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Home My WebLink About30015-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 30015 Z Date JANUARY 16, 2004 Permission is hereby granted to: ERVIN & ORS LAPAUGH 1605 CENTRAL DR MATTITUCK,NY 11952 for : DEMOLITION OF AN EXISTING DWELLING AS APPLIED FOR at premises located at 600 ZENA RD MATTITUCK Coumty Tax Map No. 473889 Section 106 pursuant to application dated JANUARY Building Inspector to expire on JULY Fee $ 288.50 Block 0002 Lot No. 043.001 16, 2004 and approved by the 16, 2005. Aut~er~zed Signature ORIGINAL Rev. 5/8/02 JEFFREY T. BUTLER, P.E. ~-n r"IVERH iLL -C~HDREHAM~ NEW YORK I 1 631-20B-BBSO January 16, 2004 Town of Southold Building Department Re: SCTM #1000-106-02-43.1 Central Drive, Mattituck Dear Sirs: Please note the following concerning this application: · The applicant intends to disconnect the existing electrical service for the purposes of demolishing the dwelling. The service and meter will be temporarily installed on an H flame under the guidelines of LIPA. The service will be reconnected upon completion of a new dwelling. Please call if you should have any additional concerns about this application. TOWN OF SOUT~HOLD BUILDING D~EPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (651) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ PERMIT NO. <~oi5-;-'7-- Ex--ed I 20 { Approved t l~{~ ,204 Disapproved a/c /' ~~ "~:" ~", Buil~g ~ector ~ '~ APPLICATION FOR BUILD~G PE~IT ~ ~STRUCTIONS Date BUILDING PERMIT APPLICATION CHECKLIST Do you have or need fl~e following, before applying? Board of Health 3 sets of Brfilding Plans planmng Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: ,20 completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of ~ plot plan to scale. Fee according to schedule. b. 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 stroll 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 withhi 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the intefira, the Building Inspector may authorize, in writLng, 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 ora Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Couaty, 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. (Ma~g address of/a~plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises If applicant is a corporation, signature of duly authorized officer (Name and rifle of corporate officer) ~ Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. (As~on the tax roll/or latest deed) Ap, pRoveS AS NOTED NOTIP? 5UILCh~ ? ~','- . 765-1802 8AM rC : ~ FOR THE FOLLOWING INSPEC ~ONS: 1. FOUNDATION - TWa ~c IlRED FOR POU~? ~ Location ofl~d on which proposed work will b~ done: 2 ROUGH - FR<k ,~ - ~ ;:_d~ B'NG House Nmb~ Seeet / 4. FJN~L ~ O0a"T~C=oN kiUST ~ ~k CONSTRUCTION SHALL M~ET THE Co~ty%~?No. 1000 S¢cfio~ /0 & B!ook m ~QU~REMENTS O~¢~ECO~F~EW Subdi~s~o~ ~iIed Map ~RK STATE, NOT R~NStBLE FOR ~e) DESIGN OR CONSTRUCTION bH~UR$. 2. State existing use and occupancy of premises and intended use and occupancy of proposed constmcti6n: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition 4. Estimated Cost 5. If dwelling, number of dwelling units if garage, number of cars ~ Addition Other Work Fee Alteration (Description) (To be paid on tiling this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front ,4j, Rear Depth Height Number of Stories , .,E, ,~ 8. Dimensions of entire new construction: Front Height Number of Stories Rear _Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name (~'Fo.r~er Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill be removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No 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 * IF YI~S, 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. STATE OF NEW YORK) b/( ~>~,..~ lf'~F-I ~ being d~y sworn, d~oses ~d says that (s)he is the applic~t ~me of in~vidual si~ing comract) above ~ed, (S)He is the (Contraeto~orporate 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 mariner set forth in the application filed therewith Sworn to befgre me this k'k Claire L. Clew Notary Public. State of NeY/Y~ No, 01GL4879505 Qualified in Suffolk Co[t~t~/ , Commission Expires Dec. 8~/~