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Home My WebLink About32238-Z FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-31999 Date: 11/16/06 THIS CERTIFIES that the building ADDITIONS/ALTERATIONS Location of Property: 30675 MAIN RD (HOUSE NO.) County Tax Map No. 473889 Section 14 (STREET) Block 2 ORIENT (HAMLET) Lot 1. 2 SUbdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 20, 2006 pursuant to which Building Permit No. 32238-Z dated JULY 25, 2006 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 COVERED PORCH, AND ALTERATIONS TO AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. The certificate is issued to TERRY MULFORD HOUSE INC (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. N 531544 07/27/00 PLUMBRRS CERTIFICATION DATED 09/01/06 KING PLUMBING Rev. 1/81 *, '" \~%~ 1 ,\ B'"-:j\ \ = '/' ",1\ \/ . CJ) '(."_:J \ APPLICATIONFORCERTIFICATEOFOCCUPANCY:. ~ "'~\ This application must be filled in by typewriter or ink and submitted to the Building Department with the fdJ~~\Vin~~~\"-o~ A. For new building or new use: \":~:;.:;- .," I. Final survey of property with accurate location of all buildings, property lines, streets, and unusdnrnatural 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 2/1 0 of I % lead. 5. 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. . Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 - . B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 < . OI~gItriding: Date. New Construction: y'" (check one) Location of Property: 3et, 1~~R~ House No. Street Owner or Owners ofProperty~ ,,~~ ~ L&> Suffolk County Tax Map No 1000, Section I L{- Block v~ Hamlet ::J. Lot ). d- Subdivision Permit No. 3~ ~? ~ "'Z- Filed Map. Lot: DateofPermit.').,!{~ ok, Applicant: t:j,:^,^ I/\j~ ~ , Underwriters Approval: -.J Health Dept. Approval: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: $ ~ 'S'~ CO ~ 31 'lCJ '1 ./ ruc....11~)') Final Certificate: /" (check one) ~ " L ~ W)J.J. , ...,...,.. Applicant Signature 1000773 I THE NEW YORK BOARD OF FIRE UNDERWRITERS IUIlIAU OF ILlCTIIICITY . 40 FULTON ITRIIT, NIW YORK, NY 10038 ~ No, ,JIll ;10077300/00 PERMIT NO.o"Z6094 . PAGE 1 DtIU THIS CERTIFIES THAT only tIN .'""*'" optp",.", '" .,CrlIHd IH""" _ _""oil by tIN __ 1UJIIIoil 0" tIN abo.. applkatio" ,,_ '" '" tIN _"''''.. of JULY 27,2000 N 531544 RALPH WILLIAMS, 30675 MAIN R01\D, ORIENT, NY I" tII"oUow"'. k1eatio". 0 _."'.", !!lII' FL [] 2ml FL OUT S..IID" Bk1ek Lot """ ._oil 0" JUf..Y 21,2000 _Iouml /0 b. '" .Olltpuo.... wUh ,ho NallDlUIl E,"1rlelIl CoM. . 13 11 1 F FIXTURE 0UILE11 9 IICliPlACID SWlTCHU FIXTURU PWOIIICINf OIHII IANGI AMr. I.W. COO1CJN8 DlCU oveNS DISH WAIIIIRI EXHAUST FANI AMI. l.W. AJItJ. loW. AIII'. LW. AMI. H.P, 9 DRYERS AMI. l.W. FURNACE MOTORS OIL H.P, 8M H.'. FUlURE APPUANCE FEEDEn _1Ee'P1. lIME Cl.DCD lEU UNIT NEAlIn MULnoOUlUT DIMMERS IVIlEMI AMY. NO. A. W..o AMI. AMP. .un." AMN: TRANS. AMY. M,', NO. Of nIT AMY. WAnI 2 IERVICE DISCONNECT AMI. AM', 'MIl NO.O' . E MIlII IQUIP. 1,2W 1'. "3W S'4W PI. R .. lll'CC. v NO. Of H'.Lle C E ~"~ NO. Of NIU7IALI A.W. lll' OMR APPARA!UI: G.r.C.I,-4 llmKl!l . DE'l'EC'l'OR, - 5 J GENERAL MANAGER 11 ~ Per ,---' !hit celtttIcale IIlUII nolbe _ In any manner; relUm to ... ollie. oIlh. Board Ii 1nc~.1nip<Icto1l1'liay be ldenllfted by Ii,.., c .,,_. ARTHUR A. RUROEDE 23865 MAIN ROA ORIENT, NY, 11957 LIC. '2334E LLL GOPY F 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 CERTIFICATION Date: 5 j;, ;O{, / ' Building Permit No. ...3~~ 3 ~ -z: owner:Q;~e<, /h)~/t/~ (tA--l.p k ') (Please print) Plumber: /!'.o'f ~~~ .. (Please print) I certify that the solder used in the water supply system contains less than 2/1 0 of 1 % lead. c-:? _ /" ~/.J-~ (Plumbers gnature) Sworn to before me this I ~ dayo~ ' 20~ ~~q~ Notary Public, ~, ~ I . ~ County ,II BARBARA ANN RUDDER Notary PubUc, State 01 New York Np. 4855805 QuelKled In Suffolk County C,,'unllllon &lIpl... Aprt114, .Q2j b 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. 32238 Z Date JULY 25, 2006 permission is hereby granted to: MULFORD HOUSE INC TERRY 30675 MAIN ROAD ORIENT,NY 11957 for : CONSTRUCTION OF ADDITION & ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. REPLACES BP# 26094 at premises located at 30675 MAIN RD ORIENT County Tax Map No. 473889 Section 014 Block 0002 Lot No. 001.002 pursuant to application dated JULY 20, 2006 and approved by the Building Inspector to expire on JANUARY 25, 2008. Fee $ 150.00 \ e ORIGINAL Rev. 5/8/02 409Y-l:: 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1 ST [] ROUGH PLBG. [ ] FOUNDATION 2ND [] IN~ON [ ] FRAMING [~AL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION REMARKS: cO DATE INSPECTOR L--_ ~cY71 ~ 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING [ ] FIREPLACE & CHIMNEY .,.,.,ARKS: W-~ /uJ ~~E~,d- __Qar,-~~ ~~/.2//-R ~,If?~~-- BG. ] INSULATION [ ] FINAL DATE - -- ~~~ 765-1802 BUILDING DEPT. INSPECTIO [ ] FOUNDATION 1ST [ ] ~NDATION 2ND [ Vf FRAMING [ ] FIREPLACE [ [ ] INSULATION [ ] FINAL Il d~ '-, ~~oftj~ 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL [ ] F9-UNDATION 2ND flh [tri'RAMING [ ] FIREPLACE & CHIMNEY REMARKS: ~.IJ1d rim, ~ IY/C /~ ~~c/~~ .. A - t7-1/} Jo; 5 /1/1;1= S7/ht-d AI~'- ([) /) /Yrf- ~ /..;;tI!;-, ~ ~ - - Sl./J/M V,e -' ~ DATE~h/N __ ____c -- ~o{c; 765-1802 BUILDING DEPT. SPECTION ] FRAMING ] FIREPLACE & CHIMNEY SMfO FOUNDATION 2ND [ ] ROUGH PLBG. [ ] INSULATION [ ] FINAL REMARKS. +- DATE ~ ~s ___________================----=----=====--=-~2~~~cOHMEH!~~-=======================. ~ ~ L t J ~~ ff"' H~ ~- INDATION ( 1ST) JGH FRAME & PLUMBING SULATION PER N. Y. STATE ENERGY CODE fl i II II I II II I I ~ II ~ ____==_-====::1:..&._== - II FINAL ==~~=====-~=====-=========-=======~======-==== ---------------------------------------------------------------------------------~------- ~ '" ~ ~ H -....0 ~~ ~ t-1l:: "''} ~ ~ ~ r .;~ o ~t ~~ ...~ ~ t:l '" '" .; 3. l'.atu<e of work (d>eck ...id. applicable): New Building .......... Addition .)t."i.f~teration .......... Hepah ............ RaIoval ............. ileIoolition ............ Other Work .....:"............................ (Descri pt ion) 4. EstillBted Cost .78..DDQ.............. fee . ..................... ..... ... .... ........ .... . ~to be paid on filing this application) If Welling, IUlber of dwelling units..1......... tumer of dwell ingwitaon each floor."................ If garage, tuloo< of ca<s .. .....7:"............................. If business, ccmnercial or mixed occupancy, specify nature and extent of each type of use...::-................. D. . f" 'f ~ 8:;1.,' .;;:;;',?\. De ( n,,' 1JrenSJons 0 exIstIng structures, 1 any: J."l.ont........................ _ Rear........ ~~........... pt 1 ..:-"1\...,...................... l1eight ......3.'.:?'.............. IUJber of Stories .....2.............. , I Dilll!nsions ot........ structure with alterations or additions: Front ....~...... RearB2........... Depth..... .';-/Q.'......... lIeight ... ..08.'.......... lblber of Stories....."2.:....... DiIrensions of entire new construction: Front......:-:-:-....... Rear ......:0-;...... Depth ...7:"......... (1eight ..........::............. IUJber oflStories ....::-............... . ""-;> , 1/:2. I -+.,~,. SIZe of lot: Front... .-:1/"'........... Rear ..... ./oUJQ......... Depth :7""..:.1....... ~~. !late of Purchase ..................... Nare of Fonner Omer ........................................ Zone or use district in loAlich pranises are situated .............................................................. Does proposed construction violate any zoning 1_, ordinance or regulation: ... ()o............. .... Wi 11 lot be regraded ....... .no........ Will excess fill be reroved fron renises: YES @ . Nares of Ome< of premisesle~<hkl/M:l:lt~.Ir<:Address 3Q(,7S.MsJnm,Ornml'hone lb..X?~.....~.c;k,. Nare of ArchitectS:lro!..,I~,..;IR~~ A.d1l-bdrMress .;2ehlW.~ Ri......... l'hone lb. 7~::~ 5. 6. 7. 8. 9. 10. JI. 12. 13. 14. 15. Nare of Calt<actor ................................... Address ................................l'hone lb. .............. Is this property within 300 feet of a tidal wetland? * YES ... x...... IV.......... *IF YES, &I1ItUD nm TRIlS'lEE..l mlMIT MAY BE RF.QJlRED:- . e::e -t-rv-o~ hOY}~ orl s::iIc:tioy") .,. DEe .+:~ _L_ I . PLOT DIAGRAM ~, &. =~ locate clearly and distinctly all wildings, ..nether existing or proposed, and indicate all set-back dimensions frau property lines. Give street and block m.uber or description according to deed, and shoo.r street ","""s and indicate ..nethe< interior or corner lot. 5:::e 6)tt~ -SHe Plevn. . . sr^,1ll (l' /'I'll T' J-rl . . / a:AJN1Y (l' ..~~.... 5.<; .... ........... (Y fl.1Y(.'I.... ..$.T. i~/ ~."!. .~... .being duly swom, deposes and says that he ;s the applicant (Nare of individual signing contract) above oared, lie is the................................................................. ......... ......................... (Oont<actor, agent, corporate office<, etc.) of said owne< nr owne<s, and is duly authorized to perfonn 0< have perfonned tile said work and to make and file thia application; that all staterents contained in this application are true to the best of bis knowledge and belief; and that tile work will be perfonred in tile IIBmler set fo<tb in the application filed therewith. S<.>om to befo<e lIE this ~ .......:~=da~/~....(:;1~....I. lbtary l.rhC .. .,". . .. ...." .."_M..... '.' ...".,.qlLI~ . .. LINDA s. TAGGMT r : Nolary~=-,,* '~v I' OuaIifiedInQB~; HI "",mission ellPlNeUaldt. Z-a> ( .\i . '~",.., ",..- .FORM NO. 1 OF SOUTHOLD ING DEPARTMENT TOWN HALt OLD. N.Y. 11971 : 765-1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEy........................ CHECK ......................... SEPTIC FORM ................... NOTIFY: CALL 1.3.04.:-.(,:10.0... Exanined.................. 19.... Approved...le:.q....... 19.~~ Permit 1b.;?bt2?t'.~... Disapproved alc .................................. . ~ ' ................. .... .... .... ..:rlJCt. MAIL TO:.................... PLICATION FOR BUILDING PERMIT Dat~.].... .., 19. 99 INSTRUCTIONS a. This applicatioo DUSt be ~letely filled in by typewriter or in ink mxI subnitted to the I\lilding Inspector wil 3 sets of plans. accurate plot plan to scale. Fee according to schedJle. b. Plot plan shoiring loc.atioo of lot arr:! of buildings 00 prenises. relationship to adjoining premises or p.d>lic streets or areas. arr:! giving a detailed descriptioo of layout of property DUSt be drawn 00 the diagran .mich is part of this applicatioo. c. The writ covered by this applicatioo may not be ccmrenced before issuance of Building Penni t. d. Upon approval of this applicatioo. the fuilding Inspector ,rill issue a Building Permit to the applicant. Such permit shall be kept 00 the prenises available for inspectioo throoghoot the work. e. Ib building aball be occupied or used in .mole or in part for any p.1I'pOse .matever IIDtil a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATIOO IS IEmmY MAIE to the Building \lepartIIImt for the issuance of a Building Permit p.1r&l8I1t to the Building Zone Ordinance of the Town of Soothold. &Jffolk County. New York. mxI other applicable Laws. Ordinances or Regulstioos. for the coostructioo of buildings. additioos or alteratioos. or for I'l!IIIJYal or demlition, as herein described. The applicant agrees to ~ly with all applicable laws. ordinances. building code. hcusing code, arxI regulatioos. mxI to adnit aJtborized inspectors on prenises mxI in build' for s . spections. . Signatur of applicant. or nII1I!. if a corporation) :;{5;J85 f.':kJoRd.J CJ..tdJCQ.J?.1 Nf./ }cf 35 (Mailing address of applicant)J I I State wther applicant is owner. lessee. agent.. architect. engineer, general contractor. electrician. phnber or builder . Ar.~b it.e.c.+...................................:................................................................. Name of owner of prenises ~~~:t:1!J-l~rz:l.t.t~.~~.~~.................................................. (as 00 the tax roll or latest deed) . / If applicant is a ""......".tioo. signature of ooly authorized officer. .....'-................................................... (Name arr:! title of ""......cate officer) Builders License lb. Plud>era License lb. Electricians License lb. ..................... Other Trade's License lb. .................... I. Location of larr:! oo.micb p,OjlO8ed work will be done...................:.......................................... .. ..2t;J:a7.0................... .~O. R:a:l............................ .Qrx;r.r&............................ IbJae lbIber Street Hanlet ~ County Tax Map lb. 1000 Section ....~~......... Block ....~......... Lot .....J.....~ &lbdivision ...................................... Filed Map lb. ............... Tnt............... (Name) 2. State existing use arr:! occupancy of prenises mxI intended use mxI occupancy of proposed construction: a. Existing use arr:! occupancy ..et~~b:\\li..\..t"E6~................................. b. Intemed use arr:! occupancy ..61rt3.1!Z..f'a-YY.\\1tj...)1251de.Y.Jt:.e............................. 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. 26094 Z Date OCTOBER 28, 1999 permission is hereby granted to: TERRY MULFORD HOUSE INC 30675 MAIN ROAD ORIENT,NY 11957 for : CONSTRUCTION OF ADDITION AND ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 30675 MAIN RD ORIENT County Tax Map No. 473889 Section 014 Block 0002 Lot No. 001.002 pursuant to application dated SEPTEMBER 8 1999 and approved by the Building Inspector. Fee $ 75.00 ORIGINAL Rev. 2/19/98 i~ ie. I>' C ,II i LlLI' I ic' i\ n. '....".' "'@ .. " I: I,: IS n ,. ,'" W:'; i/ .)JI ig~ ,'.. --.J rL8G. D',:PT. T '\~r' F SOL'THOlD Telephone (516) 765-1801 Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION TO: Edward Forrester, Director of Code Enforcement FROM: Landmark Preservation Commission DATE: October 18, 1999 RE: Building Permit - The Terry-Mulford House The Terry-Mulford House, 30675 Main Road, Orient has filed a request for a permit to alter a part of its structure to repair minor damage in the rear of the house and to alter the design of a bedroom and dressing room. The Southold Town Landmark Commission has reviewed the alter- ations in the light of Paragraph 56-7 of the Town Law and finds as follows: In designing and specifying the alterations to the Terry-Mulford House, the architect, Nancy Steelman, considered the form and function of the part of the house that needed repair and the conformance of the alter- ations to the overall style of the house. Included in her design were the fenestration and doorways where the older elements were to be re-used, the roof-lines and pitches, which are to be matched to the existing roof surfaces, the exterior cladding and details of dress and finish. In all cases she used the existing elements of the house as the patterns to be incorporated in the repairs and alterations. The Commission finds that the design of the alterations and the quality of workmanship of the selected craftsman to accomplish this work will result in full conformance to the purpose and requirements of the Southold Town Preservation Law. It therefore recommends to the Building Department that the requested work be approved. Albert J. Krupski, President James King. Vice~President Henry Smith Artie Foster Ken Poliwoda Town Hall 53095 Main Road P.O. Box 1179 Southold, New York 11971 Telephone (516) 765-18112 Fax (516) 765-1823 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD DETERMINATION OF NON-JURISDICTION DATE: May 20. 1999 AGENT: Samuels & Steelman Terry-Mulford House Inc. APPLICANT: ADDRESS: 30675 Main Rd. ADDRESS: 25235 Main Rd. Cutchogue. NY Orient. NY PHONE: 734-6405 PHONE: RE: SCTM# 1000-14-2-1 The Southold Town Board of Trustees reviewed the survey dated and received in our office on May 19. 1999 and detennined that your proposal to Construct an addition to the house and add a new porch 100' from the freshwater marsh to be out of the Trustee Wetland Jurisdiction under Chapter 97. However, any activity within 75' of the Wetland line requires a permit from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, fLtL..1 t). /~o ~ Albert 1. Krupski, Jr. President, Board of Trustees AJK/lms . New York State Department of Environmental Conservation Division of Environmental Permits Building 40 - SUNY, Stony Brook, New York 11790-2356 Telephone (516) 444-0365 Facsimile (516) 444-0360 ~ ~ ...." John P. Cahill Commissioner September 1, 1999 Ralph & Elinor Williams 30675 Main Road Orient, NY 11957 RE: Permit No: 1-4738-02309/00001 Dear Permittee: In conformance with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please read all conditions carefully. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected from the weather. Very truly yours, ~i'~ Charles T. Hamilton Permit Administrator CTH/ls NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION DEC PERMIT NUMBER 1-473B-D2309/DD001 FACILITY/PROGRAM NUMBER(S) . PERMIT EFFECTIVE DATE August 3D 1999 EXPIRATION DATE(S) Under the Environmental Conservation Law August 30, 2001 TYPE OF PERMIT . New o Renewa l o Modification o Permit to Construct o Permit to Operate 0 Article 15, Title 5: Protection 0 6NYCRR 6DB: Water Quality 0 Article 27, Title 7; 6NYCRR of Waters Certification 360: Solid Waste Management 0 Article 15, Title 15: Water 0 Article 17, Titles 7, B: SPDES 0 Article 27, Title 9; 6NYCRR Supply 373: Hazardous Waste Management 0 Article 19: Air Pollution 0 Article 15, Title 15: Water Control 0 ArticLe 34: Coastal Erosion Transport Management 0 Article 23, Title 27: Mined 0 Article 15, Title 15: Long Land RecLamation 0 Article 36: Floodplain Island Wells Management . Article 24: Freshwater Wetlands 0 Article 15, Title 27: Wild, 0 Articles 1, 3. 17, 19, 27, 37; Scenic and RecreationaL Rivers 0 Article 25: Tidal Wetlands 6NYCRR 380: Radiation Control PERMIT ISSUED TO TELEPHONE NUMBER Ralch & Elinor Williams (516) 323-3640 ADDRESS OF PERMITTEE 30675 Main Road Orient, NY 11957 CONTACT PERSON FOR PERMITTED WORK TELEPHONE NUMBER Samuels & Steelman (Nancy Steelman) 25235 Main Road Cutchogue NY 11935 (516) 734-6405 NAME AND ADDRESS OF PROJECT/FACILITY Terrv Mulford House 30675 Main Road LOCATION OF PROJECT/FACILITY Orient NY 11957 COUNTY TOWN WATERCOURSE NYTM COORDINATES Suffolk Orient DESCRIPTION OF AUTHORIZED ACTIVITY: Add an addition to a single family dwelling. All work is to be done in accordance with plans stamped NYSDEC approved. 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 Building 40, SUNY, Room 121, Stony Brook, NY 11790-2356 Charles T. Hamilton AUTHORIZED SIGNATURE DATE I. Se tember 1999 Page 1 of 4 - 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 of the State of New York, its representatives, employees, agents, and assigns for all claims, suits, actions, damages, and costs of every name and description, arising out of or resulting from the permittee's undertaking of activities or operation and maintenance of the facility or facilities authorized by the permit in compliance or non-compliance with the terms and conditions of the permit. Item B: 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 SAPA401(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 renewai, modification or transfer of this permit. Such application must include any forms or supplemental information the Department requires. Any renewal, modification or transfer granted by the Department must be in writing. The permittee must submit a renewal application at least: a) 180 days before expiration of permits for State Pollutant Discharge Elimination System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submission of applications for permit renewal or modification are to be submitted to: NYSDEC Regional Permit Administrator, Region 1, SUNY Bldg #40, Stony Brook, NY 11790-2356 General Condition 4: Permit Modifications, Suspensions and Revocations by the Department The Department reserves the right to modify, suspend or revoke this permit. The grounds for modification, suspension or revocation include: a) the scope of the permitted activity is exceeded or a violation of any condition of the permit or provisions of the ECl and pertinent regulations is found; b) the permit was obtained by misrepresentation or failure to disclose relevant facts; c) new material information is discovered; or d) environmental conditions, relevant technology, or applicable law or regulation have materially changed since the permit was issued. DEC PERMIT NUMBER 1-4738-02309/00001 PAGE..L OF ~ . 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 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. 3. Granting of this permit does not relieve the applicant of the responsibility of obtaining any other penmission, consent or approval from the U.S. Army Corps of Engineers, U.S. Coast Guard, New York State Office of General Services or local government which may be required. 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 piles, ridges across the bed of a waterway or floodplain or deep holes that may have a tendency to cause damage to navigable channels or to the banks of a waterway. 6. There shall be no unreasonable interference with navigation by the work herein authorized. 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 penmit application. Such approved plans were prepared by Nancv L. Steelman dated 7/8/99 DEC PERMIT NUMBER 1-4738-02309/00001 PAGEL OF ~ 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. 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. 3. 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 or tank storage within 100 feet of the regulated wetland or water body. 4. 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. 5. 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. 6. The permittee shall incorporate the following language as a notice covenant to the deed: "Regulated freshwater wetlands associated with NYSDEC Wetland 0-7 are located on or near the properties of Terry- Mulford House, Inc. and 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 of this permit to: NYSDEC, Regional Manager Bureau of Habitat, SUNY Building 40, Stony Brook, New York 11790-2356. DEC PERMIT NUMBER 1-4738-02309/00001 PAGE ~ OF -L DESTIN GRAF P.L.S., P.C. LAND SURVEYOR 73 WOODLAWN ROAD ROCKY POINT, N.Y. 11778 [516] 821-3442 ELEVATION CERTIFICATION ruNE 30, 1999 SUBJECT PREMISES SUFFOLK COUNTY TAX MAP DESIGNATION DlST. 1000 SECT. 14 BLOCK 2 LOT 1 FIRST FLOOR ELEVATION 9.40' I DO HEREBY CERTIFY THAT THE ABOVE ELEVATION IS CORRECT AND IS BASED ON NATIONAL GEODETIC SURVEY DATUM MEAN SEA LEVEL [ USCGS ]. DESTIN G. GRAF LAND SURVEYOR N.Y.S.LIC.50067 LETTER OF AUTHORIZATION Ralph and Elinor Williams 30675 Main Road Orient, NY 11957 516323-3646 May 17, 1999 We hereby authorize Nancy Steelman of SAMUELS & STEELMAN ARCHITECTS to act as our agent in obtaining all permits required by the Town of Southold and the New York State Department of Environmental Construction for the renovations and additions to our residence at located at 30675 Main Road, Orient, NY r~ if W~~ Owner Yh7, /~ I lcrrr ate I