HomeMy WebLinkAbout2355 Village Ln ' Town of Southold
P.O Box 1179
Southold, NY 11971
* * * RECEIPT
Date: 10/30/24 Receipt#: 335764
Quantity Transactions Reference Subtotal
1 Excavation Permits 1756 $50.00
Total Paid: $50.00
Notes:
Payment Type Amount Paid By
CK#1328 $50.00 Kramer, + Deconciliis
Architecture Pllc
Southold Town Clerk's Office
53095 Main Road, PO Box 1179
Southold, NY 11971
Name: Kramer, + Deconciliis Architecture Pllc
260 Hortons Lane
Po Box 1600
Southold, NY 11971
Clerk ID: LYNDAR Internal ID: 1756
Permit No. TOWN
OF SOUTHOLD
HIGHWAY DEPARTMENT
Peconic Lane
Peconic,New York 11958 0�
(631)765-3140
APPLICATION/PERMIT FOR HIGHWAY EXCAVATION AND REPAIR
APPLICATION IS HEREBY made to the Superintendent of Highways of the Town of Southold for the issuance of an Excavation Permit
pursuant to Chapter 237 of the Code of the Town of Southold,Suffolk County,New York,and other applicable laws,ordinances or
regulations for each individual contiguous excavation project herein described. The applicant agrees to comply with all applicable laws,
ordinances,codes and regulations,the attached"General Conditions of Permit"and"Special Conditions",if any and to permit authorized
inspectors to make necessary inspections of the job site.
Print or Type
1. Kramer+ deConciliis Architecture PLLC 631-477-8736 PO Box 1600, Southold, NY 11971
Name of Applicant Phone Number Address of Applicant
2. Ross Brothers Construction Inc. 631-772-4204 595 North Street, Manorville 11949
Name of Contractor Phone Number Address of Contractor
3. Frederic C. Scofield Jr Tr 402-680-4705 2355 Village Lane, Orient, NY 11956
Name of Property Owner Requesting Service(if applicable) Address of Owner
4. Curb Cut, 2355 Village Ln., Orient, NY
Work Description and Location(Street Number,Hamlet,Cross Street)
(a) Is construction located within 75 feet of tidal wetlands? *Yes No X
*If yes,other Town permits may be required.
NOTE: All information requested by this Signature of Applicant
Application/Permit Form is
Required for a complete application! September 10, 2024
Date
5. (a) Attached plot plan to reasonably and adequately describe the proposed work. Provide accurate schematic site plan showing the
location of all proposed excavations and relationship to adjoining premises,public streets or areas,and give a detailed description of
all site and pavement restoration work.
(b) Attach all other necessary permits and licenses for this project.
(c) Work covered by this application may not commence before issuance of a Highway Excavation Permit by the Town Clerk.
6. Tax Map No.: District 1000 . Section 26• Block -1 Lot -13
7. Starting Date: ASAP upon approval Completion Date: ASAP
8. Work Schedule: Phase Completion Date
Excavation ASAP upon approval Work Schedule
Facility Installation ASAP upon approval Must be provided
Backfill&Completion ASAP upon approval for consideration as a
Pavement Replacement ASAP upon approval Complete Application.
9. Under which authority is application being made:
See Town Code Chapter 237(E)-Provide Resolution by,or authority.from,the Utility being modified.
10. Estimated Cost of Proposed Work: $
11. Remarks: Currently no curb cut. Proposed curb cut for gravel parking area. Sending for review as in the initial stages.
Digging down a maximum of 6"for the RCA base for gravel no trenching Three rows of belgian block for the curb cut
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