HomeMy WebLinkAbout32362-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.
32362 Z
Date SEPTEMBER 14, 2006
permission is hereby granted to:
LARRY B & JOAN M KULICK
21 TORLEN COURT
HAUPPAUGE,NY 11788
for :
DEMOLITION OF AN EXISTING DWELLING AND ACCESSORY GARAGE AS APPLIED
FOR.
at premises located at
1895 MINNEHAHA BLVD
SOUTHOLD
County Tax Map No. 473889 Section 087
Block 0003
Lot No. 053
pursuant to application dated SEPTEMBER 12, 2006 and approved by the
Building Inspector to expire on MARCH
14, 2008.
Fee $
249.80
ORIGINAL
Rev. 5/8/02
9~ 6-06; 3:40PM;Co,am Dls~'lct Ofc_
;631 698 9852
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SUFFOLK COUNTY WATER AUTHORITY
2045 Route 112 Suite 1 Coram, New Yorl< 11727-3085
(631) 698-9500 Fax (631) 698-9851
September 6, 2006
Larry Kulick
21 Torlen Ct.
Hauppauge, New York 11788
RE: 1895 Minnehaha, Southold
On September 6, 2006, our representative confirmed that the water service was physically
disconnected at the above referenced location.
Please advise your contractor that care should be taken not to damage the existing vault
and/or curb box, as the cost of any repairs would be billed to the premise and no service
initiated until the balance is paid.
Sincerely,
YlJ/~~41U.{)
Michelle Thomas
Billing Supervisor
MT/dn
LIPA
117 Doctors Path
Riverhead, NY 11901
Long Island Power Authority
August22, 2006
Mr. Larry Kulick
21 Torlen Court
Hauppauge, NY 11788
RE: LIPA Ref. #T100660589
Meter 47083947
Minnehaha Blvd., Southold
Dear Mr. Kulick:
This letter is to advise you that the electric service to the above referenced
premises was removed on August 14, 2006.
If you have any questions, please contact Mr. Charlie Hicks at (631) 548-7024.
Very truly yours,
~~a{~
Design Engineer
Electric Design & Construction
SPA/rh
i 7 - 3'-$3' TOWN OF SOUTHOLD PROPERTY RECORD CARD
-Ji )/'v~''f)..)
STREET
VILLAGE
DISTRICT SUB. LOT
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~ES'2Io SEAS.
r-
AWREAGE J
T'f1?S OF BUILDING
--
LAND
IMP.
TOTAL
DATE
COMM.
REMARKS
I CB. I MISC.
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I Est. Mkt. Value .~' nil (.
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BUILDING CONDITION
-
NEWJ NORMAL BELOW ABOVE FRONTAGE ON WATER
Farm I" Acre Value Per Acre Value FRONT AGE ON ROAD / iJ' '/ I ;JV
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lillable 1 BULKHEAD
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Dormer
BUILDING PERMIT APPLICA nON CHECKLIST
Do you have or need the following, before applying?
Board ofRealth
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.netlSouthold7
7
PERMIT No.3' e. "5' 'z...;c--
Examined
Approved
Disapproved ale
20 (.
'-
,20~
Expiration
,20_
Mail to:
Phone:
v
APPLICATION FOR BUILDING PERMIT
,20_
Date
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
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 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.
.
:'1 f6f' k n r:: f. fIcl {/~p Q '.Hj e tV y
(Mailing address of applicant) ,
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
OW,nf'(
Name of owner of premises LQI'TVBku;:.c/i.... '/ TaG/) /r7 AI,) /.~A'
I
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location ofland on which proposed work will be done:
;cj-9) frJ ""1 p f,,4 hA- (j/u r/
House Number Street
c;oul-Aolc/ -1/ Y
Hamlet
County Tax Map No. 1000 Section 't ?
Subdivision
Block 03
Filed Map No.
Lot .> j
Lot
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy .z /) rI /10;11 r"
b. Intended use and occupancy p r (NO' /' 'f ~ O/) /,v - r C' r; /cf'~ -!J C c:
3. Nature of work (check which applicable): New Building ~..- Addition Alteration
Repair Removal Demolition {~ Other Work
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units /
If garage, number of cars 2.
(To be paid on filing this application)
Number of dwelling units on each floor /
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front j ;Z Y / Rear
Height (G I Number of Stories I
.
:t ,;z, Y /
.
D h .f c' /...- /
ept Ld
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front
Height Number of Stories
Rear
Depth
10. Date of Purchase
t ('.C, '7 Rear (C( >
~ { ~ j(/ov ' 9~
- I ; Name of Former Owner
Depth ;2/ >
9. Size oflot: Front
II. Zone or use district in which premises are situated
Y<9 f' 0
te (? 'f{c/p ~ II~ /
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_NO y
13. Will lot be re-graded? YES_NO_ Will excess fill be removed from premises? YES_ NO_
14. Names of Owner of premises S If/>? f.'
Name of Architect J:;I, c.1t: Brl
Name of Contractor k q.r '1, ('01,?(-
Address Phone No. 979' F3~~/
Address,(,7 ~/"'n C';l. #~Phone No 97,9 -;z/ ;:l/
Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO -L-
* 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.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)
L' rr SS.
COUNTY OF ~.J \1""0\'1- .
~ '" '\<- '-.l \ \ C \ L being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)Heisthe O~0'0€ ,,~
(Contractor, 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 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.
Notary Public
~ ~/1IJ.~liA~~
Signat e of Applicant
BARBARA ANN RUDDER
Notary Public, State of New York
No. 4655605
Qualified In Suflolk count~o
Commlealon Expires April 14,
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W ABUN;,'RT ROAO
N87"26'OO.E
STREET
DIRT ROAD
SURVEY OF PROPERTY
AT LAUGHING WATER
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N. y:
1000-87-03-53
SCALE: 1'=30'
MARCH 13, 2006
APRIL 10, 2006 (fest hole)
ASPHALT
145.00'
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BROWN Sl. TY SNIJ .SItI
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WATER IN BIIOIfN FK SAND SI'
13'
BY McDONALD GEOSCENCE.
AREA-26,253 SO. FT,
ANY ALTERAnON OR ADDmON TO THIS SURVEY IS A \IOLATION
OF SECTION 72090F THE NEW YORK STA TF: EDUCA nON LA w.
EXCEPT AS PER SECTION 7209-SUBDIVlSION 2, ALL CERnFlCA nONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF
SAiD MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
WHOSE SIGNA TURE APPEARS HEREON.
.=MONUMENT
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