HomeMy WebLinkAbout36768-Z �0 COG�.c Town of Southold 3/10/2022
0
P.O.Box 1179
co 53095 Main Rd
py o��' Southold,New York 11971
CERTIFICATE OF OCCUPANCY
No: 42897 Date: 3/10/2022
THIS CERTIFIES that the building ACCESSORY
Location of Property: 2503 Camp Mineola Rd Ext,Mattituck
SCTM#: 473889 Sec/Block/Lot: 122.-9-9.4
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
10/7/2011 pursuant to which Building Permit No. 36768 dated 10/20/2011
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:
pool terrace replacement with fence to code as applied for.
The certificate is issued to Fox,Edward&Fox,Arlene
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
ut or' e Signature
DIN
TOWN OF SOUTHOLD
o�S�FFoG�
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 36768 Date: 10/20/2011
Permission is hereby granted to.:
Fox, Edward & Fox, Arlene
PO BOX 596
Mattituck, NY 11952
To: replace a pool terrace with fence to code
At premises located at:
2503 Camp Mineola Rd Ext, Mattituck
SCTM # 473889
Sec/Block/Lot# 122.-9-9.4
Pursuant to application dated 10/7/2011 and approved by the Building Inspector.
To expire on 4/20/2013.
Fees:
ALTERATION OF ACCESSORY BUILDINGS $784.00
CO -ACCESSORY BUILDING $50.00
Total: $834.00
Building Inspector
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,.before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631).765-1802 Planning Board approval
FAX:.(631) 765-9502 Survey ;
SoutholdTown.NorthFork.net PERMIT NO. a(o7C-9 Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 20 // Flood Permit
Storm-Water Assessment Form
Contact:
Approved /1 2011 Mail to:
Disapproved a/c
Phone:
Expiration —f—
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date �3 , 20-k—
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b, Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approvalof 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 12months after the date of
issuance or has not been completed within,-1 8 months from such date. If no zoning amendments or other regulations affecting the
property,have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department*for the issuance of a.Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County,New.York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances,building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
4( igmature of applicant or name,if a corporation)
(Mailing address applicant
State whether applicant is owner, lessee,'agent, architect, engineer,.general contractor, electrician, plumber or builder
Name of owner of premises 4J
(As-on the tax roll or 1 test 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.
1: Location of land on which roposed work will be done:
House Number Street Hamlet
County Tax Map No. 1000 Section ...Block. / Lot
Subdivision 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 (check which applicable): New Building Addition Alteration
Repair Removal . Demolition -, Other Work
(Description)
4. Estimated Cost 7 �qDID Fee
(To be paid on filing this application)
5. If dwelling, number of dwelling units . Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy,.specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front ZC2 Rear 'IE;nDepth
Height ® Number of Stories'�/�
Dimensions of same structure with alterations or additions: Front — Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front
10. Date of Purchase Name of Former Owner
11. Zone or use district in which premises are situated.— le
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO7X—
13. Will lot be re-graded? YES NOWiII excess'fill be removed from premises? YES NO
y
14. Names of Owner of premises ZD g! Address 4,G5 ,S77 hone No.
Name of Architect Addresses�/ii4/� Phone No ��3 �t 0,1
Name of Contractor Address Phone No. -
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES "ANO
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES ANO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide-survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
18. Are there any covenants and restrictions with respect to this property? * YES NO 1,-' .
*-IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF `�)
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
that all statements contained in this.application are true to the best of his knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this ,l
day of 0
. 201(
C
PAA� P;qRICR RICHARDS
oblic, state of New you�
Notary Public Pio: 01 P116042467 Signature of Applicant
Qualified in suffoii€ County
Commission Expires.May
G Jill M. Doherty,President so Town Hall Annex
Bob Ghosio,Jr.,Vice-President ,`O l0 54375 Main Road
P.O.Box 1179 _
James F. King Southold,New York 11971-095.9
Dave Bergen G Q
• �O Telephone(631) 765-1892
John Bredemeyer OI�Mum
Fax(631) 765-6641
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Permit No.: 7610A
Date of Receipt of Application: July 21, 2011
Applicant: Ed & Arlene Fox
SCTM#: 122-9-9.4
Project Location: 2503 Camp Mineola Rd. Ext., Mattituck
Date of Resolution/Issuance: August 24, 2011
Date of Expiration: August 24, 2013
Reviewed by: Trustee Jill Doherty
Project Description: To replace the existing stone paving surrounding the
existing pool in-kind and with a timber pile foundation to prevent settling.
Findings: The project meets all the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code. The
issuance of an Administrative Permit allows for the operations as indicated on the
site plan prepared by Samuels & Steelman Architects dated July 19, 2011.
Inspections: Final inspection.
If the proposed activities do not meet the requirements for issuance of an
Administrative Permit set forth in Chapter 275 of the Southold Town Code, a.
Wetland.Permit will be required.
This is not a determination from any other agency.
Jill Doherty, de
Boa of Trustees
Jamas F.King,PresidentTown Hall Annex
Bob Ghosio,Jr.,Vice-President 64876 lain Road
P.O.Box 1179
Dave Bergen Southold,New York 11971-0959
John Bredemeyer Telephone(691)765-1892
Michael J.Domino Fax(631)76543641
'W111 ti,
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
CERTIFICATE OF COMPLIANCE
#0800C Date: September 18,2012
THIS CERTIFIES that the replacement of the existing stone paying awmnding the
existing pool in-kind and with a timber pile foundation to prevent settling.
At 2503 Camp Mineola Road Ext:,Mattituck,New York
Suffolk County Tax Map# 122-9-9.4
Conforms to the application for a Trustees Permit heretofore filed in this office
Dated July 21,2011 pursuant to which Trustees Administrative Permit#7 110A Dated
Aultvst 24,2011 was issued and conforms to all of the requirements and conditions of the
applicable provisions of law. The project for which this certificate is being issued is
for the replacement of the existing_sjpmpaving surrounding the existing MI in-kind and with a
timber pile foundation toprevent settling.
The certificate is issued to ED&ARLENE FOX owner of the
aforesaid property.
t�
Authorized Signature
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION No
Facility DEC ID 1-4738-02395
PERMIT
Under the Environmental Conservation law (ECL)
Permittee and Facility Information
Permit Issued To: Facility:
EDWARD FOX FOX PROPERTY
445 EAST 80 ST 2503 CAMP MIN OLA RD JSCTM 1000-122-09-
9.4
APT 8E MATTITUCK, 11952
NEW YORK,NY.10021
(212) 755-5390
Facility Application Contact:
SAMUELS & STEELMAN ARCHITECTS
25235 MAIN RD
CUTCHOGUE, NY 11935
(631) 734-6405,
Facility Location: in SOUTHOLD in SUFFOLK COUNTY Village: Mattituck
Facility Principal Reference Point: NYTM.-E: 708.3 NYTM- : 4540.8
Latitude: 40°59'30.4" Longitude: 72°31'25.1
Project Location: 2503 Camp Mineola Road- SCTM# 1000-122-09-S.4
Authorized Activity:- Construct a one-story addition, a two-story additi n including a garage,porches,
relocate existing septic tank, replace stone paving in-kind, and expand g-avel driveway. All work must
be in accordance with the attached plans stamped NYSDEC approved oi 17/9/08.
Permit Authorizations
Tidal Wetlands - Under Article 25
Permit ID 1-4738-02395/00003
New Permit Effective Date: 7/9/2008 E piration Date: 7/8/2013
NYSDEC Approval
By acceptance of this permit, the permittee agrees that the permit is contingent upon strict
compliance with the ECL,all applicable regulations, and all conditi ns included as part of this.
permit.
Permit Administrator: GEORGE W HAMMARTH, Deputy Regional P it Administrator
Address: NYSDEC REGION 1 HEADQUARTERS
SUNY @ STONY BROOK150 CIRCLE RD
STONY BROOK, NY 11790 -3409
Authorized Signature: AftDate / / ay
Page 1 of 6
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION ow
Facility DEC ID 1-4738-02395
Distribution List
SAMUELS & STEELMAN ARCHITECTS
Marine Habitat Protection
DARLEEN M GERBINO
Permit Components
NATURAL RESOURCE PERMIT CONDITIONS
GENERAL CONDITIONS, APPLY TO ALL AUTHORIZED PERMI S
NATURAL RESOURCE PERMIT CONDITIONS - A pply to the Following
Permits: TIDAL WETLANDS
1. State Not Liable for Damage The State of New York shall in no ca 3e 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.
2. Notice of Commencement At least 48 hours prior to commen cemer t of the project, the permittee
and contractor shall sign and return the top portion of the enclosed notifi ation 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 returnd, along with photographs of
the completed work.
3. Concrete Leachate During construction, no wet or fresh concrete oi leachate shall be allowed to
escape into any wetlands or waters of New York State, nor shall washin s from ready-mixed concrete
trucks, mixers, or other devices be allowed to enter any wetland or water . Only watertight or
waterproof forms shall be used. Wet*concrete shall not be poured to displace water within the forms.
4. No Construction Debris in Wetland or Adjacent Area Any debriE or excess material from
construction of this project shall be completely removed from the adj ace: t area(upland) and removed to
an approved upland area for disposal. No debris is permitted in wetland and/or protected buffer areas.
5. Storage of Equipment, Materials The storage of construction equil ment and materials shall be
confined within the project work area and/or upland areas greater than H 0 linear feet from the tidal
wetland boundary.
6. Install, Maintain Erosion Controls Necessary erosion control mea ures, i.e., straw bales, silt
fencing, etc., are to be placed on the downslope edge of any disturbed ar a. This sediment barrier is to
be put in place before any disturbance of the ground occurs and is to be r laintained in good and
functional condition until thick vegetative cover is established.
7. Runoff Directed to Upland Drywells Roof runoff shall be directed o drywells a minimum of 120
linear feet landward of the tidal wetland boundary for immediate on-site echarge.
Page 2 of 6
Ank
NUNN
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATK N
Facility DEC ID 1-4738-02395
8. Driveway/Parking Area of Pervious Material Driveway and parki ig areas shall be constructed of
NYSDEC-approved pervious materials.
9. Direct Runoff Away from Tidal Wetland and Buffer Roads, driveways, and parking areas shall
be graded to direct runoff away from tidal wetlands and protected buffer areas.
10. Sanitary Systems above Groundwater Sanitary system (bottom o tank and leaching pools) shall
be located a minimum of 2 feet above seasonal high groundwater.
11. Seeding Disturbed Areas All areas of soil disturbance resulting from the approved project shall be
stabilized with appropriate vegetation (grasses, etc.) immediately following project completion or prior
to permit expiration, whichever comes first. ,If the project site remains inactive for more than 48 hours
or planting is impractical due to the season, then the area shall be stabili2 ed with straw or hay mulch or
jute matting until weather conditions favor germination.
12. Temporary Mulch, Final Seeding If seeding is impracticable due o the time of year, a temporary
mulch shall be applied and final seeding shall be performed at the earlies opportunity when weather
conditions favor.germination and growth but not more than six months a er project completion.
13. Maintain Erosion Controls All erosion control devices shall be maintained in good and functional
condition until the project has been completed and the area has been stab lized.
14. Contain Exposed, Stockpiled Soils All disturbed areas where soil will be temporarily exposed or
stockpiled for longer than 48 hours shall be contained by a continuous line of staked haybales/ silt
curtains (or other NYSDEC approved devices)placed on the seaward Sibetween the fill and the
wetland or protected buffer area. Tarps are authorized to supplement thee approved methods.
15. Clean Fill Only All fill shall consist of clean sand, gravel, or soil (i of asphalt, slag, flyash, broken
concrete or demolition debris).
16. Conformance With Plans All activities authorized by this permit r iust be in strict conformance
with the approved plans submitted by the applicant or applicant's agent as part of the permit application.
Such approved plans were prepared by Thomas C. Samuels dated 3/8/08
17. State May Order Removal or Alteration of Work If future operal'ons by the State of New York
require an alteration in the position of the structure or work herein autho 'zed, or if,'in the opinion of the
Department of Environmental Conservation it shall cause unreasonable cbstruction to the free navigation
of said waters or flood flows or endanger the health, safety or welfare of he people of the State, or cause
loss or destruction of the natural resources of the State, the owner may b ordered by the Department to
remove or alter the structural work, obstructions, or hazards caused there y 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 complete , the owners, shall, without
expense to the State, and to such extent and in such time and manner as t ie 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 thd watercourse. No claim shall
be made against the State of New York on account of any such removal c r alteration.
Page 3 of 6
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION �
Facility DEC ID 1-4738-02395
18. Precautions Against Contamination of Waters All necessary pr autions shall be taken to
preclude contamination of any wetland or waterway by suspended solid , sediments, fuels, solvents,
lubricants, epoxy coatings, paints, concrete, leachate or any other enviro unentally deleterious materials
associated with the project.
19. State May Require Site Restoration If upon the expiration or rev cation of this permit, the
project hereby authorized has not been completed, the applicant shall, w thout expense to the State, and
to such extent and in such time and manner as the Department of Enviro amental Conservation may
require, remove all or any portion of the uncompleted structure or fill an I restore the site to its former
condition. No claim shall be made against the State of New York on ac ount of any such removal or
alteration.
GENERAL CONDITIONS - Apply to ALL Authorized Permits:
1. Facility Inspection by The Department The permitted site or facil ty, including relevant records, is
subject to inspection at reasonable hours and intervals by an authorized i epresentative 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 suspeilded pursuant to ECL 71- 0301
and SAPA 401(3).
The permittee shall provide a person to accompany the Department's rep esentative 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 facili . Failure to produce a copy of
the permit upon request by a Department representative is a violation of his permit.
2. Relationship of this Permit to Other Department Orders and Det rminations 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 term:;, conditions or requirements
contained in such order or determination.
3. Applications For Permit Renewals, Modifications or Transfers e permittee must submit a
separate written application to the Department for permit renewal, modil ication or transfer of this
permit. Such application must include any forms or supplemental infomiation the Department requires.
Any renewal, modification or transfer granted by the Department must be in writing. Submission of
applications for permit renewal, modification or transfer are to be submi ted to:
Regional Permit Administrator
NYSDEC REGION 1 HEADQUARTERS
SUNY @ STONY BROOK150 CIRCLE RD
STONY BROOK, NY11790 -3409
4. Submission of Renewal Application The permittee must submit a mnewal application at least 30
days before permit expiration for the following permit authorizations: T dal Wetlands.
Page 4 of 6
Aft
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATH N �
Facility DEC ID 1-4738-02395
5. Permit Modifications, Suspensions and Revocations by the Department The Department
reserves the right to modify, suspend or revoke this permit. The ground for modification, suspension or
revocation include:
a. materially false or inaccurate statements in the permit applicatio or supporting papers; .
b. failure by the permittee to comply with any terms or conditions o 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 a ironmental conditions, relevant
technology or applicable law or regulations since the issuance of he existing permit;
e. noncompliance with previously issued permit conditions, orders of the commissioner, any
provisions of the Environmental Conservation Law or regulations of the Department related to
the permitted activity.
6. Permit Transfer Permits are transferrable unless specifically prohib Ited by statute, regulation or
another permit condition. Applications for permit transfer should be sub nitted prior to actual transfer of
ownership.
NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS
Item A: Permittee Accepts Legal Responsibility and Agrees to Indenmification
The permittee, excepting state or federal agencies, expressly agrees to in emnify and hold harmless the
Department of Environmental Conservation of the State of New York, it representatives, employees,
and agents ("DEC") for all claims, suits, actions, and damages, to the ext nt attributable to the
permittee's acts or omissions in connection with the permittee's undertakng of activities in connection
with, or operation and maintenance of, the facility or facilities authorize by the permit whether in
compliance or not in compliance with the terms and conditions of the pei mit. This indemnification does
not extend to any claims, suits, actions, or damages to the extent attribut ble to DEC's own negligent or
intentional acts or omissions, or to any claims, suits, or actions naming t e DEC and arising under
Article 78 of the New York Civil Practice Laws and Rules or any citizen suit or civil rights provision
under federal or state laws.
Item B:_Permittee's Contractors to Comply with Permit
The permittee is responsible for informing its independent contractors, a ployees, agents and assigns of
their responsibility to comply with this permit, including all special cond tions while acting as the
permittee's agent with respect to the permitted activities, and such persor s 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 Permi s
The permittee is responsible for obtaining any other permits, approvals, l nds, easements and rights-of-
way that may be required to carry out the activities that are authorized by this permit.
Page 5 of 6
Am
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION `Imbue
Facility DEC ID 1-4738-02395
Item D: No Right to Trespass or Interfere with Riparian Rights
This permit does not convey to the permittee any right to trespass upon t ie 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 parson not a party to the
permit.
Page 6 of 6
Town of Southold
Erosion, Sedimentation .& Storm-Water Run-off ASSESSMENT FORM
PROPERTY LOCATION: C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OFA.
xav )Z—L Y STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN
s nc ec3tfon oc at CERTIFIED BYA DESIGN PROFESSIONAL IN THE STATE OF NEW YORK.
SCOPE OF WORK - PROPOSED CONSTRUCTION ITEM# / WORK ASSESSMENT Yes No
a. What is the Total Area of the Project Parcels? 6 aJ S/' 1 Will this Project Retain All Storm-Water Run-Off
(Include Total Area of all Parcels located within / 46, Generated by a Two,(2")Inch Rainfall on Site?
b. .What is the T
the Scope Total Area*of Land Clearing (S.F./Aces) ( e aY Work for Proposed Construction). ° This item will include run-off created b site — ❑
oclearing and/or construction activities as well as all
arid/or Disturbance for the proposed Site Improvements and the permanent creation of
construction
ruction activity? impervious surfaces.)
(S.F.I Acres)
2 Does the Site Plan and/or Survey Show All Proposed
PROVIDE BRIEF PROJECT DESCRIPTION (Provide Additional Pages as Needed) Drainage Structures Indicating Size&Location?This
Item shall include all Proposed Grade Changes and
Slopes Controlling Surface Water Flow.
� � 3 Does the Site Plan and/or Survey describe the erosion
and sediment control practices that will be used to
control site erosion and storm water discharges. This KEI`6Q) A&z— item must be maintained throughout the Entire
Construction Period.
4 Will this Project Require any Land Filling,Grading or
Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards M _
of Material within any Parcel?
5 Will this Application Require Land Disturbing Activities
Encompassing an Area in Excess of Five Thousand .
(5,000 S.F.)Square Feet of Ground Surface?
6 Is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction
General DEC SWPPP Requirements: or within One Hundred(100')feet of a Wetland or
Submission of a SWPPP is required for all Construction activities involving soil Beach?
disturbances of one(1)or more acres; Including disturbances of less than one acre that 7 Will there be Site preparation on Existing Grade Slopes
are part of a largercommon plan that wilt ultimately disturb one or more acres of land; which Exceed Fifteen(15)feet of Vertical Rise to ❑ '/�/
including Construction activities involving soli'disturbances of less than one(1)acre where . One.Hundred(100')of Horizontal Distance?
the DEC hes determined that a SPDES permit is required for storm water discharges.
(SWPPP's Shall meet the Minimum.Requirements of the SPDES General Permit 8 Will Driveways,Parking Areas or other Impervious
forStorm Water Discharges from Construction activity-Permit No.GP-010-001.) Surfaces be Sloped to Direct Storm-Water Run-Off
1.The SWPPP shall be prepared prior to the submittal of the Not.The NOI shall be into and/or in the direction of a Town right-of-way? —
submitted to the Department prior to the commencement of construction activity.
2.The SWPPP shall describe the erosion and sediment control practices and where 9 Will this Project Require the Placement of Material, l
required,post construction storm water management practices that will be used and/or Removal.of Vegetation and/or the Construction of any tV—/
constructed to reduce the pollutants in storm water discharges and to assure Item Within the Town Rlghf-of-Way or Road:Shoulder
compliance with the terms and conditions of this permit.In addition,the SWPPP shall Area?(This Item will NOT include the Installation of Driveway Aprons:)
identify potential sources of pollution which may reasonably be expected to affect the
quality of storm water discharges. NOTE: If Any Answer to Questions One through Nine Is Answered with a Check Mark
3.All SWPPPs that require the post-construction storm water management practice In a Box and the construction site disturbance is between 5,000 S.F.81 Acre in area,
component shall be prepared by a qualified Design Professional Licensed in New York a Storm Water,Grading,Drainage&Erosion Control Plan Is Required by the Town of
that is knowledgeable in the principles and practices of Storm Water Management. Southold and Must be Submitted for Review Prior to Issuance of Any Building Permit
(NOTE: A Check Mark(.J)and/or Answer for each Question is Required for a Complete Application)
STATE OF NEW YORK,
COUNTY OF....... ...... ...........................SS
That 1,....... .....
:.... !!!..!I/�V being duly sworn,deposes and says that he/she is the applicant for Permit,
(Name of individual signing.Document) ,,.
And that he/she is the ................................ 0/!.!Yl� �...........................
...........................................................
(Owner,Contractor,Agent,Corporate Officer,etc.) .
Owner and/or representative of the Owner or Owners,and is duly authorized.to perform or have performed the said work and to
make and file this application;that all statements contained in this.application are true to the best of his knowledge and belief;and
that the work will be performed in the manner set forth in the application filed herewith.
Sworn to before me this;
.......I........ .. .. d y o�Q "RICHARDS )1
�'�O Gy t.L9 BC, YEW s rq�`>l Vt`,2 ./.)
Notary Public: ... :. .. n.. h' E, .6..:. ...
Rinlifi d in Suffolk CoL nti Signature of Applicant)
FORM 0'6110 ' Commission Expires May 30,
TE DATA
• TEST HOLE DATA OffA
TEST HOLE DUG BY McDONALD GEOSCIENCE SCTM # 1000-122-9-9.4
ON JUNE 2, 1999 at 11 AM
PROPERTY: 2503 CAMP MINEOLA ROAD EXT.
ADDRESS MATTITUCK, NY
-•a• 0 w S
69O I
MIXED SAND, LOAM 4 CLAY w0 w i
OWNER: ED & ARLENE FOX
EL. 2.0 :• �:_=� N101F I :o. `':.: . I 455 EAST 80th ST. APT 8E
3.6 h oQ' £p�£ WILLL4Y J. TUFANO NEW YORK, NY 10021
4 LATER IN MIXED SAND, LOAM 8 CLAY N 0
_ y�✓pvK00 giy"•0S W
0 0 I
arc 8I'llwck 77 • �9 sFpso£p ._._---- --.-___------ g j ZONING: R-40 =
WATER IN BROWN 506 Pt h+T o� £ O --
TELEPHONE JUNCTION BOX A� pMp 19, ^W GI j
WELL ♦ 4-9 'qY '4M' 0' p BEACH OLIMITED ____-__.-- Z
ELECTRIC JUNCTION BOX 191• ££° FOLLY -_----- -- .; SURVEYOR: NATHAN -AFT CORWIN III
F.
\-\. , 4,, _ _ _ --- _ PO BOX 1931 O
4.4' :� IRON N 0 F
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CLAYEY SAND SG -5--1WIL OF WAY UFAND:..:, : '.:: . :.';- O O
ELECTRIC METEROgT :,,: T. . , ^ -
WATER IN GREY , , , RIVERHEAD, NY 11901
�ar _ ...._... �
13' - _ LICENSE #
50467
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WATER IN BROWN GLA .�. 3.8. SPLli PAIL FENCE
P .
4'50'50 W 70.00'
20 I -------------- - :fA N S 8 COVERAGE
WATER IN GREY CLAYEY SAND SC ,r ---- ---------------------
39'40.
23' -_ ------LANDs6APED � = �o. , w
- AREA __ �` / 00 j SITE AREA 63,993 SF = 1 .469 ACRES
—
NOTES: 08
WATER IN PALE BROWN FINE 5--------- - f-�' /'/ -----TEsr - i
�: `�_� _ I EX. HOUSE & 21107 SF �
POOL HOUSE V
TO COURSE SAND sw ~ Y :> :>: I �; JUNE 24, 1999
( i IO AUGUST 2 1999 ADDED PROPOSED HOUSE
..Q_ _ EX. POOL & 3,297 SF H
29 ; ^, ,. .r : , :'.,� �� _, ;' EXISTING AUGUST 30, 1999 SET LATH FOR N.Y.S.D.E.C. INSPECTION O
6 --------- -
1 I UNDER6ROUND JANUARY 12, 2000 REVISED SITE PLAN
4' PUBLIC WATER JULY 11, 2000 ADDED PROPOSED WATER SERVICE STONE PAVING
Q
SGA .' `, ��,� 3 SERVICE LINE JANUARY 30, 2001 UNDER CONSTRUCTION SURVEY o F"
o I c
o APRIL 8, 2002 FINAL SURVEY EX. COVERAGE 5,404 SF 8.4/o
o _ EXISTING JUNE 14 2002 REVISED CESSPOOL MEASUREMENT Q
� LEACHING POOLS
� •' '�`'�'," ` I � N JULY 31, 2002 REVISED CESSPOOL MEASUREMENT
TO REMAIN AUGUST 19, 2002 ADDED ROOF OVERHANG AT POOL HOUSE O
)45T1Nc�d': '� `= '' '::;_' ' = ;`� JUNE 27, 2003 SET MONUMENTS & RE-BARS
? -' ';' `: -`r ; I, EXISTING TIMBER JUNE 16, 2004 SET RELOCATE H.W.M. & SET RE-BARS AT 75' & 100' SETBACKS
' 5
/ --
N OT�`RI�NiAIN -L DECEMBER 7, 2007 UPDATE HIGH WATER MARK LOCATION & STAKE 100' SETBACK w
10 TO ,':' ';`: 1. ELEVATIONS ARE REFERENCED TO N.G.V.D. 1929 DATUM
;/ EXISTING ELEVATIONS ARE SHOWN THUS:1u
o " w 2. WETLANDS IF ANY ARE NOT SHOWN
6 'tirEk '' o�
! t' '' 7 p 3. FLOOD ZONE INFORMATION TAKEN FROM:
/• FLOOD INSURANCE RATE MAP No. 36103CO482 G
�- ,• ZONE AE: BASE FLOOD ELEVATIONS DETERMINED
T�t N ZONE VE: COASTAL FLOOD WITH VELOCITY HAZARD (WAVE ACTION);
"i- BEV .'.'.'.'.. EXISTING MASONRY BASE FLOOD ELEVATIONS DETERMINED
RETAINING WALL TO ZONE X`: AREAS OF 500-YEAR FLOOD; AREAS OF 100-YEAR FLOOD WITH AVERAGE
' DEPTH OF LESS THAN 1 FOOT OR WITH DRAINAGE AREAS LESS THAN
REMAIN
I \\ 1 SQUARE MILE; AND AREAS PROTECTED BY LEVEES FROM 100-YEAR FLOOD.
N�0/F O 4. THIS PROPERTY IS SHOWN AS LOT 2 ON MINOR SUBDIVISION MAP FOR PETER F. KREH
WILL PYMM I o \ '� FILED AT THE SOUTHOLD TOWN PLANNING BOARD.
& MARILYN PYMM I � S 5. SEPTIC SYSTEM MEASUREMENTS SUPPLIED BY OTHERS.
i LAM =
o otS Z
REPLACE EXISTING o _ EXI5TIN6 SANITARY
STONE PAVING IN �i - ; STONE PATIO i - 6 SYSTEM FOR ACCESSORY
BLDG. TO REMAIN en Q• Y
KIND, W/TIMBER PILES
BELOW TO PREVENT
SETTLING I'm 9 EXISTING # _ °
POOL W J• z
1•� 6 N/0/�'
WILLIAM J. TUFANO
& MILLICENT TUFANO APPROVED AS NOTED Z "
.� W• � h � o
- --------------86i____ --- - DATE is , -�f W a s
' / B.P.#
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_ 6.4 PROPOSED HAY BALES 4 SILT 765-18026 81LAM TO 4pPMTFOR THE
PROPOSED HAY = AT
y•
7.3 9,K� --- _ FENCE DURING CONSTRUCTION FOLLOWING INSPECTIONS:
-- ----- -----
BALES dSILT FENCE 7 __— --------------------------
______________ _ - -.� ��5----_-,_ 7.3 --'------7 1. FOUNDATION-TWO REQUIR D
DURING CONSTRUCTION --__--_ _ ---UOQ �' - FOR POURED CONCRETE
6 _
5.9
s -- _ Y'�--- EXISTING FENCE TO REMAIN 2. ,ROUGH-FRAMING,PLUMBING,
STRAPPING,ELECTRLCAL-&CAU KING
�- 6.7 '- c OCCUPANCY r ,
�J S E I S UNLAWFUL � I 4. FINAL-CONSTRUCTION &ELEC ICAL
EXISTING
5 "- 6 7 VEGETATED 5.4 `\�` ti1U$T BE"COMPLETE FOR C.0 PSE OF NFw�
— BUFFER o W, ITH0 UT t�F 4 .,I t `r[4 ALL CONSTRUCTION SHALL MEET T 5, PS C.
ZONE AE(EL 8_) -----=-'a 6 REQUIREMENTS OF THE CODES 0 NEW Off` 'LiG
_ _ _.---
ZONE VE(EL- 8) __
LOCATION MAP--_ ' YORK STATE NOTRESPONSIBLEF R
• ,--'' �N DESIGN OR CONSTRUCTION ERRO .
6.5 - -------- 6 4 461 JUST LEGION►AYZ 'A -
N 018350-
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- - BEACH
---- -------------------------
PROJECT NO: 0511
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N\G\A SC,, �i v�
, `�� "°� � �-� 919/11
Z S I I8 jl �� SCALE:
121=30'
go
G R E A T P E C 0 N I C B A Y SHEET TITLE:
-� SITE
PARD
PLAN
11hSCALE: 1" = 30' -0" CREAT PEC+9IVIC BAY
SHEET NO:
ENCLOSE POOL TO CODC
UPON COMPLETION
BEFORE"WATER"
CONSTRUCTION SET
BUILDING FACE
1/2" EXPANSION JOINT FILLER AND
SEALANT
PROVIDE #5 REBAR DOWELS, 12" OG
HORIZONTALLY, 18" LONG - SET 8"
INTO EXT6 GONG FOUNDATION WALL
- GROUT SOLID TYP
ry
—#4 REBAR AT W
12" O/C. _
cy g (4) #4 REBAR O
101-51, 10 8 101-5. 10.-51' 101-51110'-51110'-b"VERIFY CONTINUOUS O
PAVING EDGE AT BUILDING- U) >-
4'-6" 4" I I I I 3 SCALE: 1" V -0" z
15" DEEP 24" 1 DE I VERIFY Z
CONG FOOTING
STONE PAVERS
ON SETT)N6 BED Q
4" THK. GONG. SLAB
- - - - - - - - - - - - - - - - - - - - - - - - - - - REINFORCED w/6x6,
0
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t -
I I 8" THK GONG co C�
m I
ta THK GONG I I FDN WALL I I Z
FDN WALL of of of of of if 04 04 N of �...
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GONG SLAB TO I I -' cv (4)-#5 REBAR ~ Q
< BE SUPPORTED I � — = Q �
_— p� EXISTING PROVIDE #5 REBAR0ON EXISTING I I `9
— PAVIN&O I DOWELS, 12" OG POOL LEDGE
REMAINVERTICALLY, 24 I I z
PROTECT
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- 12" 12" W
NSTRucTlo EXT6 GONG - GROUT SOLID TYP 10" DIA. PILE �
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THICKENED SLAB DETAIL
EXISTING PIERS TO I I 2
REMAIN PROTECT EX15TIN& POOL. I I I _ SCALE: 1" = 1' -0"
BUILDING COLUMNS
POOL. HOU5E DURING
CONSTRUCTION
3
STONE PAVERS
ON SETTING BED
PROVIDE #5 REBAR - -
DOWELS, 12" OG O
4" THK,. GONG. SLAB � Z
_ I REINFORCED w/6x6, Q•
VERTICALLY, 24 LONG I I #6/#6 WWM. g• o Y
SET 8 INTO EXT6 GONG
w - GROUT SOLID TYP =
GRADE
Q
N � 0 v
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(�1 4" VERIFY 4" ( 4'-8" I I �
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EXISTING PIERS TO i GONG SLAB TO i p i w• ' 684
I REMAIN PROTECT BE SUPPORTED 8 I _� #4 REBAR AT 5tl
ON EXISTING I I 8 THK CONG r' �' Q H
O BU I LD I N6 COLUMNS - I I 12 O/G.
8 THK GONG DURIN6 CON5TRUCTI N POOL LEDGE FDN WALL 8" THK GONG '
(4) #4 REBAR N �'
_J I FDN WALL CONTINUOUS
r (2)- #5 REBAR
-� - - - - - - - - - - - - - - - +
T ' CONTINUOUS
' I CONG FOOT�IN6 - m
�
\-15"
�� � FDN WALL I �-
15 DEEP 24 i WIDE
GONG FOOTING
i i PSE OF NFwY
— - - - - - - - - - - - - - - - - - - - - - sq
- - - - - - - - - - - - - - - — #5 REBAR ® 24" 51
o�Ps c.
OG EACH WAY CONCIR-ETE FOOTING
5y2 y2 0y2 018350A
RED
8 I I fn rFREDAR
' I 5" CLR. (TYP) (5)-#5 REBAR
I PROJECT NO: 0511
- - - - - - - - - - - - - - - - - - I - - - - - - - - - - - - - - - #4 REBAR
' I ISIRRUP ® DRAWN BY: UT
— 121100 (2)- � REBAR
v CHECKED BY:LE T
A
III I III
or- = EIMBED 0-
S
EXISTING 5ETIC TANK PILING `9 = (3)-#5 REBAR DATE: 9/9/11
PROTECT DURING I I m
CONSTRUCTION I I - 24SCALE: 1/4" = 1' - 0"
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - REBAR
DRILLED SHEET TITLE:
=ry THRU PILE PILE 10" DIA. PILE
- o c, FOUNDATION TERRACE
Lu O O O O O O 1 TYPICAL OUN ATI®N SECTI® PLAN
}
SCALE:
PORCH
lot AIM
P I L I IN (03 0 N "n'A T 10 PL
SHEET NO:
SCALE: 114" 1' -0" � — �
/ �-EXISTING LEACHING
/ POOL PROTECT
DURING
I CONSTRUCTION
RESIDENCE
� l .
CONSTRUCTION SET
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w
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CICIl'� PAVE. A it N
'R/ T
I I'M
lk
jj [S
OOTY
EXISTING SETIG TANK (SOF NFWY
PROTECT DURING 5�SPS C.
CONSTRUCTION
F
ol X18350.1
T RG
6'-Sy2" 2a'-7" VERIFY I I�-�2�� I I I'-7" 5'
VERIFY � PROJECT NO: 0511
DRAWN BY: UT
— CHECKED BY: TS
DATE: 9/9/11
SCALE: 1/411 = 1' - 0"
SHEET TITLE:
TERRACE
O 7000 00 O PLAN
In IT &A C E L A ImMs
FORGH
SCALE: 114" V -0"
SHEET NO:
\EXISTING LEACHIN6
POOL PROTECT DURING
CONSTRUCTION
� � RES I DE>�1GE
CONSTRUCTION SET