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Home My WebLink About39138-Z TOWN OF SOUTHOLD ,00" '& BUILDING DEPARTMENT TOWN CLERK'S OFFICE 'T SOUTHOLD, NY �1 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#: 39138 Date: 8/27/2014 Permission is hereby granted to: 12800 Main Road LLC PO BOX 1456 Mattituck, NY 11952 To: Demolition of fire damaged building as applied for. At premises located at: 12800 Route 25, Mattituck SCTM #473889 Sec/Block/Lot# 114.-11-15 Pursuant to application dated 8/19/2014 and approved by the Building Inspector. To expire on 2/26/2016. Fees: DEMOLITION $1,264.60 Total: $1,264.60 CildingIn 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 /� Survey SoutholdTown.NorthFork.net PERMIT NO. eJ T Check Septic Form i r N.Y.S.D.E.C. "',� Trustees C.O.Application i Flood Permit Examined ,20 AUG 19 2p14 Single&Separate Storm-Water Assessment Form EPContact: (� op+�N Rp "rpp,rL T. a Mn8 Approved '20 TO'"!t,i �!,� ,;�iiT'�� L Mail to: "40'Z I*196 Disapproved a/c Vv\A.-ir I-EC.LC.I- N 1--a G SZ— Phone: G3 t -3'I S-24,31 Expiration ,20_y. P 4, 11 ��i",TED ut ding nspe APPROVE, DATe24 _�!- . . ----�'�ICATION FOR BUILDING PERMIT FEEr; !: Date Q — �� , 20 NOTIFY QUI '' ,� r.� laT AT INSTRUCTIONS 765-1802 8 A`a �; �r r_-OP, THE FOLIaOWIA%09cr1�r ��rca; mpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets,bf XCA to l'�tN. _ Fee according to schedule. l� lot and of buildings on premises, relationship to adjoining premises or public streets or areal,al�@lwaltbrw*4.h'!NG P 3. NSWTA&covered b�y t yrs plication may not be commenced before issuance of Building Permit. 4. F&A1ponQ%: T ig a4kation,the Building Inspector will issue a Building Permit to the applicant. Such a permit shall beEFelflQM pfetrri§ s avail rT_pection throughout the work. g+ ' c Irked in whole or in part for any purpose what so ever until the Building Inspector ALLeL1EDbiS�ik��►�' lt�ie'b� i� issueRwffliph iT�f 069 At' . �° YOIRefw6T6aailul itJW15-months Oif the work authorized has not commenced within 12 months after the date of issua ,QIiiaQRotCQ14 � 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. I k (Signatu a of applicanf or name,if a corporation) !?'o3 ��-lam, AA-77)ZcL9-- N4 11! LZ (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises 1 Z $op yv,,p. i N "9-o gA� G , (As on the tax roll or latest deed) If applicant is a corporation, signature of duly au o. ' officer s;2� — Zit (Name and title of corporate offs er) 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: House Number Street Hamlet County Tax Map No. 1000 Section J $Tock Lot . Subdivision l/ (4 Filed Map No. Lot �S 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .STt�2 ��DA/i &YA a7/ MtFN TS b. Intended use and occupancy SA'r+�► 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition _Other Work (Description) 4. Estimated Cost to - 7—OK 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 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories 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 SEF &E!6 Rear A-7T _Depth 10. Date of Purchase S_Tp3" Name of Former Owner G A-UR LFitJLE C S&I46 D .ZT- 11. Zone or use district in which premises are situated /27.9- 'i aCoe- 1-1,97" 4f-T 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO- 13. Will lot be re-graded? YES NOWill excess fill be removed from premises? YES_,X NO IN4W1vi4e- lu v 14. Names of Owner of premises/ZVO twf+-•WRoe4*...�ddress OR 1?44' /i94zPhone No.43/-3 7S-Wl Name of Architect Address Phone No Name of Contractor757~7 V AddressVV900 Phone No.63/-76S- 2,575 CoNTRa�rc Soutw04)�- NY /iy'7/ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * 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 * 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 10'1bet 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) SS: COUNTY OF�(�. .S7G✓�&2 R. 2 k-'s C being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the OF e: I C (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 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. Swirrito before me thi I `�i day of SY 201`C Notary Public na e ofApplicant BARBARA H. �T ANDY Notary Public,State Of New York No. 01 TA6086001 Quslified In Suffolk County Commission Expires 01/13/20.L SUFFOLK COUNTY WATER AUTHORITY 4060 Sunrise Highway,Oakdale, New York 11769-0901 August 21. 2014 Steven Busch PO Box 1456 Mattituck NY 11952 RE: 12800 Main Road. Mattituck To Whom It May Concern: On June 24, 2014, our representative confirmed that the water services were physically disconnected at the above referenced location. Please advise your contractor that care should be taken not to damage the existing vault and /or curb box, as the cost of any repairs would be billed to the premise and no service initiated until the balance is paid. Sincerely, Lisa Cetta New Construction Manager LC/ba Paul Cama nationalgrid Senior Supervisor Supervisor Customer Fulfillment Oepartment August 28, 2014 Liberty Data Systems C/o Mr. Steven R. Busch P.O. Box 1456 Mattituck. NY 11952 Email: 12800MRQOPTON LINE,NET National Grid WO#T101646398— 12800 Main Rd, Mattituck Dear Mr. Busch: This letter is to advise you that the natural gas service line to the above location was physically disconnected on August 27, 2014. Please advise your contractor that care should be taken not to damage or remove the existing gas valve curb box. This curb box will be used in the future by National Grid to reconnect the gas service line to this property. New York State law requires anyone planning underground excavation work to notify local utilities by making one call to a toll-free number to get your underground lines identified for you prior to doing any digging. This phone call needs to be made at least 2, but not more than 10 working days in advance of starting work, not including the day the call was made. The number to call is either the nationally sponsored "811", or the local number for NYC/Ll area, 1.800.272.4480.This confirmation letter of a gas cut-off does not relieve the excavator of making this"811" call. If you have any further questions, kindly contact me at 631-348-6218. Respectfully, Paul A. Cama Senior Supervisor Customer Fulfillment Department 1650 Islip Ave.Brentwood,NY 11795 T;1331.348-6216 F:516545.2333 paul.camaoutionalgrid.com www.nationalgrid.com .e WN OF SOUTHOLD PROPERTY RECORD CARD - OWNER STREET h C Q o O VILLAGE DIST. SUB. LOT D rtath Ulc M flu K oR ACR. ` I `r REMARKS f TYPE OF BLD. e)rAr PROP.I LASS car N, A , LAND IMP. TOTAL DATE SC,)(✓ t 'S" .' ' '' l� L.t 1,aC} trt�i ,�t1rM �/l& N"a 31611, oix r& P,ev -- - 17 �4 +� # <3Cb ` ? �`neriA' Gt�t�'rns ,.. /,se 5/d o -).1a c /agm t'Hdib 61 LLC i • J�?Ob -312—Y111 8 -#S&L5` sink ( ) J ' 10 — ' 560 o FRONTAGE ON WATER TILLABLE FRONTAGE ON ROAD WOODLAND DEPTH !� .7 gD MEADOWLAND BULKHEAD HOUSE/LOT TOTAL a TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT F R/ 1 R�OL ENEr- . ACR �/ �J P kssac S W: TYPE OF BUILDING J a �Qp RES. - SEAS. VL. FARM M. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 1 c 4 4 y 7 0.0 S—(p U rJ c 00 C. e'o" Anot YR 6 -3 2 3.3 — J, P —0 0-F�47,9, 11 wAe rf AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre • Value Per Value .1�Gt1^CfQ�' l$a1j Acre 44-4- :'t- M6 / rft �Q nt WVV /1/. 4. Tillable FRONTAGE ON WATEli Woodland FRONTAGE ON ROAD Meadowland DEPTH t House PlotBULKHEAD � Total DOCK imp •�• a ' V.wit Wn N■■■■■■■■■ 1Ni1IMPAM■ r■■■■■■■■■ �1C1�[�■■■■ �■■■■■■ ME MEMO mom ®E"'M',■■■NA■■■■■WE■■■N ■■■■■ ■■■■■■■■■■■■■■■■■a■■■Basement ■N■N■■ Foundation •• ,` Fire Place Recreation Room: Rooms 2nd Floor I s• - � r.g� ' Driveway oil • • ' . o i r N L.ailliAUu TZY-aAsa ` (5t6)- ` ! rLh vV7' u 1..^-� t 4 S S.t� .tt '� FnO -�� `ti 3fa s Ike •S S F •P p c� 7� 04• � is e: VN 10 IQ x AI z joo o•• x.11. v �v 11 O Z rs ` � �P ,moi, s o_ W Al t� a- 'p�'• a m '" A O r 4' i .E �� r r S •A C7 • ti A 7I. v• •SS„ s� Iy v u .� V .• '= . 'VoL' per_ P T to 0 (np �' RO h . '!' ► 6 it 4,00 04 h F n t 8 OF W4yCJ-3# i" 2o fn �iia . to d' - "JOW OR FORLAERL7 RVUOLPH C. KOPF - Z FORMERLY SECMA REEVE i N N -- SURVEY FOR LAURENCE .C.•SCUDDER, H 1 AT MATTITUC*y OATS r. •►' 31,197 i Q Q 114 • 1ti ' �S SCALE: J"=20 r TOWN of SOUTHOLD i — - - -- -- — _ - SUFFOLK COUMTY, NEW YORK xo. -�e- Orr .unAUINOaitto ALICRAM"OR&"T ju fo TWs avARANJ'££d M, NEW `�U F FO L 1: AVE :ua,c,K a vM4710f of storm" ?to.Of me SME ywfo,,r4e�+ge, naysc E wf 104a!Tait tOUCAnOMLt=. �i4k.