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Home My WebLink About43357-Z o�SUF of c,��o TOWN OF SOUTHOLD �� ay BUILDING DEPARTMENT CM z TOWN CLERK'S OFFICE o 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#: 43357 Date: 12/28/2018 Permission is hereby granted to: Gildersleeve, James PO BOX 514 Mattituck, NY 11952 To: demolish front porch roof as applied for. At premises located at: 715 Pike St, Mattituck SCTM # 473889 Sec/Block/Lot# 140.-2-22 Pursuant to application dated 12/28/2018 and approved by the Building Inspector. To expire on 6/28/2020. Fees: DEMOLITION $154.00 Total: $154.00 Building Inspector 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. q5,357 Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Y Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved U ,20 Mail to: Disapproved a/c Phone: Expiration ,20 APPLICATION FOR BUILDING PERMIT -' DEC 202018 Date �L Z , 20� INSTRUCTIONS E Thfs`,app cation MUS e 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. (Sign e of applicant or name,if a corporation) (Mailing addres of applicant) State whether applicant is owner ssee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner ofremises p (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 whiff proposed Aork will be done: House Number Street Hamlet County Tax Map No. 1000 Section 1'� Block 2— Lot ZZ 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 Other (Description) 4. Estimated Cost_ le�)o 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 ,--,re 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth Height Number of Stories r ; 8. Dimensions of entire new c : Front Rear Depth Height Number of Stories r" 9. Size of lot: Front 4S�2— Rear d Depth 2 . r� 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated_ Z�—Ze 12. Does proposed construction violate any zoning law, ordinance or regulation? YES N01� 13. Will lot be re-graded? YES NO1 excess fill be removed from premises?YES NO 14.Names of Owner ofpre/�/'e �fzvzzq—z✓ Address l '4' n No. Name of Architect Address Phone No/,'g 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. N�✓�— 18. Are there any covenants and restrictions with respect to this property? * YES NOy� * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF /) z�/ � �G� being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, CONNIE 0. BUNCH (S)He is the Notar/Public,State of New York Itte 0"B,K0 gr'nFn (Contractor,Agent,Corporate Officer,etc.) Qualified in Suffolk County Commission Expires April ��® 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 met 's � l day o C 6q 20_LL Notary Public Signature of Applicant WRVr=Y-OF PROPER SITUATE- MATrITUGK Tib?0 E TIOIL SUFFOLK couxTy,Ny 6M Q 06-.a-201 vi N %-RvLr:Cmtay T".i, 111 APP OVER AS NOTED DATE: g B.P.# 7 r FEE: BY: NOTIFY BUILDING DEPARTMENT A; '765-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: FOUNDATION - TWO REQUIRED 4 FOR POURED CONCRETE �`5, � �• '� R 2. OUt� y - FRAMING & PLUMBING 3. INSULkr4ON 4. FINAL.- G,ONSTRUCTION MUST '+ TBE C6MP§iTE FOR C 0. 1' CZANSYPU�.TION SHALL ME ET TH: REMENTS'C �F THE CODES OF NE TATE. ,NOIBLE F0 T RE Ct�SNST'RUCTIONS ERROR QL �YA ,4 r y"+Y pf� ,g:'":.^-rj.pai,.,+.,}. ..it ,-r•, ,.- _ , . COMPLY WITH ALL CODES OF RETAIN STORM WATER'RU FF NEW YORK STATE & TOWN CODES PURSUANT TO CHAPTER 21 i AS REQUIRED AND CONDITIONS OF OF THE TOWN CODE. SOUTHOLD TOWN ZBA SOUTHOLD TOWN PLANNING BOARD ., SOUTHOLD TOWN TRUSTEES w err.nim. N.Y.S.DEC - - � 1� �� f4�TyT.3. i. '}'fmo'r..Sl+FsmFp4�` �.— Y � 6a, rr 17.a 50 Pr CR 0.41 AC-RF5 JOMM C.E141EM LAND SURVEYOR � 16r; sU� aaY roc. r x EN1WNi L E 1`n rr MVEfUWAI%MY_r I9ol �, t �. � E is �.� _,. . 1 h} .` .n �" � , . �� ., ,. +E � •; .`� �� i 4 F 1 � � ;• '� t �.� J' � � ' '`�Y � �4 _� -�, �. _ nw,,,. �. � 'K � .t,