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43220-Z
{�"* TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 1,k A 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#: 43220 Date: 11/14/2018 Permission is hereby granted to: Home Rescue Solutions Inc 51 E Bethpage Rd Plainview, NY 11803 To: demolish existing building and accessory barn as applied for. At premises located at: 49295 Route 25, Southold SCTM #473889 Sec/Block/Lot# 70.-7-1 Pursuant to application dated 11/7/2018 and approved by the Building Inspector. To expire on 5/15/2020. Fees: DEMOLITION $215.20 DEMOLITION $423.40 Total: $638.60 Building Inspector TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST !" BUILDING DEPARTMENT Do you have or need the following,before applying? t TOWN HALL Board of Health SOUTHOLD,NY 11971 4 sets of Building Plans TEL:(631)765-1802 Planning Board approval FAX: 631 765-9502 n f Surve Southoldt wnny.gov PERMIT NO. D( v 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 20 Mail to: Disapproved a/c Phone: ' Expiration 12E ,( 1 76 Cf j .Z Z D ( 0VIE B ctor DPLICATION FOR BUILDING PERMIT N O V - 7 2018 Date ,20 INSTRUCTIONS EM DIN To a "177� ?ZSTe completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets o Cale.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. X,.x &,Uf C4 gnature of applicant name,if a corporation) 1Fa%X 3Y3 CiatT ALO (Mailing address of applicant) State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder GEN f At, ' C O 07-f4ACTOft- Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporatioignDa my a thorized officer (Name and title of orate 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: 4/9a r6 ^4/Day RD• /?outer sS SaurHettZ House Number Street Hamlet County Tax Map No. 1000 Section 70 Block ©7 Lot 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 X Other Work 0 Ff O a i&P"AN o ,MQ (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 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 PJU47A. &qM+€�r q�itt Fit 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor 2661—IDAL„Y Address�CPhone No. �r" _•_ g-1 5 A 0�A)q 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 R�FQUIRED. 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 ) UNG" being duly swom,deposes and says that l�' 'Fs�'1Elew York (Name of individual signing contract)above named, Notary rublic, No.OIBU6185050 (S)He is the Qualified in Suffolk County 0� (Contractor,Agent,Corporate Officer,etc.) Commission 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. Wfc re me thi day of X20 Notary Public ignature 9f Applicant PSEG Long Island I uldinu l Rvn• atian ti•rti'tc•s �({���/�c�'1��//''1��1 I.Q`�r 'a7['IV ISLAND tYr srtk'eAieryn naitk,(nrYme. T RIC DEMOLITION REQUEST DATE: Please disconnect the following electric facilities for demolition purposes at the following address: 4ga9S /3&Jte gr C) v/d 1 Electric Meter numCIL4ber(s)and/or A ount number(s): t:L 1 Requested turn off date i n- { «'Ilii.date is when}nur un inn will Ix:turnad off twd liiad hilt ge"emted.'« ! Please forward the final bill to: Address: �t� , S�Ue sv�vyL� D-zL� Please forward the demolition letter to: Address: J-O�/ �) 10Lo a-vj E-Mail:=1D G- Id.aIh I e!) Q11 /, n e-net- 1 Daytime phone number_ 0 P — 76 S— /oq a Print Name: Sign Name: r- Evan T.Steffens Nationalgrid Senior Supervisor Gas Customer Connections,NY October 12, 2018 Home Rescue Solutions, LTD C/o Dawn Polewac 51 East Bethpage Road Plainview, NY 11803 E-mail: DPOLEWACO&ROSICKI.COM ;JOELDALYUjWDPTONLINE.NET National Grid WO#T102127759 49295 Main Road, Southold,NY 11971 To Whom It May Concern: This letter is to advise you that the natural gas service line to the above location was physically disconnected in 1938 under W/O#CPR531939. Please advise your contractor that care should be taken not to damage or remove the existing gas valve curb box. This curb box can be used in the future by National Grid to reconnect the gas service line to this property. New York State law requires anyone planning underground excavation work to notify local utilities by making one call to a toll-free number to get your underground lines identified for you prior to doing any digging. This phone call needs to be made at least 2,but not more than 10 working days in advance of starting work, not including the day the call was made. The number to call is either the nationally sponsored"811",or the local number for NYC 1 LI area, 1-800- 2724480.This confirmation letter of a gas cut-off does not relieve the excavator of making this "811"call. If you have any further questions, kindly contact me at 631-348-6150. Respectfully, Evan T. Steffens Senior Supervisor Gas Customer Connections NY 1650 Islip Ave,Brentwood NY 11717 T:631-348-6150 evaa.steffensianatigtiAlgddsm n 'dimer lirudprocessingi'anationalgrid.com 11/05/2018 JOEL DALY Service To: PO BOX 343 MAIN RD SOUTHOLD,NY 11958 SOUTHOLD,NY 11958 Customer Project#: 900000081471 Dear JOEL DALY: This is to advise you that the PSEG-LI electric facilities at the above referenced location have been disconnected and removed off the building structure that is located on the property. Please note that there may still be PSEG LI facilities located within the property boundaries and that NYS law(NYCRR Part 753)requires all contractors to call for a utility locate (NY 811)prior to performing any ground excavation or regrade activity. The call to the 811 Call Center must be done at least 2 business days prior to the start of the work and confirmation of utility marks having been identified must be received from all the facility owners prior to any site work. You must also contact National Grid at 631-348-6150 to procure a letter of demolition associated with natural gas service,whether or not your home or business uses natural gas. If you have any questions regarding the above,please contact Building&Renovation Services at 1-844-341-6378 or via email at BRSLI@PSEG.com. Very truly yours, Carolyn Mackin—Manager Building&Renovation Services PSEG-LI t C-� APPR VED AS NOTED DATE: B.P.# 3 2-2P FEE: BY: NOTIFY BUILDING DEPART AT 765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR Co. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODE AS REQUIRED AND CONDITIONS & �Otlfi�16L��� ��IICJ1�Otf,���1��C.gQ�C S%FFH�II,LI STEES N RETAIN STORM WATER RU`,"J-'-r PURSUANT TO CHAPTER 236 OF THE TOWN CODE. t4 11 ZI 2�- 8L 0. pr. s I!0fD L: j LA pw,.. V '01 UK lt`e :aif FOR j 0 IV p-id m V -bits6W-by Pf 7 AT- P- L �'S.o.d-oippt. and ad* -OWN- op.•- -W�ftai-ft.:by-.n.No*y. ita L;.Pd SUFFOL.K , C0.0 N.T..Y. N.Y.. ropo 7q 701 i" S�ALE LANDS 030" 35 JUNE 5 [986 5. 34 N.Y..S.. L1 C. NO: 49668 SIS i.23. 23. -E L-EVATj I 6Ns ARE RIEFEk'ENP.Eb OFZ j4 G4 TO AN ASSUMED DATUM. QRS a ENGINEE.Ry; P.C *:K. 46 9., -k a�iClliTMQ I-4Q �fj 9.7.1. 86, -'304 f Sprint 2:37 PM 9 44% ■ Done 2 of 3 17 ...J +•gyp/� Jit Mt �;�. L�3aa o --,� ���4 ��:, a _ �. �� •. �" � _ g � �.., F � �A �_ ..� ti p y '^. � i .. y .>. ..w..�� - � ._ �� n x �� YWryy ��A �yKd� �.tT � �. may.. � "_ar�.R,a9+XF- - � �II� �_11ff T �Fv` �: ... � CCS" � �. ` .'�` _ �. _ ._ ��. °fes ��.� :� .:�� � � ��., � �� .. .. � .. k n. �� �:� .� "t°" .. � .�� °"� � .� r ��. �..,. �� - � !" .•,� �� � h • . � • � � i f` s ;k s If two F • • Sprint 2:37 PM 9 44% ► Done 3 of 3 Nr e�•l f. .Y 1' 1 r 9 , �t ry 1 R ue F .= r a OL CIA BUILDING PERMIT iSStrkUTp �UATE Ant HESS ig295 /-4 Tt r oUr crr.t,l.ry.>rl dunnq r r7,trrlc.tipn ;trr. rCtur .. ts�uirinnl [)�y,t. to get a e'rtrfrc rte of t 'rel work J fi lit It r. pl r lur\ t,run. rr n,. w � r �kr',