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Home My WebLink About29516-ZFORM 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. 29516 Z Date JUNE 28, 2003 Permission is hereby granted to: BEAR REALTY INC LITTLE 605 THIRD AVE -34TH FLOOR NEW YORK,NY 10158 for : DEMOLITION OF AN EXISTING 816 SQUARE FOOT SINGLE FAMILY DWELLING AS APPLIED FOR at premises located at 5205 OREGON RD MATTITUCK County Tax Map No. 473889 Section 095 Block 0001 Lot No. 002 pursuant to application dated MAY 28, 2003 and approved by the Building Inspector to expire on DECEMBER 28, 2004. ed Signature ORIGINAL Rev. 5/8/02 LIPA Long island Power Authority 117 Doctors Path Riverhead, NY 11901 May 15, 2003 Ms. Cynthia Caprise Peconic Bay Winery 31320 Main Rd. Cutchogue, NY 11935 RE: LIPA Ref. #T100280038 5205 Oregon Rd., Cutchogue Meter #086596329 Dear Ms. Caprise: This letter is to advise you that the electric service to the above referenced premises was removed on May 14, 2003. If you have any questions, please contact Mr. Charlie Hicks at (631) 548-7024. Very truly yours, Erika Lendel-Jongebloed t Design Engineer Electric Design & Construction ELJ/rh TOWN OF SOUTHOLD BUILDING .DEPARTMENT TOWN HALL SOUTI~IOLD, NY 11971 TEL: (631) 765-1802 · FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ~~. Expirati°n4 ~ ,20 PERMIT NO. ~-~-~ ~ [ b ~ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of ltealth 3 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: I°~ o O lf t ~ ,~> A ~ APPLICATION FOR BUILDING PERMIT Date 4 O,3 ,20__ INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ir~k and submitted to the Building Inspector with 3 sets ofplans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining prenfises 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 amenc~nents 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 perm/t 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. .pIpP, OYEO AS NOTED (Signature of applicant or nme, if a co~oration) (Mailing address of applicant) · co.ST."= Bmlders bi~l[tl~:~ENTS OF THE Electricians I}SEIl~lltteOilo.OONSllqu~' ~ ~a~ Other Trade's License No. engineer, general contractor, electrician, plumber or builder County Tax Map No. 1000 Subdivision (Name) Filed Map No. ~ F. OU_oWING iNSPECTIONS: Name ofo .rl et l ltO/ sesTwO & ~ p~ C~,~ (As on ~e t~ 7/11 If appli~~uly authohzed officer or latest deed) l. Location ofl~d on which proposed work will be done: House Number Street Hmnle(~ Section ~ Block / ~t* 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy VA ~,4rvr ORe F::.4AAI.CiV ~WF=LLINq · b. Intended use and occupancx VA O~ 4 ~v -,r 3. Nature of work (check which applicable): New Building. Repair Removal 4. Estimated Cost 5/-o o o. 5. Addition Alteration Ifdwelling, numberofdwellingunits If garage, number of cars Demolition ~ Other Work Fee ~.ff ---- (To be paid on filing this application) / Number of dwelling units on each floor (Description) 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front c~t /Rear ,~ 4- t _Depth Height 3 o ~ Number of Stories ~ Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories Rear 8. Dimensions of entire new construction: Front Height Number of Stories Rear .Depth Size of lot: Front Rear .Depth 10. DateofPurchase °c'-&7- ~7 NameofFormerOwner uVA~r~_ ~5.4~.t ~_-r, Az.., 1 l. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~/ i 3. Will lot be re-graded? YES w" NO Will excess fill be removed from premises? YES ~' NO P~u-~ /~--q ~- ,go ~T 14. Names of Owner of premises ~..ow,~r=. Address /'(yO_ Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 16. Provide survey, to scale, with accurate foundation plan and distances to pro~y kines. l 7. If elevation at any point on property is at 10 feet or below, must provid~.-topograpNcal data on su~, .e~y.~ :~,; COUNTY OF . '. , _ ~ t~'~ ~ being duly sworn, deposes and says that ¢Ohe is the applichnt (Name of individual signing contract) above named, '~ )u els the ~ ~ ' "' (Contractor, Agent, Corporate Officer, etc.) , :3 of smd owner or owners, and ~s duly authorized to perform or have performed tbe.~md work and to m .aka, and file th'i~ apphcatmn; that all statements contained in this application are tree to the best of his knowledge mid' belief; and thfit the'work will be performed in the mariner set forth in the application filed therewith... Sworn to before me this day of_ /~.gr, I 20 0 ~ Notary Public OI SI LO Note, fi' l~abllo, State of New Yodt No, 01 LO5034923 Oualified in Kings County b"emm~ssion Expires October 24, ~0