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HomeMy WebLinkAbout40123-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT y. Me TOWN CLERK'S OFFICE o . 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#: 40123 Date: 9/28/2015 Permission is hereby granted to: R17 Corp 578 Seaman Ave Baldwin, NY 11510 To: make interior demolitions to an existing single family dwelling. A building permit will be required prior to commencing any other work. At premises located at: 1285 Marratooka Ln SCTM #473889 Sec/Block/Lot# 115.-4-33.3 Pursuant to application dated 1/1/1900 and approved by the Building Inspector. To expire on 3/29/2017. Fees: DEMOLITION $100.00 Total: $100.00 7tz 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 r Survey SoutholdTown.NorthFork.net PERMIT NO. ©I Check Septic Fonn N.Y.S.D.E C Trustees C.0 Application Flood Permit Examined A 20 Single&Separate Storm-Water Assessment Form I, Contact: �'}} r Approved 20 Mail to:—Y Disapproved a/c t � �� &Ime si�/CGLY« Phone: Expiration 20 v� �L ? Building Inspector APPLICATION FOR BUILDING PERMIT f Date 4 ,20 I Cj 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 sr e in described.The applicant agrees to comply with all applicable laws,ordinances,building code,housing code,and egula ons,and to admit authorized inspectors on premises and in building for necessary inspections. of apph ant or name,if a corporation) ID C( ei(/myx ,V %l^ euT (Mailing address of applicant) LL State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises Ar1f0 (D %�vB ewa (As on the tax roll or latest deed) If applicant is a corporation signature of duly authorized officer �GL(1PiG�G',4�1i26� (Name and title of corp r to officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. • _ p 1. Lti$oof land on whic pro osed work will be doneG ��(%l��-til �y House'�1umb�a�' Street 1�,� � Hamlet s ,Coimty,Tax.lVlapNo. 1000 Section Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and iWeij.ded up and occupancy of proposed construction: a. Existing use and occupancy �R esL b. Intended use and occupancy 3. Nature of woreck which applicable) New Building Addition Alteration Repair Q�,, Removal Demolition Other Work LID /t (Description) 4. Estimated Cost OP5000• Q0 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 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 zesning law,ordinance or regulation?YES_NO 13.Will lot be re-graded?YES NO I AA Will xces fill be removed from premises?YES NO Ell-14.Names of Owner of premises Address Phone No. (f 6 4-7 Z(46 Name of Architect Address Phone No Name of Contractor CL( pw Address I LVq Phone No. 6)$25 BB5'V Rehr/(�3mwcvk) A/1 c. R C3GkiLQ.w a'B A—ve— vice v<-(-I 2j, 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 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) SS: COUNTY OF K joaP46L J wqq_a being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (Contractor,Age t,Corporate Officer,etc.) of said owner or owners,and u iorized 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. TRACEY L. DWYER Sworn tqq.�before me this NOTARY PUBLIC,STATE OF NEW YORK )4tn day of ( 2015 NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY Uj Notary Public Signature of Applicant IRES JUNE 30,2-0)g •..............................................se............................................. M. A14RINIWSTORATIONINC 1089 ROCKAWAY AVENUE VALLEY STREAM, NEW YORK 11581 (516) 825-8850 • Fax: (516)825.8852 Website: marifirestoration.com NYC'Department of Consumer Affairs H.I.C. LICENSE # 2001879-DCA September 28, 2015 RE: ITEMIZED ESTIMATED COST FOR DEMOLITION 1285 Marratooka Lane Mattituck, NY 11952 Contents removal and manipulation Removal of insulation Removal of sheetrock TOTAL AMOUNT: $5,000.00 1