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Home My WebLink About30129-ZFORM NO. 3 TOWN OF SOUTHOLD BUILEING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PE~IT'/~O. 30129 Z Date MARCH 2, 2004 Permission ms hereby granted BAPTIST CHURCH UNITY PO BOX 1203 NLATTITUCK,NY 11952 for : DEMOLITION OF EXISTING RESIDENCE AS APPLIED FOH at premises located at 655 FACTORY AVE County Tax Map No. 473889 Section 122 Block pursuant to application dated FEBRUARY 27, 2004 MATT/LAUREL 0006 Lot No. 002.001 and approved by the Building Inspector to expire on SEPTEMBER 2, ~2~. ..... ~ Fee $ 155.75 5/8/02 ORIGINAL OF' LA~' D TOWN OFSO~T~OLD TOWN HALL SOUTHOLD. NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Exarrdned ,20. Approved Disapproved a/e Expiration ,20 BUILDING PER ~3MIT APPLICATION cHECKLIST Do you have or need the followkng, before applying? Board of Flealth 3 sets of Building Plans Planning Board approval Check Trustees Con~tgct: ~]~ ~ -t Mail to: APPLICATION FOR ~ PERMIT Date d ~//~ ~ INSTRUCTIONS ~ 20~ a. This application MUST be completely filled in by typewriter or in ink and subm/tted to the BuildSng Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. _~b. Plot plan showi~rg location of lot and of buildings on prermses, relationstsp to adjoining prem/ses or pubhc streets or areas, and waterways. c. The work covered by this application may not be comraenced before issuance of Building Permit. ~ d. Upon approval of this applicatio~ the Buildir g Inspector will issue a Bui, ld4ng Permit to the applicant. Such a permit shall be kept on the premises available for inspection throughoutthe work. e. No building shall be occupied or used in whole or ha pgrt for any purpose what so ever until the Building Inspector issues a Certificate of Occupancy. £. Every building permit shall exp/re if the work authorized has not commenced within 12 months after the date of issuance or has not been completed with~ 18 months ~om such date. If no zoning amendmffms or other regulations affecting the property have been enacted in the interim, the Buildig. g Inspector may authorize, in ~' ffffdi~i~ s~r~bhtt~s. Th~re~-, ~ permit shall be required. APPLICATION IS HEREBY MADE to the Build/~g Department for the i~suance of a~B~t~nng Permit pursuant to the Building Zone Ordi ,r~n~ce ~f~.~th~ 3town of Southold, Suffolk County, New York, and other applicable. Laws, Ordinances or Regulations, for the ff~i~o'~i of buildings, additions, or alterations or for removal or.demolition as herein described~The applicant agrees m .cpmply w/th alt applicable laws, ordinances, buftd/ng code, housing ~regulmions, and to admit authorized inspectors On premises and hi build/rig for necessary inspections. /4~ignh~ture o~f appl~ant o~mme, ff a corporation) State whether applicant is owner, lessee, ~ architect, engz~er, general contractor, electrician, plumber or builder (As on the tax roll or latest deed) ..... If apphcant ~s a corporat~or~:s~gnamre of duly authorized officer (l~.ame a~'&6il'~?~3£ corporate officer) BUilders License~No::i..- ~.,, Plumbers License NB'2:.: Electricians License No~ Other Trade's License No. Location of lag_d on whic_~roposed work,will be 4one: ~ ~ /~ Ho~e N~ber S~eet / H~et Co~W Tax Map No. 1000 Section /g~ ~)ock '~ Lot Subdihsion :~..,~ ~.~ ~,, ~ ,~ [ e :~it~ Map No. ~t ~me) State existing use and occupancy ofpremis~ and intended u'~e and ~?~ ::upancy of proposed construction' a. Ex~stmg use and occupancy ~/~'~,Z}n,'/~ _:. .; Demolition Addition Alteration Other Work b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal 4. Estimated Cost T/'~. ~t9~7> ~(9 ¢'~ Fee 5. If dwelling, numb~ of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor ..imen~i.o.n~ s of e!i~sting structures, if any: Front ~"~-~ ~ Rem' eight ~fi'~% Number of Stories Dimensions of same structure with alterations or additions: Front Depth, If business, commercial or mixed occupancy, specify nature and extent of each type of use. ~- 7~/~/~ Depth '~; q ~'~ Rear Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stodes Re~ Dep~ 9. Size oflot: Front Rear 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated Depth 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~ 14. Names of Ownerofpremises. .~. Adtlress Phone No. Name of Architect ~'A'ddress Phone No Name of Contractor Aadress Phone No. NO 15 m Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO ~ * 117 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 YES, D.E.C. PERMITS MAY BE REQUIRED. .)Provide to scale, with accurate foundation and distances to lines. plan property 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: coum¥ OF$&4f (Name of individual s~g contract) (S)He is the being duly sworn, deposes and says that (s)he is the applicant above named, (Contracto~. 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 ~ this application are tree to the best of his lmowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. -- ' (JSig~'~tureq~Ap~ca~ ' BARBARA ANN RUDDER Notary P~b[io, $~ate of New York No. 4~$5805 QlleJified in S~fo ~ Coun~. Commission E~ires ~ri114. ~ BUILDINI~ PERMIT EXAMINER CHECKLIST APPLICANT: DATE REVIEWED: 04 DATE SUBMITTED: /04 SCTM# DISTRICT: 1,000, SECTION: . BLOCK: __~ LOT: SUBDIVISION: ADDRESS: CITY: ZONING DISTRICT: CONFORMING? tlUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP -Z/'C/0 Z- ., INFO / BP BP -Z / C/0 Z- ,.INFO /~BP -Z / C/0 Z- , INFO -Z / C/0 Z- , INFO SI2NGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOTS 40.000SF -100-Z4. Lot rccognition.(CREATED before June 30, 1983), LrNDERSIZED LOTS F~OM JAN.1997 100-25. Merger.(A nonconforming at any tune after 7/1/83 ~P, EQ. LOT SIZE: REQ, FI~ONT ACT. LOT SIZE: PROP. FRON~T__ PROP. REAR REQ. LOT COV. REQ SIDE REQ. HEIGHT __ ACT. LOT COV. ACT. SIDE pROP. HEIGHT PROJECT DESCRYPTION: ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: WATER FRONT? DESCRIPTION: PANEL FLOOD ZONE: APPROVALS REQUIRED SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): ___ TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: e~DEC 9/~/75 YES or NO SOUTHOLD TOWN TRUST~'ES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN; BOARD APPROVAL: YES orNO TOWN HISTORICAL PRE (SPLIA): YES or NO DTE: / / PERMIT #: DTE: / / PERMIT #: DTE: / / PERMIT ~: DTE: / 7 PERMIT #: DTE: / / PERMIT #: NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: FEE STRUCTURE: FOUNDATION: FIRST FLOOR: SECOND FLOOR: OTHER: TOTAL: sF). (~7'~ SF): SF)- ( SF)= 3. ( SF) ( SF): SF SF SF INIT OTHER TOTAL //ffl S~ {7/)~$ FEE.( / FEE FEE _ , +$ = $ SF X $ =$ +$ +$ = $ SF X $ =$ +$ +$ FINAL TOTAL: $ 117 Doctors Path RiverheaO, NY 11901 February 6, 2004 Pastor Marvin Dozier Unity Baptist Ckurch P. O. Box 1203 Mattituck, NY 11952 RE: LIPA Ref. #T100359651 Mobile Home Factory Avenue, Mattituck Dear Pastor Dozier: This letter is to advise you that there was no electric service to the above referenced premises. If you have any questions, please contact Mr. Charlie Hicks at (631) 548-7024. Very truly yours, Steven P. Aylward Design Engineer Electric Design & Construction CC: Mr. Leroy Eeyliger SPA/rh ARTCO DRAINAGE CORP. P.O. BOX 1132 MATTITUGK, NEW YORK 11952 (631) 298-9660 · FAX [631) 298-2291 Name 1 Address Church Fact&-y Ave fMattituck 369-1878 Estimate F Date 12/31/2003 Job Name/Location Factory Ave Estimate # 1746 Job # 7069 Description Total Demo house adjacent to church. Labor is at no charge. 3 - 30 yard dumpsters for demo. Containers are $700.00 each. Remove block foundation approximately 60 yards of concrete. Concrete is $20.00 per yard to dispose of. Fill for insid~ of foundation approximately 250 yards to fill in foundation. Fill is $8.00 per yard. Strip topsoil in parking area and install RCA blend approximately 100 yards of RCA to establish parking area. RCA: is $72.00 per yard delivered 2,100.00 1,200.00 2,000.00 1,200.00 This estimate is for completing the job as described above. It is based or* our evaluation and does not include material price increases ur additional labor and materials which may be required should unforeseen problems, impervious soil or adverse weather conditions arise after the work tins started. Estimated Job Cost $6,500.00 Estimated by~~ Approved & Accepted by