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Home My WebLink About29158-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29158 Z Date FEBRU 1 , 2003 Permission is hereby granted to : CHRIS MESKOURIS 1400 SOUND BEACH DR MATTITUCK,NY 11952 for . DEMOLITION & RECONSTRUCTION OF A SINGLE FAMILY DWELL AS 22 APPLIED FOR, FLOOD PERMIT INCLUDED ��Q2. aJQ—g 3 2 yS 7 at premises located at 1400 SOUND BEACH DR MATTITUCK County Tax Map No. 473889 Section 106 Block 0001 Lot No. 035 pursuant to application dated DECEMBER 20 , 2002 and approved by the Building Inspector to expire on AUGUST 21 , 2004 . Fee $ 704 . 50) }4 ff 106.1-35 w 1'75 Y $chgol Mathtuak Sch2of kauns Jamas F3otf Year 2006 Gurc�lamrfy R Land i 600fflln ¢Q0 Sound Beach Ar land 5 ra�47'i acral PokalAU 5 9U0 �iwnar '' - 1`xttat 2 � 1ax�6teYalr+e -' MrsoeRaneous 's � �aunt� 5'900 book 121B� Nane: ' James Meskouns + ,. AddlAddr, hiunc 5 X00 Paga $2d SEraet: 127 BaYarlg Rd ,i Sohoal' S 500 PAorkg � ` m Bank Cr(y 6au9fa#ton>NY �p 1132 S�after Skee`5;900 AcckNo'.ld 9aia Lokah 1 c� � , Srke 1 of 1 � band 0 of 0 , Bock Papa Satal7ateCeEliGa 1� Y�, ik 1amrl {es Rev. S y v S TZ LTI T�TT� r T�T�?k�( T'T` T�T�'Z ar-4x T �TyT�4-1v I I Applicant/ Date. me: £ Owners NaReviewed: Architect/ Date Engineer: Submitted: s— SCTM #: District: 1.000 Section: /ob Block: 1.0t3S Project p Subdivision L.ocatiol U0-0 XYZ-�-Q� �. �^ Name:_�� --T-- V Single& separate Required certification: Ye /No) Rey. p Req, l6 —� Zoning Districi: (Lot size: �D�_Actual: Ooh 7 I (Lot coveragAk Pratxised 5?�A Req. 1 Req. i r Req. + [(ront Pard Proposed: 3 [Side Yard �� a Proposed/42 _J (Rear Yard_ Proposed'f®V J Project Description: Q.�� M AGENCUERMITS Permi UIRED FOR REVIEW N.&- N-Q YM �Q Numbe /6 Suffolk County Health Dept. C New York State D. E. C. S Town Trustees �J , Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? . /� Flood Zone: 617 . T , �O�eS: • .are ' F Albert-JrYnnRpski, President Town Hall James King,Vice-PresidentO�Q$VFFD�I�'C 53095 Route 25 Artie Foster P.O.Box 1179 Ken Poliwoda �� Southold,New York 11971-0959 Peggy A. Dickerson ti Z Telephone(631) 765-1892 ip Fax(631) 765-1366 of ,� dao BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD October 29, 2002 Ms. Chris Rivera 250 Sound Beach Dr. Mattituck, NY 11952 RE: 1400 Sound Beach Dr., Mattituck SCTM#106-1-35 Dear Ms. Rivera: The Southold Town Board of Trustees reviewed the site plan (not dated) and determined the proposed two-story frame dwelling on piles to be out of the Wetland jurisdiction under Chapter 97 of the Town Wetland Code and Chapter 37 of the Town Code. Therefore, in accordance with the current Tidal Wetlands Code (Chapter 97) and the Coastal Erosion Hazard Area (Chapter 37) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal wetlands jurisdictional boundary or seaward of the coastal erosion hazard area as indicated above, without a permit. It is your responsibility to ensure that all necessary precautions are taken to prevent any sedimentation or other alteration or disturbance to the ground surface or vegetation within Tidal Wetlands jurisdiction and Coastal Erosion Hazard Area, which may result from your project. Such precautions may include maintaining adequate work area between the tidal wetland jurisdictional boundary and the coastal erosion hazard area and your project or erecting a temporary fence, barrier, or hay bale berm. However, any activity within 100' of a Wetland line or seaward of the Coastal Erosion Hazard Area would require permits from this office. This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call 2 cerely, r Albert J. Krupski, Jr. President, Board of Trustees AJK:Ims TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. lis Check Septic Form N.Y.S.D.E.C. Trustees Examinedd ,2003 Contact: Approved 120_0 Mail to: Disapproved a/c Phone: Expiration �'�2( ,20 F:- �- Building Inspector APPLICATION FOR BUILDING PERMIT { D i Date %o - 3 , 200--) { INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b.Plot plan showing location of lot and of buildings on premises,relationship to adjoining premises or public streets or areas, and waterways. c.The work covered by this application may not be commenced before issuance of Building Permit. d.Upon approval of this application,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughout the work. e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter,a new permit shall be required. 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, or 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 for necessary inspections. (Signa of applicant or name,if a corporation) x "/c (M ' ' g address of appyant) • '�`!//tet State whether whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder 6�Ve, /— Name of owner of premises /-6 v (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section f o Gp Block Lot 3.5 Subdivision Filed Map No. Lot (Name) 1 1 2. State existing use and occupancy of premises and intended use an occupancy occupancy of proposed construction: a. Existing use and occupancy -s% r z'e `es �% w" — -l b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition J/ Alteration Repair Removal Demolition Other Work � (Description) 4. Estimated Cost c;�s'o, ooy Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front .2- Rear `�` Depth Height 35.' �/ ` Number of Stones ,2 9. Size of lot: Front -!5'0 Rear -6-e- o G Depth 10. Date of Purchase� Name of Former Owners-n �n 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded?YES NO Will excess fill be removed from premises? YES NO 14.Names of Owner of premises -fall leA.,9 -- Address A/ov ��` 4-Phone No. Name of Architect Address Phone No F Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES ----NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ✓ NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey,to scale,with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) COUNTYF (Ay-l'<'�(" -j .�I�( being duly sworn, deposes and says that(s)he is the applicant ame of individual signing contract)above named, (S)He is the ,s�i,✓c i�� `� (Contractor,Agent, Co orate 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 knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this _day 0C9 f- 20 Notary Public Siffiature of Applicant CLAIRE L.GLEW Notary public,State of New York No.Ot GL4879505 Qualified in Suffolk Cou y Commission Expires Dec.8, H:,II. 53095 �4'rH T. TERRY �'iaur Koa 'I'OWiV CLERK ^' � �ri. e!`—,� P.O. fic,e 117U to fs Sr,ulhulrl. Nc,• Durk I Irl?I (tEGISFRAP of v1TA1.S1'ATISIICS �✓�^ (C?� ti Fax (S 1(,) 765- 1923 MARRIAOF OFFICER �yo'� Tcicrl,<,nc (S 1(,) 765_1 H(11 RECOROS MANAGEMENT OFFICER II 1 FREEDOM OF INFORMATION OFFICER OFFICE OF THE TOWN CLERIC TOWN OF SOUTHOLD THIS IS TO CERTIFY THAT THE FOLLOWING RESOLUTION WAS ADOPTED BY THE SOUTHOLD TOWN BOARD AT A REGULAR MEETING HELD ON AUGUST 24, 1993 : RESOLVED that the Town Board of the Town of Southold hereby adopts two (2) new forms to be used under the Flood Damage Prevent regulations 1 of the Code of the Town of Southold: "Floodplain Development Permit Application" (FDP(93) ] , and "Certificate of Compliance for Development in Special Flood Hazard Area (C/C(93) ] . _. _ TOWN OF SOU-MOLD Juditl T- 'Terry Southold Town Clerk August 25, 1993 r r APPLICATION f PAGE l of 4 TOWN OF SOUTHOLD FLOODPLAIN DEVELOPMENT PERMIT APPLICATION This form is to be filled out in duplicate. SECTION 1• GENERAL PROVISIONS (APPLICANT to read and sign): 1. No work may start until a permit is issued. 2 The permit may be revoked if any false statements are made herein_ 3. If revoked, all work must cease until permit is re-issued. 4. Development shall not be used or occupied until a Certificate of Compliance is issued. 5. The permit will expire if no work is commenced within six months of issuance. 6. Applicant is hereby informed that other permits may be required to fulfill local,state and federal regulatory requirements. 7. Applicant hereby gives consent to the Local Administrator or his/her representadve to make reasonable inspections required to verify compliance. 8. I,THE APPLICANT,CERTIFY THAT ALL STATEMENTS HEREIN AND IN ATTACHMENTS TO _ THIS APPLICATION ARE,TO THE EST MY KNOWLEDGE,TRUE AND ACCURATE. (APPLICANT'S SIGNATURE `r �"` — a DATE SECTION 2• PROPOSED DEVELOPMENT (To be completed by APPLICAIt'n NAME AD D R ESS TELEPHONE APPLICANT BUILDER ENGINEER PROJECT LOCATION: To avoid delay in processing the application, please provide enough information to easily identify the project location_ Provide the street address, lot number or legal description (attach) and, outside urban areas, the distance to the nearest intersecting road or well-known landmark. A sketch attached to this application showing the project location would be helpful. FDP(93) APPLICATION PAGE 2 OF 4 DESCRIPTION OF WORK (Check all applicable boxes): A. STRUCTURAL DEVELOPMENT ACTIVITY STRUCTURE TYPE O New Structure O Residential (1-4 Family) ❑ Addition O Residential (More than 4 Family) ❑ Alteration ❑ Noo-residential (Floodproofing? O Yes) O Relocation ❑ Combined Usc (Residential & Commercial) ❑ Demolition ❑ Manufactured (Mobile) Home (In Manu- 71 1Replacement factured Home Park? ❑ Yes) ESTIMATED COST OF PROJECTS 0-W, -oma B. OTHER DEVELOPMENT ACTIVITIES: O Fill O Mining O Drilling O Grading ❑ Excavation (Except for Structural Development Checked Above) ❑ Watercourse Alteration (Including Dredging and Channel Modifications) ❑ Drainage Improvements (Including Culvert Work) O Road, Street or Bridge Construction O Subdivision (New or Expansion) O Individual Water or Sewer System O Other (Please Specify) Alter completing SECTION 2, APPLICANT should submit form to Local Administrator for review. SECTION 3• FLOODPLAIN DETERMINATION (To be completed by LOCAL ADMINISTRATOR) The proposed development is located on FIRM Panel No. . Dated The Proposed Development: O Is NOT located in a Special Flood Hazard Area (Notify the applicant that the application review is complete and NO FLOODPLAIN DEVELOPMENT PERMIT IS REQUIRED). FIs located in a Special Flood Hawd Area. FIRM zone designation is 100-Year flood elevation at the site is:- Ft. NGVD (MSL) ❑ Unavailable ❑ The proposed development is located 'to a floodway. FBFM Panel No. Dated ❑ Ser 4 (or additional instructions. - SIGNED_ r DATE APPLICATION # PAGE 3 OF 4 SECTION 4• ADDITIONAL INFORMATION REQUIRED fTo be completed by LOCAL ADMINISTRATOR) The applicant must submit the documents checked below before the application can be processed: A site plan showing the location of all existing structures, water bodies, adjacent roads, lot dimensions and proposed development. ❑Development plans,drawn to scale, and specifications,including where applicable:details for anchoring structures, proposed elevation of lowest floor (including basement),types of water resistant materials used below the first floor, details of floodproofing of utilities located below the first floor and details of enclosures below the first floor. Also O Subdivision or other development plans (If the subdivision or other development exceeds 50 lots or 5 acres,whichever is the lesser, the applicant must provide 100-year flood elevations if they are not otherwise available). O Plans showing the extent of watercourse relocation and/or landform alterations. O Top of new fill elevation Ft. NGVD (MSL). ❑ Floodproofing protection level (non-residential only) Pt:NGVD (MSL). For floodproofed structures, applicant must attach certification from registered engineer or - architect. ❑ Certification from a registered engineer that the proposed activity in a regulatory floodway will not result in.any increase in the height of the 100-year flood. A copy of all data and calculations supporting this finding must also be submitted. ❑ Other. SECTIONS: PERMIT DETERMINATION (To be completed by LOCAL ADMINISTRATOR) I have determined that the proposed activity. A-❑ Is B. O Is not in conformance with provisions of Local Law , 19 The permit is issued subject to the conditions attached to and made part of this permit. SIGNED DATE If BOX A is checked, the Local Administrator may issue a Development Permit upon payment of designated fee. If BOX B is checked, the Local Administrator will provide a written summary of dcGciencics. Applicant may revise and resubmit an application to the Local Administrator or may request a hearing from the Board of Appeals. J , APPLICATION # PAGE a OF a APPEALS: Appealed to Board of Appeals? ❑ Yes ®- Hearing date: Appeals Board Decisioo --- Approved? ❑ Yes ❑ No Conditions SECTION 6• AS-BUILT ELEVATIONS (To be submitted by APPLICANT before Certificate of Compliance is issued The following information must be provided for project structures. This section must be completed by a registered professional engineer or a licensed land surveyor (or attach a certification to this application). Complete 1 or 2 below. 1. Actual(As-Built) Elevation of the top of the lowest floor, including basement(in Coastal High Hazard Areas• bottom of lowest structural member of the lowest floor, excluding piling and columns) is: /3 FT. NGVD (MSL). 2. Actual (As-Built) Elevation of floodproofmg protection is FT. NGVD (MSL). NOTE: Any work performed prior to submittal of the above information is at the risk of the Applicant. SECTION 7• COMPLIANCE ACTION (To be completed by LOCAL ADMINISTRATOR) The LOCAL ADMINISTRATOR will complete this section as applicable based on inspection of the project to ensure compliance with the community's local law for flood damage prevention. INSPtCTIONS: DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO DATE BY DEFICIENCIES? ❑ YES ❑ NO SECTION 8• CERTIFICATE OF COMPLIANCE(To be completed by LOCAL ADMINISTRATORI Certificate of Compliance issued: DATE: BY: Attachment B SAMPLE CERTIFICATE OF COMPLIANCE for Development in a Special Flood Hazard Area li t TOWN OF SOUTHOLD CERTIFICATE OF COMPLIANCE FOR DEVELOPMENT IN A SPECIAL FLOOD HAZARD AREA (OWNER MUST RETAIN THIS CERTIFICATE) PREMISES LOCATED AT: PERMIT NO. PERMIT DATE OWNERS NAMED ADDRESS: CHECK ONE: �-- ❑ NEW BUILDING ❑EXISTING BUILDING ❑ VACANT LAND THE LOCAL ADMINISTRATOR IS TO COMPLETE A. OR B. BELOW: A. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19 SIGNED: DATED: B. COMPLIANCE IS HEREBY CERTIFIED WITH THE REQUIREMENTS OF LOCAL LAW # , 19_, AS MODIFIED BY VARIANCE # , DATED SIGNED: DATED: C/C(93 ) New York State Department of Environmental Conservation Division of Environmental Permits, Region One Building 40-SUNY, Stony Brook, New York 11790-2356 Phone: (631)444-0365 - FAX: (631)444-0360 Erin M.Crotty Website:www.dec.state.ny.us Commissioner NJ/NPN GENERAL NOTICE for Article 25, 6NYCRR 661- Tidal Wetlands Date: October 2, 2001 Name&mailing address: Facility location: Chris Meskouris 1400 Sound Beach Drive 1400 Sound Beach Drive SCTM 1000-106-01-35 Mattituck,NY 11952 Mattituck Dear Applicant: Recently you requested a Letter of Non-Jurisdiction or determination of No Permit Necessary from this Department. In many instances our lack of jurisdiction or permitting authority is clear. Your request falls into this category. Letters of Non-Jurisdiction never expire as long as the determining feature upon which the decision was based, such as 300'distance from the tidal wetland,presence of a functional man-made structure,or elevation contour still exists. Additionally, since the letter of Non-Jurisdiction is always issued for the property and not to the owner,it is not necessary to transfer the letter to a new owner. Certain activities are clearly not within our permitting authority such as interior renovations,installation of alarm systems,new roof,windows,siding,painting, etc.,and a permit for such activities is never necessary from this Department. Accordingly,your proposal to construct an addition to an existing single family dwelling will receive no further consideration from this Departrn0m.—� Sincerely yours, Carol A. arkas Environmental Analyst I cc: Permits&Drafting Unlimited MMYOM[R,TI Calsus soca baa of ms�owrT M!R M LM a11IN1W