HomeMy WebLinkAbout51544-Z TOWN OF SOUTHOLD
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#: 51544 Date: 01/13/2025
Permission is hereby granted to:
Michael Dukmejian
70 E 96th St
New York, NY 10128
To:
Construct additions and alterations to an existing single-family dwelling as applied for per SCHD
approval.
Premises Located at:
6484 Soundview Ave, Peconic, NY 11958
SCTM# 59.-8-4.2
Pursuant to application dated 11/01/2024 and approved by the Building Inspector.
To expire on 01/13/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling- Addition&Alteration $663.00
CO Single Family Dwelling-Addition/Alteration $100.00
Total $763.00
Building Inspector
JI M bV VCI CY Yy LIII*CIPPIII-a I.IVI I, III 1aI rY a.Ical n Is/als.c vvYl q,nlo %.vI IIII IszIs .Y ..•+•�•- ��
I,IlilAine permit.
•-.,.,eo whatsoever until the Building
� 10N � TOWN OF SOUTHOLD—BUILDING DEPART
`w Town Hall Annex 54375 Main Road p. O.Box 117" Southold,
Telephone(631)765-1802 Fax(631)765-9502 hti s/ jo 11971-0959
l id onn . ov
-Date Received.
APPLICATION FOR BUILDING PERMIT
For office use only 6
PERMIT NO.
EL5— L±_ Building Inspector
dew NOV 1 22
Applications and forms must be filled out in their entirety.Incomplete
11 applications will not be accepted. Where the Applicant is not the owner,an RUMDING DM.
e coma
form(Page 2)shall b completed.Owner's Authorisation p TONYNr)F S 0 . ,
Date: l p 2- Zoe•
OWNER(S)O PRO ERTy:
Name: kLL V) XM�
SCTM#1000- 5 q_ _ e
Project Address: (o� $� SOiSi�����L� �v
` 15� 1
Phone#: ( - (0 , Email:
Mailing Address: -76
(- ►A l G1
CONTACT PERSON:
Name: "tCVkNL , n V t,� t
Mailing Address:
Phone#: 1 i
Email: --
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: PO
q
Phone#: Email: +y J"�/-"'
CONTRACTOR INFORMATION: IF
Name: aomktj gjlupFRS PJe
Mailing Address: � h n I
r
Phone#: 63 - 6739Email: tR0
ICw I i L�F I L
r1A C3 M.
DESCRIPTION OF PROPOSED CONSTRUCTION d
p mated Cost of Project:
❑Clthertrudure Addition Alteration ❑Re air ❑Demolition Estimated
Will the lot be re-graded? Yes ❑No Will excess fill be removed from premises? E34es ❑No
I, 9
1
PROPERTY INFORMATION
Existing use of property: RES v7F rY%it N' Intended use of property:
Zone or use district in which premises is situated: Are there any covenants nd restrictions with respect to
P—+6 I ❑this property? Yes covenants
IF YES, PROVIDE A COPY.
Check Box After Reading: The owner/contractor/design professional Is responsible for all drainage and storm water Issues as provided by
Chapter 236 of the Town Code. 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,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(s)for necessary Inspections.False statements made herein are
L.tnishoble as a Class A misdemeanor pursuant to Section 210AS of the New Yak State Penal Law.
Application Submitted By(print n ride):MA4P9 - K14r— -Z- MAuthorized Agent ❑Owner
Signature of Applicant: Date: 1 0 13/f zi4'
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of.New York
No.01 BU6185050
SS: Qualified in Suffolk County
COUNTY OF (,' .I � Commission Expires April 14, 2 i� 0
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
It
(S)he is the
ntractor,Agent, orpo`rat " r,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/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
day of 20 ►'`'� /1
Notary Public
(Where the applicant is not the owner)
lCtra � �" t "A� residing at G c� �G� ' V "�w (�eS
SQt " W do hereby authorize M Nr VL C-t\0 1 Z to apply on
ehalf t e Tow of Southold Building Department for approval as described herein.
U 2.`
Ownees ignature lot
�CU►D,F_1.- 0tj lC 3 , A J
Print Owner's Name
2
Sc
ott A. Russell UFFq' S'7C'OIKIWWA\' IEIK
sUpERVISOR AWANA\G 1EMENT
SOUTHOLD TOWN HALL-P.O.Box 1179 Town of So u th o l d
53095 Main Road-SOUTHOLD,NEW YORK 11971 ' +�,
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. )
- - - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other)
NAME: �QL�90%T I Date: 1212-I Z-4
Contact Infot may
tiot
Il:Alad.f l tIC1111nnC?lumhri l - •
Property Address / Location of Construction Site:
('484 SOU4D\� ►�-\'j S.C.T.M. #, 1000
mrict
_ . .._ _
Section Block Lot
TO BE COMPLETED B�` J� I�'N'_'NiE:ERING DEPARTMENT
- Area of Disturbance 15 less thati i 'E E `' I ,r"w? F,er nit is Reyui:ed I
Project does Not Discharge to 1b at_i 5 ! I:,.�'.�le No S f D E +, Permit is Re w`ed�
- Area of Disturbance Is Greater than I \cle S `t tLei Runoff Discharges Duectk
L APPLICANT MUST oa'rAIN a S,P,D.E,S. Permit
to Waters of the State of New York THE AP , m
DIRECTLY From N.Y,S. DEC- Priori to Issuance of a Building Permit.
Aiea of Disturbance is Greater Wait I Aci� & Suomi-,va!er Rua'► fl FCo%Ns Through Southold
To n'S I"`kS Systems to Waters of the St we rif Ne\\ York, THE ,A,PPLICANT tMUST OBTAIN
a S.P.D.E_S, Permit Eri-rrteer'ttt De ai`trt�er�t
Prior to Issuance of a,Qm1dq] PermR
Reviewed By: "✓
fir' Date, •✓
................... A5-BUILT SITE
.
Design professional' Ce
s Certification Required. -SUFFOLK COUI IT
Y TAX 114FOPMATION:RENOVATION.REMAINING 4 BEDPOOM5�MAP ID: 1000-059-05-021,02 X o"o
OF NEW
-fX15TING 4 BEDROOM HOME WITH PPOP05ED DORMER AIID SECOND FLOOP INTERIOR
Submit P.E.or R.A. rtification For -LOT AREA;ACRE 007.
x
The Installation and Construction of the Sewage Disposal System -PROPERTY LOCATED AT G484 50UNDVIEW AVENUE
FA
�z
SOUTHOLD,TOWN OF SOUTHOLD.SUFFOLK COUNTY,I IEW YORK
Use Form WWM-073
ORIGINAL 5UPVEY PROVIDED BY:DE5TIN GRAF L5 12-30-20014 PPOP05ED SITE PMeM"M
X111"', ................ MARK SCHWARTZ 4�A55OCIATE5 4-19-24
_0
ERTICAL DATUM-NAVD'1955 DATUM 10 467
ent of the existing sanitary system must be in -PRIVATE WELL
CK18fPING PRIVATE WATER
SERVICE TO BE MARKED OUT A
- LL HOMES WITHIN 150LF OF PROPERTY CONNECTED TO PRIVATE WATER SERVICE.
ji t, conformance with the Department's requirements. 440 SURFACE WATER OR WETLANDS WITHIN 300 FROM PROPERTY LINE
Submit completed form\MNM-080 as proof GENERAL NOTES:
.......................... I Dt5tGrl FOR,UP TO G-BEDROOM HOME
2.I/A OWT5 SANITARY REPLACEMENT DESIGN.RE USED EXISTING DEEP WICK LEACHING POOL
4% EXISTING 5CDH5 REf#:R 10-20-0029
3.SEEATTACHMENT(S) 51 TE PLAN AND REFERENCE ELEVATIONS TO BE USED FOR I/A OWi5 5AIIITA Y 5Y5TEM
C0115TRUC ITI ON OIILY.EXACT PROPERTY BOUNDARIES,UTILITY LOCATIONS AIID ELEVATIO145
ARE NOT GUARANTEED,
4 ELEVATIONS BASED ON PROPERTY SURVEY PROVIDED BY DE5TIN GRAF L5 12-30-2001
5.ON5rTE UTILITY MARK-OUTS TO BE PERFORMED BY CONTRACTOR PRIOR TO PERFORMING SITE
WORK.
G.SOIL TEST HOLE DATA PROVIDED BY MCDONALD GF05EPVICE5 4-19-2002
7 EXISTING SANITARY CF55POOL5(5)TO BE PUMPED Atli)REMOVED AS NECESSARY PER 5CDH5 W
W
STANDARDS
PROP05f 0 VA C`Wr5 RMONICf; z
/N\ 1, ONE(l)FUJI CEN-7 I/A OWT5
Z Uj
2. ONE(l)FUJI MAC I 00R BLOWER.VENT AND FUJI CONTROL A55EMBLY. W
150'FROM WELL ON 3.ONE(l)EX15TING 8'DIAMETER BY I G'DEEP PPECA5T LEACHIIIG POOL WITH DOME TO BE
PROP RTV P1U5rD
4.ONE(1)8 DIAMETER_P ruruRE EXPANSION AREA.
00V W W
GENERL SANITARY SYSTEM AJID INSTALLATION NOTE5:
I IFA AOWT5 SEPTIC SYSTEM ot5ioiro FOR,UP TO 6 BEDROOM HOME PEP SUFFOLK COUI]TY
>
DEPARTMENT OF HEALTH STANDARDS(5CDH5), Z
z 2 SANITARY GRAVITY DRAIN PIPE TO BE 4-INCH CAST IROI I AT FOUNDATION PEI IETRATION AND < Z 0
4-IIICH PVC 5DP35 DOWNSTREAM OF FOUNDATION.
M
3 I/A OWT5 SHALL BE TESTED FOR WATER TIGHTNE55 PRIOR TO ARRIVING ON51TE U51NG THE ---j :3
EXISIONG W
P00L
METHOD APPROVED BY MANUFACTURER
0
4- THE DESIGN ENGINEER SHALL OVERSEE THE OWT5 DURING SYSTEM STARTUP. C U)
�e 0
5 THE OWT5 1145TALLEK SHALL BE LICENSED,HOLD AN ENDORSEMENT FROM 5CDH5 AND BE A Nr
FUJI AUTHORIZED INSTALLER. CO U)
G. THE OWT5 1115TALLER SHALL PEG15TEP THE ON51TE TREATMENT SYSTEM WITH 5CDH5, THE
ox� DESIGN ENGINEER SHALL PROVIDE CERTIFICATION DOCUMENT5 AS REOUIPfD BY 5CDH5. CD
..... ........... 7. AN OPERATION AND MAINTENANCE CONTRACT BETWEEN THE MAINTENANCE PROVIDER AND THE
v PROPERTY OWNER SMALL BE PROVIDED TO 5CDH5 FOR I/A OWT5.
8. A GARBAGE GRINDER SHALL NOT BE INSTALLED UPSTREAM Of THE OWT5 9, WATER SOFTENER BACKWA5H SHALL NOT BE FLUSHED TO PROP05ED 5EPTIC SYSTEM.
ox
_5
10. CONTRACTOR 15 RESPONSIBLE TO OBTA114 TOWN BUILDING PERMITS AS NECESSARY rPlOP TO
INSTALLATION OF THE PROPOSED SEPTIC SYSTEM
6 -2 .
T 11 NOTE THERE 15 AN EXISTING HOUSE TRAP I/A OWT5 TO BE VENTED THROUGH 2 INCH CARBON
e VENT.
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F __�ON`T_RbL PAUFL,1MAq. Do
'JI v.,zmw
U BLOWER ASSEMBLY.AND VE M5T"�,Tp—
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Pa P15MII 11,Y), 'T �11R�111110�11f�l 0 r-
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EXISTING LEACHING T-7
PUMPED AND RE S 1L(yy.1 5T 71%1111 U)
STANDARDS. LLI z>_
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w.
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1P.0DOILFTIC .0,
I's �G MINU 15 z
EXISTING B*XI6'IPRECA
BERE". P PRECAST
—As;) "L
POOL TO D E= DRMvt y
STANDARDS.NOTE EXISTING \ 11
LEACHING POOLWIDEEP WCK I,V;tO Ui LL LLI
LL
SAND.SCDHS REFfi:RID-02-DO29 ,V 17— 2
PROPOSED FUJI rErNT ------ FUJICLEAN I/A OWTS
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IIAOWTS 0 a:
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FUTURE EXP4NSI0"—_
1<
EXISTING UN DERGTO ROUNBD
SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES ELECTRIC SERVICEE C 0-
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MARKF OUTX—
<PERMIT FOR APPROVAL OF CONSTRUCTION FORA
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<SINGLE FAMILY RESIDENCE ONLY 0
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DATE:11-13-24
DATE 12/22/2024 H-S. REF. No. R-24-1392 SCALE: 1:40
APPROVED DESIGNER:JB
5ANITARY SITE FLAN SHEET:
ALE= 1 :40 FOR MAXIMUM OF 6 BEDROOMS
0 40'
EXPIRES THREE YEARS FROM DATE OF APPROVAL