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Home My WebLink About39175-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 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#: 39175 Date: 9/12/2014 Permission is hereby granted to: Szymczak, John & Noto-Szymczak, Nicole 3500 Grathwohl Rd PO BOX 337 New Suffolk, NY 11956 To: demolish an existing dwelling as applied for At premises located at: 3500 Grathwohl Rd SCTM # 473889 Sec/Block/Lot# 110.-8-4 Pursuant to application dated 9/12/2014 and approved by the Building Inspector. To expire on 3/13/2016. Fees: DEMOLITION $550.00 Total: $550.00 Building Inspector 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. 37)75 Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 201 Storm-Water Assessment Form Contact: Approved q20_J L Mail to: Disapproved a/c Phone: Expiration 201 Building Inspector APPLICATION FOR BUILDING PERMIT Date _, 20 )q_ 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 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. 0 �MAV", (Sign ure of applicant or name,if a corporation) -S3i h LJ 'IX,i fa I( 0 y � �R SCp (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Gtw kk Cftifa4c,�- Name of owner of premises Lky 6 L\ 7_)CW Je4 (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.Sia bo ' �- Plumbers License No. Electricians License No. 9 6 a S^ m Other Trade's License No. 1. Location of land on which proposed work will be done: 35 DO G axn h l House Number Street Hamlet (('' County Tax Map No. 1000 Section () Block D of Lot Q`1 Subdivision (fig 0 svf-R I K Filed Map No1060- (16 Lot Q & - 6!J 2. State existing use and occupancy of premise and intendId use and oc upancy of pr posed construction: a. Existing use and occupancy C' S k b. Intended use and occupanc � VA n 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition XOther Work 4. Estimated CostFee (Description) (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 C.Q Depth C2 Height_ �) U Number of Stories 1 ` Z 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 Rear Depth 10. Date 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)Q___ 13. Will lot be re-graded? YES N NO Will excess fill be removed from premises? YES NO J hn k Y\ %toSSO0 6vG-t Kwok ( V4 14. Names of Owner of premises Zvm( Ic Address ) ,w SV 11tiY Phone No. Name of Architect 56Aq d ny% Al g (��}P _Address �a06 M. bu y Phone No !03 6 Name of Contractor Address "" 'D``'' " j hone No. ail Q11 I 1 HKcv1k°11^% by 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES 'ONO * 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 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) S: COUNTY OF'�QAllf 2- being duly sworn, deposes and says that she is thea li (Nathe of individual si ing contract)above named, ( ) pp cant (S)He is the (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. Swor2 n before me this-- � y of6MC :LUMBO ignature o pplicant f New York .02PAWS7274,Suffolk County Commission Expires March 30, ,— PauIA.Cama Supenationalgrid S enior rvisor Customer Fuffift nt O"art " August 20, 2014 Mr.John Szymczak PO Box 337 New Suffolk, NY 11956 Email: boobooboy472@aol.com National Grid WO#T101639908—3500 Grathwohl Rd, New Suffolk Dear Mr. Szymczak: This letter is to advise you that the natural gas service line to the above location was physically disconnected on August 15, 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/LI area, 1-800-27241480.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 1850 Ishp Ave.Brentwood,NY 11795 T:831.348-8218 F.516445-2333 paul.cana@natlonaWW.com www.nabonalgrid.com PAT NOTO INC. 30 WISCONSIN COURT BAYSHORE, NY 11706 (631)231-4343 FAX (631)231-3650 September 4, 2014 Re: 3500 Grathwohl Roan, New Suffolk, NY To Whom It May Concern: Please be advised that the water service to the above residence has been cut and disconnected for demolition and new construction purposes. Sincerely, U✓J Pat Noto PSEG SSI AND M.make thingv uY.4 firr you. CUSTOMER ORDER FULFILLMENT DEPARTMENT 175 E. Old Country Road, Hicksville, NY 11801 September 10, 2014 Mr. John Szymczak PO Box 337 New Suffolk, NY 11956 RE: Demolition Letter for: 3500 GRATHWOHL ROAD, NEW SUFFOLK, NEW YORK PSEG Reference #: T101646792 Dear Mr. Szymczak: This letter is to advise you that the PSEG electric facilities have been removed from the above premise. You must also contact National Grid at 516-545-4982 to procure a letter of demolition associated with natural gas service, whether or not your home or business uses natural gas. In accordance with the New York State General Business Law- Chapter 818, Industrial Code Rules 53, please inform the demolition contractor to notify LIPA- TELCO, Utility Control Center at 1-800-272-4480, 48 hours prior to starting work to request a mark out of the utility services in the area. If you have any questions regarding the above, please contact Patricia Law at 516- 545-3629. Very truly yours, &4' fo Carolyn Mackin, Manager Customer Order Fulfillment CM/am