obstruction to free navigation, the said Permittee will be required, upon due notice, to remove or alter this work project herein stated without expenses to the Town of Southold. The Permittee is required to provide evidence that a copy of this Trustee permit has been recorded with the Suffolk County Department of Real Properties Office as a notice covenant and deed restriction to the deed of the subject parcel. Such evidence shall be provided within ninety (90) calendar days of issuance of this permit. That the said Board will be notified by the Permittee of the completion of the work authorized. That the Permittee will obtain all other permits and consents that may be required supplemental to this permit, which may be subject to revoke upon failure to obtain same. James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD YOU ARE REQUIRED TO CONTACT THE OFFICE OF THE BOARD OF TRUSTEES 72 HOURS PRIOR TO COMMENCEMENT OF THE WORK, TO MAKE AN APPOINTMENT FOR A PRE-CONSTRUCTION INSPECTION. FAILURE TO DO SO SHALL BE CONSIDERED A VIOLATION AND POSSIBLE REVOCATION OF THE PERMIT. INSPECTION SCHEDULE ~'/Pre-construction, hay bale line 1st day of construction ½ constructed V/' Project complete, compliance inspection. New York State Department of Environmental Conservation [¥vision of Environmental Permits Building'40 - SUNY, Stony Brook, New York 11790-2356 / Telephone (616) ~.~.~ 0365 Facsimile (516) 444-0360 John P. Cahill Commissioner December 21, 1998 William& Christine Eisenreich 9 Oregon Drive Huntington Station, NY 11746 RE= 1-4738-02123/00001 Dear Para'tree= In conformance with the requirements of the State Uniform Procedures Act (Article ?0, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are rulable 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, G~WH/ls Enolosure George W. ~m~.~rth Permit Adm4nistrator NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION IDEC'PERMIT NUMBER 1-&738-02123/00001 FACILiTY/PROGILM4 RUMSER(S) PERMIT Under the EnviromtentaL C~servat ion Law EFFECTIVE DATE December 21r 1998 EXPIRATZOR DATE(S) December 31, 2003 TYPE OF PERMIT · Neu [] Renewal [] Modification n Pemit to Construct 0 Permit to Operate J 0 [] 0 [] O ArticLe 15, Title 5: Protection of Waters ArticLe 15, TitLe 15: Water SuppLy ArticLe 15, TitLe 15: Water Transport ArticLe 15, TitLe 15: Long lstaodWeLLs Article 15, Title 27: WiLd, Scenic and Recreational Rivers 0 6NYCRR 608: Water QuaLity Certification 0 ArticLe 17, TitLes ?, 8: SPDES FI ArticLe 19: Air PoLLution Control ArticLe 23, TitLe 27: Mined Lend Rectemation [] ArticLe 24: Freshwater WetLands · ArticLe 25: Tidal Wetlands 0 ArticLe 27, TitLe 7; 6NYCRR 360: SoLid Waste Management [] ArticLe 27, TitLe 9; 6NYCRR 373: Hazardous Waste Management [] ArticLe 34: Coastal Erosion Management FI ArticLe 36: Floodplain [] ArticLes 1, 3, 17, 19, 27, 3?; PERMIT ISSUED TO WiLLies and Christina Eisenreich ITELEPflONE #UI4BER (516) 997-3400 ADDRESS OF PERM[TTEE 9 Oregon Orlvef Huntington Stationf NY 117~6 CORTACT PERSOM FOR PERMITTED WORK TELEPHONE NUI4BER NAHE AND ADDRESS OF PROJECT/FACILITY Rorth Side of Bay Shore Roadf approximately 7'60 east of Kerwin BLvd.r Arshememaque LOCATiO~ OF PROJ£CT/FACILITY SCTM #1000-53-03-10 COUNTY I TOWN ~ATERCOURSE Suffolk I Southold Pipes Creek DESCRIPTION OF AUTHORIZED ACTIVITY: IMYTH COORDINATES E:719.8 N:4551.3 Construct a single famiLy d~etLing, septic system and drivemsy as sho~n on the 9/16/97 survey by Joseph Ingegrm, L.S., last revised 12/1/98 and staq)ed "NYSDEC Approved as per terms and conditions of Permit No. 1-4T58-0217.~/00001 12/17/98. By acceptance of this permit, the permittee agrees that the permit is contingent ~ strict compliance ~ith the ECL, aLL appLicabLe regulations, the General Conditions specified (see page 2 & 3) and any special conditions included as part of this permit. PERMIT ADMINISTRATOR: George W. Hammarth SIGNA~T~RE ,.~ IADDRESS BLdg. #40, SUNY, Stony Brook, NY 11790-2356 IDATE Oecelrber 21~ 1998 IPage 1 of 5 NEW YORK STATE DEPAR1MENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITFEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: Permit'tee to Require its Contractors to Comply with Permit The permittee shall require its independent contractors, employees, agents and assigns comply with this permit, including all special conditions, and such persons shall be subject to the same sanctions for violations of the Environmental Conservation Law as those prescribed for the permittee. Item C: Permittee Responsible for Obtaining Other Required Permits The permittee is responsible for obtaining any other permits, approvals, lands, easements and rights-of-way that may be required to carry out the activities that are authorized by this permit. Item D: No Right to Trespass or Interfere with Riparian Rights This permit does not convey to the permittee any right to trespass upon the lands or interfere with the riparian dghts of others in order to perform the permitted work nor does it authorize the impairment of any dghts, title, or interest in real or personal property held or vested in a person not a party to the permit. GENERAL CONDITIONS General Condition 1: Facility Inspection by the Department The permitted site or facility, including relevant records, is subject to inspection 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 representative may order the work suspended · pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a person to accompany the Department's representative during an inspection to the permit area when written or verbal notitication is provided by the Department at least 24 hours prior to such inspection. 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. General Condition 2: Relationship of this Permit to Other Department Orders and Determinations Unless expressly provided for by the Department, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirements contained in such order or determination. General Condition 3: Applications for Permit Renewals or Modifications 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 or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit 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 permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department 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 regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new matedal information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. DEC PERMIT NUMBER I PAGE 2 OF 5 1-4738-02123/00001 I PERMIT.'FVV, rev. 10/98 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 ( TIDAL WETLANDS) If future operations by the State of New York require an alteration in the position of the structure or work herein authorized, or if, in the opinion of the Department of Environmental Conservation it shall cause unreasonable obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of the people of the State, or cause loss or destruction of the natural resources of the State, the owner may be ordered by the Department to remove or alter the structural work, obstructions, or hazards caused thereby without expense to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation, or other modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore to its former condition the navigable and flood capacity of the watercourse. No claim shall be made against the State of New York on account of any such removal or alteration. The State of New 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. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other permission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended solids, sediments, fuels, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any other environmentally deleterious materials associated with the project. Any material dredged in the prosecution of the work herein permitted shall be removed evenly, without leaving large refuse piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. If upon the expiration or revocation of this permit, the project hereby authorized has not been completed, the applicant shall, without expense to the State, and to such extent and in such time and manner as the Department of Environmental Conservation may require, remove all or any portion of the uncompleted structure or fill and restore the site to its former condition. No claim shall be made against the State of New York on account of any such removal or alteration. If granted under 6NYCRR Part 608, the NYS Department of Environmental Conservation hereby certifies that the subject project will not contravene effluent limitations or other limitations or standards under Sections 301,302, 303, 306 and 307 of the Clean Water Act of 1977 (PL 95-217) provided that all of the conditions listed herein are met. 9. 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 project, the bottom portion of the form must also be signed and returned, along with photographs of the completed work and, if required, a survey. 10. 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 __ DEC PERMIT NUMBER 1-4738-02123/00001 PAGE 3 OF 5 NEW YORK STAT~ DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. To protect the values of the tidal wetlands, a permanent vegetated buffer zone shall be established. There shall be no disturbance to the natural vegetation or topography within an area extending 50 linear feet landward of the tidal wetland boundary. 2, A row of staked hay bales or approvable erosion control devices shall be placed at the landward edge of the buffer area at the commencement of regulated activities and remain in place until project is completed and all disturbed areas stabilized with vegetation. 3. Roof runoff shall be directed to drywells a minimum of 75 feet landward of the tidal wetland boundary for immediate on-site recharge. 4. Driveways and parking areas shall be constructed of pervious material. 5. Sanitary system (bottom of tank and leaching pools) shall be located a minimum of 2' above seasonal high groundwater. 6. There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activity. 7. All areas of soil disturbance resulting from this project shall be stabilized immediately following project completion or pdor to permit expiration, whichever comes first. The approved methodologies are as follows: a. Stabilization of the entire disturbed area with appropriate vegetation (grasses, etc.). b. Temporarily stabilized with straw or hay mulch or jute matting or other similar natural fiber matting within 1 week of final grading. Temporary stabilization shall be maintained until a mature vegetative cover is established. 8. If seeding is impracticable due to the time of year, a temporary mulch must be applied and final seeding performed at the earliest opportunity when weather conditions favor germination and growth, but not more than six months after project completion. 9. All disturbed areas where soil will be temporarily exposed or stockpiled for longer than one (1) week shall be contained by a continuous line of staked hay bales/silt curtain (or other NYSDEC approved method) placed on the seaward, side between the fill and wetland or protected buffer area. Tarps are authorized to supplement these approved methods. . 10. The storage of construction equipment and materials shall be confined to within the project work site and or upland areas greater than 50 linear feet from the tidal wetland boundary. 11. 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. 12. 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. 13. The project must comply with all local and federal flood plain regulations. 14. No fill shall be placed on this site without further approval from this Department. DEC PERMIT NO: 1-4738-02123/00001 PAGE 4. OF 5 NE~NYORK STATE DEPAR13dENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 15. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated tidal wetlands associated with Pipes Creek are located at the parcel located on the north side of Bay Shore Road, 762 feet east of Kerwin Blvd., Arshamomaque, Town of Southold, County Tax Map Number. Disb'ict 1000, Section 53, Block 03, Lot 10, othenvise known as the properties of William L. and Christine M. Eisenreich and their heirs, assigns, or successors. This property is subject to the provisions of New York State Environmental Consewation Law (ECL) Article 25 or its successor, and the conduct of regulated activities may occur only pursuant to ECL Article 25 if pdor approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor. Regulated activities include, but are not limited to the erection of any structure(s); excavation; dredging grading and filling; clearing of vegetation; and application of chemicals." This deed covenant shall be recorded with the Clerk of Suffolk County within 90 days of the issuance of this permit. A copy of the covenanted deed or other acceptable proof of record, along with the number assigned to this permit, shall be sent within one calendar year of the issuance of this permit to: NYSDEC, Regional Manager, Bureau of Habitat, SUNY Building 40, Stony Brook, New York 11790-2356. DEC PERMIT NUMBER 1-4738-02123100001 PAGE 5 OF ~ New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40 - SUNY, Stony Brook, New York 11790-2356 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www.dec.state.ny.us Edn M, Crotty Commissioner MODIFICATION TO PERMIT William & Christine Eisenreich 9 Oregon Drive Huntington Station, N.Y. 11746 January 27, 2004 Re: Permit # 1-4738-02123 / 00001 Eisenreich Property N/S Bay Shore Road, approx.760' East of Kerwin Blvd. Arshamomaque, Town of Southold SCTM # 1000-53-03-10 Dear Permittee: The Department of Environmental Conservation has completed its review of your November 20, 2003 request to extend the referenced Tidal Wetlands permit. We have determined, pursuant to the Uniform Procedures Regulations and the Tidal Wetlands Land Use Regulations (6 NYCRR Parts 621 & 661 respectively), that the permit may be extended. Therefore, the permit is hereby extended to new expiration date December 15, 2008. All terms and conditions remain as written in the original permit. This letter is an amendment to the original permit, and as such, must be available at the project site with the original permit and all approved plans whenever authorized work is being conducted. I can be reached at (631) 444-0371 if you have any questions or need to discuss this determination. Very Truly Yours, George W. Hammarth Deputy Regional Permit Administrator cc: BMHP N~w York State Department of Environmental Conservation Division of Environmental Permits, Region One Stony Brook University 50 Circie Road, Stony Brook, New York 11790 - 3409 Phone: (631) 444-0365 · FAX: (631) 444-0360 Website: www.dec.state.ny.us Alexander B. Grannis Commissioner MODIFICATION OF PERMIT William & Christine Eisenreich 9 Oregon Dr. Huntington Station, N.Y. 11746 August 10, 2007 Re: Permit # 1-4738-02123 / 00001 Eisenreich Property SCTM # 1000-53~03-10 N/S Bay Shore Road, approx. 760' East 0fKerwin Blvd. Arshamomaque Town of Southold Dear Permittee: The Department of Environmental Conservation has completed its review of your June 1, 2007 request to modify the referenced Tidal Wetlands permit to authorize changes in the design and orientation of the approved single family dwelling with attached garage and driveway. We hav~ determined, pursuant to the Uniform Procedures Regulations and the Tidal Wetlands Land Use Regulations, that the permit may be modified. Accordingly, the permit is hereby modified to authorize the construction of the single family dwelling with garage wing, decking, septic system and driveway as shown on the attached survey by Joseph A. lngegno, L.S. dated September 16, 1997, last revised May 25, 2007 and stamped "NYSDEC Approved Modification 8/10/07". All terms and conditions remain as written in the original permit. This letter is a modification of the permit, and as such, must be available at the project site with the original permit and all approved plans whenever authorized activities are being undertaken. I can be reached at (631) 444-0371 if you have any questions or need to discuss this determination. Thank you for your attention in this matter. Enclosure cc: BMHP file Sincerely, George W. Hammarth Deputy Regional Permit Administrator OWNER TOWN OF SOUTHOLD STREET N PROPERTY RECORD CARD VILLAGE DIST. SUB. ~/" LOT .~ ~' ,~/ ? ACR. ~ / TYPE OF BUILDING RES. ~l LAND SEAS. VL.~ IMP. TOTAL Tillable r DATE AGE BUILDING CONDITION NEW I NORMAL BELOW ABOVE FARM Acre Value Per Value Acre House Plot i CO 'MtM. CB. MICS. FRONTAGE ON WATER Woodland ~ i FRONTAGE ON ROAD Meadowland ~ i DEPTH BULKHEAD Total DOCK Mkt. Value 53-3~10 2/01 Extension ~Ex.te~psion Porch Porch Breezeway Garage Patio O.B. Total Foundation Basement Ext. Walls Fire Place Type Roof Recreation Room Dormer Both Floors Interior Finish Heat Rooms 1st Floor Rooms 2nd Floor Driveway Dinette [LR. i DR. ,jUDITH T. TE~Y TOW~ CL~RK OFFICE OF THE TOWN CLERK TOWN OF SOUTHOLD P O Rox 117¢1 Soulhold. New York I Iq?l Fax (5161 765-182R Telephone {5161 765- [801 THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993: RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations of the Code of the Town of Southold: "Floodplain Development Permit Application" [FDP(93)], and "Certificate of Compliance for Development in Special Flood Hazard Area [C/C(93)]. [\' · -: · BLDG. TOWN OF SO.:J~ ~OL.~ .... j Southold Town Clerk August 25, 1993 TOWN OF SOUTHOLD APPLICATION ~/ PAGE I of 4 FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1: GENERAL PROVISIONS (APPLICANT to read and sign): i. No work may start until a permit is issued. 2. The permit may be revoked il' any false statements are made herein. 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance ks i~sued. 5. The permit will expire ff no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to flJlf'dl local, state and federal regulatory requirements. 7. Applicant hereby gives cousent to the Local Administrator or tfis/her representative to make reasonable inspections required to verify compliance. 8. I, THE APPLICANT, CERTII~ THAT ALL S~ATEMENTS HEREIN A/~.~IN ATTACHMENTS TO SECTION 2: PROPOSED DEVELOPMENT (To be completed bv APPLICANT) NAME ADDRESS TELEPHONE APPLICANT BUILDER ENGINE.ER PROJECT LOCATION: To avoid delay in proce~ing thc application, please provide enough information to ~a.sily idcutffy the project location. Provide the street addre,~ lot number or legal description (attach) and, outside urban areas, the distance to the neace~t intersecting road or well-known landmark. A sketch attached to tl~ application showing the project location would be helpful. 5%- c 3-I0 FOP(93) AnY PLICATI O N ~ PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTUKAL DEVELOPMENT ACTIVITY [] New Structure ~Addition UI Alteration [] Relocation [] Demolition [] Replacement COST ov VROSECr s STRUCTURE TYPE ~Resldential (1-4 Family) [] Residential (More than 4 Family) [] Non-residential (Floodproo£mg7 [] Yes) [] Combined Use (Residen6al & Commercial) [] Manufactured (Mobile) Home (In Manu- factured Home Park.* [] Yes) B. OTHER DEVELOPMENT ACTIVITIES: [] Fill [] Mining [~ Drilling [] Grading [] Excavation (Except for Structural Development Checked Above) · [] Watercourse Alteration (Including Dredging and Channel ModLqcations [] Drainage Improvemen~ (Including Culvert Work) [] Road, Street or Bridge Construction [] Subdivision (New or Expansion) [] Individual Water or Sewer System [] Other (Please Specify). After completing SECTION 2, APPLICANT should submit form to Local Admkfistrator for review. I~ECTION 3: FLOODPLAIN DETERMINATION (To be completed bv LOCAL ADbIINISTRATOR) The proposed development is located on FIRM Panel No. , Dated The Proposed Development: [] Lq NOT located in a Spedal Flood Haz&rd Area (Notify the appilc.ant that the application re~iew i~ complete and NO FLOODPLAIN DEVELOPMENT PER2vflT IS REQUIRED). [] Lq located in a Spedal Flood Hazard Area. FIRM zone deaignation is 100-Year flood elevation at the site is: Ft. NGVD (MSL) [] Unavailable [] The proposed development is located in a floodway. FBFM Panel No. Dated See Section 4 for additional instructions. SIGNED DATE /KPPLICATION # PAGE B OF 4 SECTION 4: ADDITIONAL INFORMATION REQUIRED (To be completed bv LOCAL ADMINISTRATOR/ The applicant must submit thc documents checked below beIore the application can be processed: [] A site plan showing the location of ail existing structures, water bodies, adj3cent roads, lot dimensions and proposed development. [] Development plans, drawn to scale, and specifications, including where applicable: details for anclioring structures, proposed elevation of lowest floor (including basement), types of water resistant materials used below the fLrst floor, details of floodprooFmg of utilities located below the first floor and detaJJs of enclosures below the th'st floor. Also, [] Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres, whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). [] Plans showing the extent of watercourse relocation and/or landform alterations. [] Top of new fill elevation Ft. NGVD (MSL). Floodproofing protection level (non-residential only) Ft. NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or architect. Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in ~ increase in the height of the !00-year flood. A copy of all data and calculations supporting this Finding must also be submitted. [] Other: SECTION 5: PERMIT DL:I I:;RMINATION (To be completed bY LOCAL ADMINISTRATOR~ I have determined that the proposed activity:. A. [] Is B. [] Is not in conformance with provisions of Local Law # , 19 attached to and made part of this permit. __. The permit is issued subject to the conditions SIGNED , D~TE If BOX A i~; checked_, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked~, the Local Administrator will provide a written summary of deficiencies. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. APPEALS: Appealed to Board of Appeals? [3 Yes [] No Hearing date: Appeals Board Decision --- Approved7 O Yes Conditions [] No APPLICATION PAGE 4 OF 4 ~;ECTION 6: AS-BUILT ELEVATIONS (To be submitted bv APPLICANT before Certificate of Compliance is issued) The followhag information must be provided for project structures. This section mast be completed bY a registered professional engineer or a licensed land surveyor (or attach a certification to thi~ application). Complete 1 or 2 below. 1. Actual (As-Built) Elevation of the top of the lowest floor, inducting basement (in COastal Hi~:h Hazard Areas, bottom of lowest structural member of the lowest floor, excluding piling and columns) is: FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproo£mg protection is FI'. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the AppLicam. SECTION 7: COMPLIANCE ACTION fTo be completed bv LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on h~pection of the project to ensure compliance with the community's local law for flood damage prevention. INSP]ECTIONS: DATE BY DEFICIENCIES? [] YES [] NO DATE BY DEFICIENCIES? E] YES [] NO DATE BY DEFICIENCIES? [] YES [] NO SECTION 8: CERTIFICATE OF COMPLIANCE(To be completed bv LOCAL ADMINISTRATOR) Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAJ~, FLOOD HAZARD AREA (OWNrER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAME AND ADDRESS: CHECK ONE: [] NEW BUILDING [] EXISTING BUILDING [] VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A, OR B. BELOW: COMPLIANCE IS HEREBY LOCAL LAW # ,19 SIGNED: CERTIFIED WITH THE REQUIREMENTS OF DATED: Bo COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19__, AS MODIFIED BY VARIANCE # DATED ' SIGNED: DATED: C/c(93) Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: District Section Block Lot THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING~ DRAINAGE AND EROSION CONTROL PI.AH CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") inch Rainfall on Site? 2 3 4 5 6 7 8 9 (This item will include all mn-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFIow! Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Pamel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Coume Running through the Site? is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Veriical Rise to One Hundred (100') of Hodzontal Distance? Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run43ff into and/or in the direction of a Town right-of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction of any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watemourse? Ye~s N__.~o NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit EXEMPTION: Ye_...~s N._9.o Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm.Water, Grading, Drainage & Erosion Control Plan is NOT Requiredl __ __ STATE OF NEW YORK, COUNTY OF ....... ........ ss That I, .....~...~...~. ,~.~s......~.~......L.~../~t.Lcg~l~d ......... being duly sworn, d~poses ~d says fi,at he/she is &e apphc~t for Penni~ (Name of individual s~n~g D~ment) ~d ~at he/she is ~e ......... .~~ ....................................................................................................................... (Owner, Con,actor, Agent, Corette ~r, etc.) Darner and/or representative of dm ~er of Owner's, ~d is duly audmrized ~o perform or have perk)treed ~e smd work ~d to m~e ~d file ~s application; d~at ~1 smtemen~ con.ned in ~is application are U'ue to ~e best o[ Iris B)owledge m~d belief; ~d ~t ~e work will be performed in ~e m~ner set ford) in ~e application flied herem~. Sworn to before me ~is; ~o. m FO~M - 06/0~ Ou~lifled In Suffolk Ooun~ ~ 1 Oommis.ion Expi res 01/~ ~/20 ~ DONALD G, FELLER *ARCHITECT 11725 Main Rd · BOX 1692 · Mattituck, NY 11952 - 631 2985453 - Fax 298 1380 May 10, 2008 Mr. Damon Rallis Town of Southold Building Department Town Hall, Main Road, Southold, NY Re: Proposed Addition to the Eisenreich Resider~¢,, 850 Bay Shore Road, Greenport, New York Dear Mr. Rallis: In regards to the above mentioned project, I have examined the existing building and can certify that, to the besty of my knowledge, the floodwater venting is compliant with the standards of the National Flood Insurance Program. Donald G. Feller LUDLOW HOMES CONTRACTING COMPANY 105 Ole Jule Ln. Mattituck, NY 11952 Telephone (631) 298-5080 Date: April 13, 2008 To Whom It May Concern: I, Mr. William Eisenreich, hereby authorize Mr. Thomas M. Ludlow, to act on my behalf in all matters pertaining to the permitting of my consltuction project at my residence located at 805 Bay Shore Rd., G-reenport, NY 11944. The tax map number is 1000-53-03-01. Sincerely, MAY 8, NOVEMBER SURVEY OF LOT 8 & 9 AMENDED MAP '~ " OF PECONIC BAY ESTATES FILE No. 1124 FILED MAY 19, 1955 SITUATED AT ARSHAMOMAQUE TOWN OF $OUTHOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-5.5-05-10 SCALE 1 "=20' SEPTEMBER 16, 1997 JANUARY 30, 1998 PLOT PLAN FEBRUARY 8, 1998 REV$SE PLOT PLAN FEBRUARY 25, 1998 REVISER AS PER S.C.B.H.S. NOTICE APRIL 25, 1998 REVISE PLOT PLAN 1998 REVISED PLOT PLAN & ADDED ADDITIONAL WETLANDS 13, 1998 ADDED WETLANDS AS FLAGGED BY THE N.Y.S.D.E.C. DECEMBER 1, 1998 REVISE PLOT PLAN APRIL 23, 1999 UNDER CONSTRUCTION SURVEY MAY 6, 1999 ADDED TOP OF FOUNDATION GRADE MARCH 14, 2000 FINAL SURVEY MAY 7, 2007 ADDED PROPOSED ADDITIONS MAY 25, 2007 REVISED PROPOSED ADDITIONS NOVEMBER 11, 2007 ADDED DRYWELLS AREA = 18,912.30 sq. (TO TIE LINE) 0.434 ac. S.C.D.H.S. REFERENCE No. R10-97-184 CERTIFIED TO: WILLIAM L. EiSENREICH CHRISTINE Id. EISENREICH ZONE AE ZONE / / 79'54'0 NOTES: I. ELEVATIONS ARE REFERENCED 2. EXISTING SPOT ELEVATIONS ARE SHOWN THUS: EXISTING CONTOURS ARE SHOWN THUS: 8. FLOOD ZONE INFORMATION TAKEN FROM: FLOOD INSURANCE RATE MAP No. 56103C0159 ZONE AR: BASE FLOOD ELEVATIONS DETERMINED ZONE X*: TO N.G.V.D. 1929 DATUM AREAS OF 500-YEAR FLOOD; AREAS OF IO0-YEAR FLOOD WITH AVERAGE DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM IO0-YEAR FLOOD. DRAINAGE SYSTEM CALCULATIONS: ADDITION ROOF AREA: 1,000 sq. ft. 1,000 sq. ff. X 0.17 = 170 cu. ff. 170 cu. ff. / 22.;5 = 8 vertical ff. of PROVIDE (2) 6' dia. X 4' high STORM DRAIN POIOLS GREENHOUSE ROOF AREA: 120 sq. ff. 120 sq. ff. X 0.17 = 21 cu. fi. 21 cu. ff. / 8.7 = 3 vertical ff. of 4' dia. leamhing PROVIDE (1) 4' dia. X 4' high STORM DRAIN PO~OL 6' dia. Ileaching pool required pool required N.Y.S. Llc. No. 50467 APPROVED BY BOARD OF TRUSTEES TOWN OF $OUTHOLD AND j/OR EASEMENTS OF RECORD, IF ANY, NOT SHOWN ARE NDT GtJARANTEED, Nathan Taft Corwin III Land Surveyor PHONE (651)727-2090 Fox (631)727-1727 97-389 ~ ~ o~ ~ i% APPROVED AS NOTED NOTIFY BUILDING D~PARTM~NT AT 76~1802 8AM TO 4PM FOR THE FOLLOWING INSPECTIONS: ~ 1. FOUNDATION - TWC REQUIRED WITHOUT ~R~IFICATE .o. ~ou.,~ co,~.~, 2. ROUGH - 7RAMING & PLUMBING · COMPLY WITH FINLtNG & coNN~?ONs 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. F L-& r'-t CODES OF YORK STATE & TOWN CODES ~AS REQUIRED/AND CO,%;DITIONS OF / PI. UMBER CERTI~.Ti~ON , ON ~ ~~r CERr/F/CArE OF~'~ ., BA LANNJNG BOARD ~OWN TRUSTEES N,Y.S. DEC , DO NOT PROCEED,W!TH ~ , FRAMINGUNTILSURVEY ~ OF FOUNDATION LOCATION~ HAS BEEN APPRQVED~;~ , . foko. MEE r OF THE TOWN CODE LL COT~T"~dG'~ION SHAL~ ~ ~ ~ ',ri · THE REQUIREMENTS OF THE" )ES OF NEW YORK STA~E. i -- 4 VIEW