HomeMy WebLinkAbout37039-Z ts�Epp1Kc Town of Southold Annex 7/26/2013
P.O.Box 1179
cox 54375 Main Road
oy� o��}fig Southold,New York 11971
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CERTIFICATE OF OCCUPANCY
No: 36417 Date: 7/26/2013
THIS CERTIFIES that the building DECK
Location of Property: 170 Manor Rd, East Marion,
SCTM#: 473889 Sec/Block/Lot: 38.-3-1
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this officed dated
2/28/2012 pursuant to which Building Permit No. 37039 dated 3/5/2012
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:
16'X 30'deck addition per ZBA decision#6527, dated 1/19/12, as applied for
The certificate is issued to Collura, Donna&Elizabeth&Ano.
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO. 37039 7/2/13
PLUMBERS CERTIFICATION DATED
Aut rized Sign re
TOWN OF SOUTHOLD
�O�g11FF0( 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#: 37039 Date: 3/5/2012
Permission is hereby granted to:
Collura, Donna & Elizabeth &Ano.
52 Lindell Ave
Lake Grove, NY 11755
To: construct a 16' X 30' deck addition per ZBA decision #6527 as applied for
At premises located at:
170 Manor Rd, East Marion
SCTM # 473889
Sec/Block/Lot# 38.-3-1
Pursuant to application dated 2/28/2012 and approved by the Building Inspector.
To expire on 9/4/2013.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $392.00
CO -ADDITION TO DWELLING $50.00
ELECTRIC $90.00
Total: $532.00
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Building Inspector
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 from Board of Fire Underwriters.
4. 'Sworn statement from plumber certifying that the solder used in system contains less than 2/1.0 of 1% lead.
5. Commercial building,industrial building,multiple residences and similar 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.
B. For existing buildings"(prioko April 9;1957)'non-conforming uses,or buildings and "pre-existing"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$50.00,Additions to dwelling$50.00,Alterations to dwelling$50.00,
Swimming pool$50.00,Accessory building$50.00,Additions to accessory building$50.00, 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. Temporary Certificate of.Occupancy-Residential $15.00, Commercial $15.00 a
Date.
New Construction: Old or Pre-existing Building: l` (check one)
M i
Location of Property: l 6Lo O R R 6— t>�5 1 CLP! D�
House No. Street Hamlet
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Owner or Owners of Property:_ onylo— [�f2&cc<?, �. Cl I ZAL e_
Suffolk County Tax Map No 1000,Section ". Block Lot
Subdivision Filed Map. Lot:
Permit No. 3 Date of Permit. Applicant:Health Dept.Approval: Underwriters Approval:
Planning Board-Approval: /
Request for: Temporary Certificate- Final Certificate: t/ (check one)
Fee Submitted:$
—�_
Applicant Sig ature
j „
OF SO(/Tyolo
37657
`
olyc0���
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
.INSPECTION
[ FOUNDATION 1ST [ ] ROUGH PLBG.
[/ ]` FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING/STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS:
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DATE - �� INSPECTOR '
SO(/l�,
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLEIG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ] FRAMING /STRAPPING [ rINAL
[ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
[ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
REMARKS: � .
l J _
DATE l3 l3 INSPECTOR -
1' ! 1 0 • � 0 1 1,
AIL ",0
ROUGH
•I PLUMING
INSULATION PER N.Y.
STATE ENERGY • 1
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11 . COMM1
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT r Do you have or need the following,before applying?
TOWN HALL * Board of Health
SOUTHOLD, NV 11971 __"'��4 sets of Building Plans
TEL: (631) 765-1902 Planning Board approval
FAX: (631) 765-9502 — Survey
SoutholdTown.NorthFork.net PERMIT NO. 3 03 Check CS0
Septic Form
N.Y.S.D.E.C.
Trustees
Flood Permit
Examined JS,20 O ��] Storm-Water Assessment-.Form
DU Contact:
Approved J,201 Mail-tom LG- �✓�3
OCT 2 4 2011
Disapproved a/c S.�
r BLDG.DEPT. Phone: 7 3:2— Q_j
Expiration ,2013� TOWN OF SOUTNOLD 3 ' QS
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date _ a3 , 20
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 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.
ignature of applicant or name,if a corporation)
tv9 P/N IL fit /l 76,)-_
Mailing address of app ' ant)
State whether applicant i own , lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises R2 ac, AA 1 01)r1 -1- COII. 914 U Z4 e&J
(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 o.
1. Location of land n whrc p sedwor ill be done:
-House Number Street7 Hamlet
County Tax Map No. 1000 Section 3W Block 3 Lot /
Subdivision Filed Map No. a = Lot `��
2. State existing use and occupancy of premises and intended use and occupancy of propo ed construction:
a. Existing use and occupancy .e ,� /jlpyl
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
v
(Description)
4. Estimated Cost -Fee -- _
(To be.paid on filing this application)
5. If dwelling, number of dwelling units /, i ; Number of dwelling units on each floor lk,
If garage, number of cars AM,//�
6. If business, commercial or mixed occupancy;specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front - ;1U . .Rear Depth
Height Number of Stories
Dimensions f s e structure with alterati or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front 30 6f' Rear 0 Depth �e
Height �,�l ndne_5 Number of Stories A)�/y�- U
l G�
9. Sizeof lot- Frozit Rear Depth
10. Date of Purchase LA. ;I' - 0Name of Former Owner I o
11. Zone or use district in which premises are situated
12. Does proposed construction violate any onii g la ordinance or regulation? YES NO C<�1--b1X(Z-S)
13. Will lot be re-graded? YES NO,ZWill excess fill be removed from premises? YES NO
14. Names of Owner of premises (Ion Cam!( Address Phone No. c57 _8'U 33(,
Name of Architect A"h 17 w e2, ouan /°}55acA,ddress Phone No&3 `1)- 7�6�,
Name of Contractor S e I 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_,,,Z-
* 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.
18. Are there any covenants and restrictions with respect to this property? * YES NO
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Ndine of individual signing contract) abov,named,
(S)He is the ,e(t__
(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.
moms +�
Sworn to before me this 44mber
4-5 —_day of 20 11
Notaiiy uRl Signature of Applicant
Town Hall Annex o�QSUFFOI,�cpFe Telephone(631) 765-1802
54375 Main Road c Fax (631)765-9502
P.O. Box 1179 5 •
Southold, NY 11971-0959 y'jlp� �•a0� roger.richert(aD-town.southold.ny.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Donna Collura
Address: 170 Manor Rd City: East Marion St: NY Zip: 11939
Building Permit#: 37039 Section: 38 Block: 3 Lot: 1
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: as built DBA: License No:
SITE DETAILS
Office Use Only
Residential x Indoor Basement Service Only
Commerical Outdoor x 1st Floor Pool
New Renovation 2nd Floor Hot Tub
Addition Survey Attic Garage
INVENTORY
Service 1 ph Heat Duplec Recpt Ceiling Fixtures HID Fixtures
Service 3 ph Hot Water GFCI Recpt 2 Wall Fixtures Smoke Detectors
Main Panel A/C Condenser Single Recpt Recessed Fixtures CO Detectors
Sub Panel A/C Blower Range Recpt Fluorescent Fixture Pumps
Transformer Appliances Dryer Recpt Emergency Fixtures Time Clocks
Disconnect Switches Twist Lock Exit Fixtures TVSS
Other Equipment: DECK, low voltage lighting
Notes:
Inspector Signature: - Date: July 2 2013
Electrical Certificate.xls
FORM NO. 3
NOTICE OF DISAPPROVAL
DATE: November 4, 2011
TO: Elizabeth Collura
52 Lindell Avenue
Lake Grove, NY 11755
Please take notice that your application dated October 24, 2011
For a deck addition to an existing single family dwelling at
Location of property 170 Manor Road, E. Marion, NY
County Tax Map No. 1000—.Section 38 Block 3 Lot 1
Is returned herewith and disapproved on the following grounds:
The proposed deck addition to an existing single family dwelling, is not permitted
pursuant to Article XXIII Section 280-124 which states;
"This section is intended to provide minimum standards for granting of a building
permit for the principal buildings of lots which are recognizedy the town under
.280-9, are nonconforming &have not merged pursuant to 280-10."
For lots less than 20,000 sq. ft.,the required rear yard setback is 35'. The proposed deck
addition, on this lot with three front yards, indicates a rear yard setback of 17.1'.
vLfi��
uthorized Si nature
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BOARD MEMBERS UT Southold Town Hall
of SC
Leslie Kanes Weisman,Chairperson �0� yQ 1 53095 Main Road•P.O.Box 1179
Southold,NY 11971-0959
James Dinizio,Jr. Office Location:
Gerard P. Goehringer G Q Town Annex/First Floor,Capital One Bank
George Horning 54375 Main Road(at Youngs Avenue)
Ken Schneider I�Irou Southold,NY 11971
http://southoldto.wn.northfork.net
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
Tel.(631)765-1809•Fax(631)765-9064
FINDINGS,DELIBERATIONS AND DETERMINATION
MEETING OF JANUARY 19,2012
ZBA FILE: 6527
NAME OF APPLICANT: Bruce and Elizabeth and Donna Collura CTM: 1000-38-3-1
PROPERTY LOCATION: 170 Manor Rd. (corner Gillette Dr. and East Gillette Dr.),East Marion,NY
SEQRA DETERMINATION: The Zoning Board of Appeals has visited the property under consideration in this
application and determines that this review falls under the Type II category of the State's List of Actions, without
further steps under SEQRA.
SUFFOLK COUNTY ADMINISTRATIVE CODE: This application-was referred as required under the Suffolk
County Administrative Code Sections A 14-14 to 23, and the Suffolk,County Department of Planning issued its
reply dated Nov. 23, 2011, stating that this application is considered a matter for local determination as there
appears to be no significant county-wide or inter-community impact.
LWRP DETERMINATION: The relief, permit, or interpretation requested in this application is listed under the
Minor Actions exempt list and is not subject to review under Chapter 268.
PROPERTY FACTS/DESCRIPTION: The Applicant's property is a 12,761.1 sq. ft.parcel in the R-40 Zone.
The northerly lot line measures +/- 157.47 ft. along Manor Road. The easterly lot line measures 75.66 ft. along
East Gillette Drive. The westerly lot line measures 75 ft. along Gillette Drive, and the southerly lot line measures
131.49 ft. along an adjacent residential parcel. The property is improved with.a single family dwelling as shown on
the survey drawn by Kenneth M. Woychuk,L.S. last updated July 21,2010 to show proposed deck addition.
BASIS OF APPLICATION: Request for Variance from Article XXIII Section 280-124 and the Building
Inspector's November 4,2011 Notice of Disapproval based on an application for building permit for a deck
addition to a single family dwelling at: 1)less than the code required rear yard setback of 35 feet.
RELIEF REQUESTED: The applicant proposes to construct an 18ft X 30ft. rear wood deck, and requests a
variance for a 17.1 ft. rear yard setback, in a location where the Code requires a 35 ft. setback.
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AMENDED APPLICATION: During the hearing, the applicant was asked to bring the plan into more conformity
with the code. The applicant at the Public Hearing held on Jan. 5, 2012,verbally agreed to reducing the size of the
proposed deck to 16 ft. X 30ft., and increasing the proposed rear yard setback from 17.1 feet to 19.1 feet, thereby
bringing the plan into more con ormity with the code.
ADDITIONAL INFORMATION: At the Public Hearing the adjacent neighbor asked about a method to screen the
deck from view,and the Applicant agreed to provide a landscape buffer by the planting of an evergreen hedgerow.
Page 2 of 3—January 19,2012
ZBA File#6527-Collura
CTM:1000-38-3-1
FINDINGS OF FACT/REASONS FOR BOARD ACTION:
The Zoning Board of Appeals held a public hearing on this application on January 5,2012,at which time written
and oral evidence were presented. Based upon all testimony, documentation, personal inspection of the properly,
an assessment of the character of the neighborhood, and other evidence,the Zoning Board finds the following facts
to be true and relevant and makes the following findings:
1. Town Law V67-b(3)(b)(1), Grant of alternative relief will not produce an undesirable change in the character
of the neighborhood or a detriment to nearby properties. Decks are common and customary additions to residential
dwellings. The Applicant will establish and maintain landscape plantings to provide appropriate screening of the
deck from the adjacent property which will lessen the visual impact of the deck from the neighbors.
2. Town Law V67-b(3)(b)(2), The benefit sought by the applicant can not be achieved by some method, feasible
for the applicant to pursue, other than an area variance. Granting of alternative relief does reduce the amount of
variance relief necessary. Due to the overall small size of the Applicant's property(12,761 sq. ft.),the centralized
Position of the existing house on the parcel, and the fact that it has three front yard areas, a rear yard area, and no
designated side yard areas, the Applicant can not construct an addition with practical or useful dimensions without
the granting of a variance.
3. Town Law 4267-b(3)(b)(3). The variance granted through alternative relief herein is substantial since it
represents a+45% relief from the Code required rear yard setback of 35 feet. However, this Board recognizes the
somewhat unique hardship presented by the fact that this small parcel has three front yards,and no side yard area.
4. Town Law §267-b(3)(b)(4) No evidence has been submitted to suggest that a variance in this residential
community will have an adverse impact on the physical or environmental conditions in the neighborhood. The
property is relatively flat,and no land grading or tree removal is necessary to construct the proposed deck.
5. Town Law 4267-b(3)(b)(5). The difficulty has been self-created because the Applicant purchased the parcel
after the Zoning Code was in affect, and it is presumed that the Applicant had actual or constructive knowledge of
the limitations on the use of the parcel under Zoning Code in effect, prior to, or at the time of purchase. j
6. Town Law §267-b. Grant of alternative relief is the minimum action necessary and adequate to enable the
applicant to enjoy the benefit of a deck in the rear yard area, while preserving and protecting the character of the
neighborhood and the health, safety and welfare of the community.
RESOLUTION OF THE BOARD: In considering all of the above factors and applying the balancing test under
New York Town Law 267-13,motion was offered by Member Horning, seconded by Member Goehringer, and duly
carried,to
DENY, as applied for, and
GRANT ALTERNATIVE RELIEF,as noted below:
1. The rear yard setback will be no less than 19 feet.
Condition:
1. The Applicant will establish and maintain evergreen landscape plantings inside their property line for a
minimum length of 30 feet to provide adequate privacy screening of the deck from the adjacent property to the
south.
That the above conditions be written into the Building Inspector's Certificate of Occupancy, when issued.
Before applying for a building permit,the applicant or agent must submit to the Board of Appeals for approval and filing,
two sets of the final survey conforming to the alternative relief granted herein.The ZBA will forward one set of approved,Page
�- 3 of 3—January 19,2012
ZBA File#6527-Collura
CTM: 1000-38-3-1
stamped drawings to the Building Department.Failure to follow this procedure may result in the delay or denial of a building
permit,and may require a new application and public hearing before the Zoning Board of Appeals.
Any deviation from the variance given such as extensions, or demolitions which are not shown on the applicant's diagrams or
survey site maps,are not authorized under this application when involving nonconformities under the zoning code. This action
does not authorize or condone any current or future use, setback or other feature of the subject property that may violate the
Zoning Code,other than such uses,setbacks and other features as are expressly addressed in this action.
The Board reserves the right to substitute a similar design that is de minimis in nature for an alteration that does not increase the degree of
nonconformity.
Vote of the Board: Ayes:Members Weisman(Chairperson), Goehringer,Schneider, Dinizio,Horning.
This Resolution was duly adopted(5-0).
Leslie Kanes Weisman, Chairperson
Approved for filing/a70 /2012
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SO(/ry�l
Town Hall Annex Telephone(631)765-1802
54375 Main Road Fax(631)765-9502
P.O.Box 1179
Southold,NY 11971-0959
Cou ,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 22, 2013
Donna Collura
52 Lindell Ave
Lake Grove, NY 11755
Re: 170 Manor Rd, East Marion
TO WHOM IT MAY CONCERN:
The Following Items(if Checked)Are Needed To Complete Your Certificate of Occupancy:
Application for Certificate of Occupancy. (Enclosed)
Electrical Underwriters Certificate. (contact your electrician)
A fee of$50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1184)
Trustees Certificate of Compliance. (Town Trustees#765-1892)
Final Planning Board Approval. (Planning#765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept
BUILDING.-PERMIT: 37039 — Deck Addition
/ _0 Town of. Southold
f �y �
4 .
Erosion, 4edimen�tation & S'for ,Water Run-off ASSESSMENT FORM �
PROPERTY LOCATION:, S.CT:61 fi THE FOLLOWING ACTIONS MAY REgU1RE THE SUBMISSION OF A -
O� fY' /000 O3$,,.00 03.00 UO/,()OO S TORN WATER,CoRADING,DRAINAGE AND EROSIO CONTROL.PLgN
r1sire section �k: tot CERTIFIED BY A DESIGN'PROl'EOION L IN THE STATE OF NEW YORK.
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SCOPE OF WORK - PROPOSED CONSTRUCHON ITEM# / WORK ASSESSMENT FYes No
a. What is the Total Area of the Project Pafcels? j Will this Project Retain ADStorm-Water Run Off —
(Include Total Area of alt Parcels located within y a b
the Scope of Work for Proposed Construction) Generated U Two(Z)Inch Rainfall on Slfte?
(S.F./Aaes) (This item will include-all nut-off.created by site
b. What is the Total Area of Land Clearing clearing and/or construction activities as well as all —
and/or Ground Disturbance for.the proposed 3 � -Site Improvements.and'the permanent creation of
construction a ctivily? • {s.F.raaes) 'impervious surtaces,)
PROVIDE BRIEF PROJEer DESCRIPE(ON (PmvwAdibftw Pam W Needed) 3 Does the Site Plan and/or Survey Show All Proposed
Drainage Strictures Indicating Size&Location?This
]tern shall include.all Proposed Grade Changes and D
(''' 0 e& / � Gr 71/-, pew Slopes Controlling Surface Water Flow.
•3 floes the Site Plan and/or Survey describe the erosion
07 G e /G and sedimentoontroll.practices that will be tised to
control site erosion and storm water discharges. This
le) item must'be maintained throughout the Entire
Constivction Period.
4 Will this Project Require,any Land'Filling,Grading or
Excavation where there is a change to the Natural
Existing Grade Involving more than 200 Cubic Yards- • '.
of Material within any Parcel? El
5 Will this Application Require Land Disturbing Activities
Encompassing an Area in Excess of FiVei Thousand p
.(5,000*S.F.)Square Feet of Ground Surface? D. —
.6 is there a Natural Water Course Running through the
Site? Is this Project within the Trustees jurisdiction �a
General DEC SWPPP Requirements: or within One Hundred(100•)feet of a Welland.dr
Submission of a SWPPP is required for all Construction activities involving soil' 'Beach?
disturbances of one(1)or more acres;including fisturbances of less tliedone acre that. 7 Wilt there be Site preparation on Existing Slopes Grade Sl 'are part of a targer•common plan that will ultimately disturb one ormore acres of land; m'
Including Construction activities involving sou disturbances of less than one.0)acre where which Exceed Fifteen(15)feet of Vertical Rise to
'the DEC has determined that SPDES permit is required for storm water discharges. • One Hundred(10W)of 1-I6rizontai.Distance?' — -
(SWPP.P s Shall meetthe Minimum Requirements of the.SPDES General Permit. $ WIII Driveways,Parking Areas brother lmpervious
r for Storm water Discharges from Construction activity.Permit No,Gp+10�601.)- Surfaces be Sloped to Direct Storm-Water Run-Off 4
1.The SWPPP shall be prepared prior to the submtttal.of the NOL The Not shaft be - into and/or in the direction of a Town fight-of Way?submitted to the Department pff"to the commencement of constriction activity 0
2.The SWPPP shaft describe the erosion andsediment.contral practices and where 9 WI this Project Require-the Placement ofMaterial,
required,post construction storm water ffmMemeritpactIm that will be used and/or Removal of Vegetation and/or the Constr#Iction of any
constructed to reduce the pollutants In storm water discharges and-to as l"6 Item Within the Town Right-of-Way or Road Shoulder l comptlancewith ft terms and conditions of this permit In addition.the SWPPP shati area?Irhb ittrrr wtil Nor inelud.tM lristapadon or identify potential sources of pollution which may reasonably be expected to affect the n6�Ar-44,
quardy of storm waterdischarges. -NOTE: If Any Answer to gitestions One through Nino is Answered with a Cheek Mark
3.All SWPPPslhat require the postconstrudion storm watermamagement practice in a Box and the.construction site'distuFbance is between keeDS.F.31 Acre to area,
Component shall be-prepared by a quarrfied Design professional Licensed In New Yak a Storm-Water.'Grading,Drainage&Erosion Control°Plan is Required 1!jVm Town of
that is knaMedgeable in the prindples and practices bf storm water Management. Southold and M"tbe Submitted forReview Prior to Issuance of AnyBuilding PermiL
tNOT6• ACh.,% rk(at)orrJorArrwttt3ra2ch Question isW;md;o,-awmpJ.teAW5c' 1ai)
, f
STATE OF NEV�YORK, . '
COUNTY OF..:.... Q,.I
lfiat I �
.... ,•�. x�• �•��.. ..�...dv/.� r .rtf..being drily sworn,deposes and says that he/she is the applicant for Permit,
me of fn�ividuai s ni Document
And that he/she is the ................................,.......
�Con�'rae6or�AseriR ate oHteet,'eta')'.. ..........................................................
Owner and/or representative of the Owner or Owners,and is duly authorized to perform or have performed the said work and t'D
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 herewith. VINCENZA TULLO CROSBY
Sworn to before me this; ;s: Notary Public,State of New York
No.OITU6220358
Qualified in Nassau Cou
.................... .......... .......day of......
.. ,20 JI Commission Expires gpri112,�f
'Notary Public: ..._... .................. ................................
(Signature of Applicant)
:FORM 06/40
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TOWN OF SOU'THOLD PROPERTY RECORD CARD
OWNER _ STREET VILLAGE DIST. SUB. LOT
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LAND IMP. TOTAL DATE REMARKS
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REVISED PROPOSED DECK 02-06-12
ADD PROPOSED DECK
UPDATE SURVEY 07-21-10 THE WA TER SUPPLY, WELLS AND CESSPOOL
FINAL SURVEY 3-1-02 LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
FOUNDATION LOCATION 12-7-01 AND OR DATA OBTAINED FROM OTHERS.
AREA: 12,761.1 S.F. OR 0.29 ACRES ELEVATION DATUM: ___ASSUMED ________________
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYORS 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 STRUfURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: LOT 57 CERTIFIED TO: DONNA M. COLLURA;
MAP OF: MARION MANOR BRUCE P. COLLURA; ELIZABETH COLLURA;
FILED: MARCH 18, 1953 AS #2038 TEACHERS FEDERAL CREDIT UNION;
ABSTRACTS INC.;
SITUATED AT: EAST MARION
TOWN OF: SOUTHOLD KENNETH M. WOYCHUK L.S.
SUFFOLK COUNTY, NEW YORK Land Surveying and Design
a-"--' --- P.O. Fos 3, Mattituck, New York 11952
PHONE (631) 298-1588 FAX (631) 298-1588
FILE # 21-148 SCALE:'1 =30 DATE:DULY 10, 2001 N. Y. S. LIC NO. 50227 maintaining the records of Robert J. Hennessy
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