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Home My WebLink About28234-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. 28234 Z Date APRIL 2 , 2002 Permission is hereby granted to: REALTY LP MULLEN PO BOX 1408 SOUTHOLD,NY 11971 for DEMOLITION OF TWO ACCESSORY BUILDINGS (300 SQUARE FEET AND 216 SQUARE FEET, RESPECTIVELY) AS APPLIED FOR at premises located at 40 COTTAGE PL SOUTHOLD County Tax Map No. 473889 Section 062 Block 0003 Lot No. 011 pursuant to application dated APRIL 2, 2002 and approved by the Building Inspector. Fee $ 67 .40 a/2 1 Authorized Signature ORIGINAL Rev. 2/19/98 f T. TOWN O_SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Z Contact: Approved y 20Mail to: Disapproved a/c Phone: Expiration ,20 1 y Building Inspector `;?; APPLICATION FOR BUILDING PERMIT APRDate 20_0� 2 2002 ' e i s INSTRUCTIONS Vil a.This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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. (Signature o applicant or name,if a corporation) /yieil � l�►� f� �•�n(� Ali lf�Ti (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder C)Zyl X Name of owner of premises (As on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name Id title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Filed NjNo r_ Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy -'T–O R -G 1�5 Sit 4�S b. Intended use and occupancy ;L2 .pr(. 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost 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 6. If business, commercial or mixed occupancy; specify nature and extent of each type of use. S�raQ a 7. Dimensions of existing structures,�it-any: Front ff z0j& Rear epth /,,i( A�, � Height Number of Stories �� •��0' 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 NO ✓ Will excess fill be removed from premises? YES NO J 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 BEREQUIRED. 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. STATE OF NEW YORK) SS: COUNTY OF being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 kmowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this day of 1I— 20Q�2 NotaryPublic Signature of Applicant SUSAN M.JACOBS NOTARY PUIBoLIC,S2037 t NIWYO'k aualifled in Sk un 2 Commission Expires /Qpm R o. N. 86 A/ U � - N v � �D p Q O b �a u nr. 75"' /7'E. /42. 67-9 p%P� �• b "C7' l�1AP OF PROPER T Y . SURV.EYEO F'O� CAROLINE L . XOR N 7 T UATE .-q 7" SOUTHOLlO s v. moo[ K Co., N,Y' �lcrn�s ory 9j /946 L icc�scd ��-Ycyor APPROVED AS NOTED DATE• `� "?'Z B.P.#�g2�� (7/Scor�rl�cT �u cZ2c T�z�c �.er o/L z FEE:�0- �(o BY' NOTIFY BUILDING DEPARTMENT AT 765.1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS A0 on - a -3 - TOWN . OF SOUTHOLD PROPERTY RECORD CAR® OWNER STREET ,' ' VILLAGE DIST. SUB. LOT FORMER OWNER N ,-� E ,� `''f ACR., -, W _--TYPE OF BUILDING SEAS. VL. FARMCO,, CB MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS C� 3 o e? - 197 NEW NORMAL BELOW ABOVE FARM Acre Value Per Value f Acre Fillable 1 Fillable 2 "illable 3 Voodlond wompl.and FRONTAGE ON WATER ;rushland FRONTAGE ON ROAD louse Plot DEPTH BULKHEAD 'otal DOCK r COLOR TRIM J I 1 1-171$1-79 1 1 1 1 1 1- 1 1 M. Bid Foundation Bath Dinette Extension Basement Floors K. Extension Ext. Walls Interior Finish a LR. Extension Fire Place Heat DR. Type Roof Rooms lst Floor BR. Porch Recreation Roorr Rooms 2nd Floor FIN. B. Porch Dormer Breezeway Driveway Garage Patio O. B. Total FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southotd, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28234 Z Date APRIL 2, 2002 Permission is hereby granted to: REALTY LP MULLEN PO BOX 1408 SOUTHOLD,NY 11971 for : DEMOLITION OF TWO ACCESSORY BUILDINGS (300 SQUARE FEET AND 216 SQUARE FEET, RESPECTIVELY) AS APPLIED FOR at premises located at 40 COTTAGE PL SOUTHOLD County Tax Map No. 473889 Section 062 Block 0003 Lot No. 011 pursuant to application dated APRIL 2, 2002 and approved by the Building Inspector. Fee $ 67.40 Authorized Signature ORIGINAL Rev. 2/19/98 TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 PERMIT NO. Expiration ,20 __ H Examined ~/g~. ,20 ~- Approved ,20 ~,~ Mail to: Disapproved aJc Phone: Building Inspector BUILDiNG PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: APPLICATION FOR BUILDING PERMIT : "! 7, ] } Date ~ta->? ~2. ,20 O;~ i ]'-~__-D INSTRUCTIONS ' [___~-),' ,. a. This application MUST be completely ftlled in by typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plm~ 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. Thc 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. /~O/~J Ad~t'~r~' (gig~,~ture ~appfi~a~t or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general con~'actor, electrician, plumber or builder Name of owner of premises ]~_, ~J/~_~ ~'z~ t~,~ ~ ]~l,ji~,r .Jr (As on the tax loll or latest deed) If applicant is a corporation, signature of duly authorized officer (Narn~and iit~e df corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Subdivision (Name) Section 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: x a. Existing use and occupaney ~-¢-0£4~(~ ~'F~E~5- b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition ~ Other Work Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy; specify nature and extent of each type of use. 7. Dimensions of existing structures, ~n~y: Front /lj'~o~,g~. Rear Height. Number of Stories Dimensions of same structure with alterations or additions: Front Depth Rear Height Number of Stories, 8. Dimensions of entire new conslruction: Front Height Number of Stories Rear Depth 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__ NO ~,~ Will excess fill be removed from premises? YES __ NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES__ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE'ILEQUIRED. b. Is this property within 300 feet ora tidal wetland? * YES__ NO __ * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO 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. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual siLming contract) above named, (S)He is the (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 this I M~q~ day of ~4[/~9 ~ (/._. 2~O~q J Notary Publicff/ SusAN M. JACOB..S,, ~ No. k ~uafifled in SuffOI ~ - n signamr'~o~XlJlJli~an7 ~ -