HomeMy WebLinkAbout39641-Z1 fet-t_a
Permit #: 39641
TOWN 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)
Permission is hereby granted to:
RWM Enterprises Inc
PO BOX 1408
Southold, NY 11971
To: Demolition of existing structure as applied for.
At premises located at:
56340 Route 25, Southold
SCTM # 473889
Sec/Block/Lot # 62.-3-22.2
Pursuant to application dated
To expire on 10/1/2016.
Fees:
Date: 4/2/2015
3/30/2015 and approved by the Building Inspector.
DEMOLITION
Total:
$280.00
$280.00
0 PSEG SL� ND
V* Tnnke things riwr* Jnr}»u.
CUSTOMER ORDER FULFILLMENT DEPARTMENT
175 E. Old Country Road, Hicksville, NY 11801
February 17, 2015
RWM Enterprises, Inc.
PO Box 1408
Southold, New York 11971
Attn: Mr. R. Mullen
RE: Demolition Letter for:
56340 Main Road, Southold, New York
PSEG Reference #: 900000002725
Meter #'s: 93964902 & 68658354
Dear Mr. Mullen:
MAR 2 5 2015 -
This letter is to advise you that the PSEG electric facilities have been removed
from the above location.
You must also contact National Grid at 516-545-4973 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 Patricia Law at 516-545-
3629.
Very truly yours,
0 �C�c�-141--
Carolyn Mackin, Manager
Customer Order Fulfillment
CM/am
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined ,20
c.—
Approved , 20
Disapproved
BUILDING PERMIT APPLICATION CHECKLIST
PERMIT NO. -Q4 � I
MAR Z 5 2015 {'
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 Pe
Si & Separate
Storm -Water Assessment Form
tact: Z!c Af44�*-4j
Mail to:
Phone: ?6�- 3_�f''� &C
Expiration 4sl , 20
r din insp
--ATPLICATION FOR BUILDING PERMIT
T-)rJ 1E.
r Date Ammk 02 , 20/5
INSTRUCTIONS
5s
on
's appli t�IviUST t pornpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4
\hIVii' ,
sets a>tisa ur�4te plbi--�Iafi lb'scale. Fee according to schedule.
-1. + x'10 n, Wing lorrati;pp',ot and of buildings on premises, relationship to adjoining premises or public streets or
areas, a`n vvlgrw"
2..i' �YIY�uv�Ik covered b� ths;application may not be commenced before issuance of Building Permit.
1 d?` aitSh rav ��lf� ►I Application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall ble k t � �t pr Imst availableiiEiEi ction throughout the work.
6}pg;ecin whole or in part for any purpose what so ever until the Building Inspector
issueserthite,pgtrparrc
i rla`i i}di� j:lertrttt' elC W the work authorized has not commenced within 12 months after the date of
issuanc8 ag'rl beLC01a"�within 18 months from such date. If no zoning amendments or other regulations affecting the
property47fawbeen 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.
(Signature of app icant or name, if a corporation)
Pa &Ix l5 .:j�KzMeVA ,NP ell7l
(Mailing address of applicant
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises -Z�e-
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name an title of corporate officer)
Builders License No.
Plumbers License No. _
Electricians License NO.
Other Trade's License No.
Location of land on which proposed work will be done:
House Number Street Hamlet
t�e
County Tax Map No. 1000 Section BlocLot ; .
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
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work
4. Estimated Cost
If dwelling, number of dwelling units
If garage, number of cars
(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 Rear
Depth Height Number of Stories
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 15 (oJ� acjre C
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 NO
14: Names of Owner of premises Q_,F dd/��Address gd4Lh66aA Phone No. Z!2 3S
Name of Architect Address Phone No
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a 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 of a tidal wetland? * YES NOEL
* 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)
SS:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(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.
Sworn to before me this
day of A iH 20JS
N ry Publics 6t8t0a
NO. 019=39M
CUansed In Sulk* canv
OWwr"WW �,sAM N. Lo L5
Signature of Applicant
Pan -lb 16
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STREET'
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TYPE OF BUILDING
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a Acre Value Per Value
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RES.
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FARM
t COMM. � MISC. Mkt. Value � a
LAND
IMP. TOTAL
DATE
REMARKS
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a
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I
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FRONTAGE ON WATER
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FRONTAGE ON ROAD
House Plot
DEPTH
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BULKHEAD
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