HomeMy WebLinkAbout39824-ZTOWN- OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: (631) 765-1802
FAX: (631) _765 --9502
www.northf6rk.ilet/Southold/
PERMIT NO.
Examined � � EE
Approved , 006
MAY 19 20�
Disapproved a/c
. BIDd`fi�PT
'THOW '
Expiration .2
(Building Inspector)
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
Contact:
Mail to:SUFFOLK ENVIRONMENTAL
P.O. Box 2003: Brideehampton, NY 11932
Phone: (631) 537 — 5160
APPLICATION FOR.BUILDING PERMIT
Date April 22, 2015
INSTRUCTIONS
a. This application MUST be completely filled in- by typewriter or in ink and submitted to the Building Inspector, with 4
sets of plans, accurate plot plan to -scales Fee accdrdingto schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterway.
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 iri'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;Irispector'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 for1he18suan6e of a Building Pe, 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 1`aws ordinances, building code, housing co, and regulations, and to admit
authorized inspectors on premises and in building for necessary in tions.
(Signature of applicant, or name, if a corporation)
Suffolk Environmental Consulting, Inc.-
P.O. Box 2003; Bridgehampton, NY 11932
(Mailing address of applicant)
State whether applicant is owner; lessee, agent;;. architect, engineer, general contractor, electrician, plumber• or builder
AGENT
Name of owner of premises Karmen.Dadorian
(As on the tax roll:or latest deed)
If applicant is a corporation, signature of duly authorized officer.
N/A
(Name and title of corporate officer) .
Builder's License No.
Plumber's License No.,
Electrician's License No.
Other Trade's License No.
1. Location of land on which. proposed work will be done
2670 Deep Hole Road Mattituck
House Number Street Hamlet
County Tax Map No. 1000 Section 0123 Block 04 Lot , . 010
Subdivision N/A Filed Map No. N/A Lot _ N/A
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing, use arid, occupancy : , Residence r
b. Intended use and occupancy,: Residence wirth pool
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition . Other Workoop_ 1
(Description).
4. Estimated Cost $ 50,000 ± Fee
_..(To -,be paid on filing this application)
5. If dwelling, number of dwelling units N/A Number -of -dwelling units on each: floor N/A
If garage, number of cars N/A
6. If business, commercial or mixed occupancy, specify natur d � en ach type'of use N/A
7. Dimensions of existing structures, if any: Front ± N/A -_. ---Rears -"Depth:
Height N/A Number of Stories ;N/A -
Dimensions of same structure with alterations or additions: Front N/A Rear N/A
Depth _ N/A Height N/A" - Number -of Stories N/A
8. Dimensions of entire new construction: Front 20' (max.) Rear 20' (max.) Depth 50' (max.)
Height < 28.0' Number,of Stories 'f`S'tory k
9. Size of lot: Front 75' Rear 113.50' Depth 467.00'
10. Date of Purchase N/A Name of Former Owner N/A
11. Zone or use district in which premises are situated- R'-:40 — • G (� ar'res. . -
12. Does proposed construction violate any zoning law, ordinance or regulation: YES X NO
13. Will ,lot be .re -graded YES X NO Will excess fill be, removed from premises,. YES, : , NO , X . .
5 Ridge Circle
14. Name of Owner of premises Karmen Dadorian Address Manhassett, NY 11030. Phone No., (917) 973 - 3195
Name of Architect N/A Addres Phone No.
Name of Contractor NSA Address NSA Phone No. N/A
15 a. Is this property within 100, feet of a tidal, wetland or a freshwater wetland? *YES X NO .-
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS ;MAY BE.REQUIREb;
b. Is this property within 300 feet of a tidal wetland?, *YES X NO
*IF YES, D.E.C. PERMITS MAYBE REQUIRED.
16. Provide survey, to scale, with accurate foundation:plan and.distances,to property lines.
4 F 1� Y:•^.yeti "^.�, ., ..... ,, .,
17. If elevation at any point on property�is at 10 feet or below must -provide topographical data on survey.
STATE OF NEW YORK)
:SS: ?:
COUNTY OF SUFFOLK
Bruce A. Anderson being duly- sworn; deposes and says that he is the.applicant
(Name of individual signing contract) above named.
(S)He is the _ Agent - Suffolk Environmental -Consulting; Inca
(C6ntractor,.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 staternents'contained in this application are true to the best of this knowiedge'and belief; and -that -the work!will be _
performed in the manner set forth in the application filed therewith.
Sworn to before me this
% AJ day of { IC. 201 '
Notary Public Signature of Applicant
Matthew D. (vans
Notary Public of New York
No. 011Vf °53859
Qua lified-in Suffolk county
201-7
commission Expires January
Division of Environmental Permits, Region 1
SUNY C Stony Brook, 50 Circle Road, Stony Brook, NY 11790
P: (631) 444-0365 I F: (631) 444-0360
www.dec.ny.gov
NO PERMIT NECESSARY
May 14, 2015
Karmen Dadourian
5 Ridge Circle
Manhasset, NY 11030
Re: DEC# 1-4738-04384/00001
2670 Deep Hole Road
Mattituck, NY 11952
SCTM# 1000-123-04-010
Dear Mr. Dadourian:
The Department of Environmental Conservation (DEC) has completed a review of your
proposal to install a 20' x 50' swimming pool and associated structures more than 75' from the
tidal wetlands boundary as shown on the survey prepared by Kenneth M Woychuck last revised
February 23, 2015.
Based on the information you submitted, DEC has determined_ that this project is listed in
the Tidal Wetlands Land Use Regulations (6NYCRR Part 661.5) as a use not requiring a permit:
Therefore, rto permit is required under the Tidal Wetlands Act (Article 25) of the Environmental
Conservation Law.
Be advised, any additional work or modification to the project as described, may require
DEC authorization. Please contact this office if such activities are contemplated. Please note
that this letter does not relieve you of the responsibility of obtaining any necessary permits or
approvals from other agencies or local municipalities.
sla
cc: Suffolk Environmental Consulting
BOH — TW
file
George W. Hammarth
Permit Administrator
NEtW YORK Department of
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ADD PROPOSED POOL 12-10-14
UPDATED 06-02-14
FINAL SURVEY 2-1-02
FOUNDATIN LOCATION 6-27-01
THE WATER SUPPLY, WELLS, DRYW£LLS AND � CESSPOOL
LOCATIONS SHOWN -A'RE. FROM, -FIELD OBSERVA476PS
AND OR DATA O8TA'AVED FROtiI OTHERS
AREA: 37,078.1 S.F. OR 0.85 ACRES
FIRM ZONE AE (EL 8) ELEVATION DATUM. NGVD 1929 _____ _ _ ________
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A V70LATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE..
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUffURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT .THE TIME OF SURVEY
SURVEY OF: DESCRIBED PROPERTY CERTIFIED TO: KARMEN DADOURIAN;
MAP OF:
FILED:
SITUATED AT: MATTITUCK
TOWN OF: SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PUC
SUFFOLK COUNTY, NEW YORK A# Professional Land Surveying and''De9ign
FILE #20-86 SCALE: 1 =50' DATE: JUNE 9, 2000
N. Y. S. LISC. NO. 050882
P.O. Box 153 Aquebogue, Mew York 111931
PHONE (891)298-1588 FAX (031) 298'-1588
maintaining the records of Robert J. Hennessy & Kenneth M. Woychuk
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