HomeMy WebLinkAbout27023-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. 27023 Z Date JANUARY 19, 2001
Permission is hereby granted to:
LUDIVOICA ROMANELLI
1 AZALEA CT
FARMINGDALE,NY 11735
for
DEMOLITION AS APPLIED FOR.
at premises located at 3140 GREAT PECONIC BAY BLVD LAUREL
County Tax Map No. 473889 Section 128 Block 0006 Lot No. 009 . 001
pursuant to application dated JANUARY 11, 2001 and approved by the
Building Inspector.
Fee $ 116 .40
Author'�Z Signature
ORIGINAL
Rev. 2/19/98
v�LLii�v irc.r�n i irirJlr t 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
PERMIT NO. a 76 a.3 Check
Septic Form
_ N.Y.S.D.E.C.
Trustees
Examined , 20 r �; �'' 11' I! 1 Contact:.
Approved 11 ( i _, 20 O i r y;l r� Mail to:
Disapproved a/c
J
j [
Phone-
i ,
Building In ector
APPLICATION FOR BUILDING PERMIT
Date(; ' -, _ 9 , 2(b/
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 sclicdule.
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 Occupan
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 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, ordinandes,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)
(Mailing address of applicant) r
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plus ber or builder
Name of owner of premises
(as on the tax roll or latest dee 9 c t -7�g 3
DATE: B.P.#
If applicant is a corporation, signature of duly authorized officer FEE,1 16 BY:
NOTIFY BUILDING DEPART T AT
(Name and title of corporate officer) 765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
Builders License No. X31 1, FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
Plumbers License No. � 3. INSULATION
4. FINAL - CONSTRUCTION MUST
Electricians License No. BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
Other Trade's License No. THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
1. Location o land on wi h proposed k will be one: CODES. NOT RESPONSIBLE FOR
?j > DES16N OR CONSTRUCTION ERRORS
House Number Street Hamlet `T I
County Tax Map No. 1000 Section Block to Lot
Subdivision Filed Map No Lot
(Name) o°, ., t,,t .
!`i.i.'��C'��i; -' rlt y;4rj
?. State existing use and occupancy of premises and intended use nd�occupancy of proposed construction:
a. Existing use and occupancy .._
b. Intended use and occupancy
i. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
1. Estimated Cost Fee (Description)
(to be paid on filing this application)
If dwelling, number of dwelling units Number of dwelling units on each floor
If garage, number of cars
If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear Depth
Height Number of Stories
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
Size of lot: Front Rear Depth
0. Date of Purchase _Name of Former Owner
1. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation:
3. Will lot be re-graded Will excess fill be removed from premises: YES NO
4. Names of Owner of premises Address Phone No.
Name of Architect Address Phone No
Name of Contractor Address Phone No.
5. Is this property within 100 feet of a tidal wetland? *YES NO
• IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED
6. Provide survey, to scale, with accurate foundation plan and distances to property lines.
7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
TATE OF NEW.YORK)'.
" SS:
Y
'OUNTOF!a . :. --
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract).above named,
Sl-le is the
(Contractor, Agent, Corporate Officer, etc.)
I said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application;
iat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be
:!rformed in the'manne t forth in the application filed therewith.
worn to before me his
t � day 20 D
otary Public Signature of Applic t
ROBE SCOTT,JR.
Notary Pub ,State of New York
Qualified in Suffolk County
No.01 SC472508,9
Term Expires May 31,S�LQ
LIPA
117 Doctors Path
Riverhead, NY 11901
Long Island Power Authority
November 15, 2000
Mr. Pat Romanelli
88 East Hoffman Ave.
Lindenhurst, NY 11757
RE: LIPA Ref. #71904-040
3140 Peconic Bay Blvd. , Laurel
Dear Mr. Romanelli:
This letter is to advise you that the electric service to the above referenced
premises was removed on October 27, 2000.
If you have any questions, please contact Mr. A. Lawton at (631) 548-7024.
Very truly yours,
Michael Randazzo
Design Engineer
Electric Design & Construction
MR/rh
1Dot
KeySpan Energy
1
���i�r!!■■■■ 117 Doctors Path
ENERGY Riverhead,NY 11901
December 15, 2000
Pat- Romanelli
88 E Hoffman Ave
Lindenhurst, N.Y. 11757
Dear Mr. Romanelli
Per your request this letter is to confirm that the
gas service was retired at the below address on
November 17, 2000.
3140 Peconic Bay Blvd
Laurel, N.Y.
I have no information about the electric.
Sincerely,
R. Penney
Gas Const. Maint & Serv. Supervisor
RP/gsm
cc: L.IPA -ELECTRIC
00-71905-040
J_
'YOWN OF SOUTHOL D PROPERTY RECORD CAR®
OWNER STREET VILLAGE DIST. SUB. LOT
FORMER OWNER N
A E ACR.
0
n S ;� W C s TYPE OF BUILDING
Xr
;ES. 40 SEAS. VL. FARM j� COMM. CB. MISC. Mkt. Value /
LAND IMP. TOTAL DATE REMARKS
66
? 3 ,I-
Q J /�/ /s-o S'o ����' �cC.�t �• e�,lr. /+ .�oYr,n.Yi c/�i ��-nom ,�'4 -
/a/93
-AGE BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
illable 1
'illable 2
'illable 3
Voodland
wampl.and FRONTAGE ON WATER
rushland _ FRONTAGE ON ROAD
louse Plot DEPTH
-- BULKHEAD A/'.- YIJ
Aal DOCK
&A- W4 Y
,k 6N
MEMNON■
.4 Z
MEMNON■ MOMMEEMOMMOMMOOMENo
Eo moll MMNEEEMMMMMMMMEMMME
MEMMIN
EMENNOMMENMEMEMENEM
M9-3 OEM
to
iy- ��rl k �'{t; _ •t rr t JC..1 l= 1 :LC-L I ■■■�■ !� �� > ■■■■■■■■■■■■■■■
MOOSE MINNOW11*113,lull EMMEMSEMMEMEME
A .
MMEAPIrd
ONE
Foundation
�Basement
lExt. Wa 11 nterior Finish
Fire Pla
Type Roof Rooms 1 st Floor i
Recreation R Rooms 2nd Floor
Dormer
Driveway
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED:
APPLICANT NAME: perm km_,_/ DATE SUBMITTED: `
SCTM# --- DISTRICT: 1,000 SECTION: ►a; BLOCK: 6 LOT:�,�
PROJECT LOCATION nn� � n
STREET: ,3 1L(0 s�� (�l,C . C-�,cw► (3ACITY: SUBDIV. NAME:
ARCHITECT/ENGINEER: FAST TRACK: YES OR
SINGLE& SEPARATE CERTIFICATION-REQUIIRD: YES OR NO NOTES:
ZONING: PERMIT ESTIMATE AMOUNT:_$ .00
ZONING DISTRICT: R40, R80, AC, CONFORMING: YES OR NO REQUIRED LOT SIZE: SQ]
WHERE ACTUAL LOT SIZE FROM?TAx CARD ACTUAL LOT SIZE: SQ
REQUIRED REQUIRED REQUIRED
FRONT: ' PROPOSED: SIDE YD: '/ ' PROPOSED: '/ REAR: ' PROPOSED:
LOT COVERAGE: ALLOWED: % EXISTING: sf % NEW: sf % TOTAL: sf
CORNER? YES OR NO WAT ER FRONT? YES OR NO DESCRIPTION:
LOTS 40,000SF--100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.)
PROJECT DESCRIPTION: ADD.ALT,ACC OR N/D:
AGENCY PERMITS REQUIRED FOR REVIEW
NEEDED
TOWN SPETIC PERMIT: YES or NO
SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE: / / PERMIT#:R10-
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
FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18180 PANEL #: FLOOD ZONE: ,
NYS ENERGY: YES OR NO EGRESS: VENT: LIGHT:
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR SF
SECOND FLR SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
TOT( SF)- ( SF)= SF X $ _$ +$ +$ _ $
"6"ib"QED ALTERATION OR ADOITR7r ,(V'
'O THIS SURVEY IS A VIOLATION OF 0 �O
ACTION 7209 OF THE NEW YORK STATI O OC,P.
:DUCATION LAW. OI
:OPIES Of iH15 SURVEY MAD NOT BEARING O
ti0 Ory /, \
'HE LAND.SURVEYOR'S INKED SEAL OR K�
MBOSSED SEAL SHALL NOT BE CONSIDER& =�O IN/
'O BE A VALID TRUE COPY J OO p,
jNARANFEES INDICATED HEREON SHALL RUN Q
ONLY TO THE PERSON FOR WHOM THE SURV1
IS PREPARED,AND ON HIS BEHALF TO THE
TITLE COMPANY, GOVERNMENTAL AGENCY AN(
LENDING INSTITUTION LISTED HEREON, AND
TO THE ASSIGNEES OF THE LENDING INSTI- _�v
FUTION. GUARANTEES ARE NOT TRANSPERABL1 , v
[O ADDITIONAL INSTITUTIONS OR SURSf01g \
OWHERS,
Al
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NOTES• \
I, ■= MONUMENT �\ 513
\ 1i° �� ��
2. ELEVATIONS ARE REFERENCED TO N.G.V.D. X 128,6.9 o�
(MSL 1929). \
\ 1000- \01 26 rr
0 . z
N 1202-d
-J
N
TEST HOLE TESD ;�% 01,
o.D' c
DARK BROWN
SANDY LOAN 0 SSpOOL,�Op B 1 �' yc (n QI
- - 0.5' 4 GEpFF1eFRpNECO`�S p K.
9ROW NLOAMY
- ZR ' 1s C• �CS�81 .�
SAND \ C L/^\ \ 60-1 0
3.0'
p 1z2 ` P� .s sM 9,poT Fp�wE CO ,M e \
� 17.8 J�.� C•�•
i
COARSE SAND
00 �
— — 1D o' 6 O. N-►
Lo O ON /
PALE BROWN O' t;
FINE TO rf, 9 6)
MEDIUM SAND `'• ���pN\ ,-
L0` \ to Z N
GR.WATERLPILE N BTOWN13.9' OROP�F� OZ ODUMSAND FV'
17.0' co ���•
HEALTH OCPARTMENT-DATA FOR APPRObAL TO CONSTRUCT
r NEAREST WATER &AIM—MMI.: •SOURCE Of WATER PRIrTE ZPUaL1C_ O
UFF CO. TAX WP GIST 1000 SECTION-M&-BOCK 6 LOT_W_ O (V�
STREW AM MO OWELLUMi WITHIN IOQ FEET OF TMS PROPERTY 0.6 4V
OTHER THAN THOSE SHOWN HEREON., Ixs 17
■THE WATER SUPIeLYAIC SEr►iE CXVNCSAL SYSTEM "TMS 110.DCMMN N QO
WILL CONFORM TO THE STA-MDAROS Of THE SUrPCLK COUNTY DEPARTMENT b� 0 .
OF HEALTH SVrV I CE S. - all
APPLIC OT, �
W
ADORCtS QaO�.� �\e. '
TEL. O8oG4
SURVEY FOR
\N ,4v t ~\
LODAVICA ROMANELLI ° �,� ymv
oQ
AT LAUREL ���,�G ��01
16.5 ti�Np `°�
TOWN OF SOUTHOLD 158 4 �oti� ,�
SUFFOLK COUNTY , N.Y. co, 38 P
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4580
JUN.18,1990 YOUNG a Y UN
DATE • MAY 14,1990 400 OSTRANDER AVENUE,RIVERHEAD, N.Y. zo
j SCALE. I"= 40' ALDEN W.YOUNG,N.Y.S.P.E, a L.S. LIC.NO.12845
NO. 90 -0312 HOWARD W.YOUNG,N.Y.S.L.S. LIC.NO. 45893 A`Q