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Home My WebLink About34867-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34867 Z Date JULY 14 , 2009 Permission is hereby granted to: BRIAN FRAWLEY 41 E MAPLE RD GREENLAWN,NY 11740 for DEMOLITION OF FOUNDATION, & REMOVAL OF DWELLING AS APPLIED FOR at premises located at 4545 HALLOCK LA MATTITUCK County Tax Map No. 473889 Section 112 Block 0001 Lot No. 002 pursuant to application dated JULY 8, 2009 and approved by the Building Inspector to expire on JANUARY 14, 2011 . Fee $ 341 . 20 Authorized Signature ORIGINAL Rev. 5/8/02 da y Town of Southold N o g Erosion, Sedimentation & Storm-Water Run-off ASSESSMENT FORM col PROPERTY LOCATION: S.C.T.M.#: THE FOLLOWING ACTIONS MAY REQUIRE THE SUBMISSION OF A I00.0 l22 Q l ()/L STORM-WATER,GRADING,DRAINAGE AND EROSION CONTROL PLAN District Section Block Lot CERTIFIED BY A DESIGN PROFESSIONAL IN THE STATE OF NEW YORK. ———————————————————————————————————————————————————— Item Number: (NOTE: A Check Mark(4)for each Question is Required for a Complete Application) Yes No. ---------------------------------------------------- Will this Project Retain All Storm-Water Run-Off Generated by a Two(2")Inch Rainfall on Site? ✓ F] (This item will include all run-off created by site clearing and/or construction activities as well as all Site Improvements and the permanent creation of impervious surfaces.) 2 Does the Site Plan and/or Survey Show All Proposed Drainage Structures Indicating Size&Location? This Item shall include all Proposed Grade Changes and Slopes Controlling Surface WaterFlow! 3 Will this.Project Require any Land Filling,Grading or Excavation where there is a change to the Natural ❑ ✓ Existing Grade Involving more than 200 Cubic Yards of Material within any Parcel? — 4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of ® ✓ Five Thousand(5,000)Square Feet of Ground Surface? — 5 Is there a Natural Water Course Running through the Site? El -Y Is this Project within the Trustees jurisdiction or within One Hundred(100')feet of a Wetland or Beach? v 6 Will there be Site preparation on Existing Grade Slopes which Exceed Fifteen(15)feet of Vertical Rise to One Hundred(100')of Horizontal Distance? [:] S/ 7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off ® V into and/or in the direction of a Town right-of-way? — Will this Project Require the Placement of Material,Removal of Vegetation and/or the Construction of El I any Item Within the Town Right-of-Way or Road Shoulder Area? (This item will NOT include the Installation of Driveway Aprons.) 9 Wi1I this Project Require Site Preparation within the One Hundred(100)Year Floodplain of any Watercourse? ® %V NOTE: If Any Answer to Questions One through Nine is Answered with a Check Mark in the Box, a Storm-Water,Grading, Drainage&Erosion Control Plan is Required and Must be Submitted for Review Prior to Issuance of Any Building Permit! ———————————————————————————————————————————————————— EXEMPTION: Yes No Does this project meet the minimum standards for classification as an Agricultural Project? Note: If You Answered Yes to this Question,a Storm-Water,Grading,Drainage&Erosion Control Plan is NOT Required! ———————————————————————————————————————————————————— STATE OF NEW YORK, C.,O�UNTY OF"5. .L......................SS That I,...�!� ' (�:�...V�'�� e................... being duly ssv(�rn,deposes and says that he/she is the applicant for Pertnit, (Name of individual signing Document) \ And that lie/she is the .....�a9! n1J.......................................................................:...................... (Owner.Contractor,Agent,Corporate Officer,etc.) Owner and/or represenLitive of the Owner of Owner's, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements cmitained in this application are true to the best of lus knowledge and belief;and that the work will be performed in die manner set forth to the applicafion tiled herewith. Sworn to before nie d1ii !...�..... day of... �` .......................... .2009 Notary Public . Notary Public-State of.New Yon.. ( ignature of Applicant) FORM - 06/07 Qualified In Suffolk County My Commission Expires June 15.20LD TOWN OF SOUTHOLD 0�-t , BUILDING PERMIT APPLICATION CHECKLR BUILDING DEPARTMENT jJ 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 www:northfork.net/Southold/ PERMIT NO. Check ° Septic Form 20 0 / N.Y.S.D.E.C. Examined p Trustees Contact: Approved 20 67 IIAAII Mail to: VVhTtc-T Disapproved a/c 41 f2."Lr, ROs= Phone:_ (PSI) 15 i— 5 5 519 Expiration 20 2 � nn � Building Inspector D lS 1J J U L — 8 2009 APPLICATION FOR BUILDING PERMIT Date 20 BLDG.DEPT. INSTRUCTIONS TOWN OF SOUTHOLD tuls ionMON 11 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 ail 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) C-fQZ-0t4LVk0rJ. N`i. (Mailing address of applicant) State whether applicant is owner, lessee, agen architect, e gineer, general contractor, electrician, plumber or builder Name of owner of premises :�R►ATr vi (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer , (Name and title of corporate officer) rl Builders License No. 0-Wt-A �n Plumbers License No. Electricians License No. it Other Trade's License No. It 1. Location of land on which proposed work will be done: House Number Street x.:f•.�..ro.r.•,;.,�„�.y ,hamlet TT1V4V jj a++ i 4': .i A�t.t�'� Tax Map No. 1000 Section "x v County T 3 Lot Q2 Subdivision fFilei;lVIap 1\10 ,.s e Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 81tj4L1., fjwy,tl_n VW LU..1n." b. Intended use and occupancy. Nature of work(check which applicable):New Building Addition Alteration Repair Removal � Demolipion Other Work I (Description) Estimated Cost Fee (To be paid on filing this application) If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensions o iexisting structures, if any: Front q9�� Rear �9 �� Depth 3� Height 2..4 AN Number of Stories 2 1 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories d i Dimensions of entire new construction: Front Rear I i Depth Height Number of Stories Size of lot: Front ��1 Rear `15t Depth 0. Date of Purchase,l/1tsC� `i Name of Former Owner IRofb�� 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation? YES X NO 3. Will lot be re-graded? YES NO X Will excess fill be removed from premises?YES x NO t'b0S l''L"n,AOFC.24 4.Names of Owner of premises IbrZ►Aor1 FTAsW12Vj Address %,X , N.Y. t0001b Phone No 011)596-(0853 Name of Architect Address %' `RrLfau►vuK_�t,�«-t-iRhone No Name of Contractor YSARAaVR C40 iT&MG�lpr1 Address l?o e> a 934 Phone No.(i Sls IS+-51111 c�1-cutorou�,1 N.Y. 11935 5 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES X NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. (Ares.ovt ) b. Is this property within 300 feet of a tidal wetland? * YES_X NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. CLeWm Hof Nora-3u A%'-V%VAVr4 A-r_VAA=>) 6. Provide survey, to scale,with accurate foundation plan and distances to property lines. 7. If elevation at any point on property is at 10 feet or below,must provide topographical data on survey. STATE OF NEW YORK) SS: ;OUNTY OF S )j \ Fg�� W being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named,. S)He is the A olg ' Ag.Url'lT�-T � (Contractor,Agent, orporate Officer, etc.) )f said owner or owners,and is duly authorized to perform or have performed the said work and to make and file this application; hat all statements contained in this application are true to the best of his knowledge and belief; and that the work will be ierformed in the manner set forth in the application filed therewith. ;worn to before me this S_:�: day of _�J\LA 200 Notary Public Signature o pp i AtSA L.NTT Notary PJc,01 W t state6008601 York Qualified in Suffolk County My commission Expires June 15. 20 _ i it•:/? r =r :. ;(flyd;r" SOJOPYU - FOR YOUR R TIEENE r-{'I �:+ ! ''V'i LONG ISIA (LIBER 11719 PAGE289) NORMATION r; ne ,'me ok SURVEY OF PRaP1L Situate at MAP HW1. viaAPProx_Hi�Water Lin MATTI TUCKe _ __— , Town of Southold Suffolk County, N .Y. °9 b S.C.T.M. # 1000- 1 12-01 -02 '" Scale 1 = 50 w March 6, 2007 GRAPHIC SCALE 50 0 25 • 50 300 200 o L� ( IN FEET ) ac _ 1 inch = 50 ft. ' m .9 TOP UFO" -J 6.11 _ �J r Pt°n�eF COOUm h`i '� \d M0 ON r Moo x o AREA = 5I,977 5. . to Long Island Sound Tie Line .� z NE OR I. 19 ACRES s- be" . _ •� ovethon9 `F` 3� (tome \b5 e\e Z Z:a I del". eoo umeot d u. Po\e W Q t°n Ch ory Syste oo\v CP — ,t -,UJ � r_„C� t6 N Per ipes \cel r i `\ ' w a.. �3�?J E Certified- to: - ��°S°� ; I I .� ` d : =_ C' .� BRIAN T. FRAWLEY -:: STEWART TITLE INSURANCE COMPANY E. h> (10 THE EXISTENCE OF RIGHTS OF WAY \ \\ ;r a `� r-;4.• °' "y AND OR/EASEMENTS OF RECORD IF ANY, NOT SHOWN ARE NOTrj GUARANTEED. a \\ P _ ca z. c0 O Note: ALL SUBSURFACE STRUCTURES; t ' V3zE v5 WATER SUPPLY, SANITARY_SYSTEMS, O �, 7` o C? DRAINAGE, DRYWELLS AND UTILITIES, G� �\ i\ U - o U SHOWN ARE FROM FIELD OBSERVATIONS \ We\\ `� AND OR DATA OBTAINED FROM OTHERS. O \\` \\`\ ILL UNAUTHORIZED ALTERATION OR ADDITION \ \`\ = , TO THIS SURVEY IS A VIOLATION OF \\ SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. \ \ COPIES OF THIS SURVEY MAP NOT BEARING \ \\ THE. LAND SURVEYOR'S INKED SEAL OR `\ \ EMBOSSED SEAL SHALL NOT BE CONSIDERED \ `\TO BE A VALID TRUE COPY. Health Department Approval Stamp Area \a\ GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY \ o\ IS PREPARED, AND ON HIS BEHALF TO THE �� `\1\ TITLE COMPANY, GOVERNMENTAL AGENCY AND ' \%\ °1`\`", LENDING INSTITUTION LISTED HEREON, AND N' x \ \ Po\e TO THE ASSIGNEES OF THE LENDING INSTI— TUTION. GUARANTEES ARE NOT TRANSFERABLE. \ \ o 'A I R DRAWN BY-• M CAD FILE DA7E•06—13-07 LO - �— \ CHECKED BY: IN DRAWNC NO: 071390-07 SOB NO.: 390-07 SHEET OF LAND SURVEYING i SUBDIVISIONS TITLE & MORTGAGE SURVEYS 6 �d\\vowo1.5fj p%\ o� TOPOGRAPHIC SURVEYS LAND PLANNERS SITE PLANS '� a�m �BpNISIONm{U�\CKD1p9 \`. 426.85' 2 JOHN MINTO, L.S. SDfN� %t LICENSED PROFESSIONAL LAND SURVEYOR PHONE: (631) 724-4832 fV) 'SOUND AVENUE NEW YORK STATE LIC. NO. 49866 FAX: (631) 724-5455 93 SMITHTOWN BOULEVARD SMITHTOWN, N.Y. 11787