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Home My WebLink About42545-Z o�sU'�l�co TOWN OF SOUTHOLD aye BUILDING DEPARTMENT TOWN CLERK'S OFFICE �y • 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#: 42545 Date: 4/6/2018 Permission is hereby granted to: Lear, Samuel 420 E 64th St New York, NY 10021 To: demolish accessory building as applied for. At premises located at: 670 Cedar Birch Rd., Orient SCTM # 473889 Sec/Block/Lot# 15.-8-27 Pursuant to application dated 3/28/2018 and approved by the Building Inspector. To expire on 10/6/2019. Fees: DEMOLITION $224.50 Total: $224.50 Building or 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) 765-9502q2s-q Survey Southoldtownny.gov PERMIT NO. 6Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application i Flood Permit Examined ,20lD Single 16 Separate �•� E D Truss Identification Form MAR 2 8 2018 Storm-Water Assessment Form �y Contact: Approved ,20� Disapproved a/c TOWN OF S OLl) Phone:'E�1� 3p" o7b Expiration V ,20 M4!&pispector APPLICATION FOR BUILDING PERMIT n Date 20 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 'SWAI AEC LE/aR (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. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: (90 CEbl z 07_kU_WC House Number Street Hamlet County Tax Map No. 1000 Section Block Lot o2 7 Subdivision Filed Map No. Lot 2. State existing use and occupancy of premi es apd intended use and occupancy of proposed construction: a. Existing use and occupancy f� b. Intended use and occupancy WKOUT1 Oki 0� &CC 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4\en Cost v, Fee; (Tq`be paid on filing this application) 5 , number of dwelling units ; ' ' ; Number of dwelling units;on each floor , number of cars ;-_6 , mmercial or mixed occupancy, specify nature and extent of each type of use. 7s of ex' ting structures, if any: Front `w - Rear ' Depth Number of Stories " Dimensions of same str ture with alterations or additions: Front Rear Depth Height Num er of Stories 8. Dimensions of entire new construc ' n: Front Rea Depth Height Nu ber of Stories• 9. Size of lot: Front Rea Depth 10. Date of Purchase Name of ormer Own r 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, or ina e or regulation? YES NO 13. Will lot be re-graded? YES NO'>(,,,Will exce s fill be rem ed 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 tid wetland or a freshwater wetland? *Y NO * IF YES, SOUTHOLD TOWN TRUST S & D.E.C. PERMITS MAY BE REQU D. b. Is this property within 300 feet of idal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY B REQUIRED. 16. Provide survey, to scale, with curate foundation plan and distances to property lines. 17. If elevation at any point oo . property is at 10 feet or below,must provide topographical data on survey. 18. Are there any covens-'s and restrictions with respect to this property? * YES NO * IF YES, PROVIDE/A COPY. STATE OF NEW YORK) SS: COUNTY OFfA 5 + �ry)Lie Lee, being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the 0uDltieF, (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 NIGi 1^GV1 20-VD-6m - •, - • NOTARY PUBLIC,STATE OF NEW YORK 1�)Umjm Notar Publ NO.IN SUFF y QUALIFIED IN SUFFOLK COUNTY *nature of Applicant COMMISSION EXPIRES JUNE 30,29j_6 DOROSKI ELECTRIC, INC. ELECTRICAL CONTRACTOR LICENSE#2941-E P.O. BOX 781 ■ CUTCHOGUE, N.Y. 11935 41- 4 1 c9 734-7523 °.S GO iJh1 cG c vc,).er�cab-er�o I i D APR s 6 1 TOWN OF SOITTHOLD �L3,c A i ! A FINANCIAL CHARGE OF 1 1/2%PER MO(ANNUAL RATE 18%)WILL BE ADDED AFTER 30 DAYS � f 1 J rn SURVEY OF PROPERTY N AT ORIENT TOWN OF SO UTHOLD SUFFOLK COUNTY, N. Y. 1000-15-08-27 SCALE: 1'--30' 1 AUGUST 20, 2009 MARCH 10, 2010 �N a_ E E SEFWALD u� , N/0N10117CATMRIN150.00 N7 40 ` 6 t N m 3&e N g p� 24.1 AV4 z tog FO D IO ,+ SSrn 1 N C Cx zN 7.5 OR1� C� o x a GONa- cz in 6 Olo % 24.4' l Y a� '� �d f� DeCK Tf 2Z4' cti D o� 70 x v Y m c PV CL J v 14 ` a o_ z 150.00 it z PI'S X3 40sew x _ x _ 4 p cMr MICHAEL S. GREENLY NIOIF AP R VED AS NOTED D Tt B.P:1I o2S CO MPLY a FEE: BY: NEIN ®RK STATE &TH L CODES ®� NOT__ DEPAR TOIiV�I ®®�$ "AT AS REQUIRED AND CONDITIONS OF �0 7OLLO 2NAW TO 4PM, FOR THE FOLLOWING°JNSPECTIONS:' U�cd I. -FOUNDATION,'; 7w, REQIHRED FOR POUREp'CONCRETE � , r -9Q9RD 2. ROUGH.� FRAMING &_,P,LUMBING, 3. INSULATION,, 4. FINAL'-'CONSTRUCTION MUST N . BE COMPLETE FOR C.O. CERTIF/ED TO., ALL CONSTRU6TION SHALL MEET THE WELLS ARCOROBINSON REQUIREMENTS OF THE CODES OF NEW WELLS FORGO YORK STATE. NOT RESPONSIBLE FOR RETAIN STORM-WATER RUNOFF o��£wY 0 AREA-29,625 S! CONSTRUCTION ERRORS. PURSUANT TO CHAPTER 236 F THE TOVVN CODE, ■=MONUMENT •=PIPE f - 618 ANY ALTERA77ON OR ADDI77ON TO THIS SURVEY IS A WOLA7TON PECONIC SU /ya 16 OF SEC77ON 7209OIF 7HE NEW YORK STAID EDUCA77ON LAW. EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77F1CA77ONS (631) 765-5020 1797 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOr ONLY/F P.O. 80X 909 SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 1230 TRA YELER STREET*HOSE WHOSE S/GNA7URE APPEARS HEREON SOUTNOLD, N.Y. 11971 09--107