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Home My WebLink About30896-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY Date: 08/07/06 No: Z-31732 THIS CERTIFIES that the building ADDITIONS Location of Property: OFF (HOUSE NO.) County Tax Map No. 473889 Section 1 EAST END RD (STREET) Block 1 FISHERS ISLAND (HAMLET) Lot 3.15 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JANUARY 6, 2005 pursuant to which Building Permit No. 30896-Z dated JANUARY 14, 2005 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is DECK & PERGOLA ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to WILMINGTON TRUST CO. (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO_ 2093424 04/03/06 PLUMBERS CERTIFICATION DATED N/A Rev. 1/81 ~ . Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 trc:~ '1,,]'1, /, L!, JIlL J I 20 L APPLlCA nON FOR CERTIFICATE OF OCCUPANCY r TCllJl,r,.. This application must be filled in by typewriter or ink and submitted to the Building Department WI ". ~-- '. '[ 1 . ~"L" J .-..,~ A. For new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natura1 or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (8-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certitying that the solder used in system contains less than 2/10 of 1 % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engin_ responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For exlstIDg buildings (prior to April 9, 1957) DOD-t:ODformmg UIeI, or bulldmgs .ad "pre-eDstlq" laDd uses: I. Accurate survey of property showing all property lines, streets, building and unusua\ natura1 or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant If a Certificate of Occupancy is denied, the Building IDspector sball state the reasons therefor in writing to the applicant C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $25.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. 2/ to/ t(X)(D New Construction: J Old or Pre-existing Building: Location of Property: ~AST ~O tDAD House No. Street Hamlet Owner or Owners of Property: W\\.M\N.~1'~ \1U.l.St' (J:). CQu.t;;ror ftE:.L M.\LU~) Suffolk County Tax Map No 1000, Section I Block I Lot ~.IC; ( check one) ~ lSU~b Subdivision Permit No. ~o~l\ C. Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ Final Certificate: J (check one) ~~ Applicant Signature ~vc. 701) ~ LO-=l. 31j3?- 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. 30896 Z Date JANUARY 14, 2005 Permission is hereby granted to: WILMINGTON TRUST 1100 N MARKET STREET WILMINGTON DE, 19890 for : CONSTRUCTION OF A DECK & PERGOLA ADDITION AS APPLIED FOR PER DEC & TRUSTEES at premises located at OFF EAST END RD FISHERS ISLAND County Tax Map No. 473889 Section 001 Block 0001 Lot No. 003.015 pursuant to application dated JANUARY 6, 2005 and approved by the Building Inspector to expire on JULY 14, 2006. Fee $ 150.00 ~~ I I Authorized Signature ORIGINAL Rev. 5/8/02 James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen John Holzapfel 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 CERTIFICATE OF COMPLIANCE # 0129C Date July 21, 2006 Tms CERTIFIES that the deck and pergola At East End R., Fishers Island Suffolk County Tax Map # 1-1-3.15&3.16 Conforms to the application for a Trustees Permit heretofore filed in this office Dated 4/14/04 pursuautto which Trustees Permit #5918 Dated 5/26/04 Was issued, and conforms to all of the requirements and conditions ofthe applicable provisions of law. The project for which this certificate is being issued is for a deck and pergola The certificate is issued to CHRISTOPHER MILLIKEN owner of the aforesaid property. ro<~ Authorized Signature /],ocq .~l!I I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ -D~ A~ ~ON STREET - NEW YORK, NY 1 0038 ~ I rD' Vt.-.J('I\ CERTIFIES THAT I ~ Upon the application of upon premises owned by ~ ~ ~ ~ WALSH SERVICE CHRISTOPHER MilLIKEN ~ lID P.O. BOX 325 EAST END RD lID ~ FISHERS ISLAND, NY 06390, FISHERS ISLAND, NY 06390 ~ ~ located at EAST END RD FISHERS ISLAND, NY 06390 ~ ~ ~ ~ Application Number: 2093424 Certificate Number: 2093424 ~ I Section: Block: lot: Building Permit: BDC: ns11 I ~ Described as a Residential 0-599 square ft. occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ First Floor, Porch/Deck, ~ ~ 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 3rd Day of April, 2006. ~ ~ Name OTY Rate Ratio. Circuit IYm< ~ ~~~~ ~ ~ Fixture 10 0 Incandescent ~ ~ Switch 2 0 General Purpose ~ ~ Receptacle 3 0 GFCI I ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ /\/'t,t.- ~ ~ \. ~ ~ lID ~ ~ ~ seal ~ ~ ~ ~ 1 ~ 1 ~ I This certificate may not be altered in any way and IS validated only by the presence of a raised seal at the location indicated. I l!I.l!I "": :; start t.1 ~ Session A ~ [24 x 80] =~ Inbo>:: ~ Mt,rosoft Out... (1/ Building Per mlt:::: - Las., . (] P PS Ver $IOn 4 . [()II m.., 07/25/2006 15:23 FAX 631 788 7798 FlTELEPHONE J/IELll1l'lSl'ECDON llEPOlIT DATE COMMENTS - J/J>/Aj" /. ') ~'" , OS FOUNDATION (1ST) , v ~- t:j -ci,-_ ll.. ...... . ~ . ;,. . ;~ "', FO~i>ATION (2ND) ~~'" LIP . '" d 9 '/ ' /~ , -r <:> u_ ii~ ROUGH FRAlIUNG'" PLm.m1l'4'G (t\ !':l . . ~ "1 W / Os: " 1/ A a: INSULATION PEll.N. Y. !:; STATE ENERGY CODI!: 11/ ( n .. , ~'.~, / . ------- " '.IlIl -, , G. ~ hkQIP' J-JPAl- &/Ju'2'.". _ t:7 . r.. 1-{l.A./ It.tJ I R // u_ \l' FINAL - U\ , S ~- \) "...-- --- ~ / ADDITIONAL COMllO:l'iTS .......... t!, /"'fl.F ..- 3 '\. / <::'0 Q\~ ........... ./ ./ ~!ll . , .r .~ -.1'" I l;l :c~ J...';j ~ = ~ z,!:; ...,-..,... :i>;; '" .. :-J 1aJ002 ~ -~ OWN OF SOUTHOLD BUILDING lJEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlSoutholdl PERMIT NO, BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, hefore applying? Board of Health 4 sets of Building Plans Planning BO'jd approval Survey , Check >oJ Septic Form N.Y.S.D.E.C. I Trustees V Contact: Mail to: J),(j(. MltrroN c.ot-lT, {>,O. ~X 3~6 Ftst\~ tSlA~D Phone: N.,( 0G0~"\() l.. 0) (tol - ?COtb =ise.z.. l c.. )~OO _cUz.-O&IS, 20' ' ,- ,20_ Examined Approved Disapproved alc Expiration ,20_ Building Inspector -'\ C' , '~'i .- b ,j'" AP,PLICATION FOR BUILDING PERMIT Date NtW!SM1MS,ll."'\ ,20~ I I ..J 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 locatio;' oflot 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 Perni.it. 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,t4e 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 ofbuildlngs; 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. INSTRUCTIONS ~ ~O-(N', (Signature of applicant or name, if a corporation) ?A.'f'i\!fO [},. S At!:.ovt. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ~ Name of owner of premises WtW\~'=\\ON \\<-U<;\ COtv\fAN.'f (As on the 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. ~ 'Z-l t.c'1 - \-\ \ No, ot:-.TUM\NE:..P NO"\ OIS-n::..lLYI/\ \N.E;..O 'l--lc T lD E::.'-~.R.. VV\. ,1\.\1':.:0 I. Location of land on which proposed work will be done: ~AS\ W D ~AD " House Number Street r\s~~ t~16 Hamlet County Tax Map No. 1000 Section Subdivision t-\~ (Name) \ Block \ Filed Map No. ~"" Lot 5 . \5 Lot N.A ~ - , 2. State existing use and occupancy of premises and intended use and occupancy of proposed constru~tton: a. Existing use and occupancy ~\t::lE.,N c....E- W \i\-\. ~~Nt f'lVRCA-\ b. Intended use and occupancy RE:S\ v:>WCf.- IN \\\\ ~ fc~ ~ feR.C:\C>LA 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost t. 30 ,oeo Addition Alteration Other Work ~L.A 'oJ( OE:C.l<. AOOlTloN To €X1'STlN~ f'o~(Description) Fee $150 (To be paid on filing this application) Number of dwelling units on each floor N A 5. If dwelling, number of dwelling units If garage, I')umber of cars NA Uf,. 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. ~ A 7. Dimensions of existing structures, if any: Front 45 \ Height 2-4' Number of Stories 2.. Rear 4e' Depth 3':>' Dimensions of same structure with alterations or additions: Front SAM€.- Depth 5"2> 1-0" Height <::..,,6..tv\E::.- Number of Stories 8 D. . f' . F """,-I r'.1\ ""cz..I_ r. II . ImenSlOns 0 entire new constructton: ront (..)l;.l - '-'I Rear Vo IQ Height q 1- D ,. Number of Stories ON~ -""I ql 9. Size oflot: Front to ~e>t . ,1 Rear \ S 1. C- 10. Date of Purchase 4/'l.-U {qJt Name of Former Owner Rear ~f\I\(" 1\1 A. Depth 151 -0. Depth eSI . z..<tl f' A TT~SO~ ~&O 11. Zone or use district in which premises are situated R. - l '2-0 . 12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO J 13. Will lot be re-graded? YES_NO ~ Will excess fill be removed from premises? YES_NO L c..~U~1Of'I-\l:,.lL ft~"E>R.!; \su..Ntl, 14. Names of Owner of premises M.\\.U~ Address ~y Phone No.lDb\ -1~~ -14V6 Name of Architect Address Phone No Name of Contractor ~A.o:.. RA"R...\OoN. Address f\~l:\as lSl.AI\IIoPhoneNo. ~ -9.\~-08\Z; ~'( 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _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. fL.e.'.se. SE>f:> AiTMJ\E.O c..ova we::rrE:R.. ~ 9f.C... f'~I1S t-N'-\-C>'5tl? 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 'E>~f'l:>ol)...~ ~ ~o..l7Y'\ being duly sworn, deposes and says thaI (s)he is Ihe applicant (Name of individual signing contract) above named, A.8:\WT (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 me this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work 1Ili11 be performed in the manner set forth in the application filed therewith. Sworn to before me this '3 rd dayof...b <\u dX'u 2~ ~.. ~18. (?.. t,,,~ b Notary Public MARY B PAHKEWICZ Notal)' Public Stale eX New Yorl< No 52-8267950 Commission Expires 6'tl~ 0 " ~~~ Signature of Applicant TERMS end CONDITIONS 'l1je Permittee Christopher MiUiken ~;"g at East End Rd., Fishers Island '... N. Y.. a pan of <<he coosidmdoo lor the 1.....~ of <<he Pamit does \1lIdealaDd and pcescribe to the fol- lowing: 1. That the pid Jloud ol Trustees and <<he Town ol Souchold are releaed from any and aU damages, IX claims tOl: damages, of IlIlts uisiDg. cIltecdy ot 'lodirec:dy a a -'t of any opet- atloa pedotmed punuaot to this peaalt, -' <<he IIid p...,,;-.nJ, at his ot bet own expo-. defend &IJ1 -' aU $UCh suits'lnl,;.ted .., chltd.,... -' the pid P. I ..I.,.... unM fu1l1lablliq with reSpect thereto. lXI <<he <"'1lp1~ esdusioo of the !loud of Trustees of <<he TOlVlI ol ~d 2. That chis PedDlt is' vaUd for. period of 24 _ wbkh is ~ to be the ectl....ted time' requited to amplete che work 1n'tOl~ bltiboald ~- waaaat, ~ for ... exteeSioo .may be made to <<he Jloud at a IaIu Qle. 3. That this Pennit should be reIalned Indefinitely, or as loog as <<he pid Pamittee wlsIla to molntoln the struaute or project Involved, to provide evideoce to anyone ClO<ICefDeCl chat ouch- <<lzadoa was origlnaI1y obtained. 4. That <<he work involved will be lUbject to the lnspec:tloo -' .pprovU ol the Board ot iu agents, and OOlHIOI"{'n....... wi<<h che ptoWions ol che nrlglnot/"g applicadoo, may be CIlJSe fot ftMlCadoo of chis Pamit .., resoludoo ol che said Board. S. That tbere will be "0 lI"reuooable Interfermce with navigatiott as a result ol the work beIeltt .Dchorized. ' 6. That tbere obaU be 00 ittterfercace with the right ol <<he pobIIc to pus -' repus aIoog che beach Letweell high and low _let matb. ' 7. That if future operatlOllS ol <<he Town of South9W reqalte che ftlDO\'d -'lot 81teradoas ... che Jocotlnn olche wack bereln ....... ~ I . f. or if, in che oplttloo olthe Board ol T--. die , wack sba1I cause _""Ie obsttucMtt to free omg.dott. the pid p...n;.... will be reqalrcd. apott due oodce, to remove or .Iter chis work or project beteln stated ~ ~~Ufl to die Town , ol Souchold. ' , .. ,. JJ;. --- .-- ~-26 , - / - 3. 5 OWNER ~ TOWN OF SOUTHOLD PROPERTY RECORD CARD STREET VILLAGE DIST. SUB. LOT \Ji\l'Y)i~ bn ((USt- FORME OWNER 0(' r -V::U t " .1-/ --t{ i f€ '-sor') ~ Co SEAS. S r R d ~.t~fr:;;' ~tVd. fliT Rei FARM COMM. W V. ::3 TYPE OF BUILDING IMP. V~ TOTAL CB. MICS. Mkt. Value LAND / Od If "illable / (.<::.;.D (; ,> FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD Voodland r\eadowlond louse Plot 2/ " ..:? I 61 Z) "otol <') /'" ...>.:",'., , .... ... """ - /---~ "- \ ) ~ & - ,'" - COLOR TRIM - '. 1 'f ~ 'X" I~ IS l I (.,; I ISf 'J.t ....,I~ ( t< ~ / - I < I , I s/~€3 t8 1 d 8 1'51 V j 17" - ! M. Bldg. 25)(2 sr - 70f) 6.SZ> tlS-.)D . "I:xtenslon leK t,=II~- -"\ '2dS !:.,SO J3.?~ oX ::- ~- () . .- Extension / <;(-.)( .2 c:- - 415"0 f,. ~O '29fJ,5 Extension Foundation B/iP' ). Beith ,--:S Dinette I Porch Basement J;: // Floors DAI::... K. I Porch J{))(2~~.2.~ /. t)o ?~ ~t) Ext. Wails SA4~""5. Interior Finish S/L LR. I Breezeway Fire Place J Heat t:5#.14 DR. I Garage Type Roof (:.JC.J. /~ Rooms 1 st Floor ~R. 3 Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total 7688 , },.----r; .' Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York 11971-0959 Albert J. Krupski, President James King, Vice-President Artie Foster Ken Poliwoda Peggy A. Dickerson Telephone (631) 765-1892 Fax (631) 765-1366 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD May 26, 2004 Mr. Glenn E. Just J.M.O. Environmental Consulting P.O. Box 447 Quogue, NY 11959-0447 RE: CHRISTOPHER MILLIKEN EAST END RD., FISHERS ISLAND SCTM#1-1-3.15&3.16 . Dear Mr. Just: . The Board of Town Trustees took the following action during its regular meeting held on Wednesday, May 26, 2004 regarding the above matter: WHEREAS, Glenn E. Just on behalf of CHRISTOPHER MILLIKEN applied to the Southold Town Trustees for a permit under the provisions of Chapter 97 of the South old Town Code, the Wetland Ordinance of the Town of Southold, application dated April 13, 2004, and, WHEREAS, said application was referred to the Southold Town Conservation Advisory Council for their findings and recommendations, and, WHEREAS, a Public Hearing was held by the Town Trustees with respect to said application on May 26, 2004, 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, 2 . '. . . WHEREAS, the structure complies with the standards set forth in Chapter 97 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 the Board of Trustees approve the application of CHRISTOPHER MILLIKEN to construct a 28'X 18' deck with pergola, and as depicted on the site plan prepared by Richard H. Strouse last dated October 20, 2003. 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 $50.00 per inspection. (See attached schedule.) Fees: None Very truly yours, dlJ.:,$ 9. ~.t}. Albert J. Krupski, Jr. President, Board of Trustees AJK/lms Allie M. Raridon, Assoc. AlA Post Office Box 385 Fishers Island, New York 06390 December 29th, 2004 Town of Southold Building Department Town Hall Southold, NY 11971 Building Department, Enclosed are a set of revised drawings and building permit application for the Chris Milliken Residence on Fishers Island. The scope of the project is an 18' -6" x 28' -6" deck with a pergola. Also enclosed you will find the DEC approved site plan; DEC permit and the waiver from the Town Trustees. If you have any questions regarding the DEC permit information, please contact Glen Just at J.M.O. Consulting at #(631) 653-0607. Please feel free to call me at # (631) 788-7582 with any other questions that you may have. All my best, ~Llu- ~~eN\ Allie Raridon ., New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, NY 11790-2356 Telephone (631) 444-0404 Facsimile (631) 444-0360 Website: www.dec.state.ny.us e ~ Erin M. Crotty Commissioner July 19,2004 Mr. Christopher Milliken 511 Oakwood Avenue Lake Forest, IL 60045 RE: 1-4738-03350100001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Sincerely, /~;6- Marilyn :wPeter~n - Environmental Analyst MEPIls NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1-4738-03350/00001 FACILITY/PROGRAM NUMBER(S) . PERMIT EFFECTIVE DATE Julv 16, 2004 EXPIRATION DATE(S) Under the Environmental Conservation Law July 31,2009 TYPE OF PERMIT. New 0 Renewal 0 Modification 0 Permit to Construct 0 Permit to Operate o Article 15, Title 5: Protection of Waters o Article 17, Titles 7,8: SPDES o Article 27, Title 9; 6NYCRR 373: Hazardous Waste Management o Article 15, Title 15: Water Supply o Article 19: Air Pollution Control o Article 15, Title 15: Water Transport o Article 23, Tille 27: Mined Land Reclamation D Article 34: Coastal Erosion Management o Article 15, Tille 15: Long Island Wells o Article 36: Floodplain Management . Article 24: Freshwater Wetlands o Article 15, Tille 27: Wild, Scenic and Recreational Rivers o Article 25: Tidal Wellands o Articles 1, 3, 17, 19, 27,37; 6NYCRR 380: Radiation Control o 6NYCRR 608: Water Quality Certifica- o Article 27, Tille 7; 6NYCRR 360: S tion olid Waste Manaaement PERMIT ISSUED TO TELEPHONE NUMBER Christopher Milliken (847) 295-7159 ADDRESS OF PERMITTEE 511 Oakwood Avenue, lake Forest, Il 60045 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Glenn Just, JMO Environmental Consultina, P.O. Box 447, QuoQue, NY 11959-0447 (631) 653-0607 NAME AND ADDRESS OF PROJECT/FACILITY Milliken property, East End Road, Fishers Island COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Southold DESCRIPTION OF AUTHORIZED ACTIVITY: Construct a 28 Yz' x 18' 3" deck with pergola for an existing single family dwelling. The proposed project is located more than 300' from regulated tidal wetlands and is beyond the jurisdiction of Article 25 (tidal wetlands). All work must be done in accordance with the attached plan prepared by CPK Design Group on 4/7/03 last revised 10/20/03 and stamped NYSDEC approved on 7/16/04. 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. PERMIT ADMINISTRATOR: ADDRESS Ro er Evans Region 1 Headquarters, Bldg. #40, SUNY, Stony Brook, NY 11790-2356 DATE July 19, 2004 Page 1 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 approved plan. 2. Prior to commencement of any construction activities, a continuous line of silt screen (maximum opening size of U.S. Sieve #20) shall be staked along the downslope edge of any areas of filling, grading or excavation. The screen shall be maintained, repaired and replaced as often as necessary to ensure proper function, until all disturbed areas are permanently vegetated. Sediments trapped by the screen shall be removed to an approved upland location before the screen is removed. 3. Silt screen shall be recessed six 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 feetfrom 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 gravel 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 feet 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 containment system must be approved by NYSDEC staff prior to equipment, machinery ortank 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 of the permit, whichever is first. Mulch shall be maintained until a suitable vegetative cover is established. If seeding 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. DEC PERMIT NUMBER PAGE 2 of4 1-4738-03350/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ADDITIONAL GENERAL CONDITIONS FOR ARTICLES 15 (TITLE 5), 24, 25, 34 AND 6NYCRR PART 608 (FRESHWATER WETLANDS) 1. 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. 2. The State of New York shall in no case be liabie 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. 3. 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 locai government which may be required. 4. 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. 5. Any material dredged in the conduct of the work herein permitted shall be removed evenly, without leaving large refuse piies, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable chan'nels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 7. 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. 8. 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 was prepared by CPC Desion Group dated 4/7/03 last revised 10/20/03 DEe PERMIT NUMBER PAGE 3 OF 4 1-4738-03350/00001 NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION NOTIFICATION OF OTHER PERMITTEE 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 ofthe 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 S: 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. 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 Departmenifor renewal, modification or transfer ofthis 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 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 Environmental Conservation Law or regulations of the Department related to the permitted activity. DEC PERMIT NUMBER 1-4738-03350100001 PAGE 4 OF 4 NUTK;!: OF COMMENCEMENT OF CONSTRUCTION RETURN THIS FORM TO: COMPLIANCE Bureau of Habitat NYSDEC Building 40 .. SUNY J LI Stont.Brook, NY t790-2356 PERMIT NUMBER: -7138 - 0:,,> ~ 50, (){)(y) C OR FAX TO: 631-444-0272 ~ .... ~ . . ISSUED TO: eN PROJECT LOCATION/ADDRESS: CONTRACTOR NAME: ADDRESS: TELEPHONE: Dear Sir: Pursuant to General CondItion # 9 of the referenced pennij, you are hereby notified that the authorized activijy shall commence on . We certify that we have read the referenced pennij and approved plans and fully understand the authorized project and all pennlt conditions. We have Inspected the project site and can complete the project es described in the pennij and as depicted on the approved plans. We can do so In full compliance with all plan notes and pennit conditions. The pennit sign, pennit and approved plans will be avaUable at the sije for inspection in accordance with general Condition No.1. (Both signatures required) PERMITEE DATE CONTRACTOR DATE THIS NOTICE MUST BE SENT TO THE ABOVE ADDRESS A T LEAST TWO DA YS PRIOR TO COMMENCEMENT OF THE PROJECT AND lOR ANY ASSOCIA TED REGULATED ACTIVITIES. FAILURE TO RETURN THIS NOTICE, POST THE PERMIT SIGN, OR HA VE THE PERMIT AND APPROVED PLANS AVAILABLE A T THE WORK SITE FOR THE DURA TlON OF THE PROJECT MA Y SUBJECT THE PERMITTEE AND/OR CONTRACTOR TO APPLICABLE SANCTIONS AND PENAL TIES FOR NON-COMPLIANCE WITH PERMIT CONDITIONS. 9.!!.!I.I.9.!!lI.!!!!!!..I!.~.~.:::........;.................::::............................~............................::::............................:::............................~............................::::........................ NOTICE OF COMPLETION OF CONSTRUCTION RETURN THIS FORM TO: COMPLIANCE Bureau of Habijet NYSDEC Building 40 .. SUNY Stony Brook, NY 11790-2356 OR FAX TO: 631-444-0272 .. ..... .....,. PERMIT NUMBER: PROJECT LOCATION/ADDRESS: CONTRACTOR NAME: ADDRESS: TELEPHONE: ISSUED TO: Dear SIr: Pursuant to General CondItion # 9 of the referenced pennit, you are hereby notified that the authorized activity was completed on . We have fully complied with the tenns and condijions of the pennij and approved plans. (Both signatures required) PERMITEE DATE CONTRACTOR DATE THIS NOTICE, WITH PHOTOGltAf>I'J! OF mE COMFU:: TI!O ~.O,..K A,vO"'1'l A COMPLETED SURVEY, AS APPROPRIA TE, MUST BE SENT TO THE ABOVE ADDRESS WITHIN 30 DA YS OF COMPLETION OF THE PROJECT. '. ~ . I . . ~ ~ ~ u. :;,. :> , , Co . :!!: '" '" , :;,. ~ ...J ...J <I: 0:: ~ . '" , 00 ~ . ~ ~ , ~ ~ ~ Y/6'; ./ /. ./ /.// // // (. N - ~ ." , "" I : I : I : I I . ::!: '" ." , Co 13' - 8" --- -- - 27'-4"W ~ I ~ I EXISTING RESIDENCE EXISTING PORCH 13' _ 8" ------- -- --- -- -- ----- -- -........', ~ .... ..............., "", , "'" " ,",,' , I I I: I: I d I: I NEW PERGOLA - ------ I I") ,'- '-' I: I: LJ - -- - - - - - - -;'-. \ , I '- " APPROV 0 S N TED DATE: 1/14j!i '.. 303'9 & b I I "EE I.~ I e p~ NOTIFY BUlDING: '. o~RTMENT AT 765-1802 8AM T ~ -?M FOR THE FOLLOw ING INSpa~TIONS: 1. FOUNDATION. !rWO REQUIRED FOR ?OURE . OUGH - FRAMING & PLUMBING 3. 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AT TOP ANlIlOTTOM AN> STAGGBm TWO NALS AT 8t)S AN> ATEAQUFI..KlE ROOF IW'1ERS TO IIlGE. TOE HAL RAFTERS lES TO RAFTER. FACE HAL FLOOR Sl-EATJiIlG (3/4"I'I..YWOOO PAtaJ WALl.. Sl-EA TJiIlG 11I2" 1'1.. YWOOOIW'EU ROOF Sl-EAllRl!iI8" PI.. vwoOOMw 4- 16d 3-8d 8d 8d 8d 8" EDGE 1 r.r FELD 8" EDGE 112' FELD 8" EDGE 1 r.r FELD N.Oft,', c;a..OU::\," A-6 PROJECT, MilLIKEN RES. - PERGOLA ALLIE M. RARlDON, ASSOC. AlA Post Office Box 385 Fishers Island, NY 06390 Ph: 631-788 -7582 Fax: 631-788-5582 DRAWING NUMIUiR: mu, DATE: 11-04-2003 SCAl.B: 114- = l' .0- A-'1_