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HomeMy WebLinkAbout28470-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. 28470 Z Date JUNE 17, 2002 Permission is hereby granted to : BRADLEY ANDERSON 3820 SOUTH HARBOR RD SOUTHOLD,NY 11971 for DEMOLITION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 45730 MAIN RD SOUTH/PEC County Tax Map No. 473889 Section 075 Block 0006 Lot No. 011 pursuant to application dated JUNE 14 , 2002 and approved by the Building Inspector to expire on DECEMBER 17, 2003 . Fee $ 35 . 00 cv/. s Auth i ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD r 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: 765-1802 Survey LO ?0 PERMIT NO. Check Septic F�rITl' N.Y.S.D:E.0 j (; 'Trustees, ' Examined ,20 Contact: Approved ,20 Mail to: Disapproved a/c Phone: CtOr 6 •--M---' APPLICATION FOR BUILDING PERMI/ 11//11 C (• �l� /C / .. . T. ,r m Date_ pp, (L' 8 , 20 D2 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 a Certificate of Occupancy is issued by the Building Inspector: 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 haws, Ordinances ar 14941ati ns, for the construction•of"du11d1llgs; additions,.Uraher4dons-or Tor 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 * building for necessary inspections. r �LC�� i; 1'J'"& tNV((ZoNYYIrt (MC. ! (Signature of applicant or name,if a corporation) JUN 14 2002 D B X � PecON(C bLD `-?T• (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,.plumber or.builder Com:Fa)i A4- Cry rel Tif&C-t-o(� Name of owner of premises ER.NO LZi 61C?X- AfJ 0 ..;, (as on the tax roll or latest deed) If pl' gt e of duly authorized officer (Name and title of corporate officer) Builders`License No. 555 Plumbers License No. Electricians License No. Other Trade's License No. 1. Location�sl�of land on wphic//h proposed work will be done: House Number Street County Tax Map No. 1000 Section Block Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of pr6posed construction: a. Existing use and occupancy A-15AMDON ED kb) b. Intended use and occupan 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition- x/ Work (Description) 4. Estimated Cost Fee A (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. 5'ARfh! P E SkD EWill i 7. Dimensions of existing structures, if any: Front 5 Rear Pj 7� r Depth 6b D Height Number of Stories '- Dimensions of same structure with alterations or additions: Front N A Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front N A Rear Depth Height Number of Stories .,9:. Size of lot: Front .3 (0 7,d i Rear 0 12 . oU I Depth ' Z,0R .22- 10. 2210. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated A C 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be re-graded Will excess fill be removed from premises: YES NO 33�-�.� 14.Narnes of Owner of pry o-es k1�Q 0 _;Address E 5D S, WZ�Phone No. -1(�3 -- '2 -3 Name:of Architect - - .=Address. _ _ "hone No Name of Contractor_`note,00MeNrE ISAsTrnSAddress E x (9-7 Phone No. 73+—74-7 15..-Is this property within 100.feet of a tidal wetland? *YES NO V' 'lip IF YES' SOUTHOLD TOWN TRUSTEES PERMITS MAYBE REQUIRED r, 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) SS: COUNTY OF \being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the Piltractor, gent, Corporate Officer, etc.) t 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 flied therewith. Sworn to before me this Y1K day.of 20() 2-- U 0() Z Notary Public e of icant LYNDA M. BOHN NOTARY PUBLIC,State of Now Your; No.01 806020932 Malified in Suffolk Coun Term Expires March 8,20 L I 117 Doctors Path Riverhead,NY 11901 Long Island Power Authority June 6; 2002 Environmental East PO Box 197 Pe,conic, New York 11958 RE: LIPA Ref. #T100167272 & T100167277 Vacant Donald Bridge TNT SS Main Road, Peconic Gas Meter #01019909 Electric Meter #094554593 Dear Mr. Anderson: This letter is to advise you that the gas service to the above referenced premises was removed on May 25, 2002 . The electric service to the above referenced premises was removed on May 20, 2002 . If you have any questions, please contact Dianne Danek at (631) 548-7234. Very truly yours, &J,11) 4,1;19JA— al� Erika Lendel-Jongebloed Design Engineer Electric Design & Construction ELJ/am -TOWN OF SOUTHOLD PROPERTY RECORD CARD ------- OWNER STREET 45 -713 VILLAGE pp T DIST. SUB. LOT :50 CA -0ain Rcl ACR. REMARKS(oo TYPE OF BLD. __3 of (4117Z6) �,�oo PROP. CLASS LAND IMP. TOTAL DATE (D 200 FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND BULKHEAD HOUSE/LOT TOTAL -— Tn 1 1 ,71 COLOR R47 'et TRIM M. Bldg. Foundation Ce' Bath Dinette FULL Extension Basement CRAWL Floors Kit. SLAB Extension Ext. Walls Interior Finish L.R. Extension Fire Place Heat D.R. Patio Woodstove BR. Porch Dormer Fin. B. — Deck Attic Breezeway Rooms 1st Floor Garage Driveway Rooms 2nd Floor O.B. Pool An 17��11 0i TOWN OF SOUTHOLD PROPERTY 'CARD / OWNER STREET "' ' VILLAGE DIST. SUB. LOT ( u Id- A-,er ZI-q-/"Jp e--4-6 1?,r FORMER OWNERI N ACR _`u` v,:91_ -•���.r '`'�`-'.?`-,-' cs,,..� �t��',4 a°"5�' <:a Ll 6 ". _ •�J' 7'-^: .,�Gr kti"`7�`��" �Oi.�3 Go.e�P e e�. C `- S W TYPE OF BUILDING x _ �S©Al/ ^J F` v - - S,eR e�ry�•R��a�x`57.'- - _ . ,. RES. SEAS. VL. FARM 3 COMM. CB. MICS. _Mkt. Value LAND IMP. TOTAL DATE REMARKS /� �✓ �n�l�/y� /;,' �'�.' �t� r- ./_-��`'-^' �!_-:r may'" , .. r`, .. ._ 6 0 ,Y f��� i✓ w Y<< 'r'_ r�•F:. Q vh E/+_C.:_.1 v�/%_ E2 �y.t-L. /}�.f. �n /t r �- ��F S-Va*_0 15 66 6C1 �,' lE.x/ F1- *. --v Oil f' 7 r r. 2, (yl 700)X-L . 6 _0 [J Ca AGE` BUILDING CONDITI N d�4i �1 �' rt, — � NEW � � p1O MAL � �' A COVE .:r ,i - FARNI I oo 3 c e /481a Per S/,3Y r s15/1 rr Acre ! Tillable " ! 6 C) O �. ; F AGE ON WATER `� Woodland j FRONTAGE ON ROAD ; Meadowland DEPTH 3 i g y �Sb v i a House PlotBULKHEAD `(`� `'' 6.520kir Total � •'.�',�;. �.a�d. . :.� �� �� rr i, Ad � v � DOCK ' ,�lyd ��PPta. `�15 '�' D!a 1t• G2 S 'Ri.,F pyre. ■■■■■■■WaY■■■■■■■■■■■■■MEN m® ■■■■■■i� 'i■■fil !'■■■■■■■■■■■■■'i■®■■ - ■■■■■■ UM Uu■■■■■■■■■■■■■■■■ ■■■■■■I malmismisommmommommomm■■ ■■■■■■■■ ,ice■■■®■■■■■® ■■■■■■ + • •. E Interior inish I r .- . r ® - nd Floor • • s BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: 6 /-7/02 APPLICANT: DATE DATE SUBMITTED4'/jF:/02 -//y/oz' SCTM#DISTRICT: 1,000, SECTION: 915_,BLOCK: 6, LOT: J 1 STREET ADDRESS: 15430 TAT o95 CITY: 6mjwoLb SUBDIVISION: /V/J; PROJECT DESCRIPTION:- �Mpc 1Tiotil A1�1 C )U`JTII. c�.��- ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: FAST TRACK? "U/4- SINGLE & SEPARATE CERTIFICATION-REQUIRED? NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZ LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/1/83 ZONING DISTRICT: CONFORMING? REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT PROP. FRONT REQ SIDE ACT. SIDE REQ. REAR PROP. REAR REQ. HEIGHT PROP. HEIGHT WATER FRONT? DESCRIPTION: PANEL #: FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE:—/—/ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) VENT (SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE 1. ( SF)- ( SF)= SFX$ =$ +$ +$ =$ 2. ( SF)- (SF)= SFX$ =$ +$ +$ =$ IW 1i 11 u''SOUTHOLU TowN OF plLLlpk 0� FSHfTN S O9•p3�p'� E ,�.r� - �.�-• _ 0 F 337.47' q 1 rte. JANET HE!�gOER k ETHEL SCHR S 08.42 30 E __ SJQ9.p3 N/offs 5 �-�'"'� 3��, 4 ^.� .�------�r -._.--- - ..�_-..-•�''-" _ ..... . •. .. ..,. ., .. .. ... ....'. 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