HomeMy WebLinkAbout13495-z FOU'M* NO. S
TOWN OF SOUTItOLD
BUILDING DEPARTMENT
TO~VN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 13~95 Z
Permission is hereby granted to: ~' ,,
...~..~.......~, ........ ..0...~......L~ ..............
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~...~.~.~.....~.:..~.:.....!.!..~.~..~.. . ~
,o..~..~~i..~.~ ........ ~.....~'""-'~" ...... ~ ........
~ ~ ~ ~ ~4, . ~ ..........
Coun~ Tox ~o,~ ~o. ,000 Seat,on .... /..~ ......... B,o~k ...... ..~.~ ........ Lot
pur~uon, to opplicotion doted ...~..~...~.. ........................ , 19.?...1~.., ond oppmved by the
Building Inspector.
Building Inspector
Rev. 6/30/80
N~W YORK STATE DEPARTMENT OF BNVIPDNF~NTAL CONSERVATION
Regplatory Affairs .Unit
Bldg. 40, SUNY-L.Room 2!9 ......
S~ony B. ronk,, h~ "'1~794
...................... '""(516) 751.7900
BLDG, DEPT.
TOWN OF SOUTHOLD
A review has bee~ ~,ue of your proposal to: , ' , .
New York Stat~ ~partmsnt of Em~n~ntai Conse~ation has found parcel ~ p~oJ~t to be;
Greater than 300~ from inve~tori~d tidal wetlands,
greater than 100 in leng¢~ c~strug1:ed pricr~o ~eptember 20, 19~7.
..... L~ward of 10' ~ur ~lmvatlon abov~ ~am sea leal o=. a .grg~l,
ural ~lop~ ~
~ezefore, un' permit un&ar 'Article 25 (Tidal WetLqudg. of the Enxd. romme=tal
Conservation Law) is req~red at ~iwtime s~ the euz~nt pr~os*al is b~yo~d
8tat~ ~ndat~d Jurisdiction pur~t to. th~s act. Howler, any addl~onal work
or ~difi~tiOnS to ~e.~roJect ~y r~q~re a pe~t~ /It is your res~ns~llty
to notify tl~-offi~ ~ ~iti~g, i~. much ~ditio~'.Wo~k of ~fi~ons are
co~~,
Lmnxtward of topographical crest of bluff, clif£ oz~ dune. im excess of 10
feet i~ elava~ioa above mean~sea, level.
~ YOR~ STATE DEPART~T OF ENV~PD~ C0~SEP~VAT~ON Regulatory A~aira ~it ~.~ .......
S tony ,.~ok,-'-~ -' 11794 ,
A revle~ has be~n made of your proposal to:
/7,
New York State Department of Em:~rcnm~.%%tal Conservation has fouz~d 'the
_ p~t~el _~. project ~o be:
Greater than 300' from inve~%toTied tidal wetlands.
Landward of ast, bs~J.a.t ~,-~aae S~--,I ...... ~. ~+~tm:r.%e~"'~O 19~'/.
_ ~ward of 10' ~tour elmvatiou a~,'e 'me~ sea le~l ~ a gr~l, nat-
ural slope.
' feet t~ ~vation ~ve ~. se~ level.
-*~fo~, no*'pe~t ~der Article Z5 (Tidal Wet]ands of the
~n~ation Law) is req~red at this time since the c%z~.t pr~,(::~:3], ts ~y~d
State ~dat~ ~ur!s~c~ion pursuant to this act. H~.;eg~r, ~ny a6Yl~cmal work
or ~difi~ttons to ~e project may req~re a pe~t. It is your res~ns~
to notify tldm-offt~, ~ ~ttmg, if. su~h ~ditlo~ work of ~dificn~°~ are
co~d.
Ve~ t~Y ~ura ~
~Dantel J. Z arkin
' / ' Regional Su~ Of
F~g~to ~' A f L~'s
FORM NO. 3
TOWN OF $OUTltOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
To P. '.~..~..~.~.
..¢~..-...~.~...,...~.~...~7.~..
PLEASE TAKE NOTICE that your application dated ~
for pemit to ~_~(W..~~..~(~(~. ~ ........ at
House No. Stroot Hamlet
County Tax Map No. 1000 Section . ,~ ....... Block . O.~ ....... ~t O.~.~.' ff. ~.~
Subdivision ................. Filed Map No ..... ' ............ Lot No .............. .~...
is returned herewith and disapproved on the following grounds..~'~t52.'.'~..5'~. ~.'~...
.~...~ ~ ~ ~ .~ ~... c ~...~ ~..~: ~ ~....~ ~...
~.~.. ~ ~.~.~c ~. z..~.~
av ~/80
FOUNDATION (1st)
COMMENTS
FOUNDATION (2nd)
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
qODE
FINAL
ADDITIONAL COMMENTS:
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPEC~FOR
P.O. BOX 728
TOWN HALL
$OUTIIOLD, N,¥, 1197!
TEL. 765d 802
This is to advise you that the job under building
permit no. 13495Z issued to Jack Newman
on 10/24/84 for A~cessory is completed and
a final inspection bas ( ) has not ~--~-been done.
An-Underwriters Certificate is needed
In order to complete this file, it is necessary that
a Certificate of Occupancy be issued. Please fill out the
enclosed form, return same to the above office with a check
for $10.00 payable to tile Town of Southold. Please indlcace
to Whom the Certificate of Occupancy is to be mailed, and
arrange with this office for an inspection date
Occupancy or nsc in unla~fnl without a Certificate of
Occupancy. Plenne help ,s to clear up this matter so ~bat
legal action does not have to be taken.
Thank you for yo.r prompt attencion.
Very trt, ly _y~,
Victor Lessard
Executive Administrator
VL:gar
encl .
NEW YORK STA~ DEPARTMENT OF EN~IP. ON~.~NTAL CONSERVATION
Regulatory Affairs Unit
Stony B~rook~- N~ '~i794
ML~, DEPT,
TOWN OF SOUTHOLD
A review has bAen'made of your proposal to:
New York State bepar~men~ of En~t~nmene~l Consezwatfon has ,.ound
Greater than .300~ from inventoried tidal wetlands o
greater than 100~ in lengtl~ const~-uct, ed prior,to Sep~emker 20~ 19~70-
Landward of 10~
ural slope.
contour elevation above mean sea leal o~ a gradual~ nat-
Landward of topographical nrest of bluff~ cli££ or duma i~ excess of 10
feet i~ elevation above mean~sea, level~
-'~e~fore, no"permit under ~Article 25 (Tidal Wetlands. of the
Conservation Law) is required at ~]~is' time since the current proposal is beycald _
State mandated ~urisdiction pursuallt to this act, However, any additio~al work
or modifications to the ~roJect may require a permft~ It is your responsibility
to notify thJ-~--office~ in ~fiting~ if. such additlo~ work of ~f~t~ons are
co~d,
'FORM NO. 1
.TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Approved .~....-~.....~...~ .... ', 19~..~. Permit No.]. .~..~.q..~."..~.
Received ........... ,19...
Disapproved a/c .....................................
(Building Inspector)
APPLIC~,TION FOR BUILDING PERMIT
INSTRUCTIONS
Date .................. , 19...
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 giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
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 issued a Building Permit to the applicant. Such permit
shall he 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 Occupancy
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 the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regnlations, 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.
.......... f....z4., · .............
(Signature of applicant, or name, if a corporation)
./.4 fl
..... (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises . ~.~ £.~..~g~.~ ..........................
(as on the tax roll or latest deed)
If ~c~ i~~n, signa~3e ~ffly authorized officer.
/ / (Name a~fco~orate officer) ~ ~ ~ ~O.
~ilder's License No, ~f f f~ ~.~)~ ..... ~j ~ o/,
Plumber's License No .........................
Electrician's License No .......................
Other Trade's License No ......................
1. Location of land on which proposed work will be done ..................................................
................... &o. te.:( . . . .............. ¢/.< .....................
House Number Street Hamlet
County Tax Map No. 1000 Section .... ].7.~. ......... Block '-~ 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 ...................................................... -.. ?. ...........
b. Intended use and occupancy ........ .fi(./..~ ........................................................
3.Nature of work (check which applicable): New Building . ~ ..... Addition . .. ........ Alteration , 2 ........
Repair Removal Demolition ' Other Work
(Description)
4: Estimated Cost . 4~7.Q~.~..0-- .-7 ~.: ~ ('~(~o4m./A)4 .~.~&~
.............................. Fee ... r.. ~ ..........
~' (to be~p~d on filing this application)
5 If dwelling number of dwelling units ~ Number of dwelling un~ts on each floor
If garage, number of c~s ................................................ : .................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . ~./~ .............
7.D~en~ons of existing structures, if any: Front ~ . Rear ~ Depth ~ .........
Height .. ::'. ....... Number of Stories ....... :'. .....
D~ensions of same structure with alterations or additions: Front..~.. :.
De ~ ~' Heit
. P . · ............. ~ ....... .~ ......... Number of Stg~es .....................
8. D~mens~ons of entire new construction' Front ~' ' ~ ~0 ~ [ ~~~'~. '
~e~gnt ...... Numoer o~ ~tones
10. Dateof urchase ......... ~ ................ Name of Former Owner .~ ~. ~.~. ~.~
11. Zone or use district in which premises are situated ~/~/~ i ~r~'~ ~~'~
12. Does proposed constrnctio9 violate any zoning law, ordinance or regula~on: ,.. ~...'C. ~'. ....
~3. Wnl ~ot be regraded .... y~..:..: ........ . ...... W,n eScess fll be removedXrom ~sea: ~ No
14. Nme of Owner ofpremisesO&q~. ~~ .... Address ............ ,. Phone No ~g~7~¢~' . .
Nme of Architect .......... / .... ,..
........... Address .............. : .....Phone No ................
Nme of Contractor .~d0&( .~. ~ ............. Address/g gZ ~¢~ ~ ..... Phone No ................
PLOT DIAG~
Locate clearly ~d dis~nctly ~1 bufld~gs, whether existing or proposed, ~d. iadicate M1 set-back d~ensions from
prope~y Hnes. Give street ~d block number or desc~ption accord~g to deed, ~d shew street names ~d indicate whether
interior or corner lot. ,t~ ~~/~',
2
STATE OF NEW YORK,
COUNTY OF ................. S.S
.... ~.q~. ~M2~tz:g~ ........................... being duly sworn, deposes ~d says that he is the applic~t
(Name of individual signing contract)
above named.
He is the
(Con,actor, agent, corporate officer, etc.;.)
of said owner or owne~, ~d is duly authorized to perform or have performed theismd work and to m~e and file this
application; that ail statements cont~ed ~ this application are true to the best of his ~owledge and belief; and that the
work will be performed in the m~ner set forth in the application filed therewith.
Sworn to before me this
.... ~.., ..... ~ ..... day of.~~.. ~m, 19~ .
":' T ....... .... :....: ....