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Home My WebLink About37368-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 #: 37368 Permission is hereby granted to: Ozolins, Helmars & Ozolins, Jocelyn PO BOX 26 Date: 7/17/2012 Orient, NY 11957 To: demolition of dwelling due to fire. At premises located at: 600 Majors Pond Path, Orient SCTM # 473889 Sec/Block/Lot # 26.-2-39.13 Pursuant to application dated To expire on 1/16/2014. Fees: 7/16/2012 and approved by the Building Inspector. DEMOLITION Total: $471.00 $471.00 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SnutholdTown. NorthFork. net PERMIT NO. Examined ,20 Approved Disapproved aJc · 20 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before appbing? 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 Co.tnc,: tU.- Mail to:~.__ Phone: ~1' ~/~ ~ [ Expiration ,20 il J}r'kz'-~:-:~----'--'--'~ Iii I1~ Buildim~ Inspector ,! OUt. 16 2012 lr,, ' ~ , '1~}~__._____~ 1Date ~ ' : ~'_~:-- NSTRUCTIONS 7/ o .20/ a. Tbis application MUSI' 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 schednle. 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 no! be commenced before issnance of Building Permit. d. Upon approyal of this application, the Building Inspector will issue a Building Permit to tbe applicant. Such a permit shall be kept on the premises available for inspection throughout tbe work, e. No bni[ding shall be occupied or nsed in whole or in part for any purpose what so ever until tbe Building Inspector issues a Certificate of Occupancy. f. Every bnilding permit shall expire if the work authorized has not commenced witbin 12 montbs after the date of issuance or has not been completed within 18 ntonths from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, tbe 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 Depamnent tbr the issnance ora Building Permit pursuant to the Building Zone Ordinance of the Town of Sontbold, Snflblk County, New York, and other applicable Laws, Ordinances or Regtdations, for tbe 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, hoosing code, and regulations, and to admit anthorized inspectors on ~remises and in building for necessary inspections. ,.,,~~"F'-'"~~~// (Si~'ture of apl~likam"or name, ifa corporation) ' - 7~gailing address of applicant)//[g,~'"~.._ State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of'premises ~(.~'t~_ 9 "~/.--ke/k3 (55 ~~ (As on the tax roll or latest deed) If applicant is a co~oration, signature of duly authorized officer (Name and title of corporate ofricer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. L72~},~p~.,~f land on which proposedt~ork will be done: House Number Street I Hamlet County Tax Map No. 1000 Section~.~ Block ~ Lot ~'3~, oub&v sion Filed Map No. Lot a. Emst~ng use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Demolition 1~ Other Work (Description) Fee (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 of Stories Rear _Depth 9. Size of lot: Front Rear Depth 10. ])ate of Purchase 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 ~ 13. Will lot be re-graded? YES__ NO ~Will excess fill be removed from premises? YES 14. :Names of Owner of premises [/~?r'~,~ t5 Z~/,4/~ddress {a ~ ~A,,,,.Vt~'5 0~OO~ho~n~ No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet cfa tidal xvetland or a freshwater wetland? *YES NO ~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE R~QUiRED. 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. 18. Are there any covenants and restrictions with respect to this property? * YES__ NO-'L,,''~ '' · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY Ol~'~,_t ~ ~4.~{,~"'1/~I~ ~t~_ ~"'~-.~ being duly sworn, deposes a,,d says that (s)he is the applicaut (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the (,~ O,~a',:f~-~d ir, $'affe2k C,~unt'.; (Contracto Corporate Officer, etc.) Comm'ssion Expires April 14, 2~ [,o of said owner or owners, and is duly authorized to perfbnn 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 perlbrmed in the manner set forth in the application filed therewith. Sworn to before me this A!~-nL/:h day of Q~l/c~%. 20 /~ Nota~ Public ~ S~tgnature of Applicant 5,URVE"r' OF: LOT HAP OF: '1'111 I OIN 'rERRAc~ I=APJ"IS, F:I! ~ OCT, 4, Iqq4 ,A,5 # qs"t2 51TUA'r~, ORII~qT TOl,~h 5OUTHOI 5UITOLK COUNTY', NY E:,U~.VE ¥ E D FOUNPATJON LOCATION FINAL 00-14-01 .E~FFOL~ C, OLJNTY TAX # Nc)nog P-.. NOTE~,: · MONUMENT O PIPE A~--EA ; 6'1,4q5 5F Ot~ FEHA FLOOD ZONE X N w+. S88°21 '50"E Lot #2 Lot #I VACANT 270.00' N88°21 '50"W Rowe 30~.95 Drive Lond no,,~ Or Form¢c t~ ~EPTIC. LOGATION~ PR. OVII2EE;' B"¢ GONTI;;~,.GTOR d~P-.APHIC, ~GALF I"= 50' Lot ~4 VAGANT Lot #3 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S. LIC. NO. 50202 RIVERITEAD, N.Y. 11901 369-8288 Fax 369-8287 REF.-TIGER~PROS\99-195