HomeMy WebLinkAbout52178-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#: 52178 Date: 08/13/2025
Permission is hereby granted to:
HIM Group LLC
67A Cuttermill Rd
Great Neck, NY 11021
To:
construct a single-family dwelling as applied for per Planning&SCHD approvals. Land clearing
commenced priorto building permit issuance.
Premises Located at:
205 Kat's Ct, East Marion, NY 11939
SCTM# 21.-3-15.2
Pursuant to application dated 01/26/2024 and approved by the Building Inspector.
To expire on 08/13/2027.
Contractors:
Required Inspections:
DRAINAGE, FOOTING/REBAR, FOUNDATION 1ST, FOUNDATION 2ND, FRAMING/STRAPPING , PLUMBING ,
ELECTRICAL- ROUGH, FIRE RESISTANT PENETRATION , ELECTRICAL- FINAL, INSULATION , FIRE SAFETY
INSPECTION , FIRE RESISTANT CONSTRUCTION , FINAL,
Fees:
Single Family Dwelling-NEW $5,355.00
CO Single Family Dwelling-New $100.00
Total $5,455.00
Building Inspector
mr TONIVN OF SOUT OLD —BUILDING DEPARTMENT
Town Hall Annex 54�15 Main Road P. O. Box 1 179 Southold, NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502
X
Date Received
APPLICATION FOR BUILDING PERMIT
L UE
For Office Use Only
0
PERMIT NO, Building Ins et r:
7- 1
Applications and forms.must,be filled out in their entirety. Incomplete,
applications wilJ not`be i tcepted. Where the Applicant is not the owner,an
Owner's Authorization foAr# (Page?)shall he completed. ��°��.m;a,
1 Date: J �4I
OW NE (S)OF PROPERTY:
N �} I F} CIW UP LLG I !
Project AcldressZCS 1 OUPPT _ Z�.ST M A 2-1 0 AJ N
F Phone#: 6 1�5-200 Email.
C, Mailing Address; "`�
CONTACT PERSON:_
Name: i E O N I rC gg S r ° 1
Mailin-Address O C.,T ft LUEZ V E7RST LPL L/C. S:,d
Phone#: � �-- i Email je..d i,,J,. IT
I ESIGI 'PF�t7lµ sslt l is I.II F DRI A"tlIll « , it
a, 1'N �' o r, rA �0,11
1
Name: 9, `Y TOtJEZ
Mailing Add ess
Of10 r : L 4 , aa`ZH 00.
CO
1 i"I tbi INFORMIA�ION.
Name: G C
I ia�lirag Address:
tii 0 v -' �e,o !
_ .
P_
hone#• �
D,ES RIP`TIC o:PROPOSED CONSTRUCTION �
1/- New Structure LJAdc ition 7JAIteration ❑Repair ❑Demolition Estimated Cost of Prc;ectµ� l
Other
_W i 1 the iot be adea: ,7Yes � � p � � ra
&�3' 1 nl �Pi.',5YtS �.._.b .a
. �- ,�lii!excess fill be removed fro .
N3
..,, .
PROPERTY INFOR "
\q�",Zinguse of l4 aWwk s der t lirEe tm5ef °
C Or o. E. -,+JwStfict l P 4."m"'w:,rps is�,�A',xated,, Are there any covenards and restrictions with respect to
this property? E.�YesOjNo IF YES, PROVIDE A COPY..
. i
L'Wter 236 of Use,Tows Cbde,. APPMMN IS HEREBY M m"x r r the i a w;djr4 pamit pursuart Building Zone
OrdarArxe of the rm%M of south suffoak,County,Now Yaait and Qe"3gVbMbit Lan,orTrwancts or itepwtion�for th*cam ucdon,of buildmra
for removal or demAHM The (*MU*�an a b*bws.ee �war�,bwu coda.
hmmns code nd rqpJatiam cs oran aeg t raia^i � t to es and in is)f%w aetsswaV k4lPetdcm rahm stautemenu hero o-n ara
punishabte as a rW=Wrmaa=pw3wat to seclim 1.0,E of the
Application Submitted By(print name). �nN I�1' /�( G���1 uth dzed Agent 00,wner
Signature of Applicant.
Date:
STATE OF NEWYORK)
�.� being duty sworn,deposes and says that s is the applicant
!„ sign:ng cor cQ above named,
Contractor,Agent,Corporate Officer,etc,)
, f said cwner w,r w ner-5,tt if.mj iS aly authorized to perform or have performed the said work and to make and file this
application;that all staternents contained in this application are tine to the best of his/her knowledge and belief,and
that the work will be performed in the tanner set forth in the application file therewith,
Sw orri before me this -77d
L�-Aay of 4714 20
Notary Public
p,ETFtOS STELLATOS
PROPERTY OWNER AUTHORIZATMORY pUBUC, TATE OF NEW Y
ORK
Segistration No,01ST6277565
(Where the applicant l not the owner) Qualm,ed in,CtWens
mission Eo
le
w residing at ,
A
CT
lwch
__..�
dui hereby authorize to apply on
un n of o artment for apprroval as des rl
a
01 n r" sgnature , to
a
ll 17
int Owner's Name
Z
*a.93
Albert J. Krupski, Jr. � �" 5T�O�][�l��l[\wA\TIER
SUPERVISOR ( r
I��l[A\I�A\G]EM[]ENT
SOUTHOLD TOWN HALL-P.O.Box 1179 �1p 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town
own of Southold
CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM
APPLICANT INFORMATION TO BE COMPLETED BY T�. HE APPLICANT
ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER.
APPLICANT: (Property mOwner, Design Professional, !agent, Contractor, Other
NAME; .. mop LL.0 Date: 1 Izsl24
?.te
r ioAy
Contact Irifornlatt Sri
Pro erty Address / Location of Construction Site.
S.C.T.M. # 1000
- Sect,or, B :?ck Lot
TO BE COMPLETED BY SOI THOLD TOWN ENGINEERING DEPARTMENT
Area of Disturbance ,s less than I Acre. No S.P.D_E:S, Permit is Rru. ed`:
I'-oject does Not Discharce to Water; of the State. No S.P.D.E.S. Permit is Read ,-ed !
area of Disturbance is Greater than i :Acre& Storm-m-'ater Runoff Discharges Directly
❑ co Waters o t^e State of New York. THE APPLICANT �'IUST OBTAIN a S.P.D.E.S. Permit
DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Buildmp, Permit.0 - Area of Disturbance is Greater than, I .acre & Stcn-n-%-eater Runoff Fio\vs Through Southo!d
Town's 'iS4 Systems ra Waters o the Stage of New York THE APPLICANT MOST OBTAIN
a S_P.D.E,S Per quit through t'h,e Sothcl , r c� Ertineert+a Drtr��e It
Prior to Issuance of a Bu in.q Permit.
Resie�xed By
4 �// Date.
MAILING ADDRESS:
PLANNING BOARD MEMBERS P.O. Box 1179
JAMES H.RICH III + Southold,NY 11971
Chairman
OFFICE LOCATION:
MIAJEALOUS-DANK , Town Hall Annex
PIERCE RAFFERTY 54375 State Route 25
MARTIN H.SIDOR (cor. Main Rd. &Youngs Ave.)
DONALD J.WILCENSIC enlufm` Southold, NY
Telephone: 631 765-1938
www.southoldtownny.gov
PLANNING BOARD OFFICE
TOWN OF SOUTHOLD
August 7, 2025
Ms. Patricia Moore, Esq.
51020 Main Road
Southold, NY 11971
Re: Pederson Standard Subdivision
Revegetation Plan Performance Guarantee
205 & 105 Kat's Court, East Marion
SCTM#1000-21.-3-15.2 (Lot 2) and 15.3(Lot 3) Zoning District: R-40
Dear Ms. Moore:
The Planning Board has reviewed the cost estimate you submitted for Lot 3, and has
revised it to reflect their original requirement in the letter dated July 16, 2025 repeated
below:
1. Provide a cost estimate to implement the approved revegetation plan, including
the cost of the plants, the cost for planting and the cost to water them until they
are established.
The cost estimate submitted did not include all of the plants on the approved
revegetation plan, and substituted smaller plants without prior approval by the Planning
Board, nor did it include the cost to plant.
Below is a table comparing the approved revegetation plan's list of plants with the cost
estimate list submitted. The estimate you submitted is missing 3 trees, 29 shrubs and
14 smaller plants. In addition, 39 of the plants shown are of the wrong size (smaller than
required).
Southold Town Planning Board Page 12 August 7, 2025
Applicant's Cost
Approved Plan Species Size Oty Estimate List Qty Size
Nyssa sylvatica 3.5"cal 2 Nyssa sylvatica 2 3-3.5" cal..
Hex opaca 3.5"cal 3
Juniperusvirginiana 6-T ht. 14 Juni perus vi rgi ni ana 14 6-T
Am el anchi er canadensi s 3gal. 29
Vaccinium corymbosum 5gal. 23 Vaccinium corymbosum 23 3gal.
Kalmia Latifolia 5 gal. 27 Kalmia Latifolia 27 3 gal. (wrong size)
Lobelia Slphiliata 3 gal. 14
Viburnum prunifolium 3 gal. 12 Mburnum prunifolium 12 2 gal. (wrong size)
Liatris spicata 1 qt 61 Liatris Spicata 61 quart
Based on prevailing local industry standards, the cost of planting is generally estimated
at approximately two times the cost of the plant materials themselves. This factor
accounts for labor, equipment, soil preparation, and initial watering. These planting
costs were not included in the original estimate.
Attached please find the revised bond estimate that meets the requirements of the
Planning Board's approved revegetation plan. This will be on the August 11, 2025
Planning Board meeting agenda for a decision to accept the bond estimate. If your
client would like to submit the performance guarantee by Monday, we can streamline
the process by accepting that in the same resolution. If your client requires more time to
produce the performance guarantee, you could request a special meeting on the date of
the next Planning Board work session, which is August 24, 2025. Of course it can be
submitted any time after that as well.
As outlined in our previous letter, these are the steps after the bond estimate is
accepted by Planning Board:
1. Building permit for Lot 3 may be issued after the performance guarantee has
been received and accepted by the Planning Board and Town Board.
2. Revegetate Lot 3 after the construction is completed and in the appropriate
season.
3. The performance guarantee can be released upon a finding that the plantings
were installed according to the plan.
4. Prior to a certificate of occupancy for Lot 3, the plantings will be reinspected to
ensure their survival. Any missing or dead or dying plantings will need to be
replaced prior to receiving the C.O.
4
Southold Town Planning Board Page 13 August 7, 2025
For Lot 2 (205 Kat's Court) Planning has coordinated with the Town Engineer on the
road construction, and he has let us know that after his most recent inspection, he found
that the road improvements have been completed to the point where a building permit
can be issued for Lot 2.
In summary:
• For Lot 2, 205 Kat's Court, the building permit may be issued; and
• For Lot 3, 105 Kat's Court, the performance guarantee for the revegetation, in the
amount shown on the attached bond estimate, must be provided before a
building permit may be issued.
If you have any questions, please call the Planning Department at 631-765-1938.
Sincerely,
r
Heather Lanza, AICP
Town Planning Director
Encl.
cc: Benjamin Johnson, Assistant Town Attorney
rr I
Town Hall Annex` Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O. Box 1179 Z,
Southold, NY 11971-0959 ',
BUILDING DEPARTMENT
NOTICE OF UTILIZATION OF TRUSS TYPE CONSTRUCTION PRE-ENGINEERED
WOOD CONSTRUCTION ANDIOR TIMBER CONSTRUCTION
Date: — I2
Location of Property: _ 5.-
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)
„ _ w Pre-engineered wood construction (PW)
Timber construction (TC)
in the following location(s) (check applicable line):
..... Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof framing (FR)
Signature:
Name (person submitting this form):
Capacity(check applicable line):
Owner
✓_ Owner representative
TrussRegl5.docx Effective 1/1/2015
°d•r»rcv.'nm w'wara ww ammr w.• �,o .r':` 'I"nmm�as''�
HEALTH DEPARTMENT USE NOTES 400 Ostrander Avenue,Riverhead,New York 119OI
tel.631.?27.2305 Pox.651.12.0144
„ EwnPwr.:-Vr lCERTasacn4T 14 d'PQRIRED_ admIneg0YnCj"Insering.GOm
Mc SUU TlP-E:..OR R,A.. CKRTrriu^Taopr LANE T SHALL BEMODELC
MANUFACTURED BY FUJIQE USA.
USA.
; IA/OWTS u 9 H 2.THE DESIGN ENGINEER,FUJICLEAN USA
U"c�xz fw�'�.r_ia�r�uvw fxwca f"r,>ea srwiirrlou,a
o:N REPRESENTATIVE,AI�SCDHS s Fox FienLAwaaas. SUFFOLK COUNTY REPRESENTATIVES SHALL OBSERVE THE HgWdrdKYa r Land'6-04or
PERMIT FOR APPROVAL OF CONSTRUCTION FOR A INSTALLATION OF THE OWTS AND LEACHING TTkr nraa C.i+olpor t,P roPeoskwool"hoor
SINGLE FAMILY RESIDENCE ONLY SYSTEM.APPROVAL FROM ALL THREE PRIOR TO PouglCs7..�,�F('al""obwl5VMO*w
BACKFILL r7mwl A.r4aamor,
. ^" \ 3.THE SYSTEM START UP WILL BE COMPLETED��
DATE 11/30/2023 KS,REF„.NO. R-23 1519 UNDERCLEAN USADIR REPRECT SENTATIVE.
E. SITE DATA
FUJICIEAN USA REPRESENTATIVE.
` MIPP'RA'1Vk;'O 4.AN EXECUTED OPERATION AND AREA=2.3372 ACRES
-r FORMAXIMUM OFRS FROM DATE BEDROOMS MAINTENANCE CONTRACT BETWEEN THE
6
s / G"IRC THREE TEOFAPPR(7VAL MAINTENANCE PROVIDER AND PROPERTY `SUBDIVISION-SUFFOL C STANDARDSUBDIVISION'FILEDINTHEOFFICE
":� OWNER MUST BE SUBMITTED TO THE SUFFOLK OF THE CLERK OF SUFFOLK COUNTY ON J1R,101,023 AS FILE N0.12278.
COUNTY DEPARTMENT OF HEALTH SERVICES
(SCDHS)PRIOR TO APPROVAL OF THE LA OWTS "MAXIMUM PERMITTED CLEARING =25%OR 25,452 SF
REGISTRATION BY THE SCDHS IN ACCORDANCE " CLEARING FOR PROPOSED IMPROVEMENTS =22,956 SF
S / WITH ARTICLE 19 OF THE SUFFOLK COUNTY
/ % SANITARY CODE. " VERTICAL DATUM =NAVD(1998)
r" 5.FINISHED FLOOR ELEVATION(S)TO BE
VERIFIED BY THE ARCHITECT. " DEPTH TO GROUNDWATER(AREA OF SANT.SYSTEM) =37 FT
6.THERE ARE NO WELLS WITHIN 150'OF THE - NUMBER OF BEDROOMS(DESIGN EQUIVALRM =6
O &, 'rn'. PROPOSED SANITARY SYSTEML " MINIMUM REQUIRED i/A OWTS CAPACITY =660 GAL
�✓ o ' "�'i�f / / I 7.THERE ARE NO SANITARY SYSTEMS WIT}{IN "PROVIDED I/A OWTS CAPACITY =700 GAL
' O C I 150'OF THE PROPOSED WELL
I � sAx.SYSTEM O � �U � � m 'LEACHING SYSTEM REQUIRED =400 SFSWA
I .'' � -ti.✓''.. I "LEACHING SYSTEM PROVIDED =400 SFSWA
DRAINAGE CALCULATIONS
P ! f,ro ✓ / 1 00 "" 1 now or formerly
IL W noo a Kart d FUME AREA 1 ENGINEER'S CERTIFICATION
„,.. � T� I Anthouea'Kaitery VOLUME PROVIDED =196 CF
sA&SYSTEM 1,175 SF x 2112 x LO
(Dw
O I HEREBY CERTIFY THAT THE WATER SUPPLY(5)ND/OR SEWAGE DISPOSAL
YSTEM(S)FOR THIS PROTECT WERE IDE5rGNED BY ME OR
1 / / aA.. i " "^.�,°4 `^'-1',.,.... I VfX.UM REw#: 4, ;AREA.2 cLOTNE NGROUNDWATER CONDMONSK AR H
B'DIAx5'DEEP DRYWELL 212 CF
ALL PA
! -.�r \o Q<,TLRE..( ) -
EXCAVATION INSPECTION REQUIRED 821 SF x 2/12 x 1.0 137 CF CONSTRUCTION STANDARDS IN EFFECT AS OF 'S
t s - , -.-. FOR SANITARY SYSTEM VOLUME PROVIDED 1
T11' h d --._•.„.,,, USE NEW DW#2 �, •r ,..
o `^ BY HEALTH DEPARTMENT 8'DLAx4'DEEP DRYWELL =169 CIF 0 t 4
LIME.REQ 49ED(11RLVEWAY AREA), HOWARD SOB 9'1
W.Y ,�Ay-i,L.S. 3Ur g,...
\ __....._ w 3„442 SF x 2CL2 x ID 574 C,!"... THOMAS C.W T,N.Y.5.P.E.NO.61483 ..
wir
DOUGLAS E.ADAMS,N.Y.S.P.E.NO.SM97
I I I a I w,- ,� v -� EWLF#1
.�' ryt 1 ��-
USIEN
/1* \ \\ (2)B" 1'A„x7"DEEPDRYWEI'.Y.5 =591CF!
SURVEYOR'S CERTIFICATION
I _ "WE HEREBY CERTIFY TO KALI C O Q R O U P LLC THAT THIS SURVEY
\� \ 1 I Y � � \\ \S w or formerly`(w Y TEST HOLE DATA WAS PREPARED IN ACCORDANCE WITH THE CODE OF
tveo"S.Cambouraki5 SURVEYS ADOPTED BY THE NEW YORK STATE A
Iry.. '/+,B 'CY#1'' J'Y(G/ /!'. d.1a I I I FROM FI.EDMAP� T /�, � 4 \ \ (Dwelling) PROFE55iONAL LAND SURVEYORS.
I I \ \ * "`-` aQ, yo� i I I I t " 1 1 \ DARK 0.0,
( 3 l mw
BROWN
II \\ \ \ wuz ' t I� \\I ti II II OPEN SPACE 191"I _ _ ` \ _ �M l.o' 0" � 4
I dI M E�SEM � II I p_ I \V SILT9 'M "
� I � � 1 SANDY
41
now formerly (ML) HOWARD W.YOUNG,N
is N - ll i ,'I I I I I P d l George S.\Cambourokis 6.0'
0"
o I I � (vamM) BROWN
I / ! I Ro LrIr
! l I \ SAND SURVEY FOR
TY
(SM)
KALICO GROUP LLC
�1 /, BROWN 30.0'
?ao n a ! i r / / ! 0 FINE TO LOT 2 PEDERSON STANDARD SUBDMSION"
/, '411 � / �.! N% ANDM at East Marion,Town of Southold
ow�z !/ / k w / d' C \ I now or formerly (SP) Suffolk County,New York
a / / �' )° +a I / Y 51Rbda"vdsm Niki Mangos 37.0'
C t 2 /
�,., 1 1 y (Dwelling) NO WATER BUILOMS PERMIT PLOT PLAN
/ I a
/ / _' > ENCOUNTERED
'�P erS n a'lanclar SUbdivi&ia I Rtw Coun Tox olstri=t 1000 s-u�rr 21 81-1, 03 L.I. P/015
�, M�
I d OPEN SPACE 1 I. P „p _
d / OPF,IN 25,2018
SPACE c�, f ✓U t / PRE VATd'$7M(I T\ g 'o"j Q LEGEND FIELD MAP PREPARED COMPLETED OCT.04.2023
/ PRESERVATION ---:N S°57'40rE- E30.96"- -_____ / I E�MENT I \ 'Z AEX,SANITARY
srsTQR Record of Revisions
,EASEMENT
O DB =DISTRIBUTION BOX
DW =DRY WELL REVISION DATE
FE =FUTURE EXPANSION BP DATA _... OCT,26 W23
LP =LEACHING POOL
LCB =LEACH.CATCH BASIN
f m�
OWTS =ALT.SANT.SYSTEM
� VIF =VINYL FENCE P
/ / can Ig�m}asa-ease,as homes so I Ir I
/ �� /ry •ad��•,to saw®Ir,aro=e o•I�I. �I I, � WIF -WIRE FENCE - _.._........
=MFELL LATERAL J Us 11 I / / 589°57'40"W 00.OQ -_ 4 - ❑ MINUMENT5Er10D 25 50 - IOD PJNA1.1aUY Y L I I I / now or formeF / ! now or formerly ■ =MONUMENT FouND Stale:1 - 50'
Helen cnntV ki5 !/J Ir1 Greg Png) v STAKE FOUND DWGT JOB.01O.9_009530003_023 0136-bp 10F 3
(Va0