HomeMy WebLinkAbout37205-ZTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 37205
Permission is hereby granted to:
07670, LLC
CIO DAVID SHANKS
30 SURREY LANE
Date: 5/9/2012
To:
TENAFLY, NJ 07670
demolish an existing 14'X 28' dwelling as applied for, LIPA/utility disconnect letter
required
At premises located at:
46975 ROUTE25,SOUTHOLD
SCTM # 473889
Sec/Block/Lot # 69.-5-18.1
Pursuant to application dated
To expire on 11/8/2013.
Fees:
5/9/2012
and approved by the Building Inspector.
DEMOLITION
Total:
$217.60
$217.60
~ng Inspector
Jun 12 2012 2:20Ft'1 HP Faxl"ludd Vyd 6317651245 page 2
3UN-11-2012 10:52 F:q~N~U I N GR~I, JP
P.02
CUSTC~I~R O~DER ~FI'LI2~NT DEI~.
Mr, D~v/d Shank~
Surrey I~ LLC
30 Surrey Lane
Tcn~,'yq NJ 07670
ge:Demolition 785 Lower Rd,, Southold, NY
T101355601 Electric, T10115560~ Gas
This is ~e advise you ri.at 1i~ LIPA electric facilities ~d Nationa~ Grid gas facilities at ~he
above re~rence locat/On have been removed,
in a~cor,dance with the New York State General Business Law- Chapter 818. Industrial
Code R~es 53, please iaforrn the demolition contractor to noti~ LIPA-TELCO. Utility
Con,mi Cr. ntcr at I.~0-272-44i0, 48 hours prior to startia8 work to request a mark out of
;he u~ili,,-y services m 1he a~ea.
ir'yea na~¢ any questions regarding thc above, pleaac con, act Cuslomet O:der Fulfillment at
5 '.,5-545-?~ 782.
Very ~'~ly yours, .,.
C~co:r~r Orae: Fulfillment
TOT¢:~._ P. ~
Jun 12 2012 2:20F~'d HP FaxNudd Vyd 6317651248 page 1
MUDD
VINEYARDS, LTD.
39005 Counu/Road 48
Southold, L.I. New York, 11971
Est. 1974
Vine~rd Development
Management - Comultin~
Phone 63I 765 1248
Fax 631 765 9495
FAX COYER SHEET
DATE:
TO:
FAX #:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork. net
Examined 9/,/~ 20 {/]~
Approved 5~/~ .20] ~
Disapproved a/c
Expiration · 20
PERMIT NO.
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
C.O. Application
Flood Permit
Single & Separate
Storm-Water Assessment Form
Contact:
Mail to:
Phone:
APPLICATION FOR ~ PERMIT
d /
Date ,20
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink aod submitted to the Building Inspector with 4
sets of plans, acctirate'plot plan to scale,. Fee according to scbedule.
b~ Plot plao showiug 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 issuauce of Building Permit.
d. Upon approval of this applicatioo, the Buildiug htspector 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 aoy purpose what so ever until the Building Inspector
issues a Certificate of Occupaocy.
f. Every bui!ding'permit shall expire i~;,;lle ~ork authorized bas oot commenced within 12 months after the date of
issuance or has not been completed withiu 18 months from suOh date. If no zoning amen~lmerits or other regulations affecting the
property }lave beeo enacted ill tile interim, the Building Inspector may authorize, io writing, the extension of the permit for an
addition six months. Thereafter. a new permit shall be ~:equ.ired.
APPLICATION IS HEREBY MADE to the Building Departmeot for the issuance of a Building Permit pursuant to the
Building Zone Ordiaance of the Town of Soutbold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for tile 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. ~f(~Jican~~a'
( 'g p_ ' , 'corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, a~e_nt: architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises 3A/~ga~ ,,J~//d~4/t~'~
(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.
Location of land on which pro. posed work ~ill be., done:
House Number Street Hamlet
County Tax Map No. 1000 Section ~:~ ~' Block
Lot /~7~. /
Subdivision Filed Map No. Lot
2. State existing use and occupancy ofpremisqa and intended use and occupan, cx of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy.
3. Nature of work (check which applichlp,!e~' New Building Addition Alteration
Repair Removal ~r'Demolition ~ Other Work
4. Estimated Cost
5. If dwelling, number of dwelling units
If garage, number of cars
Fee
(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
Height. Number of Stories
Rear
Depth
Dimensions of same structure with alterations or additions: Front
Depth. Height_ Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number 0'f S~ories ·
Rear .Depth
9. Size of lot: Front
10. Date of Purchase
Rear Depth
Name of Former Owner ~
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
1 3. Will lot be re-graded? YES NO Will excess fill be remo, ged_f129m_ llremises~_ YES NO~
14. Names of Owner of premiseshaL~} ,,,,~rt~/~"Addres~{~} ,Jl~Jliil~Y ~ Phone No.
Name of Architect Address Phone No
Name of Contractor [~',,~ ~./~ Address/~(-~,~Y~- Phone No. ~..~,/
15 a. Is this property within 100 feet cfa 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 cfa 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 ,at3y 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
· 1F YES, PROVIDE A COPY.
NO
STATE OF NEW YORK)
SS:
COUNTY OF )
(Name of ndividual signing contract) above named,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
being duly sworn, deposes and says that (s)he is the applicant
CONNIE D. BUNCH
Notary Public, State of New York
NO, 01BUfllR~80
Qualified in Suffolk County
Commission Expires April 14, 2 ~}~,
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 applicatiou 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.
S}~j~rn to before me this '
tel~ day of ~f~4'...,~ 20 I'~
Notary Public
t Signature'of Applicant ~
07670 LLC
30 Surrey lane
Tenafly New Jersey 07670
Dear Southold Building Department,
This letter is to confirm that we have retained Steven
Mudd of Mudd Vineyards LTD to represent us with respect
to the demolition permit for the larger building on Lower
Road in Southold. The tax map number is 1000-69-5-18.1
Sin~erely ~
David Shanks
Sole member
O767O LLC
30 Surrey Lane
Tenafly NJ
LAND ~MP.
TOWN OF SOUTHOLD PROPERTY RECORD CARD
TYPE OF OLD.
TOTAL
CLASS ~ l
DATE
VILLAGE
--suB. LO.~'~''=~
FRONTAGE ON wATER
FRONTAGE ON ROAD
DEPTH
BULKHEAD
_LABLE
~DLAND
MEADOWLAND
HOUSE/LOT
Extension
Extension
Extension
patio
Porch
Deck
Breezeway
Garage
Pool
Foundation
Basement
Ext~ Wails
Fire Place
Oormer
Driveway
Beth
Floors
Interior Finish
Heat
Woodstove
Attic
Rooms 1st Fioor
:looms 2nd Floor
COLOR
TRIM
Oinette
Kit.
BR,
Fin, B.
~EW~ ~.]~K STATE
COMMERCIAL
DRIVER LICI~NSE
ID: 322 098 853 CLASS B
MUDD
STEPHEN,D
CouNTY RD 48
~HOLD NY 11971
DOB: 09-24,.~4
00¢ 00~ 001 0