Loading...
HomeMy WebLinkAbout11304-z FORM NO. ~ TOWN OF $~UTHO~I. TOWN HALL SOUTHOLD, N~ Y. BUILDING ,PERMIT! (THIS PERMIT MUST BE KEPT ON THE PRE/~IS~S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ' N? 113~)4 Z Permission is hereby granted to: ...©~z..-.~..~.~.....Z~.,., ~z.~;~_ .... ....... ,o .....c~. ~ ~.rz~. ~ r..... ~.~......~.....~: ~r~..... ZZ~.~.. ~.~.. ~ .......... .......... ~z.~.~ ~.....~~/~ .................... ?., ...... ,~......~ ............. :: .......................... . Coun~ Tox Mop ~o. 1000 S*ctio~ .... ~..~: ...... Block ~.~. .......... Cot ~o ...... ~ ....... pursuant to ~pplicotion d~ted ....... ~.~ ......... ~.,...~....~......, 19.~, ~nd *pprovod by the Building Inspector. Fee $../.~..~.~ ..... FIE~D I~SPECTION '~. FOUNDATIOk~ (lot) COMMENTS FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY q,ODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ · d~....5~v/..,~x..~x:..~.~ ............ .~ ~.~ ~ ~.~. . ~..~ .... PLE~S~ T~ XOTI~ t~ ~o~ ~li~tio~ O~t~O .... ~. · · ~ ........... ~ ~.. for pe~it to construct..~.~4~ .............................. Location of Property ~? Z© ~~ /~ ~~;C~ ~ h;~ ~o~ ........... ~ ..... ~t .~t t County Tax Map No. 1000 Section ...~Z ..... Block .. ~ ....... ~t ...~ ...... Subdivision ..... ~ ....... Filed Map No ......... ~ ....... Lot No .................. is returned herewith and disapproved on the follow~g grounds Building Inspector P.O. BOX 728 SOUTHOLD, NY 11971 FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT ( 16) 76 -180a T0~ HALL MAIN ROAD SOUTHOLD, NY APPLICATION FOR DEV__$_L. OPMENT .PERMIT Instructions: The application to the Building Inspector includes (each in duplicate) 1. For~u No. l0 filled out in ink or typewritten, 2. Sur- vey of premises with elevations above meau sea level, 3. Drawings of pro- posed work. The application must give complete information to show that the proposed can comply to the Local Law No. 1-1980, Chapter 46 of the Code of the Town of Southold known as "Flood Damage Prevention Law" of the Town of Southold. The applicant must submit approvals that any other agency requires. General Standards as required in Section 46-17 of the law to minimize flood damage: A. B. C. D. Anchoring of structures, including tanks and mobile homes Use of construction material and methods Design and location of utilities Subdivision proposal with drainage, public utilities design and base flood elevations Specific Standards as required in Section 46-18: ' A". Residential construction B. Non-residential construction C. Mobile homes The applicant must submit plans sub ~peaifications as well as any other information requested by the Building Inspector to substantiate the facts that the structure has or will have the lowest floor, including basement/ cellar, elevated above the base flood elevation or; if permitted by the Federal Regulation, that: 1. such structure is flood proofed in such manner that below the base flood level the structure Ks water tight with walls substantially and impermeable to the passage of water, 2. that structural components are capable to resisting hydrostatic and hydrodynamic loads and effects of buoyancy, 3. applicant must sub~it certification by a registered professional engineer or architect that the standards set forth in Section 46-18B (1) (2) (3) of the Southold Code are satisfied. Coastal Hish Hazza~d area (V Zone) 46-19. Applicant shall submit plans, specifications including-the required certifications and such other in- formation as the Building Inspector may require in that ~he provisions of 46-19 are complied with. Mobile homes are prohibited. The lowest portion of the structural members of the lowest floor cannot be lower than the base flood elevation with all space below open except breakaway walls. Sand dunes. If sand dunes exist on the premises and the apDlicant pro- poses to alter same, plans and specification must be shown in detailed nature of any alteration submitted. ~uildtn8 Permit. A Building Permit is also required for any structure. Both a Development and a B~lld~no Permm~ must be issued before any work can start in a special flood hazzard zone. A written disapproval or a permit must be issued within ten (lC) working days. During construction, the inspector shall be notified in time so he may make the required inspections. Upon completion, the required certification fo the final elevations and work must be submitted before t~e approval to use or occupy can be approved. 4/80 (Fill out the form on the back of this sheet) Application Received FORM NO. 10 APPLICATION FOR DEVELOPMENT PERMIT In the Town of Southold 1. Type of Development Proposed: Addition and/or Alterabion[] Other (specify) . .-~. 2. Elevation Data in relation to above mean sea levJl of: (a) Lowest floor elevation, including basement _ . feet (b) In a V Zone, bottom of lowest structural member New Structure (in61uding storage- tanks~ Flood Proof Below ,Base Flood Ele,vation[~ inches feet inches FIRM--Flood Insurance Rate Map, Zone designations Location of Property: County Tax Map No., Distr~ct, 1000, Section O?__~ Block ...... Lot(s) Sulsdivision , Filed Map ~/ __ Lot(s). Permission to be ~a_nted: -~_]0wner as above~Ne~ Owner Approval from other(s) before Pezm~ib is issued: DEC ...... WETLANDS (Town Board) HEALTH SERVICE ZBA BUILDING PERMIT PLANNING BOARD 0wner. iq, Con.t,,aotl , Lesse !--I, Asentl l, Con-. traetor~-% and agree to comply with all applicable sections of the (;ode of Bbs Town of Sou~hold; County, and State s-nd to' admiB authorized in- specters to premises authorized to perform or ha~e. performed the said work eJad to make and file thisapplication,' ' that fall statements contain-' ed in this application are true to the best of my knowledge and belief and that bhe work w~ll be performed in the manne~set forth in the application filed therewith. STATE OF NE14 YORK ' y-hz SWORN TO THIS applicant,s mailing address ~d phone if not given above: 4/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 TEL.: 765-1802 Examined,.7o, g¢.. Approved '~I:' D~sapproved~/c ~m~.~~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~../.~.'~.(.'~..~. .... Date >..~JN¢..[ ......... 29 g/ INSTRUCTIONS a. This application must be completely filled ~in by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildiugs on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl: cation. 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 pern 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 whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describr Tim applicant agrees to comply with all applicable laws, ordinances?building code, housing code, and regulations, mid admit authorized inspectors on premises aud in buildiogs for necessary inspe~- - (Signature o~ applicant, or name, if a corporation) , n..:..z~ ,~i .<~--'.~.~.....~ .~..q ,. ~. k. cx~.u...~.f?.'.x, p (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil& Otoe¢ .e,, X~e of owner of premi~es ©R~t-e> -~' id v;'V¥<.m~.-X.., r.o~.:.¢ ......................... ................ Ot~ ............. +. ..... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly anthorized officer. (Name and title of corporate officer) Builder's License No. , ·: ...................... Plumber's License No..{7. ~ .... {5~1 .~. ....... Electrician's License No...: ................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. · :3.$7.~.. k~,~...¢.,/.5. .... .q,,..o.~.>?. ......... ~...o:C.~?...t:.:D.. ru.~ ....................... House Number_~. M0rer,- SrO~ 3)1 Street llamlet .~..--.-- '~. County Tax Map No. 1000 Section ..... .O.??. ........ Block .... .C? .'¢7'. ..........Lot ................ Subdivision ..................................... Filed Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... 3 .Cc..t4. ...... l ............................... b. Intended use and occupancy ......................................... 3. Nature of work (check which applicable): New Building ...... Addition .... Repair .............. Removal .............. Demolition ~ 0 o 000 ~ ..... Fcc ......... ...... Alteration .......... Other Work ............... (Description) $. Estimated Cost ................. ./ .......... .(to be ?aid on filing this appl~i~a, ttion) 3. If dwelling, number of dwelling units...(~1~, ·.. Number of dwelling uniys on each floor...~a~.,... If garage, number of cars ............................................ i ............................ L If business, commercial or mixed occupancy, specify nature mid extent of each tyP/e of use ............ ct P~ ....... ?. Dimensions of existing structures, if any: Front...'.~ ~. ........ Rear . .Q~.~...: ....... Depth .~ .)e' ........ Height ............... Num. ber of Stories ................... ,~ ........ ............. '~ 2 ............ Dimensions of s~ne structure with alterations or additions: Front .~.). ~ ....... ; ..... Rear..~4. ' ............. Depth .... ~. .............. Height ...................... Number of Stories ............. _ ........ 3. Dimensions of entire new construction: Front ............... Rear ....... ~ ....... Depth ............... Height ............... Number of Stories ........................... ; ............................ 3. Size of lot: Front ...................... Rear ...................... ~ Depth ...................... ). Date of Purchase ............................. Name of Former Owner i ............................ 1. Zone or use district in which premises are situated ........................ , ............................ L Does proposed construction violate any zoning law, ordinance or regulation: ... ~ ............................ 3. Will lot be regraded ............... · .............. Will excess fill be removed from premises: Yes N~ Name of Architect ~.,~C~ff.£ .~5.0 .~.qT~lf[.~ ......... Address~h~V.g.P. 7)0~570 ]F..C.~. Phone No ................ Nmne of Contractor .~. ........................ Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. iCdicate all set-back dimensions from :operty lines. Give street and block number or description according to deed, and show street name~ and indicate whether ~terior or corner lot. TATE OF NEW/Y~DRK, ~ ,~ ,~ ou~v~OF ~._,~.~ ..~.,~,rd7.. ~'~ ~ ...~;ff~~~ .......... being duly sworu, deposes and says that he is the appl)cant (Name of individual signing contract) hove named. is the ......................... ~ .................................................... (Contractor, agent, corporate officer, et~.) said owner or owners, ~d is duly authorized to perform or have performed the; said work and to m~e and file this pplication; that all statements contained ~ this application are true to the best of his ~owledge and belief; ~d that the ,ork will be performed in the m~ner set forth in the application filed therewith. worn to before me this ~ ~' ........... ....... ..... ....... , ..... .................. ~O~V. tus~:~t'~ ~0~ ,V~ ~ ' i (Signature of applicant) ,Y 'OCCU AflCY OR IS JflLAWFUL FEE:~ BY: ~ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1, FOUNDATION - TWO REQUIRED FOR pouRED CONCRET~ELu~BING .................................... ~2~, ROUGH , FJ~MING & P 3. INSULATION · 4 FINAL - CONSTRUCTION ,MUST ...................................... : .............. ~Ec0~'PLETE FOR-C~ O. ' ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ~ L~.~,/j~'~'~ Cj'~TE CONSTRUCTION & ENERGY -- ~:OuES. NOT RESPONSIBLE FOR DF~IGN OR CONSTRUCTION ERRORS. Unauthorized aJferatioh ,~ this documenJ- violation o~ sccHon 7209 the New Yo!'[: .~ale Educa~ NYS PE~ 42a17 Un'authodzed, alferatlon or