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HomeMy WebLinkAbout34964-ZFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEP~qTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-34749 Date: 12/17/10 THIS CERTIFIES that the building SWIMMING POOL WITH DECK Location of Property: 4250 ORCHARD ST ORIENT (HOUSE NO.) (STREET) (HAMLET) County Tax 14ap No. 473889 Section 27 Block 3 Lot 3.14 Subdivision Filed Map NO. __ Lot No. __ conforms substantially to the Application for Building Permit heretofore filed in this office dated AUGUST 13, 2009 pursuant to which Building Permit NO. 34964-Z dated AUGUST 28, 2009 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY IN GROUND SWIS~4ING POOL WITH DECK FENCED TO CODE AS APPLIED FOR. The certificate is issued to RICHARD & CLARA SERRA (OWNER) of the aforesaid building. SUFFOLK COUNTY DIZPAR~)H~lff OF RRALTH APPROVAL ELeCtrICAL <~TIFICATH NO. PLD]4BERS U~'rIFICATION DA'i'm N/A 34964 0~14~10 Rev. 1/81 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. 34964 Z Date AUGUST 28, 2009 Permission is hereby granted to: RICHARD & CLARA SERRA 173 DUANE ST NEW YORK, NY 10013 for : CONSTRUCT IN GROUND SWIMMING POOL WITH DECK PER APPROVED PLANS, DEC, TRUSTEES AS APPLIED FOR at premises located at 4250 ORCHARD ST ORIENT County Tax Map No. 473889 Section 027 Block 0003 Lot No. 003.014 purs,,~nt to application dated AUGUST 13, 2009 and approved by the Building Inspector to expire on FEBRUARY 28, 2011. Fee $ 250.00 Authorized Signature ORIGINAL Rev. 5/8/02 Form No. 6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY This application must be filled in by typewriter or ink and submitted to the Building Department with the following: A. For new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation fxom Board of Fire Under0vriters. 4. Sworn statement l~om plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industhal building, multiple residences and shnilar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. Bo For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-exisilng" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Tempora~ Certificate of Occupancy - Residential $15.00, Commercial $15.00 /-/.25'o House No. New Construction: Location of Property: Oate. / o Owner or Owners of Property: /~l C4G/'n'P--O {'q-~p Suffolk County Tax Map No 1000, Section E) -~ '~- Old or Pre-existing Building: Street (check one) Subdivision Foot. Pre.~ t r' t/-OO~ Permit No. Hamlet Health Dept. Approval: Block Od)~ ~ Lot Filed Map. Lot: Date of Pe~t. /[ ~ [0~ Applic~t: t/ ~o ~o~~ ~"~ t ~ Unde~fiters Approve: Planning Board Approval: Request for: Temporary Certificate Fee Submitted: Final Cen/ficate: (check one) Tovm 1 lall Annex .51373 Main Road 1:'.O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-180'2 Fax (631) roger, richert~town.southold, nv. us BI TILDING 1)EPARTMENT TOWN OF $OUTHOLD CERTIFICATE OF ELECTRICIAL COMPLIANCE SITE LOCATION Issued To: Richard Serra Address: 4250 Orchard St. City: Orient St: NY Zip: 11957 Building Permit #: 34964 Section: 27 Block: 3 Lot: 3.1z WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE Contractor: DBA: Tri Tech Elec East Inc License No: 44137-me SITE DETAILS Office Use Only Residential I~ Ind°°r l~ Basement ~ Service Only I~ Commedcal Outdoor 1st Floor Pool New Renovation 2nd Floor Hot Tub Addition Survey Attic Garage INVENTORY Servicelph ~ Heat ~ Duplec Recpt ~ Ceiling Fixtures ~1 HID Fixtures Service 3 ph Hot Water GFCI Recpt Wall Fixtures ~l Smoke Detectors Main Panel NC Condenser Single Recpt Recessed Fixtures I'~ CO Detectors Sub Panel NC Blower Range Recpt Fluorescent Fixture I'~ Pumps Transformer Appliances Dryer Recpt Emergency Fixtures[~ Time Clocks Disconnect Switches Twist Lock Exit Fixtures [~l TVSS Other Equipment: swimming pool Notes: includes, pool bonding, sub pannel, 3 GFCI circuit breakers, 1 GFCl recpticle, 1 pump, 2 pool lights, cover control system, heater. Inspector Signature: Date: June 14 2010 81-Cert Electrical Compliance Form TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INS~JL-ATION [ ] FRAMING / STRAPPING ~ FINAL [ ] FIREPLACE&CHIMNEY [ ] FIRESA,-..~flNSPECTION [ ]F~[~'r,~'r~ [ ]F~REREgST4NTPB~ETRA'fl0~ -. REMARKS:.~,~c.~ ~'~.~-~-~ ~4~'~-.~' /~/o ~.4-~ DATE ¢ 7 INSPECTOR 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net PERMIT NO. Approved (~I' I~ ,20~~L~ Disapproved a/c 13 BLO~. OE~. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Storm-Water Assessment Form Contact: oxdz4t_ Fad rrw vn mhone:t ld24 B2 - ' q3't >PLICATION FOR BUILDING PERMIT Date,J LLU Z I, 20 INSTRUCTIONS I pletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 aRer 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. (Signature of applicant or name, if a corporation) 70 5c , 474 Ea 4 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises E ldL¥O SCV V ~X-- (As on the tax roll or latest deed) /k./,.f~3ppli~nt is a corporation, signatu!;e of duly authorized officer -. h, eqo 4 b v,.,mr ,cte_ r d-vrlb (Name and title of corporate offic,~r)'~ -- Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: 47.%0 Orchrl House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Block 0 ~ Filed Map No. Lot ~, J ,4- Lot 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost (/J 0; F)OC) 5. If dw/lling, number of dwelling units If ~rage, number of cars Fee Addition Alteration Other Work ?q~lYlqf'flllq[lOD('] (D. dstri ption) 0 (To be paid on filing this application) Number of dwelling units on each floor 6. lfb/~ness, commercial or mixed 7. Din~nsions of existing structures, if any: Front H/eight. Number of Stories occupancy, specify nature and extent of each type of use. Rear Depth Rear Depth i~epenSions of same structure with alterations or additions: Front th Height. Number of Stories 8. D,)(nensions of entire new construction: Front Rear ~leight Number of Stories 9. SiC of lot: Front Rear Depth 10. D/e of Purchase. Name of Former Owner / 11. Zooe/or use district in which premises are situated 12. Does~proposed construction violate anWzoning law, ordinance or regulation? YES NO .7 _ 13. Will lot be re-graded? YES NO ~ Will excess fill be removed from premises? YES NO 14. Names of Owner of,oremises~l.2~~Address. Phone No. Name ofArchitect[~( [DTI[I Iq [VI/]I/VY'/Y~ Address .'L'st) fllt~S'~ N~ Phone No Name of Contractor.~_ 1%3-1 IX I ?~,EYl_C,,~fLI/~.~Q~dress~4~,7~(t -~H Phone 15 a. Is this prope~t~'within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SO}kTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIi~,ED. b. Is this~>t6perty within 300 feet of a tidal wetland? * YES NO * IF YES~T).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. 18. Are there any covenants and restrictions with respect to this property? * YES__ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF ) G ¥ f ~(') ~ '~1~¥ ~j ~ ~ being duly swom, deposes and says that (s)he is the applicant ('Nan~ of indiviffual signing contract) above named, (S)He is the ~ ~ (~/fl~ (Contractor, Agent, Corporate 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. CHRISTINE FROMM Pul)Ih=, State of New ~ No, 01 FRS 187273 Oualified In Suffolk Courlty ~ Explr~ May 19, 201~ Signature of Applicant James F. King, President Jill M. Doherty, Vice-President Peggy A. Dickerson Dave Bergen Bob Ghosio, Jr. Town Hall 53095 Route 25 P.O. Box 1179 Southold, New York I1971-0959 Telephone (631) 765-1892 Fax (631) 765-6641 June 20, 2008 BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Mr. Shawn Barton Suffolk Environmental Consulting, Inc. P.O. Box 2003 Bridgehampton, NY 11932-2003 RE: JAMES HAAG 4250 ORCHARD ST,, ORIENT SCTM#27-3-3.14 Dear Mr. Barron: The Southold Town Board of Trustees reviewed the survey prepared by Howard W. Young last dated June 2, 2008 and determined the proposed construction of a single- family dwelling, deck, swimming pool, sanitary system and driveway to be out of the Wetland jurisdiction under Chapter 275 of the Town Wetland Code and Chapter 111 of the Town Code. Therefore, in accordance with the current Wetlands Code (Chapter 275) and the Coastal Erosion Hazard Area (Chapter 111) no permit is required. Please be advised, however, that no construction, sedimentation, or disturbance of any kind may take place seaward of the tidal and/or freshwater wetlands jurisdictional boundary er seaward of the coastal erosion hazard area as indicated above, or within 100' landward from the top of the bluff, without further authorization from the Southold Town Board of Trustees pursuant to Chapter 275 and/or Chapter 111 of the Town Code. 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. · ' This determination is not a determination from any other agency. If you have any further questions, please do not hesitate to call. Sincerely, Jame .~King, Presid~ Board of Trustees JFK:lms DEC PERMIT NUMBER FACILITWPROGRAM NUMBER(S) NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL cONSERvATiON PERMIT Under the Environmental Conservation Law EFFECTIVE DATE September 17, 2008 EXPIRATION DATE(S) ~2013 TYPE OF PERMIT _~ New 13 Renewal [3 Modification [3 Permit to Construct D Permit to ~ DAr~cle 15, T~e 5: Protection of Waters 13 Adlcle 17, Titles 7 8: SPDES [] Article 27, Title 9; 6NYCRR 373: D Adicle 15, Title 15: Water Supply D Article 15, Title 15: Water Transport [3 Article 15, Title 15: Long Island Wetls D Article 15, Title 27: Wild, Scenic and Re~'eatlonal Rivers 13 6NYCRR 608: Water Quality Certification PERMIT ISSUED TO [3 Ailicle 19: Air Pollution Control D Afflcle 23, 'l~le 2Z: Mined ~ Reclamation [3 Article 24: Freshwater Wetlands · Article 25: Tidal Wetlands [] Art~e 27, Title 7; 6NYCRR 360: Hazardous Waste Management [3 Article 34: Coastal Erosion Management [] Ar~cle 36: Floodplain Management [] Articles 1, 3, 17, 19, 27, 37; 6NYCRR 380: Radiation Conlrol TELEPHONE NUMBER ADDRESSOF PERMITTEE 11957 CONTACT PERsoN FOR PERMITTED WORK TELEPHONE NUMBER NAME AND ADDRESS OF PROJECT/FACILITY 11932 537-5160 ~CTM# 1~0-O27-03-003,014 ~~ ~WATERoCURSE N~ORDINATES DESCRIPTION OF AUTHORIZED ACTIVITY: E: N: Construct a two story single family dwelling, pool, deckl a concrete retaining wall and clear vegetation. The property located greater than 300 feet from the Tidal Wetland boundary as shown on the survey Prepared by Young & Young, last revised 7~25/08 is beyond Article 25 (Tidal Wetlands) jurisdiction. All work must be done in accordance With the survey Prepared by Young & Young last revised 7/25/08 and stamped NYSDEC approved on 9/17/08. By acceptance of this permit, the permittee agrees that the permit is contingent upon strict compliance with the ~CL, all applicable regulations, the General Conditions specified and any Special Conditions included as part of this ~rmit. DEPUTY PERMIT ADMINISTRATOR: ADDRESS ~ ~;;':mber17,2008 Pa e 1 of 4 -- NEW YORK STATE DEPARTMENT OF ENVIRONMENTAL CONSERVATION SPECIAL CONDITIONS 1. Any debds or excess material from construction of this project shall be completely removed from the adjacent area and removed to an approved upland area for disposal. No debris is permitted in tidal wetlands or protected buffer areas. ~,2gr. All areas, of s. oil disturbance resulting from the approved project shall be stabilized with appropriate vegetation asses etc.) Immediately following project completion or prior to permit expiration, whichever comes first. If the project site remains inactive for more than 48 hours or planting is impractical due to the season, then the area shall be stabilized with straw or hay mu ch or juta malting until weather conditions favor germination. 3. A row of staked haybales or other approved erosion control devices Shall be placed at the landward edge of the buffer area or place haybales at edge of restricted area as shown on plans, prior to commencement of any regulated activities and remain in place and in good, functional condition until the project is completed and all disturbed areas are stabilized with vegetation. 4. Roof runoff shall be directed ir~to dry well~ a minimum of 100 linear feet landward of the tidal wetland beundary for immediate on-sita recharge. 5. There shall be no draining of swimming po°l water directly or indirectly in tidal wetlands or protected buffer.areas. 6. At least 48 hours prior to commencement of the project, the permittee and contractor shall sign and return the top portion of the enclO§ed notification form certifying that they are fully aware of and understand all terms and conditions of this permit. Within 30 days of completion of project, the bottom portion of the form must also be signed.and returned, along with photographs of the completed WOrk. DEC PERMIT NUMBER 1-4738-03843/00001 PAGE 2 of 4 Item A: NOTIFICATION OF OTHER PERMITTEE OBLIGATIONS , Permitfae Accepts Legal Responsibility and Agrees to Indemnification The permittee, excepitng state or federal agencies, expressly agrees to indemnify and hold harm ess the De riment Environmental Conservation of the State of New York, its repmsenfait~,es, emofowes nn,~ ..~.,~ · ........... pa of and damages, · · ....... ~-a--~o t ucc, ) mr all claims, suits fo the extent atbibutable fo the palm;fee's acts or omissions in connection vath, or operation and maintenance of, the facility or facilities authorized by the permit whether in compliance or not in compliance with the terms and conditions of the permit. This Indemnltication does not extend to any claims, suits, actions, or damages to the extent attributable to DEC's own negligent or intentional acts or omissions, or to any claims, suits, or actiOns naming the DEC arising under,.Articie 78 of the New York ( Practice Laws and Rules or any citizen suit or cA, il hts and Item B: Permittee,e Contractors to Comply .wri?~/p~PrrmO~Slon under federal or stafa laws. The Permittee is mspOflsible for informing its independent contractors, employees, agents and assigns of their responsibility to comply with this permit, including all special conditions while actt, .a. nd such pemone shall be subject fa the ............. ng as ~e perm;fee s agent wffh ms ctto me pormittee. " ..... ~"~uuns rot wola.ns of ina Environmental Consurva~ La~v~se~i~s~rict~ Item C: Permiffee RespOnsible for Obt;fnlng Other Required Permits The perm;fee is msponslbts for obtaining any other to carry out the ~ . permits, approvals, lands ea Item D: ~- =._l,..v.itJ. es_th~t am aulhonzed by this perm[ , ssments and rights-of-way that may be recluimd This pern~;t~Us~io~,ornmvnSvP.a_s~ °r Inte.r~era with Riparian Rights -- vested in a person not a ,.o"-. ,- ,,*- ~uu,u.~u me ;repairmen[ oi' any r~hts titl., ~.- ~-,^----, .P n nghts of others in order ~.;,,x ~u u~u perm.. ---o ..... ,-~=~a~ ~ ma! or personal property held or GENERAL CONDITIONS General Condition t: Facility Inspection by the Department The perreitiod site or facility, including relevant re~m:ls, is subject to inspection at masunabta hours and intervals by an authorized reprsssntattye of the Department of EnvirOnmental Conssrvation (the Department) to determine whether the perm;fee ia complying with this permit and the ECL. Such reprseenfattve may order the work suspended pursuant to ECL 71-0301 and SAPA 401(3). The permittee shall provide a parson to accompany the Depadment'a representative during an inspection to the permit area when rs~estad by the Department. . copy of this permit, including all referenced maps, drawings 'and special conditions, must be available for inspectiOn by the Department at all times at the Project site or facility. Failure to pmduco a copy of the permit upon request by a Department representative is a violation 0f this permit. General condition 2: RelatiOnship of this Permit to Other Department Orders and Determinations Unless e)~prossly provided for by the Depailment, issuance of this permit does not modify, supersede or rescind any order or determination previously issued by the Department or any of the terms, conditions or requirsment~ contained in such order or determination. General Condition ~: Applications for Permit Renewals or Modifications The Permittee must submit a Separate written a lica applloation must include any forms or sunn by the Department must be in writing. * · ~,,,,~, moomcation or transfer granted The perm;fee must submit a renewal application at least! a) 180 da~s before expiration of permits for State Pollutant Discharge Ellminatiqn System (SPDES), Hazardous Waste Management Facilities (HWMF), major Air Pollution Control (APC) and Solid Waste Management Facilities (SWMF); and b) 30 days before expiration of all other permit types. Submtssfon of apPlk:atiOns for permit renewal or meditication ers to be submitted to: NYSDEC Regional PermitAdmlnistrator, Region I,SUNY Sro General Condition 4: Permit Modlfl ,_~_ _ ny'Bro~k, 50 Circle Road, Ston Brook, N - cations, Suspensions and Revocations bythe De~Yartroent Yl1790 3409 · The Department reserves the right to modify, suspend or revoke this pemlit n accordance with 6 NYCRR Part 621, The grounds mr modification, suapensfon or revocation include: ~ materially false or inaccurate statements in the pen~it application or supporting papers; failure by the perm;fee to comply with any terms or conditions of the permit; c) eXceeding the 8sups of the Project as described in the permit appiicallon; ' d) newly discovared mafaHal information or a mafarial change in environmental conditions, relevant technciegy or applicable law or regulations since the issuance of the existing permit; e) n°nc°mpllance With prevleusly issued permit conditions, orders of the commissfoner, any provisions 0f the Environmental ConsurvaUOn Law or regulations of the Department related to the permitted activity. 4 N.ew York State Department of Environmental Conservation · · Division of Ep~ironmental Permits, Region One SUNY @ ~tony E~ook, 50 Circle Road, Stony Brook, NY 11790 - 3409 Phone: (631) 444-0352 FAX: (631) ~.~.O404 Website: www.dec.state.ny, us September 17, 2008 Alexander B. C-~annis Commissioner · Mr. James F. Haag · P.O. Box 28 Orient, N.Y. 11957 Re: Permit #1-4738-03843/00001 Dear Permittee: In conformanc~ with the requirements of the State Uniform Procedures Act (Article 70, ECL) and its implementing regulations (6NYCRR, Part 621) we are enclosing your permit. Please carefully read all pei,~dt conditions and special permit conditions contained in the permit to ensure compliance during th6 term of the permit. If you are unable to comply with any conditions, please contact us at the above address. Also enclosed is a permit sign which is to be conspicuously posted at the project site and protected fi.om the weather. Sincerely, ~eR. Pasquini Environmental Analyst Jm'/dj Enclosure Town of Southold Erosion, Sedan & S--~o~ A$$-$$MENT FOR.'.' P~ ~lon ~ ~-- ~K: :r~ BY A D~IGN PROr~o~O~ IN ~E STATE OF N~ ~OE Kern Number: (NOTE: A Check IV~ark (~) for esch Question IS Required for a Complete App~lesiton) Yea No 1 Wtil this Pralect Reteln All Storm-Water Run*Off Genemtnd by a Two (2") Inch Rainfall on Site? (This item Will Include all ruff*ofT created by slle cleating and~ eseslmction activities as well as all Site Irapflwements and the pem~ment creation of ~ surfaces,) 2 D<les the Site Plea end/or 8uwey Show All Pl~=poesd Drainage Glruc{ures indlceBng Size & i..ocat~)n? J [~] 'l~s Item sh~dl Include al~ Prapoesd Grade Chmlgns and Slopes Controlling Surfaes WeterFIow~ 3 Will this Projec~ Require any Land Felling, Grading or Excavation where there is a ~tmnge to the Natural · ~'~ Ex~sting Grade Involving mom than 200 Cubic Ymds of Material wftbin any Parae~ 4 Will this Application Requlm Land Distuff~ng Ac~zlt~s Encompassing an Area In Ex, ess of Five Thousand (5,000) :Square Fes~ of Ground Surface? 5 Is there e N~teml Water Course Running through the Site? Is this Preject withln the Trustees Judsdicti~ or within Ocs Hundred (100') lest of a Wetland or Beach? 6 Will there be Site Preparatten on E. Jdsting Grade Slopes which Exceed Fllteon {15) feet of Verf~c~l Rise to One Hundred (100') of Hodzontel Distance? . 7' Will Driveways, Perldng Areas or other Impen, loas S un~aces be Sloped to Direct Stom~-Waler Run~fT into and/or in the direotton of a To~n right-of-way? any itera Within the Town Right-of4'Vay or Ro~d Shoulder Area? {This item will NOT include the Installation of Driveway Aprons.) 9 W~I this Project R.qulre Site Praparauon within the Oas Hondred (100) Year Floo~p~arn of any Watercourse? NOTE: If Any Answer to Questions One through Nine is Answered with a Cheek Mad( te the Bex, a Storm-Water, Grading, Drainage & Erosion Control Plan Is Required and Munt be Subrallted for Review PHor to tesuanee of Any Building Permltl E~MPTION: Dees this projec~ meet the minlmura standards for clesslticetlon e*m't Agriouitu~ Project? Note: If You Answerad Yes to thte QuesUon, a Storm.Water, Grading, Drainage & Eroulon Control plan is NOT Required] Yes No FORM STATE OF NEW YORK, COUNTY OF ........................................... SS ...... . ' '~i~ ~'~'~ ~'~;;~-~; ~'~:~; ~' ....................being duly ~m, deposes and say~ that he/shc is thc applicant for Pe. mnit, And that he/she i~ the ~ ~ ~-~*lx ( ~ Owner and/or rcprcsentetive of the Owner of Owner's, and is duly authorlzed to perform or have performed the said work and to make and file this appli~tlon; that ail statemenbi con.heM in this application arc true to the best of/tis knowledge and boiler; that the work will be performed in the manner set forth in the application filed hercwlth. OH~l~[l~£ FROMM Sworn to bcforc me this; I~ ?.ublio, St~ ot NBW ~ NO. 01FR6187273 Ouallfled In Suffolk County , ~ommisslofl Explrel May 10, Town l-lall Annex Main Pu~d TdeNmac (~1) ..... TOWN OF SOUTHOLD ~ ~_r <,.., ~)~' %/' . REQUESTI=:D BY. ' ' -"-. ' ~i" -- Oate: (~- ~° lO CompaflyName: I~1 ~"~C~ ~(.~CTI~IC_ ~f~l"- /~C. Name: . . ~l~nse No.: ~ ~ JOB~ITE INFORMATION: (*!ndi~tes ~uimd infom~afion) ' ame: *Address: *Phone No.: Tax Map Distd~: 1~ S~m ~* ~ B~: ~ Lot ~ *BRIEF DESCRI~/ON OF WORK (Plea~ p~ Cleady) (Please Circle All That Apply) *Is job ready for ir~peCfiOn:. *Do you need a Temp Certificate: ~f NO Final 350 400 Other Rough In Temp Informer!on (If needed) · · Service Size: 1 Phase 3Phase 100 150 200 300. · New Service: Re'connect Underground Number of Meters Change of Service Additional InfOrmation: PP~YMENT DUE WITH APPLICATION 82~Reque~ ~or Inspectjo~ Fom~ Overhem:l 12/16/2008 15:04 2129298833 GLUCKMAN MAYNER PAGE 02/83 , GL~'UCKMAN MAYNER ARCHITECTS 2so Hudson Street New York NY 4'-0" POST ( AND ~RE FENCE FOR POOL BACKW~) / ~ / 5.00 4 ': x '" PROPOSED -- PROPOSED GRAVEL DR~'E PROPOSED p PROPOSED NEW SEPTIC SYSTEld PROPOSED 2-STORY DWELUNG . LP ~D GAUGE (2 B~OROOU) ~ ~ "' / / _~ ~' LP '~ ~ 12/16/2008 15:04 2129298833 GLUCKHAN NAYNER PAGE 83/03 G L~U~'C K M A MAYNER ARCHITECT:5 tel 212.929.0100 PROJECT NO DRAINAGE CAL~L'~LATiONS FOR 2" RAINFAL~ ROOF AREA: 1,560 DECK AREA: 690 SF TOTAL AREA: 2,250 SF REQUIRED DRAINAGE' ,376 CUBIC FEET DRAINAGE PROVIDED: DRYWELLS 1 & 2 DIM: 8 FT DIA. X 4 FT DEEP CAPACITY: ,3.14 X 16 SQFT X 4FT = 201 CUBIC FEET X 2 DRYWELLS = ¢02 CUBIC FEET TOTAL DRYWELL ,3 DIM: 8 FT DIA. X 4 FT DEEP. DEDICATED FOR POOL BACKWASH. N ,\ ./ ?~,;0 B~ DC DEP[ TOWF. OF SOUIHOLD ~1 '1't~ DATA ~ ~ } Ho~orc~ ~¢. Young, L~m:~ ~yor E:,Ut~VEY FOt~ ~I~,H~D PA~T OF LOT "HAP O~ BE~JOLAI¢ ~[ Orlen[, To~n oF ~u[hold ~P~ol~ Coun~, Ne~ ~or~ I I I I I ~1~= I" = ~00' I N \ \ \ \ 5ANITA~¥ 1,4EA5 A 5T LPI LP3 LP4 DC)' LP5 51' JR, EIvlENTD 4'/' 52' 4~' ~ITE DATA .~ = I.&~'"/4 AC. lli~G ~ ~2~ID 5GL FT. 51,1R. VEYOf~ GERTII=IC, ATION e ~ H~RE~If C4~'l~f' TO RICHARD SERRA & CLARA R, IC, t-IARD ~ * GLAt~k ~ PA~T ~ LOT ~ ~ PART OF LOT ~ "HAP OF ~15 ~5" ~[ ~len[, To~n oF ~u~ol~ ~FFolK ~un~, ~ YopK I ~unt~ T~x ~p D~[ m~o ~ ~ m~ OB Lot ~.m4 ~ o~ ~vl~lon~ ~ ' ' I I ~le, I* ~ I~' 4'-0" POST AND WIRE FENCE 5,00 F ', I:,/ PROPOSED PROPOSED ¢~XISTINB POST AND WIRE FENCE CF B D F 474 / + <55 , DRAVELj OR,V_E~i)(iSRYWELL~.//' PROPOSED 2-STORY DWELLING AND GARAGE (2 BEDROOM) SEPTIC SYSTEM / \ / .6,0, SUBDIvrsroN LOT NE1N CONTOUR RESTRICTED AREA AS SHOWN ON + 576 5¸61 EXISTING SPOT ELEVATION NEW CONCRETE RETAINING WALL + 5c0 WELL F - PROPOSED EXISTING POST AND WIRE FENCE 4250 ORCHARD STREET SITUATE: ORrENT TOWN: 80UTHOLD SUFFOLK COUNTY, NY BUFFOLK COUNTY TAX MAP: 1000-27-05/5.14 ZONING DISTRICT: R 200 NON-CONFORMING FLOOD ZONE: AZ-9 AREA: 1,8874 ACRES DRAINAGE JLATIONS FOR 2" RAI ROOF AREA: 1,560 DECK AREA: 690 SF TOTAL AREA: 2,250 SF REQUIRED DRAINAGE: 2,250 SF X .167 FT 576 CUBIC FEET DRAINAGE PROVIDED: DRYWELLS 1 & 2 DIM: 8 FT DIA. X 4 FT DEEP CAPACITY: 5.14 X 16 SQFI X 4FT - 201 CUBIC FEET X 2 DRYWELLS = 402 CUBIC FEET TOTAL gENERAL NOTF: ALL DRAWINGS, SPECIFICATIONS, PLANS, IDEAS, ARRANGEMENTS AND DESIGNS REPRESENTED OR REFERRED TO ARE THE PROPER~ OF AND OWNED BY DLUOKMAN MAYNER ARCHITECTS WHETI-IER THE PROJECT FOR WHICH THEY ARE MADE IS EXECUTED OR NOT THEY WERE CREATED, EVOLVED, DEVELOPED AND PRODUCED FOR THE SOLE USE ON AND IR CON- NECTION WITH THIS PROJECT AND NONE OF THE ABOVE ~AY BE DIBCLOSED OR GIVEN TO OR USED BY ANY PERSON, FIRbl OR CORPORATION FOR ANY USE OR PURPOSE WHATSOEVER INCLUDING ANY OTHER PRO JECT, EXCEPT UPON WRITTEN PERBISSION AND DIRECTION OF OLUCKMAN MAYNER ARCI-IITECTB. NO. DATE SUBMISSION DETEMBER 2008 BUILTIN6 DEPT. SURVEYOR Young & Young ~00 Os[rander Avenue RiverheDd, NY 11901 MEP ENGINEER Engineering Consultants 501 Fir[h Avenue, Suite 1809 New York, NY 10017 STRUCTURAL ENGINEER Ross Dollond, P.E, 40 Mary's Lane Stone Ridge, NY 12484 OLUCK~AN ~AYNER ARCHITECTS 0%6 5 200~ SERRA OUEST HOUSE SCTM# 1000-27-03-5.14 4250 ORCIIARD STREW, ORIENT, NEW YORK 11957 OSITE PLAN PROJECT NO 08008 SITE DRAINAGE PLAN SCALE' 1/20"= 1'-0" DATE 5 DECEMBER 2008 DRAWN AOl CAD FILE 8D5 SITE DRAINAGE © CopyrigNt Oluckman Moyner Architects 1 PROPOSED 4'-0" POST AND WIRE FENCE, DETAIL SEE A012, Q PROPOSED DEDK ON RESTRICTED AREA AS SHOWN ON FILED MAP PROPOSED 2 STORY DWELLING / AND OARAGE (2 BEDROOM)' PROPOSED // // ~)POOL PLAN /~ISTINO POST AND WIRE FENCE SUBDIVISION LOT LINE~ I 57b q buZ, ~ 563 NEW CONTOUR EXISTING SPOT ELEVATION i 4 95 N WELL 594 EXISTING POST ~D WIRE FENCE POOL EQUIPMENT AT 11'-0" ABOVE SEA LEVEL (BASE FLOOD E[EV= 9' 0"), FOR DETAILS SEE DW6 A012, ~"X 10" MAHOGANY APRON ~"X 8" MAHOGANY DECKING 2" X 8" WOOD FRAMING 12" DIA. CONCRETE FOOTING STONE COPING 9" STONE TILE BAND WATERLINE GUNITE POOL -- "STEEL REBAR AT 12" OC G 4250 ORCHARD STREET SITUATE: ORIENT TOWN: SOUTHOLD SUFFOLK COUNTY, NY SUFFOLK COUNTY TAX MAP: 1000-27 05/5,14 ZONING DrSTRICT: R-200 NON CONFORMING FLOOD ZONE: AB-9 AREA: 1.8874 ACRES ALI DRAWINGS, SPECIFICATIONS, PLANS, IOLAb, ARRANGEMENTS AND DESIGNS REPRESENTED NEFFI,'RED TO ARE FNE PROPERTY OF AND OWNM b, Gl UCI<blAN klAYNER ARCHI1ECTS WliEFliEN ,Ill PROJqff FOP, WHICH FHEY ARE MADE IS kXECIJll Nol FHFY ¢/£RE CREATLD, EVOLVEP~, QFVtlr]I,D AND PROOUCE~ IBR TIlE ROLE USE DH AMI> IN NIZCIIDN Wllll I'll% PROJECT AND NUB flF FIE AISL,," NIAY BE DISCLOSH) OP` PJVEN lO ON USED BY PERSON, FIRM ON CDNPORAI'ION ION AN/ lISp rR PURPOSE WNAISOEVER INQU[/iNC ANY OlIILN Pih, J£C1, EXCEPT MPON WRllTEN PERMISSION ANh DIRLOIION DF CLUDKMAN MA~NEP` ARCIIllECTS. NO. DATE SUBMISSION 27 JULY 2009 BUILDING DEPT, ~ 20 AUG 2009 BUILDING DEPT, REV, PROPOSED GRAVEL DRIV '% O~SCUPANCY OR USE't~, UNLAWFUL WITHOU~ CERTIFICATE A,~PRQVED AS NOTCh OF OCCUPANCY ~EE. ,.,,n,~, ab~,, .__~ NOTIFY BUll DING LFFARTMENT AT 765-1802 8AM TO 4 lam FOE{ THE FOLLOWING rNSPEC FIONS: 1. FOUNDATIgN. FWO REQUIRED FOR POURED CONCRETE 2. ROUGR - FRAMING & PLUMBING 3. INSULATION 4 FINAL - CT)~r~TRUETfON MI]ST BE COMPLE"E FOR CO, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORN STATE, NO1 RESPONSIBLE FOB DESIGN OR CONSTRUCTION ERRORS. SURVEYOR Young & Yoong 400 OstrEiladel AveDue RiveFhemd, NY a l~O'l 631.727,2505 MEP ENGINEER I loningkorl Engir/eedng CoDsolkants ,501 FlflN Avenue, SulLe I~t)9 New 'Furl,,, Mk I00i7 212.3589801 STRUCIURAL ENGINEER Ross P E 40 Lone Stone Ridge, NY 12484 UCKMAN MAYN ER ARCHITECTS UPON FLOOD ZOXE.~ Z ~ d-'~ COMPLY WiTH CHAPTER "4,8" FLOOD DAMAGE PREVENTION $OUTHOLD TOWN CODE. BOUTHOLD TOWN PLANNING BOARD LITHq.[',-i ~':Tm ' RETAIN STORM WATER RUNOFF PURSUANT TO CHAPTER 236 OF THE TOWN CODE. SERRA RENTAL PROPERTY SCTM# 1000 27 05 5.14 4250 ORCRARD STREET, ORIENT, NEW YORK 11957 PROJECT NO, 08003 POOL PLAN SCALE AS NOFED DATE 27 JUL" 2009 .AW , A01? Fa Copvnq'nk Oluckmmn Morner Archi~ecLs