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Home My WebLink About30683-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) Date OCTOBER 4, 2004 Permission is hereby granted to: JOHN & WF JERNICK PO BOX 226 SOUTHOLD,NY 11971 for DEMOLITION OF AI~ EXISTING DWELLING ~qD THREE ACCESSORY BUILDINGS AS APPLIED FOR at premises located at 1020 TOWN HARBOR LA SOUTHOLD County Tax Map No. 473889 Section 064 Block 0005 Lot No. 007 pursuant to application dated SEPTEMBER 21, 2004 and approved by the Building Inspector to expire on APRIL Fee $ 344.30 ORIGINAL Rev. 5/8/02 Fax (516) 765-1823 Telephone (516) 765-1800 Town Hall, 53095 Main Road P_O. Box 1179 Southold. New York 11971 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION TO: FROM: DATE: RE: Southold Town Building Department Southold Toxxm Landmark Preservation Commission - Mel Phaff- Member September 30, 2004 Demolition of Property at 1020 Toxvn Harbor La., Southold SCTM #1000 - 64-5-7 - Jemick & Dobbin The Southold Toxxm Landmark Preservation Conmfission gives permission for the demol/tion of the above property. Herb Adler recused himself on this decision, as he knows the owners. TO$~2N OF SOIJTtlOLD B UIL D [NC~ D E P.MIT~ItE N~F TOX~qN HALL · ~UT~O~D~'~' 11971 TEL: (63D 765-1802 :n~wv. noktDfoxk.~Southol~ Ex--ed ,t Dismpproved wc BIJTLDING PEP, uMIT APPLICATION CHECKLIST ·tpo ypu havre or need the following, b~fore appl~g? Bo~ of H~ 3 sets ofBuil~g PI~ planning Bo~d approvM Su~eT ,. Chqck Tms~es Mail to: '"'----~ ~ XPpLICATION FOR BUILDING PERMIT a. Th~s apn~cari:b~{kk~fU.fS?b.~,d~l~e~ely filled in by t3~ew~ter or in ~ and sub'tied ~o ~e Building ~spector with 3 sets or plans, 1~¢~t~t~ to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on pre~ses, reiationship to adjoi~ng pre~ses or pubiic streezs or areas, and wate~va~s. c. The work covered by this appllcabon may not be con~enced before issuance of Building Pe~t. d. Upon approval of this application, the Building ~spector will issue a Buil~ng Pe~t to the applicant_ Such a pemt shall be kept on the pre~ses available forlnspecfion tl=oughoar the work. e. No building shall be occupied or used in whole or in pa~ for any propose what so ever until the Buildi~ ~spector issues a Ce~ificate of Occup~c>. i Eveu' building pein'fir shall expire if the work authorized has not co~lenced wi~ 12 momhs aRer the date of issuance or has nor been cmnpleted within t 8 momhs from such date. If no zo~g amen~ents or other ~e~lations affecting the prope~y have been enaezed N the mtehm, the Building ~sp~ctor may ~u~o~e, m x~tin~, the extension of the pe~t for an addition six m25nr~i Ther~fter, a ney? pe~t shali be required_ APPLICATION IS HEREBY M,~E to the B~ddNg Dep~ent for the issuance ora Bu~dNg Pe~t pfirsu~t to ~e Build2tg Zone Ordinance of the Town of Sou~ol~ Suffolk Corny, New York, and other applicable Laws, Ordin~ces or Re~lations, roy the'const~ction of buildings, additions, or alterations or for removal or demolition as herein described. The applicant agrees to con¢[v with MI applicable laws, ordinance, building code, housing code, ~d re~lations, ~d to ad~t authorized inspectors on ~e~ses and m bmldmg for pecess~¢ ~spections. (Signature of applicant or name, if a corporation) 103 David Pis.ce , Hillsda~e N.J.' 07692 (Mailing address of applica~0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Nameofownerofpremises Jernick % Dobbin 103 David Plgce Hillsdale ,N.J..07.~42 (As on the tax roll or latest deed If applicant is a corporation, signature of duly authorized officer 6Name and title of cm~porate officer) Builders LlcanseNo. Plumbers License No. N.J. # 4720 Electricians License No. Other Trade's License No. NYC Master # 1060 1.' Location of land on which proposed work xvill be done: 102.9 Town Harbor Lane Southold N. Y. 11971 House Number Street County Tax Map No. lO00 Section Subdivision tUqame) 64 Hmnlet Block ~I~_ 7 Filed ~~~ll~o t 2. State existing use and occupancy of premises and intended use and occupancy of proposed;¢onsn-action: a. Existing use and occupancy Pre existing O 0 b. Intended use and occupancy Residen%ual Use R 40 zone Nature of work (check which applicable): New Building Repair Removal Demolition X 4. Estimmed Cost 5. If dwdling, number of dwelling units If garage, number of cars Fee Addition Alteration Other Wotfkr'ading oZ $ oil (DescMption) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specie' nature and exteut of each t),pe of use. 7. Dimensions of existing structures, if an3': Front Height_ Number of Stories Rear Depth Dimensions of same structure with alterations or additions: Front Depth. Height. Number of Stories 8. Dimensiqns of entire new construction: Front Height Number of Stories 9. Size of lot: Front 77,77 Rear 77,65 Rear ' D~p~ Depth167.8i & 174.36 Rear lO. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated R /40 12. Does proposed construction violate an5' zoning Iaw, ordinance or regulation? YES NO X 13. Will lot be re-_m-aded? YES NO X Will excess fill be removed from premises? YES NO X 103 David Place 14. Names of Owner of premises Jernick%DobbinAddress Hillsdale, N.J. Phone No. 201 664 2.229 Name of Architect Address Phone No :- Name of Contractor Address Phone No. 'i 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOX,~,5'q TRUSTEES & D.E.C. PERMITS 3,,L&-Y BE REQUIRED. b. Is this property wirffin 300 fbet ora tidal wetland? * 5'ES NO X * IF YES, D.E.C. PEILMITS MAY BE REQUIRED. X 16. Provide survey, to scale, vd, th accurate foundation plan and distances to property lknes. 17. If elevation at any point on property is at I 0 feet or below, must provide topogaphical data on suwey. STATE OF NEW YORK) cou, rr¥ os: ~d ~ ~m ~ ~0, ~D ~ ~ I ~ bein~ d~3' sworn deposes =d says ~at :s)he is the applic=r (N~e of in~vidua[ si~ug contract) above n~ed, (Contractor, Agent, Co,orate Officer, etc.) of said owner or ox~mers, and is duly author/zed to perform or have per~-ormed the said work and to make and file tb2s apphcation; 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 tbrth in the application flied therewith. t ~-~- S ig~,amre o f _.X4oplic ant F TO ItrN SURVEY OF PROPERTY A T SOUTHOLD TO WN OF SOUTHOLD SUFFOLK COUNTY, NE W YORK 1000-64--05-07 SCAI.E: 1"=20' ,/AN. as. zooa HARBOR I,,4NE ?n 77. 77' _~, ~--q '""'" "i' " ~'~'1,~ .'/ ~~::, , ~ -1. _ N e6'29'20. ~ ,i 7Z55' '3L/B~ZV]3I~N NAp OF PBUNDER3 ~.?TA TE~' FILE N~ ~34 FILE~ HAy 10~ 19~7 LOT 100 · -=NONUH~SN T 0 f7 .297