HomeMy WebLinkAbout41867-Z sv of 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)
Permit#: 41867 Date: 8/8/2017
Permission is hereby granted to:
Latin America Center Inc
14 Crestwood Rd
Port Washington, NY 11050
To: demolish fire-damaged dwelling as applied for.
At premises located at:
2820 Stanley Rd, Mattituck
SCTM # 473889
Sec/Block/Lot# 106.-8-58
Pursuant to application dated 8/2/2017 and approved by the Building Inspector.
To expire on 2/7/2019.
Fees:
DEMOLITION $100.00
Total: $100.00
Bui rd� g Ins e
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 ny.gov PERMIT NO. f Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined '20 Single&Separate
Truss Identification Form
Storm-Water Assessment Form
Contact:
Approved ,20T� Mail to:
Disapproved a/c
Phone: (0- C.)IfPP
Expiration '20 17
D [EVE Si or
D
AUG ® 2 2017 APPLICATION FOR BUILDING PERMIT
BUILDING DEFT. Date LcS , 20L7—
TOWN
0 l 7TOWN OF SOUTHOLD
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.
(Signature of applicant or name,if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises VIf mac,
(As on the tax roll or latest ed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate gfice,-) ,,r
;.
Builders License No.
Plumbers License No. r
Electricians License No.
Other Trade's License No.
I. Location of land on which proposed work will be done:
House Number Street Hamlet
County Tax Map No. 1000 Section (�(p� :lock Lot �8
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed const ction:
a. Existing use and occupancy p cS���1 Air-Cle-A ( C)L&� :X-re)- rC d ✓Yta J�
b. Intended use and occupancy
3. Nature of work(check which applicable): New Building Z Addition Alteration
Repair Removal 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
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 .Rea.r_ __,
Depth Height Number of Sto"ie t s ''�,`j `? i ,T► `•�
1
8. Dimensions of entire new construction: Front Rear 41`"i Depth ? r
Height Number of Stories
9
9. Size of lot: Front Rear Depth
e�i.�+..:iao
1.�'bw i,�4
10. Date of Purchase Name of Former Owner y
11. Zone or use district in which premises are situated
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 Address Phone No.
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 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 )
hsooery being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signi contract)#ve named,
CONN19 0.BUNCH
(S)He is the Natow Public,State Of Now York
(Contractor,Agent, Corporate Officer, etc.) No.OISUB1
mialiii n Fxo In rimes Apro 2Q�
of said owner or owners, and is duly authorized to perform or have pei r�e�IWe 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.
S�ygrn to efore me this
G Y16f day of 20
e_le�N� L%k�a' �
Notary Public Signature f Appl'cant
'
KEY
Symbol Des-ptw R=1,020' N 68.11'20" E , PROPERTY
�� OF
_65--Existing Contours(C.1=2') L=178.02' 190'± r—--'r�"—
1 372 JEPJCHO CORP.Proposcd Coalours(C 1=I') N 78'11'20" E. 200' 5�5 17 —•�-(j
R=215',L=328.34' r IIID ON THE
2 N/F / PROPOSED SANITARY SYSTEM 1,500 GAL. SEPTIC ro°j SEP 1 7 2130T ;La SUBDIVISION MAP OF
\ \ 372 JERIHO TANK (8' DIA. x 5' LIQUID DEPTH) WITH H I j t^._.•--•=---s FIELDS ALOMA�TITUCK
Oo CORK DOME AND (2) 8' DIA. x 8' DEEP LNG f _��
03 m Lot('V POOLS (LOC. OF FUTU SHOWN) P.0•B• ~I` FILED:MARCH 31,2006 AS MAP NO 11370
\ \ L G \
(Vacant) — _200.02 1 V
° 1 —4SITUATE AT
0" %/N 83.21',21'1 proposed 69 18.7• LP Ln
�8 a MATTITUCK
Roof Line\ ST p �,� TOWN OF SOUTHOLD
\ \ t ?O _ �F\ o 1 SUFFOLK COUNTY,NEW YORK
SEYMNOER 14.2007
I PROPOSEDLID
\ RESIDENCE
\ FFE: 71.5' I ` O �^ \ /oV AREA OF PARCEL = 35,095± SO.FT. OR 0.806± ACRE
r 'NOTES
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`/ 1 MEASUREMENTSAREINACCORDANCEWmI US STANDARDS
a
Co.
O ,2' pROQOSEO V O 0 O 2 BEARINGS SHOWNARE ARE REFERENCED TO FINAL PLAT OF-rHE FIELDS AT
78
\ p0 1 Existing CP te< ` MMATTITILIC AP ND 71370LLEDMARCH3I,ROOSINTHESUFFOICCOUNTYCLERKSOFFICEAS
m \ ' J Bldg, , Seal a `j •p✓ l�yr�� 3. UNAUTHORIZED ALTERATON ORADDmON TOA SURVEYMAP BEAWNGA
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y O 4 ONLY COPIES FROM THE ORIGINAL OF THIS SURVEYMARKED WITHANORIGINAL
OF BE VAU TUE COPIE'S'EMBOSSED'OR'INKED•BEAL SHALL RECONSIDERED
Cp TO BE VADD TRUE COP/ES
rD
P S,\ �'GOragePREPARED
1 , G� CERTIFICATIONS CCORDIMITH7HEEXISHEREONTINBC/GNIFY ODEOFPRACTITHAT IS SURVEY CEFORLANDASURVEYORS
G Q ` t 1 n ADOPTED BYTHE NEWYORK STATEASSOCIATION OFPROFESSIONAL LAND
75,6 6 1 SURVEYORS SAID CERTIFICATIONS SHALL RUN ONLY TO THE PERSON FOR
1 WHOM THE SURVEYIS PREPAREDAND ONH1S BEHALF TO THE TIRECOMPANY,
43,4' GOVERNMENTALAGENCYANDLENDINGINSRTURONDSTEDHEREONANDTO
THEASSIGNEESOFTHELENDINGINSTITUTION.CERTIFICATIONSARENOT
TRANSFERABLE TO ADDITIONAL MSTIrUTIONS OR SUBSEOUENTOWNERS
ProposedPROPOSED
^ S. RIGHTS-0OFSHOWN ARENDTCERTIF/ED
m ° Roof Line DTIV
\
Plan Notes: T. THE SURVEYCLOSES MATHEMATICALLY
o ���-' m — /_ ti� N/F 1. Existing con urs from Final Road&Drainage Plan as prepared by Young&Young Land
AP
372 JERICHO CORP Surveyors of my 30,2004 and surveyed January 28,1992(Datum:NGVD 1929 USC&GS).
f� •T D Lot #5 2•Proposed Residence as per Model C-Arebitectural Drawings by Axelrod&
L/ (Vacant) ChervenyArchitects,A.I.A.,P�(7ctober 2006.
a
M. \ m �' 3.Proposed Sanitary System is designed for a total of 6 Bedrooms,
DATE: OP 1 = _
SUFFOLK EAL
P V •+ 66 S Of NEW y NEPROPERTYTAXMAP
° FEE: T R T / t� °RDISTRICT 1000
a' yA,O• Q U LKERS '1- SECTION 113 00
DATE idY DS6CAD'TIDN APPBOV.eY
NOTIFY UILrDINf�GDEI�ART ENT o °� BLOCK 020G REVISIONS
r ; m t,- Lor osB o00
765-1802 AM 16 T 111�111111111111�l I'll I Fields at MattTtuck
i , I Su ,I&County,Now York
FOLLOW�IFNG IN ffrTION�; N Zv� e 0 IherBb Certify thatthismapwasmadefrom LOT #4 (Parce1#50)
6 Gn No 04950 Bn ctu y MixW:�Pl dbymeo09/14/2007 R"ildin Residence
1. FMIDA N POST CONSTRUCTION FOUIMMON SURVEY
k A - TVvO RE PD 'S5 I "S�o LAPo 9
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3. INSULATION ,•;,P
4. FINAL
- COP, TION• MUST NEW ye AS REQUIRED AND CONDITIONS OF OCCUPANCY OR
BE COMPL;�i� F_);�t
ALL CONSTRLO T ION SHALL MEET THE USE IS UNLAWFUL
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR SMTNR �Rl ARD WITHOUT CERTIFICATE
DESIGN OR CONSTRUCTION ERRORS. SOUTHOLD TOWN TRU TEES
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