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HomeMy WebLinkAbout28049-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. 28049 Z Date JANUARY 29, 2002 Permission is hereby granted to: FRANCOIS A LEBOURHIS PO BOX 228 EAST MARION,NY 11939 for DEMOLITION OF AN EXISTING DECK, APPROVED BY EXPIRED PERMIT. NUMBER 26431-Z at premises located at 4200 ROCKY POINT RD EAST MARION County Tax Map No. 473889 Section 021 Block 0003 Lot No. 032 .pursuant to application dated JANUARY 28, 2002 and approved by the Building Inspector. a Fee $ 35 . 00 ori ed Signature COPY Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING PERMIT APPLiUATION CHECKL: BUILDING DEPARTMENT Do you have or need the following;before apply TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Binding Plans TEL. 765-1802 .< 6 l Survey PERNIIT NO.29 7 Check Septic Form ' N.Y.S.DX.C. Trustees Exammed Z 20 0�' Contact:. Approved 120 Mail to: • Disapproved a/c A,) '0Z Building Inspector C A-t C, APPLICATION FOR BUILDING PERMIT ' /Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with sets of plans, accurate-plot plan to scale.Fee according to schedule, b, plot plan showing location of lat and of buildings on promises,relationship.to adjoining premises or public streets c 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'is=aBuilding Permit to the applicant. Such a perm: 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 a Certificate of Occupa is issued by the Buiding Inspector. APPLICATION IS H EBY MADE to the Building Departmmt for the issuance of a Building Permit pursuant to the- Building heBuilding Zone Ordinance of the Town of Southold,Suffolk County,New York, and other applicable Laws, Ordinances or Regulations, for the construction of bindings,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,an4 regulations, and to admit authorized inspeetors,on premises and in building for necessmyinspections. (Signature of applioantor name,if a corporation) (Mailing address of applicant) State whether applicant is.owner,less •wen�cbitect, engineer,general cQnUvctor, electrician,plumber or•builder 11KName of owner of premisesi2aNC©i� - �� %�,e�c�/z /1 S (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, Location of�land on which poled work will be done: /CaC'��i� 0�3 House Number Street Hamlet County Tax Map No: 1000 Section a 1 Block Subdivision Fred Map No. Lot, 2: State existing use 20occupancy of pret>ais d intended e and occapancy of proposed construction: a. Existing use and occupancy b. Intended_use and occupancy �(e_ Ck _woo 3. Natnre of work..(check which applicable):NewBullel;nq Addition Alteration Repair Removal olition Other Work -(Description) 4. Estimated Cost �; -Dom ee (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 strictures,if any:Front . Rear Depth Height Number of Storied Dimensions of same structure with alterations or additions: Front• Rear Depth Height Number of Stories 8. Dimensions of entire new construction:Front RearDepth 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 constriction violate any zoning law,ordinance or regulation: 13. Will lot be re-graded -- Will excess 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. Is this property within 100 feet of a tidal wetland? *YES �NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS B IFQUMED 16. Provide survey, to scale,#with accurate foundation plan and distances to.property lines. • 4 (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. COUNTY OF } Cel being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contrast)above named, (SAIe is the `�- (Contractor,Agent, Corporate Officer,etc.)' of said owner or owners,and is duly authorized to perform or have p'af-onned the said work and to make and file this application; that all statements contained itt this application are true to the best of his lmowledge and belief,•and that the work will be performed in the#manner'set forth in the application filed therewith, Sworn to-b4ore me this 2:eL-day of20� 7'. Notary Public Signature of Applicant' HELENE D.HORNE Notary Public,State of New York No:4951364• Qualified in Suffolk Coupt� Commission Expires luny 22,' oCG O { f i TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. ' SUB. LOT p-Be)11 N" oc —A FORMER OW ER N E Q � -SC ACR. . ' + � (/ Gar) z .r 0 1 S W TYPE OF BUILDING RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS / (J s4 j Al AQ So 51(©© zee Yrs Elie - :� w-tte Gx � fis W? - /7/6 (omal a9�/ i' i W?-7- Lnyr J Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD Meadow[and DEPTH f � House Plot BULKHEAD Total COLOR ( ''�� TRIM , i .,.......amu. ,f • _ I l M. Bldg. 3 �, 0 Extension Extension Extension Foundation ' ` ��^ � 1. Smith ;' Dinette Floors t K. Basement t ti J t Porch Ext. Walls Interior Finish Breezeway Fire Place Heatt r DR. Garage �.. �' ., - Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total �Q USE IS URAVSEUL 7 ; WITHOUT CERTIEIC TE �. d OCCUPANCY J2� A R ED AS NOTED DATE: ��B.P.# O NO FY BUILDING DEP_ ARTMENT AT 765.1802 9 AM TO 4 PM FOR THE FOLLOWING`INSPECTIONS: - . 1. FO9.�NDATION'--.TWO REQUIRED FOR POURED COWRETE - BO 17 _ .. _... 2. ROUGH ._FRAMING-$c PLUMBING ., 3. INSULATION- 4—FINAL CONSTRUCTION MUST 0 _ _ d_ BE CO;MPLE'fE FOR C.O. ALL CONSTRUCTION .SHALL MEET THE REQUIREMENTS OF THE WX ` STATE-CONSTRUCTION,-.& ENERGY 0 �ES..--NO RESPO B &F ------------ vi _ R • i �q is t ' i - + Acv �, -------- _ _.: ..___. , 7121 ------------- U ter,,,.• _ / FORM NO. 3 TOWN OF SOUTnOLD BUIL.DXNG DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PS KEPT N �RUNTZL' FULL MLNFTHE WORYALTIZE]) PERMIT NO. 26431 Z Date APRIL4 2000, permission is hereby granted to: GREGORY LECRANN PO BOX 82 EAST MARION NY 11939 for DECK ADD1TION TO EXISTING SINGLE FAMILY DUELLING at premises located at • 4200 ROCKY POINT RD EAST MARION County Tax Map No. 473889 Section 021 � Block 0003 .Lot No. 032 _ pursuant to application dated APRIL- 3 2000 and approved"by the Building Inspector. Fee $ 75.00 Authorize ignatu�re COPY Rev. 2/19/98 7.IOfj V4 STV _ Yv-q .$Z=50 ZO/0I/10 '- Ed WdST:20 E00E SE -UL-f- OESZSbb8ZL "ON 3NOHd WOdj 1 I TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREETS VILLAGE DIST. " SUB. LOT FORMER OWNER , N� E 4ti\AtA(� -,fit ACR. S W� TYPE OF BUILDING A- �,e PO RES. SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS f XW oda t � :. �. s"A? � ,` h o ",g V -- 2-1 ..t-...e��Y' � -�-�l w�� �: .it � F�. s r�� Rr,� �c.���^� •�1A +�-i��� f 4/-7-7- /7/(, d1ock hai,411 �ev N�jc GO( Z-Occ�\, 1. Tillable 1 � FRONTAGE ON WATER Woodland Or FRONTAGE ON ROAD / y jd t e) (� Meadow[and DEPTH House Plot BULKHEAD Total COLOR l �.� ,: TRIM L4 a T gs f d ' 0��}•.+ate"" ''%�- Q�' c� �- Y . is r r i M. Bldg. , I Extension Extension Extension Foundation ���c,G ^-,•f' �� t' Bath ' ;° Dinette P•eFloors ehy � _ , , �— ,- Basement r rs ( K f £' ' F Ext. Walls ! � ""'' `` Interior Finish 1 . Porch - ,.�., Breezeway Fire Place Heat DR. r. ,. Garage y�. �\f Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B O. B. Dormer Driveway Total vr� y 8 Z .� �acxas•', �ff�-eta