The URL can be used to link to this page

Home My WebLink About43206-Z 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#: 43206 Date: 11/8/2018 Permission is hereby granted to: JMJ Mattituck Prop Inc c/o Jeannette M Judge PO BOX 1533 Mattituck, NY 11952 To: demolish an exisiting accessory garage as applied for At premises located at: 12125 Route 25, Mattituck SCTM # 473889 Sec/Block/Lot# 141.-4-36 Pursuant to application dated 10/30/2018 and approved by the Building Inspector. To expire on 5/9/2020. Fees: DEMOLITION $301.00 Total: $301.00 1011ding Inspect r. TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631)765-1802 Planning Board approval FAX:(631)765-9502 Survey Southoldtownny.gov PERMIT NO. Check Septic Form MY S.D E.0 Trustees C.O Application Flood Permit Examined 1 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: {� �1 Approved 20 "nspxt�� Mail to\\ C) %c x k\S'33 Disapproved a/c1 r tc,Yh� y%�CC_�tu -/ 1(,Q'5\z-^ R 72 Phone: a OCT 3 2018 APPLICATION FOR BUILDING PERMIT Date 20$ BUMDING DEPT. jC� as INSTRUCTIONS TOWN OF SOUTHOLD 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,hou ' ane d regula' and to admit authorized inspectors on premises and in building for necessary inspectio ignature of applicant or name,if a corporation) 11g5� (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises [JIY\-T Cic)-TP-Q,v,0� vv-1 (As on the tax r II or latest deed) If applicant is a corporation,signature of. uulY uthorized officer J O (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 whichropose work wi �� N`f 119 S2 House Number Street IHamlet County Tax Map No. 1000 Section_ J 9 _t_Block C y Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premise intended use and occupancy of proposed construction: a. Existing use and occupancy C 2 Rid O�r 'a2— b. Intended use and occupancy 3. Nature of work(check which applicable).New Building 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 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 —7 S mo-1.47N 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/<:214.Names of Owner of premisesnn Address 1701-A IS37.61 4404 Yhode 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 NOx * 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 ) CONNIE D.BUNCH being duly swom,deposes and say 4 0q'6i1be 81111ligaal New York (Name of individual signing contract)above named, NO.01 BU6185050 Qualified in Suffolk County (S)He is the ^�fnntissian Expires AOril 14,2MD (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. Swo before me t 3 day of U 20/ Notary Public gnature of Applicant N SURVEY OF PROPERTY AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, N.Y. 1000-141-04-36 SCALE. 1'=30 AUGUST 2,2018 SOUND AVENUE °F xl as.resr,° MATMIJCK PRESBYTER N/O/f Z a� �.E CHURCH OMS HOLDING CORP aY.viceoe. pF (� sEcae. eY 164.43• oss $ o ° saau-50 E N/0 F ]a•y an.Wu MAC IHSH la ASPHALT y°p4 0 0..•s a 113.77- cw; lw� A° OT9 0.]IL o red /^°r• ^ e/o 4..o. (yT una w� N79-j,. my 1.41 AY NW, g ].e � KEY N/o/F ea•s —e7.03• Q —REBAR CORTESE xa's zea `hp (rj �Q KELL • -STAKE . b —TEST NO(f • -PIPE ■ -MONUMENT -NETLAND FUG `Q,-URLITY PONE -HYDRANT —X—x- -il— aR. ESEVADONS REFERENCED TO HAM 88 / ANY ALERAnON OR ADDITION ro MS SURI£Y IS A WO AnON OF SECTION 72OWF NO. 49618 THE NEW YORK STATE MUCA170M UW.EXCEPT AS PER WCIlON 7109—AMWSON PECONIC SURWYOR$ P.C. 2 ALL CERMCAnQVS HEnECN ARE VALO FOR DYS MAP AND COWES THEREOF AREA= 13,517 S0. FT. (631)765-5020 FAX(6J1)765-1797 ONLY F SA ro MAP OR COPIES BEAR THE IMPRESSED SEAL OF 7HE SURWYBN MHOsE P.O. BOX 909 SIGNATURE APPEARS HEREON. oUTH �r STREET 18-140