HomeMy WebLinkAbout44609-Z ods 2Z TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y 2 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#: 44609 Date: 1/22/2020
Permission is hereby granted to:
Block, Carla
C/O Burner Law Group P.C.
12 Research Way
East"Setauket, NY 11773
To: demolish existing accessory garage as applied for.
At premises located at:
2875 Hyatt Rd, Southold
SCTM # 473889
Sec/Block/Lot# 54.-1-12
Pursuant to application dated 12/20/2019 and approved by the Building Inspector.
To expire on 7/23/2021.
Fees:
DEMOLITION $464.50
Total: $464.50
B ing
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
Southoldtovvnny.gov -PERMIT NO. Check
•Septic Form ,
N.Y.S.D.E:C.
Trustees
C.O.Application
6 Flood Permit '
Examined 2( Single&Separate
I
Truss Identification Form
Storm-Water Assessment Form
Contact:
Appi oved ,20'?Z Mail to:
Disapproved a/c
Phone:
Expiration Q 20 O "
~ ,' Building Inspector
DEC 2 0 2019 APPLICATION FOR BUILDING PERMIT
A .: , '� Date Peevh b�,- 023 , 20 �q
t A' , INSTRUCTIONS �. —�—
a. This application MUST be completely filled in by typewriter or in ink and submitted to th'eBuilding'Inspector with 4
sets of plans, accurate plot plan to scale:Fee according to schedule. - -
b. Plot plan shbwing location of lot and of buildings on premises,.relationsh'ip to adjoining premises"or public streets of
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 aBuilding Permit to the applicant. Such a permit
shall be kept on the premises available for.inspection throughout the vvor'k.,,-
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 regulation's 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 sha11 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.
L46 k4 15-0 a)6�kLYL
(Signature f applicad or na a if a corporation)
QtGgSL1Ia- _ 23s 4,,dersa 11 R u 41,C -m-7 1
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder
Name of owner of premises. 1 . o►naIjeeh v��ou
(As on the td roll,or lateV 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.
OtherTrade's'License No.
1. Location of land on which pro 0 e work will be done: `
2-8''Is H� ct 4 o ad so'k fid;o d 119r7't
House Number treet Hamlet
County Tax Map No.' 1000 Section Bldcic Lot �Z
!
Subdivision_ ' Filed Map,No. Lot _
1 •
2. State-existingluse and occupancy of-premises ani intended use and,occupancy of proposed construction:
—� a. Existing use and bccupancy' �.50u f j„14 Tocu-vn,. Cb�,dewned ,,,
`b.- Intend;ed use and occupancy
3. Nature of work(check which_applicable): New Building 4dd
ition Alteration
Repair Removal Demolition X Other Work
(Description)
4. Estimated Cost _ Fee
(To be paid on filing this application)
' 5. If dwelling,'ni' mber of dwelling units Number of dwelling units on each floor
If garage, number of cars 1 i
i+
6. If business, commercial or mixed occupancy, sp cify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front Rear Depth
Height Number of Sto ies ;
•
Dimensions of same structure with alterations or additions: Front Fear
Depth Height Number of Stories
8. Dimensions of entire new, construction: Front Rear n•De*T �
'Height Number of S ones ;
13 1 9. Size of lot: Front Rear Depth
10.'Date of Purchase Name of, ormer Owner
' 11. Zone or use district in which premises are'situate
12. Does proposed'construction violate any zoning law, ordinance or regulation?YES,NO
13. Will lot be re-graded? YES NO Will ex 'ess fill be removed from premises?YES NO
14. Names of Owner of premises ' Address Phone 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 NO }
* IF YES, D.E.Q. PERMITS MAY BE RE,QUIREP,
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 r'below, must provide;topographical data on survey.
18.'Are there any covenants and restrictions with res ect to,this property? * YES NO_,
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF k )
!,
pt) ✓pct 1 A lr -Z>1 `AehbK.c` 2 being duly sworn,deposes and says that(s)he is the applicant
(Name of individual si ning con act) above named,
(S)He is the
(Contractor,Agent,Corporate Officer, etc.)
1
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 1herewith,
Sworn to before me this
day of 20_
Notary Publi T ACEY L. WYE Signature o Applicant
NOTARY PUBLIC,STA OF NEW YORK
NO.01 DW63 900
QUALIFIED IN SUFF LK COUNTY
I
BUT
SURVEY OF PRO ERTY
SI T UA TE
OF/yA SOUTHOLD
TOWN OF SOUTHOLD
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S.C. TAX No. 1000-54 01—12
SCALE 1"=30'
JUNE 19, 2019
AREA = 45,536 sq, ft
h° 1.045 cc.
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NOTIFY BUILDING CI,-
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765-1802 8 AM TO q PM 17 ENT AAT
FOLLOWING INSPECT IONS• OR THE
I. FOUNDATION - T4i -,�
PREPARED IN ACCORDANCE WITH THE MINIMUM FOR POURED CC',"
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STAHDAROS FOR TITLE SURVEYS AS ESTABLISHED 111 IL 2. ROUGH ^TETE
BY THE LIALS AND APPROVED AND ADOPTED , •� „,. ` ' - FRAfvil;"N�„ , r L MBING
FOR SUCH USE By THE NEW YORK STATE LANDTITL1 1
E ASSOCIATION. RETAIN STORM WATER RUNOFF 3, INSULATION
4, FINAL - CONSTPU;,TION
PURSUANT TO CHAPTER 236 UST
BE COMPLETE FOR C 0
OF THE TOWN CODE. l ALL CONSTRUCTI(,-N SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
NYS La No 50467 �t, �, YORK STATE. NOT RESP �j
O SIBLE FOR
U111111EI ALTERATION 11 Nathan Taft Corwin ��� TOTTHSSURR90FSTHENEWTIOORN�STATE 1`DITIONL; DESIGN R CONST TI
RRORS.
EDUCATION LAW.
Land Surveyor COPIES OF THIS SURVEY NAP NOT BEARING 11 1`\I
THE ENO SURVEYOR'S INKED REAL OR v YYY
EMBOSSED SEAL SHAH NOT BE CONSIDERED LL 1
TO BE A VAUD TRUE COPY
Successor To Stanley JIsaksen•Jr I.S. CERTIFICATIONS INDICATED HEREON SHALL RUN
Joseph A In a nD L S ONLY TO THE PERSON FOR WHOM THE SURVEY L 1 ,r�NYL
9 9 IS PREPARED,AND ON HIS BEHALF TO THE L L •<V1
TITLE COMPANY.GOVERNMENTAL AGENCY AND \ L
rifle Surveys —$UbdMslOns — Site Plans — Construction Layout LENDING INSTITUTION LISTED HEREON,AND 1
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PHONE (631)727-2090 Fax (631)727-1727 THIONE CERTIFICATTIONS ARE NOTIGNES OF THE 'TRANSFERABLE. L
OFFICES LOCATED AT MAILING ADDRESS L O
1566 Main Road P 0 Box 16 THE EXISTENCE OF RIGHTS OF WAY �±
Jomesporl. New York 11947 Jamesport, New York 11947 AND/OR EASEMENTS OF RECORD,IF FJ
ANY,NOT SHOWN ARE NOT GUARANTEED,