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Home My WebLink About38769-Z BUILDING DEPARTMENT 0940e3f TOWN OF SOUTHOLD 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 38769 Date: 4/7/2014 Permission is hereby granted to: Olsen, Gregory & Olsen, Darlene PO BOX 158 Laurel, NY 11948 To: Demolition of an accessory garage as applied for. At premises located at: 6645 Great Peconic Bay Blvd, Laurel SCTM # 473889 _ Sec/Block/Lot # 126.-10-20 Pursuant to application dated 3/28/2014 and approved by the Building Inspector. To expire on 1017/2015. Fees: DEMOLITION $222.40 Total: $222.40 tQuAilding ctor 7Z TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following; before applying? TOWN HALL Board of Health SOUTHOLD, NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: 631 765-9502 / Surve SoutholdTown.NorthFork.net PERMIT NO. 6 Check _,~e Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20 Storm-Water Assessment Form ontact: Approved 20 MAR 28 203 ~ J Mail to: Disapproved a/c D . L 10'rr - ;'JT01_ Expiration 20 Phone: APPLICATION FOR BUILDING PERMIT Date a g 20 `C 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 1, f 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 thepermit 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 .goupty,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, buI r. ilding code, h using code, and regulations, and to admit authorized inspectors on premises and in building for necessary-inspections. ignature of applicant or name, if a corporation) 0, 13 ox 15- Fr 4-t-UaP- ( 00,r 040 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises O.' Y r kl 0-0-jerk O 1 S 1~-.? (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 of land on which proposed work will be done: 6645- f~CON,"c [3v1~Y slow, ~OLOa-<--~ House Number Street Hamlet ,ry County Tax Map No. 1000 Section a 6 Block Lot q ~ Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy cG~ re•-y 4 b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal-IL~Demolition_~Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 0 Al r-_ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front lol ( 4 Rear /pZ Depth 3 y Height Number of Stories__ _ I Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front C co ~ Rear l D O t Depth O? 56 10. Date of Purchase Name of Former Owner e rid 4St 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, or4mance or regulation? YES NO 13. Will lot be re-graded? YES ? NO Will excess fill be removed from premises? YES_ NO 14. Names of Owner of premises, ~ -94a--Address ~°r `Phone No. 6 (a 9Sr r? $7 Name of Architect Address =r... Phone No Name of Contractor Address " Phone No. 15 a. Is this property within-100 feet of a tidal w6tland or a freshwater wetland? *YES NO v" * IF YES, SOUTHOLD TOW14 TRtSTEES & D:E`C. PEPRITS MAY BE QUIRED. b. Is this property within 00 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 V * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: OF 5001 tk- ) CO YO y being duly sworn, deposes and says that (s)he is the applicant a e of individual signing contract) above named, CONNIE D. BUNCH Notary Public, State of New York (S)He is the 0 c,J H e/t r ? ~d( No. OISU6185050 (Contractor, Agent, Corporate Officer, etc.) Commission Expires April 14, 2 C 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. Sworn to before me thi ^ ^ - (I- day of _I t `G" 1' 20_ ~ 1 /4PO~ Notary Public Signature of App scant SURVEY OF PROPERTY SITUATE OJ LAUREL Pe ~ yJ~O o1 4 2° O kp TOWN OF SOUTHOLD Tri' SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-126-10-20 009,~4~ ~a"~ 30 5E \ \ 1-161i0 5,.1F~~o~ ti SCALE 1"=20' ~i.oJ6~ 'L \ (n JULY 9, 2013 F, \ AREA = 25,000 sq. ff. 0.574 ac. II3t d CERTIFIED TO: GREGORY OLSEN Cqp !S .A DARLENE OLSEN S; M1~ d Q WlE ~ tl AhQ B.3 S °O ¢ tl e.b 0 9b 1l`l ' BM1 lly • . • i 9 `Z` ~J 1 ~ G a •y~ ~`~H , , s Qp. . PREPARED IN ACCORDANCE WITH THE MINIMUM T~ STANDARDS FOR TRLE SURVEYS AS ESTABLISHED q VYY SY THE L.I.A.L.S. AND APPROVED AND ADOPTED `v\ FOR SUCH USE RY THE NEW YORN STATE LAND TIT -E ASSOCATID SE OF NfNv Y ~ 225' ~ 'PZ'f, ~r( d~ O f. ~A c a my k 2 ~(q 11 N.Y.S. Lic. No. 50467 O' °o"o tx UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A MOIATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION N LAW. Nathan Taft Corwin iii COPIES OF THIS SURVEY MAP NOT DEMING THE SLAND SE SURVEYOR'S INKED E CO SI Land Surveyor HALL NOT BE CONSDERED TO TO BE BE A D A VALID SEAL SHALL COPY. CERRFlCATIONS INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE Successor To: Stanley J. Isaksen, Jr. L.S. TIRE COMPANY, GOVERNMENTAL AGENCY AND Joseph A. ngagn0 L.S. LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEE OF THE TENTING TO TH CEftG EES OF ARE NOT TRANSFER SFER ABIE. Title Surveys - Subdivisions - Site Plans - Construction Layout PHONE (631)727-2090 Fax (631)727-1727 THE EXISTENCE OF RIGHTS OF WAY OFFICES LOCATED AT MAILING ADDRESS AND/OR EASEMENTS OF RECORD, IF 1586 Main Road P.O. Box 16 ANY, NOT SHOWN ARE NOT GUARANTEED. Jannesport, New York 11947 Jannesport, New York 11947 1 33-1641