HomeMy WebLinkAbout28956-ZFORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-29328
Date: 03/24/03
T~IS CERTIFIES that the building ADDITION
Location of Property: 675 MEADOW LA MATTITUCK
(HOUSE NO.) (STREET) (HAMLET)
Cou~lty Tax Map No. 473889 Section 115 Block 5 Lot 7
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated NOVEMBER 27, 2002 pursuant to which
Building Permit No. 28956-Z dated DECEMBER 2, 2002
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 SUN ROOM ADDITION TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR.
T~e certificate is issued to ROBERT M & MARILYN j LOBICK
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF ~IEALT~ APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DA'£~
Rev. 1/81
N/A
113937 03/10/03
N/A
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28956 Z
Date DECEMBER 2, 2002
Permission is hereby granted to:
ROBERT M LOBICK
675 MEADOW LA
MATTITUCK,NY 11952
for :
CONSTRUCTION OF A SUNROOM ADDITION AS APPLIED FOR PER DEC AND
TRUSTEE CONDITIONS WITH FLOOD PERMIT
at premises located at 675 MEADOW LA
County Tax Map No. 473889 Section 115 Block
pursuant to application dated NOVEMBER 27, 2002
MATTITUCK
0005 Lot NO. 007
and approved by the
ORIGINAL
Rev. 5/8/02
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/I 0 of 1% lead.
Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing ail property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicaFt:ffa Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the }applicant.
C. Fees ~
1. Certificate of Occupancy-New dwelling $25.00, Additions to dwelling $25.00, Altera~t~ g ~w~g $25.00,
Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25 ~ '
4. Updated Certificate of Occupancy- $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
New C °ns t ruct i°n: '<:JdhlT)O~'/ Date. (_~//~¢t~) ~
Old or Pre-existing Building: (check one) .
LocationofProperty: C 7~ ~C~L2 ~
House No. ~,j~ Streetitr,~/~ Hamlet
Owner or Owners of Property: ~/
Suffolk County Tax Map NO 1000, Section il5 Block C)(~O ~ Lot
Subdivision ~4li~[x~ -~3t~g5 , ~7p~-- FiledMap. Lot:
Permit No. 2~. ,-?C- ~-- Date of Permit.~,//c~/~C,~ Applicant:_~DJ~'[~.. _ -~ ~l~.~'~cD__ _
Health Dept. Approval: X~,~,, Underwriters Approval:
Planning Board Approval: ~/'~
/
Request for: Temporary Certificate
Fee Submitted: $
Final Certificate:
(check one)
~pplicant Si~fire
LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC.
670 MIDDLE COUNTRY ROAD
ST. JAMES, NEW YORK 11780
(631) 265-3075
Fax (631) 265-6057
Application No.: 113937
Permit Number: BP28956
Block: Lot:
Section
Owner: Mr. Lobick
Address: 675 Meadow Lane
Municipality: Mattituck
OwnerPhone:
No. ITEM SIZE
2 Switches:
4 Receptacles:
1 GFCl Devices:
0 Dimmers:
2 MedlumBaseFIxtures:
0 FluroescentFIxtures:
0 HID:
0 RangeOvenCookTop:
0 DryerElectrlc:
0 ExhaustFans:
0 CellingFans:
0 DW:
0 Laundry:
0 HeatlngEqulpMotors:
0 ExitSigns:
0 EmergencySIgns:
[.O~ATION OF WORK: [~Basement
Agent:
Address:
NY
License#:
Agent:
No. ITEM
0 SubFeeds:
0 Timers:
0 Transformers:
0 ACEqulpmentCentrah
0 ACEqulpmentWlndow
0 MotorsbyHP:
0 Generators:
0 WhlrlpoolHotTub:
0 Microwave:
0 WaterHeaterElectrlc:
0 SmokeDetectors:
0 TrackLightlngStrip:
0 ElectrlcHeat:
0 PumpMotor:
0 Disconnects:
0 FutureOutlets:
[] FirstFloor
North Country Electric Corp
11 Harmony Lane
E. Setauket NY
Rc6
11733
SIZE No.. ITEM SIZE
0 PoolsAbvBIo:
0 PoolslnGround:
0 Pools Filter:
0 Pools Lights:
0 CO Detectors:
0 Disposal:
0 Metal Halide Lamps:
0 RefrlgUnlte:
0 WalkinBox:
0 ExhaustUnit:
0 SteamShower:
0 BreadWarmers:
0 GarbageDIsp:
0 CentralVac:
0 ChandelierLIfts:
0 ElevatorLIfts:
[~ SecondFIoor [] Outside [] Addition ~ Survey [~ New Const.
Comments Sunroom on Second Level Final 3/11/03
/ Additions
Phase: I Volts: Wire CU Conductor # of
Type: Size: Meters:
er. ber,.A.E./.Electrical Certificate Certificate No.
LONG ISLAND ELECTRICAL INSPECTION SERVICES, INC,
Certificate Issued on: 3/10/03
Issued to Mr. Lobick
Address: 675 Meadow Lane
Mattituck NY
North Country Electric Corp
11 Harmony Lane
E. Setauket NY 11733
113937
THIS CERTIFIES T~7 ~OCAL DISTRICT
INSPECTOR CONI~U(~' AI~ INSPECTION OF THE
VISIBLE PORTION/Or EleCTRICAL
INSTALLATION [~I~S~F ;3 t;IEREIN AND IS
COMPLIANT VV/CT~t~FI[ R~ENT NATIONAL
IAEI Certified Inspector
"EveEy Dfflt is ~ Vacation" i
Dear Mr. Wohlars:
Februaw 13,2003
Bruce Wohlars
Redwin Industries
1603 Lakeland Avenue
Bohemia, New York 11716
RE: Robert LOBICK Sunroom
Deck Support
TEMO INC.
20400 Hall Road
Clinton Twp., MI 48038
800 344-TEMO
586-286 0410
FAX: 586 226 1706
Infernet: www.temosunrooms.com
I have reviewed the deck for the above referenced customer to determine if the
additional loads imposed by constructing a TEMO Sunroom can be supported.
The proposed TEMO Sunroom will cover the entire 12 foot by 22 foot existing
deck.
DECK DIMENSIONS FOR ENCLOSURE: 22 FEET by 12 FEET
SUPPORT BEAMS: Double 2x10
JOISTS: 2x8 at 16" on center
PIER SUPPORT: 10 Each - 4X6 Posts on 16" diameter concrete piers
POSTS: 10 EACH
The proposed patio enclosure is manufactured of light-weight materials. The
following loads will be imposed on the deck.
LIVE LOAD: 2 psf
SNOW LOAD: 35 psf
DEAD LOAD (of enclosure materials): 1,878 pounds
Based on the information provided and the attached calculations, it is my
professional opinion that the existing deck will properly support the proposed
TEMO Sunroom.
eif you have any questions or require additional information.
~, PE
Z
LU
t--
Z
Z
uJ
Z~
uJw
Z
uJ
Z
0
Z
w...~
0 -r___
I.- 1--n
i._n'
W~
(DO
z
0~ ~
0<~ ~
0
0
' ' .pI~,I'I!H T. T.I~I2~RY
TOVv~ CLE rCt(
OFFICE OF THE TOWN CLERK
TOWN OF $OUTHOLD
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
two (2) new forms to be used under tiie
of the Code of the Town of Southold:
Application" [FDP(93)], and "Certificate
Special Flood Hazard Area [C/C(93)].
Town of Southold hereby adopts
Flood Damage Prevent regulations
"Floodplain Development Permit
of Compliance for Development in
B L:;'G. 02PW.
TOWN OF SOL~OLD. ,
Judith T. Terry
Southold Town Clerk
August 25, 1993
APPLICATION
PAGE I o( 4
TOWN OF SOUTHOLD
FLOODPLAIN DEVELOPMENT PER_MIT APPLiCAT'iON
This form is to be filled out in duplicate.
SECTION I: GENERAL PROVISIONS (AP?LICAJ~rF to read and
1.. No work may start until a permit is L%ucd.
2. Thc permit may be revoked il' any false statements arc made herein_
3. If revoked, all work met cease until permit i~ re-issued.
4. Development shall not be used or occuplcd until a Ccrtificatc of Compliance is issued.
5. Thc permit will cxpirc il ~o work is commenced within six montl~ of issuance:.
6. AppLicant is hereby informed that other permits may be required to fi.d/ill local, state and federal regulatory
requirements.
7. Applicant hereby gives eonsent to thc Local Administrator or his/her representative to make ieasonabl¢
inspections requlrcd to vcrlf~ compl;ancc.
8. I, THE APPLIGANT, C~RTIF'Y THAT ALL STATEMENTS HEREIN AND I~ A'FI~ACHMEFFI'S TO
- THIS APPLIGATION ARE., TO 2:~F~..BEST OF MY K~ OWLEDGF--~ TRUE AND ACCUPokTE.
SECTION 2: PROPQSED DEVELOPMENT (To be completed by APPLICANT}
NAME ADDRESS
TELEPHONE
B U LDm ; ,
ENGINEER
PROJECT LOCATION:
To avoid delay in processing thc application, please provide enough information to easily identify thc project
location. Provide thc street address, lot number or Icg, al description (attach) and, outside urban areas, the
distance to thc nearest intersecting road or well-known l~dma.rk A sketch attached to this application showing
the project locadon would be helpful.
FOP(93)
APPLICATION
PAGE 2 OF 4
DESCRIPTION OF WORK (Check all apple.able boxcs)'
A STRUCTURAL DEV~LOPMENCF
.STRUCTURE TYPE
[~ New Structure
~Addition
[2] Alteration
[] Relocatioa
[] Demolitioa
Ct Replaoemeat
,~ Residential (l~l Family)
[] Residential (More than 4 Family)
Nou-rexiden0al (FloodprooFmg7 [] Yes)
[] CombLued Usc (l:L~idential & Commercial)
[] Manufactmed (Mobile) Home (In Manu-
factured Home Park7 [] Ye.s)
ESTIMATED COST OF PROJECT
B. OTHER DEVELOPMENT ACI IVITIES:
[] Ftll Fl Mining FI Drilling [] Grading
[] Excavation (Except for Structural Development Checked Above)
' Fl Watercourse Alteration (Including Dredging and Channel ModLfications)
[] Drainage Improvements (Including Culver~ Work)
Fl Road, Street or Bridge Construction
[] Subdivision (New or E.~aasion)
[] Individual Water or Sewer~yste~ ,.7~
[] Other (Please Specify) ~::~'~,.d,,t/ /~Ogg/°'/
After completing SECTION 2, APPLICANT should submit form to Local Ackniaistrator for review.
SECTION 3: FLOODPLAIN DETERMINATION {To be completed by LOCAL ADMINISTRATOR)
Thc proposed development k located on FIIZM Panel No. , Dated.
Thc Proposed Development:
Fl Is NOT located in a Special Flood Hu?ard Area (Notify thc applicant that thc application
review b complete and NO FLOODPLAIN DEVIELOPMHNT PERMIT IS REQUIRED).
r"l Ls located in a Special Flood Hazard Area.
FIRM zone de.qig~a6on ii
tOO-Year flood elevation at the site is: Ft. NGVD (MSL)
[] Unavailable
Cl The proposed development is located in a floodway
FBFM Panel No. Dated
[] See Section 4 for additional inslrucrions
SIGNED
DATE
BUILDING PERMIT EXAMINER CHECK LIST
APPLICANT: e~-~ ,a,oO (Y~e-, _~ ~-6 ~,r~
SCTM# DISTRICT: 1,000, SECTION: I I ~'-~, BLOCK:
STREET ADDRESS:~_ ~~_ CITY:
LOT:
DATE REVIEWED: ~- / i~,/02
DATE SUBMITTED:j_Lk:~ =}/02
PROJECT DESCRIPTION: ~'oD~2cocrl
ESTmATED PROJECT COST: ~q/5 ARCHITECT~' 'l
SUBDWISION: ~/~
FAST TRACK? ,O 0
SINGLE & SEPARATE CERTIFICATION-REQUIRED? ,~o NOTES: ~
LOTS 40,000SF -I 00-24 Lot recognition.(CREATED betbre June 30, 1983), UNDERSIZED lOTS FROM JAN.1997 100-25. Merger.(A nonconforming at any timc after 7/1/83
ZONING DISTRICT: ~-t-/~2 CONFORMiNG? ,oo
REQ. LOT SIZE: "/gl o$ O ACT. LOT SIZE:/~/~_ REQ. LOT cOV.~:~°~
REQ. FRONT ,~o~ PROP. FRONT~..~REQ SiDE ~m/.2~
REQ. REAR 3,5/- PROP. REAR / REQ.'HEIGHT
ACT. LOT COV.
ACT. SIDE /
PROP. HEIGHT
WATER FRONT? ¥~-',5% _DBSCRIPTION: ¢oo~ (,,~t,a~,~ ~
APPROVALS ~OUI~D
SUFFOLK COUNTY HEALTH J~PT: YES or (~)(BED #): DTE: _/ ./_ PERMIT #:R10-
TOWN SEPTIC RECEIPT: Y of~__~
NEW YORK STATE DEC: Pvm-~c 9/,JTS '~ S)or NO
SOUTHOLD TOWN TRUSTEES: ""-(~r j~
TOWN ZONING BOARD APPROVAL: YES or~.
TOWN PLAN. BOARD APPROVAL: YES or~.
TOWN HISTORICAL PRE (SPLIA): YES or
NYS ENERGY: YES OR NO : ~//~
EGRESS (18 H min.? 4 sq total) _ VENT (SQ. FT. x 4%). ' --LIGHT (SQ. FT. x 8%)
BUILDING PERMITS OPEN/EXPIReD: BP -Z / C/0 Z- ,
HAVE PRE CO'S: Y OR N BP -Z / C/0 Z- ,
NOTES:
FEE STRUCTURE: FQUNDATION: ,~,.~, c( SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT
TOTAL: SF FEE
1.(
SF)- (
_SF)= SF X $__=$ +$
2.(
SF)- (
.SF)= SF X $ =$ +$
OTHER TOT~.Q~I.,..~
NeW Yorl[ 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
Erin M. Crotty
Commissioner
July 8, 2002
Robert Lobick
675 Meadow Lane
Mattituck, NY 11952
Re: Permit #1-4738-03002/00001
Dear Mr. Lobick:
In conformance with ~he requirements of the State Unifom", Procedures Act (Article 70,
ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit.
Please read afl conditions carefully. If you are unable to comply with any conditions, please
contact us at the above address.
Also enclosed is a permit sign which is to be conspicuously posted at the project site
and protected from the weather.
Sincerely,
Agency Program Aide
Enclosures
CC:
Christopher Trapasso, Redwin Industries
BOH
File
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL GONSERVATION ' ~ : '~" ~
DEC PERMIT NUMBER
1-4738-03002/0000t
FACILITY/PROGRAM NUMBER(S)
! - ' I EFFECTIVE DATE
: Jul}' 10, 2002
T ' F-XPIRATION DATE(S)
Under the Environmental ~ July 10, 2007
.. ~.o._n.s_e.~vat~.o_n_ L_a.~ .... I
TYPE OF PERMIT · New [] Renewal [] Modification [3 Permit to Construct r~ Permit to Operate
[] Article 15, Title 5: Protection of
Waters
[] 6NYCRR 608: Water Quality
Certification
[] Article 27, Title7; 6NYCRR 360:
Solid Waste Management
[] Article 15, Title 15: Water Supply
E~ Article 15, Title 15: Water Transport
[] Article 15, Title 15: Long Island Wells
E~ Article 15, Title 27: Wild, Scenic and
Recreational Rivers
[] Article 17, Titles 7, 8: SPDES
[] Article 19: Air Pollution Control
[] Article 23, Title 27: Mined Land
Reclamation
· Article 24: Freshwater Wetlands
[] Article 25: Tidal Wetlands
[] Article 27, Title 9; 6NYCRR 373:
Hazardous Waste Management
[] Article 34: Coastal Erosion
Management
[] Article 36: Floodplain Management
[] Articles 1, 3, 17, 19, 27, 37;
6NYCRR 380: Radiation Control
PERMIT ISSUED TO
Robert Lobick
TELEPHONE NUMBER
(631)298-5485
ADDRESS OF PERMITTEE
675 Meadow Lane, Mattituck, NY 11952
CONTACT PERSON FOR PERMITTED WORK
Redwin Industries, Inc., 1603 Lakeland Avenue, Bohemia, NY 11716
TELEPHONE NUMBER
(631)567-5577
NAME AND ADDRESS OF PROJECT/FACILiTY
Lobick Properb/, 675 Meadow Lane, Mattituck, NY 11952
COUNTY ] TOWN
Suffolk Southold
DESCRIPTION OF AUTHORIZED ACTIVITY:
WATERCOURSE
Deep Hole Creek
Freshwater Wetland MT-15
NYTM COORDINATES
E: 709.0 N: 4541.0
Construction of deck and sun/screen room. All work is to be done in accordance with the attached plans sram ped
NYSDEC approved on July 8, 2002.
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ECL, all applicable
regulations, the General Conditions specified (see page 2 & 3) and any Special Conditions included as part of this permit.
PERMfT ADMINISTRATOR: (KAF) ADDRESS
Mark C, Carrara, Region 1 Headquarters
Deputy Permit Adminstrator Bldg. #40, SUNY, Stony Brook, NY 11790-2356
AUTHORIZED SIGNATURE ~/~- ,
Page 1 of 4
NOTIFICATION OF OTHER PERMITTEE
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, 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 acti'~ities
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 inter~tional acts or emissions, or to any claim=,
suits, or actions naming the DEC and arising under article 78 of the New York (~'ivil Practice LaWs and Rules or any citizen
suit or civir rights provision under federal or state laws.
Item B:Permittee's Contractors to Comply with Permit
The permittee is responsibre 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.
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 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.
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 BIdg #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 in accordance with 6 NYCRR Part 621. The
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 of the permit;
c) exceeding the scope of the 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 EnvJrenmental Conservation Law or regulations of the Department related to
the permitted activity.
DEC PERMIT NUMBER I PAGE 2 OF4
1-4738-03002/00001
I
NEW YORK STATE I
ADD, ITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 2~, 34 AND 6NYCRR
( FRESHWATER 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 unreasonab~
obstruction to the free navigation of said waters or flood flows or endanger the health, safety or welfare of
people of the State, or cause Joss or destruction of the natural resources of the State, the'owne~may be ordered-
by the Departm ant to remove or alter the structural work, obstructions, or hazards caused thereby without experme
to the State, and if, upon the expiration or revocation of this permit, the structure, fill, excavation; or ot,he~;~
modification of the watercourse hereby authorized shall not be completed, the owners, shall, without expense
the State, and to such extent and in such time and manner as the Departm ant 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 focal government which may be required.
4. All necessary precautions shall be taken to preclude contamination of any wetland or waterway by suspended
solids, sediments, fuais, solvents, lubricants, epoxy coatings, paints, concrete, leachate or any ether
environmentally deleterious materials associated with the project.
Any material dredged in the conduct 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 bank s of a waterway.
6. There shall be no unreasonable inter¢ erence 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 shaJl sign and return the top
portion of the enclosed notification form certifying that they are fully aware of and understand all term s 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 ~pnaid L. Maim, Jr. on June 1, 2002.
· DEC PERMIT NUMBER
1.4738-03002/00001
PAGE 3 OF 4
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
SPECIAL CONDITIONS
1. Any work, disturbance, and storage of construction materials shall be confined to within the "Limit of Clearing and
Ground Disturbance" as shown on the approv ed plan.
2. Prior to commencement of any construction activities, a continuous row of straw bales shall be staked end to end
on the downslope edge of any areas of tilting, grading or excavation. The bales shall be maintained, repaired and
replaced as often as necessary to ensure proper function, until all disturbed areas are permanently vegetated. The
average useful life of a bale is approximately 3-4 months. Sediments trapped by the bales shall be removed to an
approved upland location bef ore the bales them selves are removed.
3. Straw bales shall be recessed two to f our inches into the ground.
4. Any demolition debris, excess construction materials, and/or excess excavated materials shall be immediately and
completely disposed of on an approved upland site more than 100 feet from any regulated freshwater wetland. These
materials shall be suitably stabilized so as not to re-enter any water body, wetland, or wetland adjacent area.
5. All fill shall consist of clean soil, sand and/or gray el that is free of the following substances: asphalt, slag, flyash,
broken concrete, demolition debris, garbage, household refuse, tires, woody materials including tree or landscape
debris, and metal objects. The introduction of materials toxic to aquatic life is expressly prohibited.
6. All equipment and machinery shall be stored and safely contained greater than 100 feet landward of the regulated
wetland or water body at the end of each work day. This will serve to avoid the inadvertent leakage of deleterious
substances into the regulated area. Fuel or other chemical storage tanks shall be contained and located at all times
in an area greater than 100 f eat landward of the regulated wetland or water body. If the above requirement cannot
be met by the permittee, then the storage areas must be designed to completely contain any and all potential leakage.
Such a containm ant system must be approved by NYSDEC staff prior to equipment, machinery or tank storage within
100 feet of the regulated wetland or water body.
7. All areas of soil disturbance resulting from this project shall be seeded with an appropriate perennial grass, and
mulched with straw immediately upon completion of the project, within two (2) days of final grading, or by the expiration
ofthepermit, whichever is first. Mulch shall be maintained until a suitable vegetative cover is established. Ifseeding
is impracticable due to the time of year, a temporary mulch shall be applied and final seeding shall be performed as
soon as weather conditions favor germination and growth.
8. Suitable vegetative cover is defined as a minimum of 85% area vegetative cover with contiguous unvegetated
areas no larger than 1 square foot in size.
9. The permittee shall incorporate the following language as a notice covenant to the deed:
"Regulated freshwater wetlands associated with MT-15 are located on/near the properties of Robert Lobick and
his/her/their heirs, assigns or successors. This property is subject to the provisions of Environmental Conservation
Law (ECL) Article 24, and the conduct of regulated activities may occur only pursuant to ECL Article 24 if prior
approval is given by the New York State Department of Environmental Conservation (NYSDEC) or its successor(s).
Regulated activities include, but are not limited to clearing of vegetation; application of chemicals; excavation; grading
and filling; and erection of any structure(s)."
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 ~f this permit to: NYSDEC, Regional Manager Bureau of
Habitat, SUNY Building 40, Stony Brook, New York.11~90-2356.
DEC PERMIT NUMEER ] PAGE 4 OF 4
1-4738-03002/00001
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 19, 2002
Redwin Industries A/C Lobick
1603 Lakeland Avenue
Bohemia, NY 11716
To Whom This May Concern,
Please take notice that following a full review of your permit application, to construct a
sunroom addition to a single family dwelling at 675 Meadow Lane, Mattituck, NY,
SCTM# 115-5-7, we are returning the application as incomplete. The following
information is required before we can issue your permit:
1.) A variance from the Southold Town Zoning Board of Appeals or
compliance with Southold Town Code. The proposed construction is not
permitted due to insufficient front yard setback. Southold Town Code requires
that all construction occur outside of at least 35 feet from Meadow Lane.
Currently, the proposed sunroom addition is noted as being +/~ 30 feet from
Meadow Lane. You may, of course, amend the permit application to comply
with zoning.
Please feel free to resubmit the application when you have addressed the above
referenced concerns. If you choose to seek relief from the Zoning Board of Appeals,
please resubmit you application, along with your survey and a check for $35 dollars. If
you have any questions, you can contact this office at (631) 765-1802, between the hours
of 8:00 a.m. and 4:00 p.m.
. ursI
Authorized Signature
CC: File
Albert J. Krup~ki, President
James King, Vice-Pre~ident
Artie Foster
Ken PoIlwoda
Peggy A. Dicke~son
October 18, 2002
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
5outhold, ~E
TelephO~a
Mr. Robert Lobick
675 Meadow Lane
Mattimck, NY 11952
RE: 675 Meadow Lane, Mattituek
SCTM#11
Dear Mr, Lobick:
The Board of Town Trustees took the following action during its regular meeting h
Wednesday, October 16, 2002 regarding the above matter:
WHEREAS, ROBERT LOBICK applied to the Southold Town Trustees for a per
provisions of Chapter 97 of the Southold Town Code, the Wetland Ordinance of th,
Southold, application dated July 29, 2002, and,
WHEREAS, said application was referred to the Southold Town Conservation Adv
for their findings and recommendatiom, and,
WHEREAS, a Public Hearing was held by the Town Trustees with respect to said
October 16, 2002, at which time all interested persons were given an opportunity t~
and,
WHEREAS, the Board members have personally viewed and are familiar with the
question and the surrounding area, and,
WHEREAS, the Board has considered all the testimony and documentation submil
concerning this application, and,
WHEREAS, the structure complies with the standards set forth in Chapter 97 of th,
Town Code,
WHEREAS, the Board has determined that the project as proposed will not affect
safety and general welfare of the p~ple of the town,
NOW THEREFORE BE IT,
,wn Hall
5 Route 25
Bax 1179
w York I1971-0969
(631) 765-1892
51) 765-1366
on
t under the
town of
ory Council
plicafion on
,c heard,
emises in
Southold
health,
RESOLVED, that the Board of Trustees appwve the application of ROBERT LOBiCK to
extend an eXisting wood d~ck 12'X 16' to 12'X 22' wide then build a 12'X 22' glaS~ and screen
surgoom on 12'X 22' deck. Re-vegetam 30' from the landward edge of the wetland//~long the
southern portion on the property and la~'n area between dwelling and Wetlands to be ~overed
with woodchips and as depicted on plan dated October $, 2002 pm'pared by Suffolk !
Environmental Consulting, Inc. ,,
BE IT FURTHER RESOLVED that this determination should not be considered a d~t~mination
made for any other Depariment or Agency, which may also have an apphcatwn pen~ing for the
same or similar project. ~
Perrmt to construct and complete project will expire two years from the date the pe~lt as s~gncd.
Fees must be paid, if applicable, and permit issued within six months of the date of~fis
notification.
Inspections are required at a fcc of $5.00 per inspection. (S~ al~ached schedule.)
Fees: $5.00
Very truly yours,
¢
Aibe~ $. ~ps~, ~r.
P~sid~t, Bogd of Trust,s
AJK/lms
tS:GI
Board Of Southold Town Trustees i
SOUTHOLD, NEW YORK
ISSUED TO ROBERT LOBICI~
u/h rization
Pursuant to the pr~wlsions of Chapter
the State ef New YorE, 1193: and Chapter 404 M the Lew~ ef the
State of New York 19S2; and the Southeld Torn Orcfinarme
rifled ."REGULATING AND THE PLACING OF OBSTRUCTIONS
IN AND ON TOWN WATERS AND PUBUC LANDS and the
REMOVAL OF SAND, GRAVEL.OR OTHER MATERIALS FROM
LANDS UNDER TOWN'WATERS;L; end in accmdenee wffh the
Resolution of T~e B~ard adopted at · meeting held ~a October ].6! !.
.Z@..0...g...'.., and in consideration of the sum of $...,?,?..:,~..0. ....... paid by
Robert Lobtck
of ................. ~.t.~.t.~.~ .................................... N, Y. and subjed to the
Terms and Conditions. listed en the revere aide hereof,
of SM Town' Trmte~ luthedxes end peemits the folowing:
ell'in accordance wi~ tim detailed slaee~mat;ebS es
· the originating application. .
IN ..WITNESS WHEREOF, The said Board of Trustees heee- J
cams ~ Corporate. Seal to be affixed, and these pr~enh to i I
be subscribed .by · ',rn~i~.ity of gm sald ~o~rd as of.thls dat~.
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971-0959
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
November 19, 2002
Redwin Industries A/C Lobick
1603 Lakeland Avenue
Bohemia, NY 11716
To Whom This May Concern,
Please take notice that following a full review of your permit application, to construct a
sunroom addition to a single family dwelling at 675 Meadow Lane, Mattituck, NY,
SCTM# 115-5-7, we are returning the application as incomplete. The following
information is required before we can issue your permit:
1.) A variance from the Southold Town Zoning Board of Appeals or
compliance with Southold Town Code. The proposed construction is not
permitted due to insufficient front yard setback. Southold Town Code requires
that all construction occur outside of at least 35 feet from Meadow Lane.
Currently, the proposed sunroom addition is noted as being +/- 30 feet from
Meadow Lane. You may, of course, amend the permit application to comply
with zoning.
Please feel free to resubmit the application when you have addressed the above
referenced concerns. If you choose to seek relief from the Zoning Board of Appeals,
please resubmit you application, along with your survey and a check for $35 dollars. If
you have any questions, you can contact this office at (631) 765-1802, between the hours
of 8:00 a.m. and 4:00 p.m.
Authorized Signature
CC: File
7E5-1~02
BUILDING DEPT.
INSPECTION
[ ~I~UOUNDATION 1 ST [
] ROUGH PLBG.
] INSULATION
] FINAL
[ ] FOUNDATION 2ND [
[ ] FRAMING [
[ ] FIREPLACE & CHIMNEY
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
FOUNDATION 1ST
FOUNDATION 2ND
FRAMING
ROUGH PLBG.
[ ] INSULATION
[ ] FIREPLACE & CHIMNEY
DATE
INSPECTOR
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH P~G.
[ ] FOUNDATION 2ND [ ] IN.~4ON
[ ] FRAMING [,~]...FINAL
[ ] FIREPLACE~,_HiMNEY (~_ ,..,
REMA~RKS: ~'
PECTIOi'q REPORT [ '~.
FIELD INS DATE COMMENTS
~o~,~I~IO~ os~ ,
FO~A~ON (2~)
ROUG~ ~G &
PL~G
STA~ E~R~ CODE
~D~ON~ CO~S / .
TOW?;' OF ~OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: 765-1802
BUILDING PERMIT APPLICATION CI-fECKL1ST
Do you have or need the followiug, before applying ?
Board of Health
Survey. ""
. Septic Form
/ t-:', N.¥.S.I).E.5,,
- · ,- _ __
Examined '1 ,20 ~ ~ Contact:
~ ~, ~I Build'rog ~pe~tor
t ~_..;~ :~.]/~ ~PPLICATION FOR BUILDING PERMIT
Oate /
INSTRUCTIONS
a. This applieation MUST be completely filled ha by typewriter or in i~ and submitted to the Building Inspector with 3
sets. of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, ~ind,waterw&ys.
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 permk
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 a Certificate of Occupancy
is issued by the Building Inspector.
APPLICATION IS I-IEKEBY 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, additionsl or {alterations or for removal or demo[ition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorize, at ~spec?ors on premises and in building for p~e. ssary inspections.
(Mailing Mdr~ss of applicant)
State wheth~~essee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner ofpremise;' ~JT.O ~%/~ 7' ,~ fi~/~! LL/Aj ZIg/,~
(~ on ~$ m roll or latest deed)
I f~f~~o+~ f d~y ~d ~me ~de of ~orate office)
Builders License No.
Plumbers LicenseNo.
Electricians License No.
Location of land on which proposed work will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
Hamlet
~, ',
Block ,c,:,; '.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
b. Intended use and occupancy
3. Nature of work (cheek which applicable): New Building
Repair Removal Demolition
4. Estimated Cost ¢ ¢~9~'90. "-
5. If dwelling, number of dwelling units
If garage, number of cars 2,
Fee
Addition
Other Work
Alteration
(Description)
(to be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Din~ensious of existing structures, if any: Front
Height. Number of Stodes
Rear
Dimensions of same structure with alterations or additions: Front
Rear
9. Size of lot: Front
Depth. Height A¢O
Dimensions of entire new construction: Front / 2
Height /O i Number of Stories !
10. Date of Purchase
Number of Stodes
Rear .Depth
q¢/
Depth ZZ¢.' -.,700.
Name of Former Owner f/q~'/~-~'/6/~f ,~]~-/~ ~J~J
l 1. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation:
13. Will lot be re-graded ~/~ Will excess fill be removed from premises: YES NO
14: Names of Owner ofpremi.e~/~'~r .~0,/5 l'°tSte-tXddress/d~ff/EIq¢Cdr7%5~C'ThoneNo~'"*-"~'" Z~ ¢__~'"tf fi ~
Name of Architect Address Phone No
Name of Contractor ~'2~u2),~ ,,~'Pc,$7-~-/~ Address/~-L~'~-,(,~ AX,Phone No, ~?oT-~r 5"~' -/
15. Is this property within 100 feet of a tidal wetland? *YES NO
· IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If eleVation at any point on property is at 10 feet or below, must provide topographical data on survey,
STATE OF NEW YORK)
SS:
COUNTY OF )
~/L/ILLI41~ ~rJ--~l~/O ))£W'l~q being duly sworn, deposes and says t~aat (s)he is the applicant
(Name of individual signing contract) above named,
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set froth in the application fried therewith.
Sworn to before me this'~X
/ ~ day of r~.~_.~.~t~;r..4 200~
~ dry Public -- --
Si~ture of Applicant
ELIZABETH A STATHI$
NOTARY PUBLIC, State of New Yod{
No._01ST6008173, Suffolk County
~eml ~:xpires June 8, 20~. ~.-
t1~' oo
DOAIAZ-D Z. AdAIZAd,
Z
~°
1213
I-']
]~/8
~0//_ L/go :NOIlVlAI~IL-INO3
0 9!,/I. g
(Id g~' L/
d
...... i,--- ~ _ S-I':INVd _
44'5 E~ 44.5 E~ 44.5E
2 ~/8
;!
NIMC]3~ ~0/6!./!.l. gOl~'l,M~.O
Ol
//
III~ 1111 ,',.1.".;~
SN015~3~1
1~380W '~01801 ~
( ) 'Hd I ' :NOS~I3clS3-1VS