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Home My WebLink About34867-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) PERMIT NO. 34867 Z Date JULY 14, 2009 Permission is hereby granted to: BRIAN FRAWLEY 41 E MAPLE RD GREENLAWN,NY 11740 for : DEMOLITION OF FOUNDATION, & REMOVAL OF DWELLING AS APPLIED FOR at premises located at 4545 County Tax Map No. 473889 Section 112 pursuant to application dated JULY Building Inspector to expire on JANUARY HALLOCK LA MATTITUCK Block 0001 Lot No. 002 8, 2009 and approved by the 14, 2011. Fee $ 341.20 Authorized Signature ORIGINAL Rev. 5/8/02 Town of Southold Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM Item Number: PROPERTY LOCATION: S.C.T,M, #: District Section Block Lei THE FOLLOWING ACTIONS MAy REQUIRE THE SUBMISSION OF A STORM-WATER, GRADING; DRAINAGE AND EROSION CONTROL PLAN CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Ye~s N~o 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Wa~er Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all run-off created by site cleadng and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces,) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface Waten=low! Will this Project Require any Land Filling, Grading or Excavation where there is a chaege to the Natural Existing Grade Involving more than 200 Cub c Yards of Material within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of F ve Thousand (5,000) Square Feet of Ground Surface? Is there a Natural Water Course Running through the Site? Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical Rise to One Hundred (100') of Hpezontal Dislance? Will Driveways, Parking Areas or other Impervious Sudaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town right*of-way? Will this Project Require the Placement of Material, Removal of Vegelation and/or the ConsIruction of any item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons,) Will this Project Require Site Preparation within the One Hundred (100) Year Floodplain of any Watercourse? NOTE; If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water, Grading, Drainage & Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! EXEMPTION: Yes N__~o Does th s project meet the minimum s andards for c ass fica ion as an Agricultural Project? Note: If You Answered Yes to this Questlom a Storm-Waten Grading, Drainage & Erosion Control Plan is NOT Required! STATE OF NEW YORK, ~- ,f'c, COUNTY OF~.~..., ................ (Name of individual signin9 Documenl) make and file tiffs application; that all stutcmcu[~ ,:uncci' m 't:, ~,~ ,q)pli{ation arc lrue to the bcsl of Iris knowledge and belief; and that the work will be pcrformcd m otc m~mnc~ .;c: i ,~: :~ d,.c apph,.:auor~ filed herewith. Sworn to before me thi; ............................................... day of ... ~ 20.~. Notary Public: ........ ~ L:'WITT . ,~iy,l.t. .......................... FORM - 06~07 ~,.,,.,,~.s,~a,c~.~ ...->, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined Approved Disapproved a/c Expiration ., 20 JUL 2009 BLDG. DEPt. TOWN OF SOUTHOLD PERMIT NO. ~7¢f~ 7~ BUILDING PERMIT APPLICATION CHECKLI~ Do you have or need the following, before applyin; Board of Health 4 sets of Building Plans Planning Board approval Survey Check · Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: ~ Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 ,. Thi~ application mull be, >mpletely 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 fi~om 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 Southold, 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. (Signature of applicant or name, ~f a corporation) (Mailing address of applicant) owner, lessee, agen a~t~neer, general contractor, electrician, plumber or builder State whether applicant is Name of owner of premises ~f~l/qQ ~~ (As ~'on~he tax 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 roll or latest deed) 1. Location of land on which proposed work will be done: House Number Street County Tax Map No. 1000 Subdivision ame) Section ............ I-t~let ~ BI~ek ~ O~ ~$iled MaP No. Lot 0% Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~l~r6~l~r~ ~ tL~ ~T.l..ladr-. b. Intended use and occupancy. Nature of work (check which applicable): New Building Repair Removal ~ Demol~ion Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions of.e~tlst~ng structures, if any: Front. _~e} ~-Gg Rear ,~OL(,~ Depth Height ~' (.¢?) Number of Stories r)._ Dimensions of same structure with alterations or additions: Front Depth Height · Dimensions of entire new construction: Front Height Number of Stories Size oflot: Front ~1 Rear ~[~ 0. Date ofPurchase~l~4ro ~ t).~a~, Name of Former Owner 1. Zone or use district in which premises are situated Rear Number of Stories Rear .Depth Depth construction violate any zoning law, ordinance or regulation? YES.)< NO__ ('~-t~ 2. Does proposed 3. Will lot be re-graded? YES NO )~ Will excess fill be removed from premises? YES ;>q NO t'bo ~. ~. ~ ~'~F~. 0.~ .... . _ _ 4. N~es of Owner ofprmises ~ ~m~ Address ~,X, ~2Y'~ Phone No?ll? ~ ~B~ Nme of Architect ~x~m~ Address~hone No (~$~q~B~ N~e ofContractor~ ~O~~ Address P.~ ~$~ Phone No.(~S~) ~ ~ 5 a. Is this prope~y within 100 feet ora tidai wetl~d or a ~eshwater wetl~d? *YES ~ NO ~ * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PE~ITS MAY BE REQUI~D. ~~ b. Is this prope~y wi~in 300 feet of a tidal wetl~d? * YES ~ NO * IF YES, D.E.C. PE~ITS MAY BE ~QUI~D. ~ ~ ~*~m~ ~~) 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. ITATE OF NEW YORK) SS: :OUNa OF 93 4k xL) ~ ~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, S)He is the r~ (~4'~T~Z~b (Contractor, Agent, C6rporate Officer, etc.) ,f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; hat all statements contained in this application are tree to the best of his knowledge and belief; and that the work will be ~erformed in the manner set forth in the application filed therewith. Notary Public iSLAN1) 50UN'O LoHG - Ced/fled fo: THE EXISTENCE OF RIGHTS OF WAY AND OR/EASEIdENTS OF' RECORD IF ANY, NOT SHOWN ARE NOT GUARANTEED. Note: ALL SUBSURFACE STRUCTURES: WATER SUPPLY, SANITARY SYSTEMS, DRAINAGE, BRYWELLS AND UTILITIES, SHOWN ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS, UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION GUARANTEES ARE NOT TRANSFERABLE. I ORA~ ex /~M I c~$ ~ oAr~ 06- f5-07 CH£OKED B~ J~ ~ DRA~N~ NO 07~ Z90-07 ~ ~0' 590-- 07 SHErT ~ 5O LAND SURVEYING SUBDI~/ISIONS 2 TITLE & MORTGAGE SURVEYS TOPOGRAPHIC SURVEYS LAND PLANNERS SITE PLANS JOHN MINTO, L.S. PHONE: (631) 724--4-832 FAX: ('631) 724--5455 93 SMITHTOWN BOULEVARD SMITHTOW]V, N.Y. 11787 ~COPY FOR YOUR INFORMATION SURVEY OF PROP£RTY~ situate at "' ATTITUCK Town of Soufhold Suffolk Counfy, N.Y. S.C.T.M. # 1000-112-01-02 Scole 1"= 50' March 6, 2007 GRAPHIC SCALE o 25 50 100 '( IN FEET ) 1 inch = 50 AREA= 5t,92'7 S.F. to Long Is~oM Sound Tie Line OR I. t9 ACRES Heolth Department Approvol Stomp Areo 2O0