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Home My WebLink About31959-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. 31959 Z Date MAY 3, 2006 permission is hereby granted to: END REALTY LLC EAST 112 NEW SOUTH ROAD HICKSVILLE,NY 11801 for : DEMOLITION OF A 4,000 SQUARE FOOT FIRE DAMAGED BUILDING AS APPLIED FOR at premises located at 4880 DEPOT LA CUTCHOGUE County Tax Map No. 473889 Section 096 Block 0002 Lot No. 003 pursuant to application dated MAY 3, 2006 and approved by the Building Inspector to expire on NOVEMBER 3, 2007. Fee $ 590.00 '-- .---..-.,'- e ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.netlSouthold/ BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: PERMIT NO. 31 q s '1-e-- ~/?, Examined (' Approved .-/c:::, Disapproved a;/ II !r I (, ,20_ ,2"_ Expiration , 20 ::; Mail to: Phone: ., MAY 2 ' APPLICATION FOR BUILDING PERMIT Date (V\t\.i L ,2006 INSTRUCTIONS I <LThis 'a'pplicat,ion MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sefs-ofplaris, accurate plot plarrtrr'scale. Fee according to schedule. b. Plot plan showing location oflot 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 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 amendments 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 permit 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 South old, 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. €""C\j <l- bh-d ~ ~ L Lc-- (Signature of applicant 0 harne, if a corporation) Ii L /JuJ (~i~~d!!!s !f.;t.~~f~ il 80( State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder OV--h.Rr- Name of owner of premises --f~(1I iY f.: ---II r2-~ q--~ L L L (As on the tax roll or la est deed) If applicant is a corporation, signature of duly authorized officer rJ~/A.r...'" (" ).,.~''''^tl''' - /4..~, ~ ~ Me~~~t'"' (Name and title of corporate officer Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. I. Location of land on which proposed work will be done: 4.?fo pQn<7~ LtA;-.JL L,..J-~o.-:;.,.. / /"-"'.."t' House Number I Street / Hamlet County Tax Map No. 1000 Section Subdivision q6 Block 7-- li,,,y "; Filed Map No. '. ~:',. ~'~H:':; "_n , ''1~q (Name) Lpt,3:'" ",li Lot' ,""? '!,.-.~ '" '.; ir ...."." 2. State existing use and occupancy of premises and intended use and occu a. Existing use and occupancy ~::> ,,+. ~ ' ancy of proposed construction: t.,~,. \1'(;"1 b. Intended use and occupancy TIY6ii i ) otc:::. I ___ ~ 3. Nature of work (check which applicable): New Building Repair Removal I ~ Demolition ,~ Addition Other Work Alteration (Description) 4. Estimated Cost 1/1 '" \<'.,'7 ,r-~ Fee ...._.____. (To be paid on filing this application) 5. If dwelling, number of dwelling units ~ Number of dwelling units on each f1oor~_._ ~. If garage, number of cars J 6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use. I;:,\' (At 0 f?tj--r/'>'~ 'J ~OO"" 1'1t fC~. 7. Dimensions of existing structures, ifany: Front 'Rear 'U'" Depth. ...._____ Height Number of Stories j) IlL 1<::..' ? Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front /V/ I~ Height Number of Stories 9. Size oflot: Front '1...- -r A ('(.1 Rear 10. Date of Purchase to II'" Ii r Name of Former Owner , ~ Rear Depth Depth L-e ~ A,.... .? _ {.' . t...(? ",^." I II. Zone or use district in which premises are situated -L~ ,.,....,W ~? Q)'--{.".<,// 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~ U-L . /VI )-\" c '4~, \\, .,V ~ IIJ"".! 14. Names of Owner ofpremisesr",j Y (:,,01 p..u }[d(l[ress \ \'\... /1.1><./ j ,,~.t-'1>hone No.1 S-'~) 'tiS' --"1.el' 00 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 _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 YES, D.E.e. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. /V'/ A 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. .,-v/A STATE OF NEW YORK) SS: COUNTY OF. \'_fh)Yl O{C\A,L ,( J....... \.......""""''' ~~;" being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S )He is the Met>-~p,,-/ Pt\/'r~.r G~ (:"\JY (Contractor, Agent, Corporate Of er, etc.) k.vjJ JLe4 \ 1-+_[ U~_ 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 manner set forth in the application filed therewith. Sworn to before me this 1- ~C\ dayof;V\ ^ '" 20 ~ \ C1L.rp _<I ~ Notary Public HOWARD RABIN NotarY Public, State Of NlIW York NCl. 01AA4829195 QuallflllCl In Na88au County CommIeelon Ellpirea January 81, aooe ~ dz:L/--f:/<- Signature of Applicant