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Home My WebLink About27374-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall j Southold, N.Y. i i i BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIRI�S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 27374 Z Date JUNE 11, 2001 Permission is hereby granted to: THOMAS SIDLAUSKAS & WF 2005 DEEP HOLE DRIVE MATTITUCK,NY 11952 for CONSTRUCTION OF AN ACCESSORY ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR YARD AREA. at premises located at 2005 DEEP HOLE DR MATTITUCK County Tax Map No. 473889 Section 115 Block 0014 Lot No. 016 pursuant to application dated APRIL 17, 2000 and approved by the Building Inspector. Fee $ 50 . 00 �Y \ AuthorizeUdignature COPY Rev. 2/19/98 FIELD INSPECTION REPORT MATE :,.,,,.3. F COMMENTS FOUNDATION ( 1ST) j FOUNDATION (2ND) 'I II I ROUGH FRAME � I� PLUMBING I F} INSULATION PER N. T. STATE ENERGY I N CODE H I FINAL -- --==--_ ADDITIONAL COMMENTS_ _— ---____------ od H H G H ` R . 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 j 3 sets of Building Plans (� ,' Of.Survey Check Septic Form N.Y.S.D.E.C. n Trustees .��.� .��..... , a Examined 20 Ll f t t � Approved {ol"S ,20,31 PERMIT NO. � Disapproved a/c "BuildiQInspector APPLICATION FOR BUILDING PERMIT Date-. 920 4 INSTRUCTIONS t 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 sale.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 application. 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 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 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 co and re ations, and to admit authorized inspectors on premises and in building for necessary inspection (Signature of a]rphjWnt or name,if a corporation) (Mailing address of applicant) 9 S-y State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder — �d2✓ltdii!!:� Name of owner of premises (as on.the tax roll or latest deed) If applicant isa.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. 14 1. Location of land on which proposed wo will be done: • sly .' t`/'' 0 • . : cud House Number Street County Tax Map No. 1000 Section i 15- Block N Lot 1 Subdivision �c G- Filed Map No. 4a S G Lot S— ame) 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, �}�a _ 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work Qon (Description) 4. Estimated Cost l��r-a_�, 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. 7. Dimensions of existing structures,if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth `f` Height Number of Stories 9. Size of lot: Front 100.(P 9' Rear SS;o Depth !S6.5� ff- I-71:47 10. Date of Purchase lac.tel, Name of Former Owner fTe 1r1JL C � . 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law;ordinance or regulation: na 13. Will lot be re=graded_ Will excess fill be removed from premises: YES 14. Names of Owner of remisesc �f Addressc ' p x,„�t Phone No.a9$ aL ( Name of Architect Address Phone No Name of Contractor Address Phone No. 15. Is this property within 300 feet of a tidal wetland? *YES NO mak. • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, indicate scope of project,to scale,with 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) � " COUNTY Ors SS: n 0 ,&crS being duly sworn,.deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the 0 to iV e-cr- (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 day of_ 20 0 � fD V"In er,(L Notary Public Signature of Applicant LYNDA M.BOHN NOTARY PUBLJC,State of mew ybrk No.01 B06020M OuallfledTerm F-XPrres Ma cn 20� T, !pf iJ AS M f-of s OCCUPANCY OR �s " Map . FEE*nt10 . Suff. Co. Flo no. 0S4 USE 4S 'UN U FY BDING D ,. RTM Y AT mr -_ ITHO W V T .: ; _FOUDWINGINSPECTIONSE:� 1 `FO DATI{ N .-. TWO RE 3UIR r UR VG FOR POURED ZaIA�$U fiAMING $t Pt 111AB#NG -. o� C -Al :fOf 4 , 3. L�cT�OsN : � ) k 4..FiNAL. . CONSTRUCTI"I .M1lS�T rlirfi DRAT' ' " 81r COMPLETE FO i� c.4 Lo, 44( s` ALL GONSTRUMON` SHALL M[:ET THIS L1 ®. ENCLOSE POOLTO C OE r , UOON COMPLETIO E' .RfQUtREMENTS OF:'TtfiE Nat S CONSTRUCTION ENERGY BEFORE"WA f CONST O Sa . .N T RESPONStBt E :.FOR `i i` ^• DESIG R f'STRUCTIC& ERRI RS z: N ft- CASE l�. � � �RpERWRiTER3 CERTIEI 7i f EQ R ,. •. 'REDS 'Cly- SCHW lCk/' AMID a - , SCHWlCKL ��l17-"'fir Al .( } A, F 44 rucvC TT t OL OF a - t SCAM= SQ+F Mot li =rte^ ♦ � 1 ' 'c• t ..'M � fsi� i 4n141F �i�Pi�y�..��` Ito 4 r.. . 2 f.;.: .. .; -_., x .,.,. R,... ... �. Pin- - } ,* }.• � .! �,*),.� hi S f4 r jjjyI��".jr� r `°.4. .'�.`a =w f ''3' •�. r'., t .'� !ur'N' z.._r` , _ 1, O'CAttil"- Lade g ey �wswnns.�" fU`ifas Y'�Cr�CG Y