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Home My WebLink About43402-Z o�sUfEoc�°oTOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 43402 Date: 1/18/2019 Permission is hereby granted to: Petersen, Joseph 85 Silver Colt Rd Cutchogue, NY 11935 To: Demolish an existing swimming pool and deck (fill pool and remove surrounding deck). At premises located at: 85 Silver Colt Rd., Cutchogue SCTM # 473889 Sec/Block/Lot# 95.-4-18.1 Pursuant to application dated 1/11/2019 and approved by the Building Inspector. To expire on 7/19/2020. Fees: DEMOLITION $272.80 Total: $272.80 may. Bui ing Insp ter- 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. �LFtOl, Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,205 Single&Separate 19 CC A- D Truss Identification Form Q 2019 Storm-Water Assessment Form l JA�1 Contact: Approved h, ,20 '� Mail to: p c _57 S I -42'r�LT/�� Disapproved a/c hOf �7.5 ' 47/l/ Phone. &3 I` 3/ 3O Expiration 20(/y uilding Inspector APPLICATION FOR BUILDING PERMIT Date / - ��- , 20_�T. 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 re s, and to admit authorized inspectors on premises and to building for necessary inspections. 'v ( ig ture of applicant name,if a corporation) �� -. ,a- _ ,e•IA4tVl X10111 Y RUII_l�C`+( Iry(�'� _titan ��/ i /CMaili d of app c ) Yom—!'�-(� ati X02i0'T, g engineer, , State w1ter!p��1, anta o„�unery lessee-a enol architect en ineer general contractor, electrician plumber or builder j ,,0 .� �n,nr,l'IC��1 rOR Fuji"-)D ^/ Name of owner2o �rerriises�c`c, °� � Ha 611e b44f 3. 1NJ!11_I� 10�� ._��,J�i,0�' mul; (As on the tax roll or latest deed) If applicant 's a goVofiitinm,`signature of duly author,Ced officer c G,J!PLt_ 1,p1L:-I � PIE °':L'. r ctn� (Name and_titf6 o'cb'rl`porate officer)" i" EOR 1j Builders License U- Plumbers License`No. 7'°;;�, rni�ST�1UC%l Or :-A v Electricians Licens6'l�lo. Other Trade's License No. 1. Location of land on icl}pr p os ed work wi e djr '� V House Number Street Hamlet County Tax Map No. 1000 Section �� Block Lot / ' Subdivision Dr o D c eu.) P i16d Map No. Lot 2. State existing use and occupancy of premises ar ded usl and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy P-0 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work I I I til o®�a� ✓� uJ� ri n�C 4. Estimated Cost SODO • (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 6./' NO Will excess fill be removed from premises?YES`�NOc� 0. ZJ- 14.Names of Owner of premises �-P�1 Address 9'.5-.51 t%t/-Q,►r' hone No. 3I -377 I63Q 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 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) S: COUNTY O M( e Pr n being duly sworn, deposes and says that(s)he is the applicant Name of individual signing contract) above named, (S)He is the 0 woc V-- (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 tl day of 20—ft flww EY L. DWY otary P161 i c NOTARY PUBLIC,STATE OF NEW YOR4 nature of Alicant NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2-0,--1d-- 3, —�— � N DoT W- ? 39 pp.• Q %b' < 440 i f tjtih a M10 Sp R o � Y 25 00' pr �s L=39 27 p c cT I— \ / •�� ,� e. r,CC,tI _ 5 �- CID D P s,�J � ,i��• anti 1,�:SPO D`�� , �� ./(„� l�O�Os � �VTB' ��t yD��N t � � � C('J !�• J L/�IT � / r SURVEY FOR SUFFOLK COUNTY DEPARTMENT OF HEALTH ]EN VICE: JOSEPtf PETERSON AUG 7,1985 f'1 L07 I,-OREGON VIEW ESTATES� MAY 9,.985 FOR APPROVAL OF CONSTRUCTION ONLY AT CUTCHOGUE DATE JAN 7,1985 ' TOWN OF SOUTHOLD SCALE, 1'•T50' DATE HS REF,go SUFFOLK COUNTY,NEW YORK NO 04-1275 1 MUM UTWOR12tD ALTERATIONORAODtimN TO THIS' GUARANTEED -OF TVEy,� APPROVEDSUNVEV 0 A VIOLATION d StcTIOM 7200 OF THE METR A GU NTY CO. NCW TDR ST1TL LDUCATION LAW M COPICL d TIMI"WIT 001 WANING TNI LAND SOUTH O S �,pI09N,3 }* � wNvtWIN'1 NICD SEAL ONtNRO1TEO un SMALL JOSEPH T 8 YOG NOT ME CONSIO[RSD TO SE A VALI D TRul co- RwwnMCA AR [S OITEO WMCM S L NOM CHILI 19 BERN HEALTH DEPARTMENT-DATA FOR APPROMAL TD CONSTRUCT TtP30k FOR WHOM THE SURVEY 11 PREPARED p AMC d M[ O 0 TO TK TITLE COMP.GOVERN- R RIAME1T WATEN 11410-161•M]ODRc[OF WATER PIHV%Tt 1-FURIC_ A[NraL AOEIICT AM LANCING M1T)TO TION LISTED lk�•, M IVF CQ T1G1 Wa►[HT gL1KtT1011041 DIDCN s'L LOT ybL 11oISn,AND TO THE ASSHIMUS OF THE L[NOING :1 ■rapt aK A bOtLLMS WITHIN100 FEST OF TNS FROP[AtT MSTITVTIOM GUARART[d ARE NOT TAAMSFERAOLE OTHER THAN THOSE$HOWN N[MION M ADDITIONAL IMSTITUTICK OR SUOSEWCHY 1D 45 OWHEMS M flit WAYm SUHLT AID EEMRK DISPOSAL STSTt1 RSI THIS no-D[MCt WRL CzaL TO TN[STAINMAOS OF TN[SIWFOLII COIMTT OLPARTNtNT *01 C2911TIN6TANCESIDIIM IBES A FROM A SPICFI UM[S L d H[KTN SMICES TO POSE 1 &a[Mot T ARI SE •snQFm OSS lmsol "LH:A.T PURPOSE AMC ARt MOT TO E USED TD o T Epocl FMDFERTt uN[s n FOM THE[Rfcrin d F[H[t■ aDn[Sf TEL YOUNG al YOUNG 4" pNY0R E RNEEw NOTES A-STAKE ALDEN W YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR N YS UCENSE NO.12845 HOWARD W YOUNG. LAND SURVEYOR HMl.OGT171d s�LM,S[P1u tANM(srlAKnwOLRfo)sIONr NIRLON MY LICENSE NO 45893 ARC FMON FMMD OOO[RMTIOMS AID OR OA7A OOTANRO►PION OTN[RS SAANOIS a SONS MC.1046 I