HomeMy WebLinkAbout51949-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#: 51949 Date: 05/28/2025
Permission is hereby granted to:
Luckyfront LLC
333 Central Park W Apt 106
New York, NY 10025
To:
construct accessory pool house as applied for per SCHD approval.
Premises Located at:
38015 Route 25, Orient, NY 11957
SCTM# 15.-2-15.8
Pursuant to application dated 12/16/2024 and approved by the Building Inspector.
To expire on 05/28/2027.
Contractors:
Required Inspections:
Fees:
Accessory-New Structure $165.50
CO Accessory $100.00
Total $265.50
II
wilding 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 littns-,HYA"v.soutiioldtownfly.flov
Date Received
iL
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector. C
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 Authorization form(Page 2)shall be completed.
Date: December 12, 2024
OWNER(S)OF PROPERTY:
Name:Lucky Front LLC scTM# i000- .'II. 1000-15-02-15.8
Project Address:38015 Main Road Orient, NY 11957
Phone#: 646-734-3579 Email:chad@gallant.cc
Mailing Address: PO Box 613 Orient, NY 11957
CONTACT PERSON:
Name: Sean Forestal
Mailing Address: 508 Main Road Unit 3 Riverhead, NY 11901
Phone#:631-808-3323 Email: info@artisancai.com
DESIGN PROFESSIONAL INFORMATION:
Name:Jonathan Schloss Architect
Mailing Address:277 Broadway 13th Floor New York, NY 10007
Phone#:212-213-5546 Email:jschloss@jonathanschloss.com
CONTRACTOR INFORMATION:
Name:Artisan Construction Associates, Inc.
Mailing Address:508 Main Road Unit 3 Riverhead, NY 11901
Phone#:631 -808-3323 Email: info@artisancai.com
DESCRIPTION OF PROPOSED CONSTRUCTION
®New Structure ❑Addition ❑Alteration ❑Repair IRDemolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? ®Yes ❑No Will excess fill be removed from premises? ®Yes ONO
1
PROPERTY INFORMATION
Existing use of property:Residence Intended use of property:Residence
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-80 this property? Eyes *No IF YES, PROVIDE A COPY.
lM Check Box A'fteir 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 pass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name):Sean Forestal BAuthorized Agent ❑Owner
Signature of Applicant: Date: December 12, 2024
STATE OF NEW YORK)
SS:
COUNTY OF Suffolk )
Sean Forestal/Artisan Construction Associates, Inc.
,being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Contractor
(Contractor, Agent,of said owner or owners, and is duly authorized to perform Corr have tperformed the said work and to male """�i"""
application;that all statements contained in this application are true to the best of his/her knowled " �
, "!
that the work will be performed in the manner set forth in the application file therewith. t ,+" NEW YORK
"
NTARY
Sworn before me this �saiidin
12 December 24 0'• '' `" � �'
OiCU639 '
PS
day of , 20 "
10tary Public ",,,%�ON E ?\'
(Where the applicant is not the owner)
Jonathan Chad Gallant 333 Central Park West Apt 105
1, residing at
New York, NY 10025 Sean Forestal/Artisan Construction Associates, Inc.
do hereby authorize to apply on
my beh a Town of Southold Building Department for approval as described herein.
12/12/24
Owner's Signature Date
Jonathan Chad Gallant
Print Owner's Name
2
Building Department Application
AU'I'HO ATION
(Where the Applicant is not the Owner)
')I, We af— residing at
(Print property owner's name) (Mailing Address)
do hereby authorize
rDP%TA(-
(Agent)
wC lwf o(.I f3 '. L to apply on my behalf to the
Southold Building Department.
(Owner's Signature) (Date)
-: dQ ATKA,W ( t(Ap lTittC ME!"�dE
(Print Owner's Name)
Albert J. Krupski, Jr.
S"F
SUPERVISOR lw][A�N A�G]El\ul[]ENT
SOUTHOLD TOWN HALL-P.O.Box 1179 O
53095 Main Road-SOUTHOLD,NEW YORK 11971 Town n Of So u th o l d
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: 1 �rAns+y Date:
0,11 A
Contact Information: 3-,,) (rs,
° „
3
Property Address / Location of Construction Site:
S.C.T.M. #: 1000
District
r'
Section Block Lot
TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT
- - - - - - - - - - — — - - - - - - — - - - - - - -- - - - - - - - - -
- Area of Disturbance is less than 1 Acre. No S.P.D.E.S. Permit is Re r.aired I
Project does Not Discharge to Waters of the State. No S.P.D.E.S. Permit is Re uired I
0 - 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 Department
Prior to Issuance of a Building Permit.
Reviewed By: Date: lo?"/7 ,�J
FORM SMCP-TOS December 2024
e � C � ele � IR I 1WV
NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION
Division of Water„ Bureau of Water Permits
625 Broadway, Albany, New York 12233-3505
P: (518)402-8111 F: (518)402-9029
www.dec.ny.gov
12/19/2023
Chad Gallant
Chad Gallant
38015 Main Road
Orient, New York 11957
RE: ACKNOWLEDGMENT of NOTICE OF INTENT for
Coverage Under SPDES General Permit for
Storm Water Discharges from CONSTRUCTION
ACTIVITY— General Permit No. GP-0-20-001
Dear Prospective Permittee:
This is to acknowledge that the New York State Department of Environmental Conservation
(Department) has received a complete Notice of Intent (NOI) for coverage under General Permit No.
GP-0-20-001 for the construction activities located at:
Gallant Residence
38015 Main Road
Southl, NY 11971 County: SUFFOLK
Pursuant to Environmental Conservation Law Article s to is effective five (5) bus Hess days from
coverage under GP-0-20-001 for the above construction
12/11/2023, which is the date the Department received your complete eNO1.
The permit identification number for this site is: NYR11 M069. Be sure to include this permit
identification number on any forms or correspondence you send the Department. When coverage
under GP-0-20-001 is no longer needed, you must submit a Notice of Termination to the Department.
Additionally, authorization to discharge under GP-0-20-001 is conditioned upon compliance with Part
II.C. of GP-0-20-001, specifically the following:
1 . A final Storm Water Pollution Prevention Plan has been prepared;
2. When applicable, project review pursuant to the State Environmental Quality Review Act (SEQRA)
has been satisfied;
3. Where required, all necessary Department
anits suject othe bNewto the Uniform Procedures Act York State agency, have been
(see 6 NYCRR Part 621), or the equivalent from
obtained, unless othervVise notified by the Department pursuant to 6 NYCRR 621.3(a)(4).
NEV VORK Department of
sr�rtc Environmental
avvrrnralr
conservation
If other UPA permits, or the equivalent, are required, you must submit a preliminary SWPPP to the
appropriate Permit Administrator at the Regional Office listed in Appendix F to GP-0-20-001. The
preliminary SWPPP must be submitted at the time that the applications for all other UPA permits, or
the equivalent, are submitted to the Department.
Note: Construction cannot commence until all of the above have been satisfied.
Please be advised that there is an annual regulatory fee of$110, which is billed by the Department in
the late fall. The regulatory fee covers a period of one calendar year. In addition, since September
1 , 2004, construction stormwater permittees have been assessed an initial authorization fee which is
now $110 per acre of land disturbed and $675 per acre of future impervious area. The initial
authorization fee covers the duration of the authorized disturbance.
Should you have any questions regarding any aspect of the requirements specified in GP-0-20-001,
please contact me at (518) 402-8114.
Sincerely,
0 L- -
David Gasper
Environmental Engineer
cc: RWE - 1
SWPPP Preparer
DEA Engineering
Adams, Douglas
PO Box 14
Setauket, NEW YORK 11733
RING DATA
'OP SOIL ISM)
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IROWN'&PALE BROWN FINE SILTY
;AND WI SOME FINE TO LARGE
;RAVEL(SM)
'0' SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES
ALE BROWN FINE TO MED.SAND WI
R.SILT&SOME FINE TO LARGE PERMIT FOR APPROVAL OF CONSTRUCTION FOR A
;RAVEL(SW) SINGLE FAMILY RESIDENCE AND
0'
Cabana
ALE BROWN FINE TO COARSE SAND
it TR.FINE TO LARGE GRAVEL(SW)
0. DATE 9/5/23 EF_ NO. R-23-1129
T.BROWN FINE SILTY SAND WI TR. APPROVE® "•
INE TO LARGE GRAVEL(SP) TOTAL MAXIMUM BEDROOMS 8�0
101 EXPIRES THREE YEARS FROM DATE OF APPROVAL
ALE BROWN FINE TO COARSE SAND WI
INE TO LARGE CRUSHED GRAVEL(SIN)
!.0'
ALE BROWN FINE TO COARSE SAND WI
INE TO LARGE CRUSHED ROCK(SW)
'.0'
IGHT BROWN FINE TO COARSE SAND
11 TR.FINE TO SMALL GRAVEL(SW) HEALTH DEPARTMENT APPROVAL STAMP
!.0'
IGHT BROWN FINE TO MEDIUM SAND WI
R.FINE TO SMALL GRAVEL(SW) REVISIONS
IGHT BROWN FINE TO COARSE SAND
Il SOME FINE TO COARSE GRAVEL(SW) e
IGHT BROWN FINE TO COARSE SAND WI
OME FINE TO COARSE GRAVEL(SWISP) +
w" ems'
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ST BORING, INC. 081912
IOUNTEREDFS �
S.C.T.M.: DIST. 1000 SEC. 15 BLK. 2 LOT. 15.8
ndon Engineering, P.C. ORIENT HOUSE
38015 MAIN ROAD
1755 Sigsbee Road ORIENT, NY OF
Mattituck, New York 11952
(631.) 298-1986 (631) 298-2651 fax
N76048'2911E 18,58'
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/ , \ SINGLE FAMILY RESIDENCE
(SLEEVE I SERVICE IN A 2"PIPE 5'MIN. WITH PRIVATE WELL I
+25.61 .FROM DRAIN&WASTE LINE AT CABANA)
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\ �~ PROPOSED SPA PROPOSED POOL y FOR JANITAR
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+26,82/� pqd�+ 2w:"� + z5.5o CABANA P1RR.CLOSED LOOP 2•W y
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EXISTI STRUCTURES T ROOF W H A CARBON - 10, } 25.67 / I
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__� __ . IN8TALLED ON A 4 P SLAB
"`�.,,, ' B AND TO
" "" SCDHS STANDARDS _ _�_
At T SHEET) lfl Y advance,t®sehad4
"�3
— �
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TO CONTROL PAN
Wss PROPOSED F' ESIDENCE 27.33
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SBEDR Oe +26.91 26 PROPOSED VA FUJI USA r _A..b.andonme..nt of the existi_nm!conf
+24.50 +za. a o, La IRLI WASTEWATERTREATMENT ormance
with the De
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n LIPA'EA SEMEN - w +20.19 t- Y g
`'O ,r' I 2:5. ✓ / \ I sur i).E
" •p y� I \ PROPOSED WATERILI' Y W 55
0.d?. '1 V BItL @
SINGLE FAMILY RESIDENCE +25,66 \ ` I The Installation anu-�on<
WITH PRIVATE WELL 'w +� +z°`� I U sE
� � y
9 1 \
ry� aI PRCgOEITIED ELECTRIC 26.33 y
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BE PLACED +25.49 + 7
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CMF d +25.10 0.