HomeMy WebLinkAbout51891-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#: 51891 Date: 04/30/2025
Permission is hereby granted to:
Zimmer LLC
c/o Mark Breen
Orient, NY 11957
To:
demolish (4)structures and construct a single-family dwelling as applied for per SCHD approval.
Contact with NYS DOT shall be conducted prior to construction commencement.
Premises Located at:
29525 Route 25, Orient, NY 11957
SCTM# 13.-2-7.14
Pursuant to application dated 01/31/2025 and approved by the Building Inspector.
To expire on 04/30/2027.
Contractors:
Required Inspections:
Fees:
Single Family Dwelling-NEW $3,218.38
DEMOLITION $3,086.20
CO-RESIDENTIAL $100.00
Total $6,404.58
u fc ing Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax (631) 765-9502 his://www.southoldtorwiuz V. Ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
If
PERMIT NO. 5 1�q I
Building Inspector:
I ,
Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorizati n form(Page 2)shall be completed.
Date:
�JWNER(S OF PROPERTY:
Name: ' SCTM#1000-wzt\ .............. A
Project Address: Qq?5�2s-r &1 0
'
t
Phone#: lid � EmaiUA
Mailing Address: a Z 0,5P
CONTACT PERSON:
Name:
Mailing Address: Oro
Phone#: Em(0-1 / —ASL---� I
ail.
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: AM
Ab'd Ck
�
Phone#:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: — �! Email fie'
DESCRIPTION OF PROPOSED CONSTRUCTION
Netiw Structure ❑Addition ❑Alteration ❑Repair C?errtolition Estimated Cost of Pr 'ect:
❑Other $ T OU
Will the lot be re-graded? es El No Will excess fill be removed from premises? ❑Yes o
1
PROPERTY INFORMATION
Existing use of property: I Intended use of property:
Zone or use district in which premises is situated: Are there any c�Ves
nts and restrictions with respect to
this property? ONO 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
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(pr" t ): Cg<u,thorized Agent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF )
oLbeing duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the .......... OAJ� *144M�_
(Contractor, gent, rpoiate 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/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� lap r 20—aS
LAURA FLEMING Notary Public
NOTARY PUBLIC-STATE OF NEW YORK
No.01FL6434464
Qualified in Suffolk County PROPERTY OWNER AUTHORIZATION
my commission Expires 06-06-2026(Where the applicant is not the owner)
I, residing at L
OAMdo hereby authorize apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
W 'n, �� �C-e-pry
Print Owner's Name
2
Building Department Agglication
AUTHORIZATION
(Where the Applicant is not the Owner)
residing at 2 44D s" t j oi,ti1
(Print property owner's name) (Mailing Address)
0( s " Mn 1 CA-do hereby authorize julaL D�A
(Agent)
JOE. to apply on my behalf to the
Southold Building Department.
C't•
(Owner's Signature) (Date)
A 2 :
(Print Owner's Name)
LAURA FLEMING
S,3, Y � NOTARY PUBLIC-STATE OF NEW YORK
No.01 FL6434464
(� Qualified in Suffolk County
My Commission Expires 06-06-2026
01 s � �.. ;
4/17/2025
MARK BREEN Service To:
24405 MAIN RD 29525 MAIN RD
ORIENT NY,NY 11957 ORIENT,NY 11957
Customer Project#:900000219814
Dear MARK BREEN:
This is to advise you that the PSEG-LI electric facilities at the above referenced location have
been disconnected and removed off the building structure that is located on the property.
Please note that there may still be PSEG LI facilities located within the property boundaries
and that NYS law(NYCRR Part 753)requires all contractors to call for a utility locate(NY
811)prior to performing any ground excavation or regrade activity. The call to the 811 Call
Center must be done at least 2 business days prior to the start of the work and confirmation of
utility marks having been identified must be received from all the facility owners prior to any
site work.
You must also contact National Grid at 631-348-6150 to procure a letter of demolition
associated with natural gas service,whether or not your home or business uses natural gas.
If you have any questions regarding the above,please contact Building&Renovation Services
at 1-844-341-6378 or via email at BRSLI@PSEG.com.
Very truly yours,
Katherine Giane/lllii�
Building&Renovation Services
PSEG-LI
Evan T.Steffens Nat 1 O n a l gri
Senior Supervisor
Gas Customer Connections,NY
April 2, 2025
Zimmer, LLC
C/o Mark Breen
24405 Main Road
Orient, NY 11957
E-Mail: 247_$_Qt
.SMINE CEDA NOLLSHOMES.COM
National Grid WO#: T 102667245
Service Address:
29525 Main Road
Orient, NY 11957
To Whom it may concern,
This Letter is to advise you that National Grid investigated your request and confirmed that the
subject property does not have an active gas service line.
By Law, excavators and contractors working in New York City and Nassau and Suffolk
Counties must contact New York"811" at least 2 full business days, not including the day
of contact, prior to digging by calling "811" or by using the website https://newyork-
811.com/.
This confirmation letter of no active gas service line to the subject property does not
relieve the excavator of contacting NY "811".
If you have any further questions, kindly contact me at 833-359-0645.
Respectfully,
Evan T. Steffens
Senior Supervisor
Gas Customer Connections NY
1650 Islip Ave,Brentwood NY 11717
T:833-359-0645 evanwsteffens�i na4 t raaC gd.com 1vidirk r cess n -n tional rid.com,
FFQ
Albert J. Krupski, Jr. °5t Ir S']C'ORlMMA' ]El[L
SUPERVISOR MANA ]EIS IENT
w
S5 Main R D TOWN
UTHOHALL ,NEWBox K Town of Southold
53095 Main Road-50UTHOLD,NEW YORK 119T1 �.»
CHAffER 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: Fleming Date:: 1/31/2025
t ,a
tsp
Contact Information: laura@cedarknollshomes.com
E-Mail&Telephone Number;
631-231-1518
Property Address / Location of Construction Site:
29525 Route 25 S.C.T.M. #: 1000
Orient, NY 11957 District
13 2 7.12/13/14
Section Block Lot
TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
Area of Disturbance is less than I Acre. No SY.D.E.S. Permit is Re utre 9
❑ - Project does Not Discharge to Waters of the State. No S.P.D.E.S.Permit is Required I
❑ - Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Discharges Directly
to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S.Permit
DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Building Permit.
❑ - Area of Disturbance is Greater than 1 Acre&Storm-water Runoff Flows Through Southold
Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN
a S.P.D.E.S.Permit through the Southold Town Engineering E2gineeripg Department
Prior to Issuance or a Buildin Permit,
P'
0"
Reviewed By: _ Date )
FORM " SMCP-TOS December 2024
Town Hall Annex uu " Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P. O. Box 1179
Southold, NY 11971-0959
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION AND/OR TIMBER CONSTRUCTION
Date:
la5-
Owner:
Location of Property: `
Please take notice that the (check applicable line):
New commercial or residential structure
Addition to existing commercial or residential structure
Rehabilitation to an existing commercial or residential structure
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW)
Timber construction (TC)
in the following location(s) (check applicable line):
�ITIT Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof framing (FR)
Signature:
Name (person
(p s mitting this form): IV
Capacity(check applicable line):
Owner
Owner representative
TrussReg15.docx Effective 1/1/2015
1j IIkid"I
SITE: 29525 LAAIN ROAD GROUNDWATER MANAGEMENT ZONE IV: 600 GPD/ACRE
ORIENT NY 111957 SITE SERA BY PRIVATE WELL: 300 GPD/ACRE
AREA TO BE DEVELOPED WITHIN 2 LOTS- S.C.T.M. TAX LOT 1000-13-2-7.12&14 �
SCTIA it tl 1 -2 7-11Z 13&14, LOT 7-12:12 ACRES+LOT 7.14:2.499 ACRES=14.499 ACRES �
GROSS LOT AREA: 7641,261±SO FT.(17.54LnACRES)> D
) AISTED.ALLOWABLE SANITARY FLOW:14.499 ACRES X 300 GPD/ACRE =4,349i.7fM GF�
SITE CLIENT DRIVEN SOLUTIONS
'C
SCDF@5 REFERENCE NO.: �SYSTEM DENSITY� ,,A ALCU ONS, P.W.GROSSER CONSULTING PVVC ENGINEER
AND HYDROGEOLOGIST,P.C.
EXIST-BILDG-A-5,065 SF BARN NO.1 @ 0.04 GPD/SF =202.60 GPD
amm JaM aS.vWNW.x,.atlNS M'.
EXIST-BLDG.B-8,027 SF BARN NO.2 @ 0.04 GPD/SF =321.08 GPD Pron�.l83eu't 1,NY.rnrr Ie
F—(01)5 DS
PROP. D-2,811SINGLE FAMILY RESIDENCE @ 0.04 GPD/SF =112.44 GPD Ey L INFO@P ROSSMCOM
3DO.00'GPD .. �y CONSULTANTS
E�IISIf..�lL.®I[FBMG TO BE EXIST. -C-2,811 SF BARN N0.3 0.04 G TOTAL -936.12 GPD Y"
REMOVED
Pam.-2-STOW SINGLE
pA FAMILY I WEULI G
F.E.EI.12.W' VICINITY MAP
EXIISi1F..BUUDING TO BE FRCP. SANITARY SYSTEM SCALE: 1"=800'
REMOVED FOR BUILDING 4
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Revised Plan Approved1I32025 29525 MAIN ROAD
f
- ORIENT,NY 11957
Y
3 �� aA,° ,
Expires
9l16/2025 PROPOSED
SCDHS ►
rb rr SANITARY SYSTEM
EXIST. 1-STORY BARN NO.1 TO REMAIN 29525 MAIN ROAD
Suffbik C'a1�.y Department Of�'IG'.jf&cervices ORIENT,TOWN OF SOUTHOLD
= AREA, ,065 SF Approval!twr C i stroction-Other Tim Suagle Family SUFFOLK COUNTY,NEW YORK
RSS BUILDING)
�11
1 STORY BARN N0.2 TO REMAIN Reference No. 7 Irow Soo s&IA
EX M r�
r
OVERALL
RALL
` . AREA: 8,027 SF Use(s) ltitItFall,y Resin I
T.1-STORY 1 NO.3 TO REMAIN (DRY BUILDING) These plans havelieee�rawiewed for genera•cwT.�ance with Suffolk
TE
ARE•:p►:2,811 S1F County DepartnsE=Of Health Services sxan&"ds;,, relating to water(DRY BUILDING)) supply and se:,Am a disposal. Regardlb--4s PLAN of any omissions, I'
OVERALLSITE PLAN inconsistencies ar I<a& of detail, construc6m its; Tequired to be in
accordance with
SCALE: 1'"=150' standards, ldards,unsssyedfkaall Ikead v hd permit
the DeFixtment This approval
C- t,
0 150 300 ww to tlr tiNa/ s its expires 3 years fialsr,tf4e approval! date, u � ended Or renewed.
1
NOT SuIt7llMCnun O rJtHear t
Ir< SCALE.- 1'"= Call(631)952-5754,48 hours in 12/26/2018 va�� �� 1 4
SURVEY INFORMATION OBTAINED FROM L.K. CLEPNWIA�S9^ Q 9P-
OTES ENGIMER9l`Mr-& 1" advance,to schedule ins on(s). Approval Date ry-- CKH2401 �
URVEYING,DPC DATED DECEMBER 13,2024_
Mrlr