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Home My WebLink About33517-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. 33517 Z Date NOVEMBER 8, 2007 Permission is hereby granted to: 427 OSTRANDER AVENUE RIVERHEAD,NY 11901 for : PARTI~tL DEMOLITION OF AN EXISTING SINGLE FAMILY DWELLING AND ALTERATIONS AS APPLIED FOR. at premises located at 1855 DEPOT LA CUTCHOGUE County Tax Map No. 473889 Section 102 Block 0001 Lot No. 009.001 pursuant to application dated OCTOBER 22, 2007 and approved by the Building Inspector to expire on MAY Fee $ ' 100. ~0~x' 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.net/Southold/ Approved t ,20 Disapproved a/c Expiration 20 __ PERMITNO. 55 f9' 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: Mail to: Building [nsp~cto~'~ ~ APPLICATION FOR BUILDING PERMIT Date IO[o)~ ,200~- [ INSTRUCTIONS ' a. This'application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of plan~ 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 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. (Sig~u~e ~'~pplic~nt~'~name, if~ corporation) ess of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or ~uilder Name of owner of premises ~'-10)~t ~IL ~~ (As on th~ 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. Location of land on .w~hich proposed~ work will be done: House Number ~ Street- - H~nlet County Tax Map No. 1000 Subdivision ~, ! (Name) Section /000 Block / 0 & ' p.~ Filed Map No. ~~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intc~nded use and occupancy 3. Nature of work (check which applicable): New Building_ Addition Alteration Repair Removal Demolition y Other Work 4. Estimated Cost 400. OO Fee 5. If dwelling, number of dwelling units I If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~t. Je. t.[ Rear Height ~O ~ Number of Stories ~ Depth Dimensions of same structure with alterations or additions: Front Depth Height_ Number of Stories Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front ~OO. 2.~ Rear ~OO .'2-~ Depth .Depth 10. Date of Purchase q//O ~ Name of Former Owner r~o.f-}Bctro._ C~-fo._.~..~. 11. Zone or use district in which premises are situated '~ ~ O 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 X 14. Names of Owner of premises~ Address~Phone No. (05 Name of Architect'~O~V [qqlffl ~{2~ ~e.}~ ' A. ddre_s~~Phone No (o B ~ Name of Contractor '1a5 bet~-4:~a- ~ Co-~nd~s~ ..... ~ - Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * 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 X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO )(' 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO /~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) COUNTY OF~S: 40 c2 (Name of ~divid~al sign{ng~ontract) (S)He is the being duly sworn, deposes and says that (s)he is the applicant above named, OoJtO e__L (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 tree 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. ~e of~.p~ant ~ Town of Southold E~osion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM PROPERTY LOCATION: S.C.T.M. #: District Section Block Lot 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. Item Number: (NOTE: A Check Mark (~) for each Question is Required for a Complete Application) Yes N.~o 1 2 3 4 5 6 7 8 9 Will this Project Retain All Storm-Water Run-Off Generated by a Two (2") Inch Rainfall on Site? (This item will include all mn. off created by site clearing aed/or construction activities as well as all Site Improvements and the permanent creation of impervious sun'aces.) Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size & Location? This tern sba nc ude a Proposed Grade Changes and Slopes Controlling Sur[ace WaterFIowi Will this Project Require any Land Filling, Grading or Excavation where there is a change to the Natural Existing Grade Involving more than 200 Cubic Yards of Matedal within any Parcel? Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of Five Thousand (5,000) Square Feet of Ground Surface? Is them 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 VerlJcal Rise to One Hundred (100') of Horizontal Distance? Will Ddveways, Parking Areas or other Impervious Sudaces be Sloped to Direct Storm-Water Run-Off into and/or in the direction of a Town dght..of-way? Will this Project Require the Placement of Material, Removal of Vegetation and/or the Construction 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 Watemoume? 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 Permlfl EXEMPTION: Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question, a Storm-Water, Grading, Drainage & Erosion Control Plan is NOT Requlredl Yes No STATE OF NEW YORK, COUNTY OF ........................................... SS That I,. ............................................................................... being duly sworn, de'poses and says that he/she is the applicant for Permit, (Name of individual signing Document) A~d that he/she is the .................................................................................................................................................................... (Owner, Contractor, Agent, Corporate Offmer, etc.) Owner and/or representative of the Owner of Owner's, and is duly authorized to pefforn~ 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 herewith. Sworn to before me this; ............................................... day of ............................................ ,20 ..... Notary Public: .......................................................................................... (Signature of Applicant) FORM - 06/07 LOTQ I I I --% JOSEPH FILE SUFFOLK S.C. TAX SURVEY OF LOT 1 MAP OF & BARBARA GRATTAN No. 11403 FILED JUNE 27, 2006 SITUATED AT CUTCHOGUE TOWN OF $OUTHOLD COUNTY, NEW YORK No. 1000-102-01-9.1 SCALE 1"=50' SEPTEMBER 8, 2007 AREA = 80,077.40 sq. fi. 1.838 ac. CERTIFIED TO: ROBERT J. BARRY JR. JOYCE N. BARRY WELLS FARGO BANK, N.A. STEWART TITLE INSURANCE COMPANY THE EXISTENCE OF RIGHTS OF WAY AND/OR EASEMENTS OT RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED. Nathan Taft Corwln III Land Surveyor PHONE (631)727-2090 Fax (631)727-1727 a7 34