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Home My WebLink About35975-ZTown of Southold Annex 54375 Main Road Southold, New York 11971 4/8/2011 CERTIFICATE OF OCCUPANCY No: 34900 Date: 4/8/2011 THIS CERTIFIES that the building Location of Property: SCTM #: 473889 Subdivision: ADDITION/ALTERATION 745 Cases Lane Ext, Cutchogue, NY 11935, Sec/Block/Lot: 109.-5-14.45 Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this officed dated 10/8/2010 pursuant to which Building Permit No. 35975 dated 10/26/2010 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: additions, including decks, to an existing one family dwelling as applied for. The certificate is issued to Rubin, James & Rubin, Phyllis (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DATED 35975 1/18/11 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. 35975 Z Date OCTOBER 26, 2010 Permission is hereby granted to: JAMES & PHYLLIS RUBIN 129 SOUNDVIEW DRIVE LAKE SUCCESS,NY 11020 for : ADDITION & ALTERATION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 109 pursuant to application dated OCTOBER Building Inspector to e~ire on APRIL 745 CASES LA EXT CUTCHOGUE Block 0005 Lot No. 014.045 8, 2010 a_nd approved by the 26, 2012. Fee $ 464.00 ! Authorized Signature ORIGIN~.L Rev. 5/8/02 Form No. 6 TOWN OF $OUTHOLD 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 fi'om Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commemial 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 ofpropeFty showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect sigued by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasous therefor m writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alteratious to dwelling $50.00, Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, 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 Cmlificate ofOccnpancy - Residential $15.00, Conrmercial $15.00 New Construction: Location of Property: Date. Qld or Pre-existing Building: c'w//~(check one) House No. "'~ Street Hamlet Owner or Owners of Property: 7)-0_ ~x Suffolk County Tax Map No 1000, Section Subdivisiou PermitNo. 3~'~ 7-~' ~- DateofPermit. Health Dept. Approval: Planning Board Approval: / ,/0/4/ o Underwriters Approval: Request for: Temporary Certificate Fee Submilted: $ ,5"o .or) //0 °7 Block O Filed Map. applicani: Lot Lot: Final Certificate: c-'"'//(check one) ~Applicant $igoature Tol',n I lall Annex 1375 Main Road P.(). l';ox 1179 Soulhold, Nh' 11971-095!~ Tclcllhont (63D 765-1802 Fax (631) 765-9502 ro.qer, dchert~town.southold.n¥ us BI tiLl)lNG I)I,;PARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION ssued To: Rubin Address: 745 Cases Lane Ext City: Cutchogue St: NY Zip: 11935 3uilding Permit #: 35975 Section: Block: Lot: WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE 3ontractor: DBA: Dan Wilcenski Elec LicenseNo: 4723-me SITE DETAILS Residential Commedcal New Addition Service I ph Service 3 ph Main Panel Sub Panel Transformer Disconnect Other Equipment: Office Use Only Indoor ~ Basement ~ Service Only ~ Outdoor 1st Floor Pool Renovation 2nd Floor Hot Tub Survey Attic Garage INVENTORY Hot Water GFCl Recpt A/C Condenser Single Recpt NC Blower Range Recpt Appliances Dryer Recpt Switches Twist Lock Ceiling Fixtures E Fluorescent Fixture ~.__ Emergency Fixturel~ Exit Fixtures L HID Fixtures Smoke Detectors CO Detectors Pumps Time Clocks TVSS Notes: Inspector Signature: Date: Jan 18 2011 81-Cert Electrical Compliance Form 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 [ ] ELECTRICAL (ROUGH) ~.~ELECTRICAL (FINAL) REMARKS: DATE ~ INSPECTO~ TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ~ FOUNDATION 2ND [ ] ROUGH PLBG. ] INSULATION ] FINAL ] FIRE SAFETY INSPECTION ] FIIIE RESISTANT PENETRATION [ ] FRAMING / STRAPPING [ [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT CONSTRUCTION [ REMARKS: DATE INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. []INSULATION []FINAL FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSFECTION FIRERESlSTANTC0NSTRUC'n0N [ ] F~RERES~rANT/~.NETRAT~N REMARK~ DATE '//) - ~ ~ -/O INSPECTOR TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ( ,~ FIRE RESISTANT PENETRATION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ ] RRE RF.~I~TAI~ OONSTR~ REMARKS: DATE INSPECTOR~//~~/~/ TOWN OF SOUTHOLD BUILDING DEPT, 765-1802 [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING / STRAPPING [ ] FIREPLACE & CHIMNEY [ [ ] FIRE RESISTANT C0flS111UCTI0fl [ REMARKS: INSPECTION [. ]/~JGH PLBG. [/,~ INSULATION [ ] FINAL ] fiRE SAr,'. T' IILg~CTION ] fiRE RESISTANT PENETRAl10N DATE INSPECTOR~./~~. TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]~ON [ ] FRAMING / STRAPPING [//]~FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] m~m~s~STAN'rcoNsmUCl'K~ [ ] RREREs~r~TPr~iLm~Tm. REMARKS: ~ ~¥'-~ d~.///~ DATE TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined J o/>qo, 2o ~o Approved ;.a/~. 20 [0 Disapproved a/c PERMIT NO. 3Tq? BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before apply'ng? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: Mail to: /~44~/~ 5"C~[~I~.T~-~ Phone: 754 4 / ££ ~ ' , i' Bmldmg Inspector ~pletely 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 premfses 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 Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an addition six monthsl 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, housin~code, and regt ;~n~ and to admit authorized inspectors on premises and in building for necessary inspections. /~( /~ fl// . : name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee ngineer, general contractor, electrician, plumber or builder Nameofownerofpremises J/~,,/f~j"' 4~ 5/~nth0~e [o/' tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block 1:~ ..5- Lot Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~"/4d~'6~ f~,,q rq. ~-~,J~t~' ~ ~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition ~ Alteration Other Work Fee (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 of existing structures, if any: Front Rear Depth Height_ Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories 9. Size of lot: Front "n~0 Rear Rear Depth Depth 10. Date of Purchase t Name of Former Owner 11. Zone or use district in which premises are situated ]/~ ~ l 2. 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. Names of Owner of premises /~ ~/,ad Address Name of Architect ~,¢C. {~.,-'~F2'ff//" 'L- Address Name of Contractor Address Phone No. /''t/g ~'~P 7 ~o Y ~ Phone No 72 ¢ ¢/~ ,/~ Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES /k' NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ~ 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) COUNTY OF%otff~: cONNIE D. BUNCH Notaly Publlo, St~te of New York No. 01BU~I BSO~O O~mml~ E~inm April 14~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~,~,~ P/~~'~,~ (Contractor, Agent, (Yorporate 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 ~'"~ day of ~)c~ 20J~ Notary Public Jill M. Doherty, President Bob Ghosio, Jr., Vice-President James F. King Dave Bergen John Bredemeyer -- BLDG DEPt. ]O\l!t, OF SOUTHOLD BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE Town Hall Annex 54375 Main Road P.O. Box 1179 Southold, New York 11971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 # 0629C Date April 6, 2011 THIS CERTIFIES that the 525 sf. addition to the existing dwelling, expansion of the deck, and gutters, leaders and drvwells At 745 Cases Lane Ext., Cutchogue Suffolk County Tax Map #109-5-14.45 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 6/3/10 pursuant to which Trustees Wetland Permit #7361 dated 7/21/10 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 525 sf. addition to the existing dwelling, expansion of deck, and gutters, leaders and drvwells. The certificate is issued to JAMES & PHYLLIS RUBIN owners of the aforesaid property. NEW ¥ORK~ PROPERTY ADDRESS: ~- . . . ~,~c ' ._~-9~ ,,it/fir Cbat)ter 11 ! ~T~ C6~ Of ~u~old ~ in a~or~ce wi~ ~c ResoluUon of the ~o~a oil~[~ ~1~ ~d ~n co.ideation of ~licafion fee ~ ~e s~ of $250.00 ?id by J~e~ & phyllis R~bh ~d ~biebtto'~iTe~andCon~ifl°ns~s~t~.m ~ ~ ~ : ~ Wetland Per~t to eons[me~ a 53~ square foot ad&fion to dtoex and thee~g , . ~- ~...~ ~2den t~d~ells to contain roof__ runoff., and in accord~ce w,ffi~hl~er ~$6. John0f thec. To~ Code,Storm Water Runoll;:an~:~ ~ on Ehlers Land Su~eyor, October 4, 2010. NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03976 PERMIT Under the Environmental Conservation Law (ECL) Permittee and Facility Information Permit Issued To: JAMES RUBIN 129 SOUNDVIEW DR GREAT NECK, NY 11020 PHYLLIS RUBIN 129 SOUNDVIEW DR GREAT NECK, NY 11020 Facility: RUBIN PROPERTY 745 CASES LN EXT CUTCHOGUE, NY 11935 Facility Application Contact: MARK K SCHWARTZ PO BOX 933 CUTCHOGUE, NY 11935 (631) 734-4185 Facility Location: in SOUTHOLD in SUFFOLK COUNTY Facility Principal Reference Point: NYTM-E: 711.5 NYTM-N: 4542.1 Latitude: 41000'09.6'' Longitude: 72°29'06.7" Authorized Activity: Construct addition to existing single family dwelling. Expand existing deck and install drywelL All work shall be in strict conformance with the attached survey stamped "NYSDEC Approved" on September 20, 2010. SAP-I-09-13 Please be advised that your proposed project is located more than 100 feet from regulated freshwater wetlands. Therefore, no permit is required pursuant to the Freshwater Wetlands Act (Article 24) and its implementing regulations (6NYCRR Part 663). Permit Authorizations Tidal Wetlands - Under Article 25 Permit ID 1-4738-03976/00001 New Permit Effective Date: 9/20/2010 Expiration Date: 9/20/2015 Page 1 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03976 NYSDEC Approval By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable regulations, and all conditions included as part of this permit. Permit Administrator: GEORGE W HAMMARTH, Deputy Regional Permit Administrator Address: ('/Z~ NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKIS0 CIRCLE RD STONY BROOK, NY 11790 -3409 Authorized Signature: ~~ Date 7/~_~_~_/ '"tO Distribution List MARK K SCHWARTZ SHERRI L AICHER Permit Components NATURAL RESOURCE PERMIT CONDITIONS GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMITS NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS NATURAL RESOURCE PERMIT CONDITIONS - Apply to the Following Permits: TIDAL WETLANDS 1. Regulated Activities Authorized By This Permit This permit authorizes only those regulated activities / structures identified under the section Description of Authorized Activity. NYSDEC does not issue after-the-fact or as-built permits. This permit does not authorize activities, or legitimize the existence of structures, which would have required a permit but for which no permit or other authorization has been granted NYSDEC. 2. Conformance With Plans All activities authorized by this permit must be in strict conformance with the approved plans submitted by the applicant or applicant's agent as part of the permit application. Such approved plans were prepared by John C. Ehlers last revised August 12, 2010 and stamped "NYSDEC Approved" on September 20, 2010. Page 2 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03976 3. Notice of Commencement At least 48 hours prior to commencement of the project, thc permittec and contractor shall sign and return thc top portion of the enclosed notification form certifying that they arc fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, thc bottom portion of thc form must also be signed and returned, along with photographs of the completed work. 4. Post Permit Sign The permit sign enclosed with this permit shall be posted in a conspicuous location on the worksite and adequately protected from the weather. 5. Failure to Meet Permit Conditions Failure of the permittee to meet all the conditions of this permit is a violation of this permit and grounds for an order to immediately cease the permitted activity at the project site. 6. Accessory Structures Must Be At Least 75 Feet Landward of The Wetland Boundary This permit authorizes the construction of new accessory structures located in the adjacent area at the prescribed minimum setback only. Structures located in tidal wetlands, or structures in the adjacent area but located less than 75 feet from the wetland boundary, are not authorized. 7. Development Restrictions New accessory structure construction projects authorized by this permit must meet ail of the applicable development restrictions of 6 NYCRR Part 661.6(a)(1), (4) and (7): - The 75 foot minimum wetland setback requirement for all principal structures and all non-water- dependent structures exceeding 100 square feet in area. - The 20% maximum adjacent area coverage limitation for impervious structures and surfaces. - The. 75 foot minimum wetland setback requirement for ail hard surface driveways, roads, parking areas and similar impervious surfaces exceeding 500 square feet in area. 8. No Changes to Septic System This permit does not authorize any alteration, expansion or replacement of existing septic systems. 9. Area of Disturbance for Structures Disturbance to the natural vegetation or topography greater than 25 feet seaward of the approved structure is prohibited. 10. Straw Bales or Other at Tidal Wetland A row of staked straw bales or approvable erosion control devices shall be placed at the landward edge of the buffer area or 75 linear feet from the tidal wetland boundary, or as per the NYSDEC-approved plan, prior to commencement of any regulated activities and remain in place and in good, functional condition until the project is completed and all disturbed areas are stabilized with vegetation. I1. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales / silt curtains (or other NYSDEC approved devices) placed on the seaward side between the fill and the wetland or protected buffer area. Tm'ps are authorized to supplement these approved methods. Page 3 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC 1D 1-4738-03976 12. Vegetate All Disturbed Areas The permittee shall revegetate all exposed faces and disturbed areas to prevent soil erosion prior to the project completion or expiration date of this permit, whichever comes first. 13. Roof Runoff Directed to Drywells Roof runoff shall be directed to drywells with the capacity to store / recharge the runoff from a 2 inch / 24 hours precipitation event. All drywells shall be located a minimum of 75 feet landward of the tidal wetland boundary. 14. No Unauthorized Fill No fill or backfill is authorized by this permit without further written approval from the department (permit, modification, amendment). 15. No Disturbance to Vegetated Tidal Wetlands There shall be no disturbance to vegetated tidal wetlands or protected buffer areas as a result of the permitted activities. 16. No Construction Debris in Wetland or Adjacent Area 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 wetlands and/or protected buffer areas. 17. Storage of Equipment, Materials The storage of construction equipment and material~ shall be confined within the project work area and/or upland areas greater than 100 linear feet from the tidal wetland boundary. 18. Concrete Leaehate During construction, no wet or fresh concrete or leachate shall be allowed to escape into any wetlands or waters of New York State, nor shall washings from ready-mixed concrete trucks, mixers, or other devices be allowed to enter any wetland or waters. Only watertight or waterproof forms shall be used. Wet concrete shall not be poured to displace water within the forms. 19. Precautions Against Contamination of Waters 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. 20. State May Require Site Restoration 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. Page 4 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03976 21. State May Order Removal or Alteration of Work 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 o£ any such removal or alteration. 22. State Not Liable for Damage 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. GENERAL CONDITIONS - Apply to ALL Authorized Permits: 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 requested by the Department. 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 or facility. Failure to produce a copy of the permit upon request by a Department representative is a violation of this permit. 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. Page 5 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4738-03976 3. Applications For Permit Renewals, Modifications or Transfers The permittee must submit a separate written application to the Department for permit 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. Submission of applications for permit renewal, modification or transfer are to be submitted to: Regional Permit Administrator NYSDEC REGION 1 HEADQUARTERS SUNY ~ STONY BROOKI50 CIRCLE RD STONY BROOK, NY11790 -3409 4. Submission of Renewal Application The permittee must submit a renewal application at least 30 days before permit expiration for the following permit authorizations: Tidal Wetlands. 5. Permit Modifications, Suspensions and Revocations by the Department Thc Department reserves thc right to modify, suspend or revoke this permit. Thc grounds for modification, suspension or revocation include: a. materially false or inaccurate statements in the permit application or supporting papers; b. failure by the permittee to comply with any terms or conditions 9fthe permit; c. exceeding the scope of thc project as described in the permit application; d. newly discovered material information or a material change in environmental conditions, relevant technology or applicable law or regulations since the issuance of the existing permit; e. noncompliance with previously issued permit conditions, orders of the commissioner, any provisions of the Environmental Conservation Law or regulations of the Department related to the permitted activity. 6. Permit Transfer Permits are transferrable unless specifically prohibited by statute, regulation or another permit condition. Applications for permit transfer should be submitted prior to actual transfer of ownership. Page 6 of 7 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION Facility DEC ID 1-4735-03976 NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS Item A: Permittee Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepting state or federal agencies, expressly agrees to indemnify and hold harmless the Department of Environmental Conservation of the State of New York, its representatives, employees, and agents ("DEC") for all claims, suits, actions, and damages, to the extent attributable to the permittee's acts or omissions in connection with the permittee's undertaking of activities in connection with, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This indemnification does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actions naming the DEC and arising under Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision under federal or state laws. Item B: Permittee's Contractors to Comply with Permit The permittee is responsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while acting as the permittee's agent with respect to the permitted activities, 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 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. Page 7 of 7 Town Hall ~mex 54375 Main Road P.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 REQUESTED BY: Company Name: Name: License No.: Address: Phone No.: *Name: *Address: *Cross Street: *Phone No.: Permit No.: Tax Map District: BUILDING DEPARTMENT TOWN OF SOUTHOLD APPLICATION FOR ELECTRICAL INSPECTION //(~ /t// 73c-,,-. ~i \(_e_~, ~.: Date: /Z//,' ~,~/.'r~ JOBSITE INFORMATION: (*Indicates required information) ~J{~ ~. 1000 Section: ~1 (~ Block: ~ Lot: I ~-, u/-~- *BRIEF DESCRIPTION OF WORK (Please Print Cleady) Poo ¥ clo ,r . (Please Circle All That Apply) *Is job ready for inspection: ~Do you need a Temp Certificate: Ternp Information (If needed} - *Service Size: 1 Phase *New Service: Re-connect Additional Information: 82-Request for Inspection Form NO YES ~ 3Phase 100 150 200 300 350 400 Underground Number of Meters Change of Service PAYMENT DUE WITH APPLICATION Final Other Overhead of Southold ~ Erosion, Sedimentation & S.torm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: $.C.T.M. #: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A ~g)~ d'/ec~o~ Di~ocf /¢~' ~'j' STORM-WATER. GRADING, DRAINAGE AND EROSION coNTRoL PLAN District Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. $COPEOI~WORK - PROPOSED CONS'J.'IiUCI'ION ITEM# / woRKAssE~$MENT ] Yc~ No a. WhatistheTotelAmaofthePmjectPamels? 7~,, ../,~=(,~r~v/t '1 WillthisPmjectReteinAllStorm-WaterRun-Off (Include Tofal Ama of all Parcels located within . ' Generated by a Two (2") Insh Rainfall oe Site? the Scope of Work for Proposed Comimc6on) (This item will include all mn-off created by site b. What is the Total Ama of Lond Clearing ' clearing and/or construction actWitfes es wel~ es a# and/or Ground Disturbance for Ihs proposed / ~.~'d ..~ ~" Site Improvements and the permanent creation of coDEtmstlon acUvity? impervious surfaces.) is~:., ~,.) 2 Does the Site Plan and/or Survey Show All Proposed PROVIDli: BRIEF PP.O. IF_.6T DESCltu~I'iON 0'.:vae~:mIP~..:~,~3 Drstnnge Structures IndicaUng Size & Location? Tnls ~/ r t Item shall Include all Proposed Grade Changes and (/~/V~??~ ~ C ~ Z / z~ ~ .~C Slopes ~llng Surface Water Row. / 3 Does the Site Plan and/or Survey descrlbe lhe ereslon /'~r.r~;;~'p~,/t/~ /~l-~/~::~ ..~.fZ~././~..-- and sediment centrol pmcitces that will be used to '-I-I control see ereslon and storm water dlssharges. This ~_g--c~'~ Eem must ~ mlmlr~d thres.~ the Construction Period. 4 Will this Project Requira any Lend Filling, Greding or Excevedon where there is s change to the Natural r'~ Existing Grade Involving mom than 200 Cubic Yards U of Material within any Parcel? . 5 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Frye Thousand¢/..v_ (5,000 S.F.) Square Feet of Ground Surface? 6 Is there a Natural Water Course Running through the i-1,--..1 Site? Is this ProjeCt within the Trustees jurisdiction General DEC ~WPPP Req~ents: or within One Hundred (100!) feet of a Weflaed or Submission e4 a SWPPP is required fo~ all Construction activi~s irwolving soil Beach? disturbances of cms (!) or mom ac. ms; including disturbances of less than one acre that 7 Wilt there be Site preparation on Existing Grade Slopes are part of a larger common pisn that will uaimatuly disthrb one or nmm acres of land; which Exceed Fifteen (15) feet of Verticst Rlae t° I includiog C~lstrucllo~l activltiss isvoWing soil disturbances of ~ess than one (1) ac~e where One Hundred (100,) of Horizontal DistenCe? the DEC has determirmd thai a SPDES permit b requbed for storm water discha~ges. . SWPPP'$ Shall meet the Minimum Requi~menth of the SPDES General Permit I 8 Will Driveways, Parking Areas or other Impen'ious th~ storm water Discharges fTem Collstructthn activity. Permit No. GP-O-10-OOt.) Surfaces be Sloped to Direct Storm-Water Rut~Off 1. The SWPPP shall be pmparud pdor to the subrshtuJ of the NOI. The NOI shall be into and/or in the direcUon of a Town right-Of-way? submitted to the Depodment prior to the commencement of constmc~en actlvby. . z Tho sw~w...~ th,.=,,. ,. ,,~*k. =,,:.,~,,.., :o.m ~-.,~,,. ~ .m., 9 Will this Pr°ject Require the Plaesment of Mateflal, requksd, pest-comm~Uo~ sthna watur rnan~ement pmcUces that will be used and/~ RemOVal of Vegetetipn and/or the Construction of any r~ co~m~ed to reduce the poluth~ts is sthra water dlscbeq~s and to assure Item WIthhl the Town Right-of-Way or Road ShoulderLT.J compliance with tl~ thm~ and conditions of this pemllt. In addllkxt, the SWPPP shall identify pofenllal soumss of pollution which may masenably be expected to alfect the Area? Iwa* ~r. wa sot I.~.~. the ~,~,a~. d ~ N,.-~ q ualliy of sth~n watur dischaltle.'~ NOTE: If Any Answer to Que~Uons One ~.~n~Jgh Nine is Answe~nd with a Check Mark 3. NI SWPPPs that require the post-construction stem water rn~nngement practice In a Box and Ihe conat~tlon site disturbance is betwee~ ~,00e S.F. & component shall be pespared by a qualified Design Professional Licensed In New York a Storm-Water, Grading, Drathage & Ero~tun Contn~ Plan is Requlend by the Town of that is kn~4edgeabis in the principles and practices of Storm Water Management southold and Must be Submitted for Revisw Pger to issuam~ of Any Buth~ P~'mth '.e..... L.'. ....... o. COUNTY OF .. ~.:~..~..~_. C ..~..... SS Notary Public, State of New Yo~ . ~ No. 01BU6185050 ~ Qualified in ~lff~k ~ounty m ,,, ,me :, ................................... ...... .7... ................................................. . ( . ~, Age4t/cmpa'atu or,:~, ate.) ..... Owner and/or representative of the Owner or Owners, and is duly anthoriz~d to p~Zorm or have performed the said work and to make and ~le tl~..'.s applicalion; that all statemenLs contained in this application are true to the best o£his knowledllt: and bclinf; an*] that the wonk will be performed in the manner set £orth in thc application £ded herewith. -- // Sworn to I~forc me ~s; ~ -- ..., . /')// / / ............. .............. ............. ...... .......................... ......................... FORM - 06/t 0 'l'o~x n I Iai] Annex 54375 Main Road P.O. Box I t79 SouthoM, N Y I 1971-09,5!t I clcphonc (631) 763-1802 l:ax (ti31 ) 763-9302 BI qLI)IN(; I)I~2PARTMI~NT TOWN OF SOUTHOLD March 1,2011 James & Phyllis Rubin 129 Soundview Drive Lake Success, NY 11020 RE: 745 Cases Lane Ext, Cutchogue TWO WHOM IT MAY CONCERN: The Following Items Are Needed To Complete Your Certificate of Occupancy: __ Application for Certificate of Occupancy. (Enclosed) Electrical Underwriters Certificate. A fee of $50.00. __ Final Health Department Approval. __ Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) __ Trustees Certificate of Compliance. (Town Trustees #765-1892) Final Planning Board Approval. Final Fire Inspection from Fire Marshall. Final Landmark Preservation approval. Building Permit: 35975-7 addition/alteration I ~ Retph H nC°-W or fOrmerl,, ~ " ~ / I S.eO.o~,so,,E / ~ ~ ~ .... ~ ~,~.~ I~ I ~1, /~ / ~* -50-5/ "' r~ YOUNG ~ YOUNG 5URV~'r' OF: PROPF:tR'I-'r' 51TUATE, C.,UTC,~ TOI,',IN; 5OU'THOLP 5UP:FOLK C.,C;~INT'r', N'r' .SUb, ME'rED JAN. 2e, 2OIO DATA ~. 1:2, 2~10 51./:FOLK Cx2JNT'r' TAX # IOOO - IOq - .5 - 14.45 JAMES RUBIH' PHY~ J.T.~ RUBIH' l!l ! SEP 3 0 2010 O PIF~ FOUND A 5TAKE FOUND P_LEVATION REF:ERENC. E N~V'D '2q DATUM FLOOD ZONI~ A5 ANNOTATED FROH FEHA FLOOD ZONE HAP NO. ~610~.T, OI~,H Ar'e~ = -'/5,120 5,. F. Area = I."/245 Acres ~.RAPHIC, ~T, ALE I"= Srl~ DATA: P~TLAND FLAO~ TIE/::) TO I~AC.C, HARI5 ~ I~'r' 5URV'E'r'OR JAN. 26, .2OIO A.~ LIMIT OF HI~H LAND NO APPROVED BY ~,3ARD OF IRUSTEE$ ~V~N OF SOUTHOLD \ W+ E S JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 R1VERHEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-C:\Documents and Settings\OWner'0My Documents'uMy Dropbox\lO\10-106 with improvements.pro BUN DING DEPARTMRNT INFORMATION ~, 6" O.C. ~ ~'t ~0~ ROOF P~SS~ ZOOS D~G~, ZON[ 2: ~gG 23.~5. -2~. 12 ~ ~ /m~l stra~ ~r nd~ ~ N~: NJ de~m~n pre,ute ~1~ ha~ ~ FOR pOURED com mCRETE SO~OLDTOWN~A ~ STRAPDING ELECT {~CAL & CAULKING D RObj~. FRAUtNG F .UL'BI"G, "- ~ ~DTOWN P~N) ~ iNSULATiON - A ~hAL- Co~STRUC' ION & ~L~CTRmCAL .,. N,Y.~,DEC ALLCONSTRUCT~" Si m m P~ae 5,m~ L~4 or RETAIN STORM ~"rATER RUNOFF - ~. ~ ~G'o.c. OF THE TOWN'CODE. N~ D&~ ~o~ -- -- P~de ~mm~n MG or equal m~l straps ~ tie OC( ;UPANCY OR H(,' q CERTIFICA ~ fou~on w. II -~, ~ G'~ UNDERWRITERS CERTIFICATE X , ~om ~ a ~u,u,.e * D ~Wl N G LIST Fo~dafi~ PI~ · IG'O.C. ~3 5~10N5 NOT TO ~CA~ DF '>DES ,O BOARD Floor Plan = I'-0" I E'~'P Second Floor Plan - Exlsbn0 ~;o Remain Scale: ~" = I Deck Dinm,~Room 14'- JY~' Masf. er BedrOOm I~J~hen Garage Bath First; Floor Plan - Proposed Scale: )/4" -- 1'-(7' MARK SCHWARTZ 2a49~ MAIN ROAD CUTCHOGU~ ~ YORK Floor Plans A-2 Exl~tln~j East Elevation I--xlstln~j North Elevation II Proposed East Elevation 5c~le:J~"= I'-0' Proposed North Elevation 5~le: ,V4" = I '-0" MARK SCHWARTZ Al~CmTr~'c~l~ IN~ 2~ MAIN IROAD CUTCHOGt~ N~V YORK Pe~t ~: El~afiom A-4 Ex~51;~n0 West; Elevabon Exlsbn0 5out;h Elcvabon l=ro?oscd West; Eleva~c~on F'roposed 5out;h 5cal¢:,V4" = I'-0" A~d~mn MARK SCHWARTZ ~0~ Pe~t ~: El~a~om A-5 WIND LOAD PATH CONNECTION AND CONSTRUCTION DETAIL DRAWINGS USE THE FOLLOWING APPROVED USP METAL CONNECTORS FOR PROPER WIND RESISTANT & GOOD CONSTRUCTION. FOLLOW MANUFACTURE'S RECOMMENDED INSTALLATION INSTRUCTIONS TO ACHIEVE MAXIMUM UPLIFT LOAD CAPACITY. RAFTER -- WALL SrdD 0 ENDWALL CRIPPLE STUD -- RIDGE ~ LEDGER BATHTUB I lEADER :. DOUBLE JOIST SIDEWALL RAFTER 0 ,-'~~ TDROUGH- ROOF EXHAUSI RAFTERS MAINTAIN SiLL PLA1E(S) (..) WALL SHEATHING STAPPINB TO BE ATTACHED TO WALL DTUDS @~S"OC AT WALL -- MAINTAIN GAP · ATTIC SHALL BE PROVIDED WITH A ~ %'// ~' [~'-~FASCIA AND ALL WINDOW/BOOR OPENING dACK STUDS /~ /BETWEEN WALL FINISH AND 'LOOR JOISTs,, 8"DEPTH "gPLsTA24NUMBER I DESC R'PTION APPLICATION /' / ' ~// ROOFING TO AVOID SOAAING WALL StUB 0 ~ NOTTHE SPACELESS ~.ANvENTiLATED.1/150 OF ALLTHEoPENINGsAREA ~; BUTLER WOOD GIRDER ¢< ~ / %% -¢ SHALL BE COVERED ~ITB CORROBIOM ONTIN, SCREENED ! I RAFTER 'i 9~'2 ?'~ "A FLASHING AT WITh' 1/2" x 8" ANCHOR DOLT CONC. SLAB,I; -DOOR FRAME ~;. ,~¢ ,'A ~'A ~'A A %NOTCB BEAM FOR MUDSILL iF REQUIRED MAXfM"M I ~ SUBFLOOR FLOOR JOIST DEPTH JSP NUMBER DESCRIPTION APPLICAIION INSTALL R'O" O,C.! ANCHOR BOLT CONNECTION FOUNDATION ~/8" DIA. ANCHOR BOLq SUPPORTING MAXIMUM SPACING SILL PLATE ro FOUNOA'ilON (CRAWL SPACE OR FOUNDATION~ 1 STORY 72" OC SILL PLATE TO FOUNDATION (DRAWL SPACE OR FOUNDATION) 2 STORIES 38" DC ~/ALL BOTTOM PLATE TO FOUNDATION 1-2 STORIES 57" OC (SLAB ON-GRADE)