HomeMy WebLinkAbout28566-Z FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMI/UNTILCOMPLETION OF THE WORK AUTHORI
PERMIT NO. 28566 Z Date J Y 16, 2002
Permission is hereby granted to : /
LEDA C BRUNDAGE
122 WILLOW STREET
GARDEN CITY,NY 1,Z530
for
CONSTRUCTION OF AN ACCESSORY GARAGEN THE REQUIRED REAR YARD AS
APPLIED FOR. TRUSS CERTIFICATION QUIRED PRIOR TO CO
at premises locate/8e
MASON DR CUTCHOGUE
County Tax Map No. 104 Block 0005 Lot No. 035
pursuant to applicY 15, 2002 and approved by the
Building InspectorANUARY 16, 2004 .
Fee $ 75 .
Authori ed Sig ature
�
\ 1 � l11
COPY
Rev. 5/8/02
FIELD INSPECTION REPORT DATE COAD ENIS
FOUNDATION(1ST) a
----------------
C
m
FOUNDATION(2ND)
- O
HH,
ROUGH FRAMING& a
PLUMBING
INSULATION PER N.Y. V
y
STATE ENERGY CODE
FINAL
ADDMONAL COMQIENTS
S
O
Z
M
z
a=
BUILDING PERMIT EXAMINER CHECK LIST
DATE REVIEWED: ? //6 /01
APPLICANT: DATE SUBMITTED:9 /OD
SCTM# DISTRICT: 1,000, SECTION: J>, BLOCK: P� LOT:
STREET ADDRESS: CITY: � � SUBDIVISION: X.�114
PROJECT DESCRIPTION: Cc__ Sc� �
ESTIMATED PROJECT COST:ARCHITECT/ENGINEER: FAST TRACK?
SINGLE & SEPARATE CERTIFICATION-REQUIRED? 1�NOTES:
LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at any time after 7/:
ZONING DISTRICT: I?A0 CONFORMING? No
REQ. LOT SIZE: Od0 ACT. LOT SIZE:Q90 REQ. LOT COV. o,90�a ACT. LOT COV.
REQ. FRONT 3 VPROP. FRONT ./ REQ SIDE-3`/3` ACT. SIDE
REQ. REAR 61 PROP. REAR I-- REQ. 11EIGHT PROP. HEIGHT
WATER FRONT? )SAO DESCRIPTION:
PANEL #: -� FLOOD ZONE:��,
APPROVALS REQUIRED
SUFFOLK COUNTY HEALTH DEPT: YES or �01ED#): DTE:_/_/_ PERMIT#:R10-
TOWN SEPTIC RECEIPT: Y
NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o 0
SOUTHOLD TOWN TRUSTEES: YES o
TOWN ZONING BOARD APPROVAL: YES o
TOWN PLAN. BOARD APPROVAL: YES o .
TOWN HISTORICAL PRE (SPLIA): YES O
NYS ENERGY: YES OI�O : 0-
EGRESS (18 H min.? 4 sq total) VENT(SQ. FT. x 4%) LIGHT (SQ. FT. —_
BUILDING PE ' OPEN/EXPM,ED: BP 56D4 -Z/C/O Z ,
HAVE P S . R N� BP -Z/C/O Z- ,
NOTES:
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR: SF
SECOND FLOOR: SF
OTHER: SF INIT OTHER TOTAL
TOTAL: SF FEE FEE FEE
1. SF)- ( SF)= SFX$ =$ +$ +$ = s
2. ( SF)- ( _SF)= SFX$ =$ +$ +$ = $
o�OS�fFO��-cOG
o� y�
Town Hall,53095 Main Road WGy Fax(631)765-9502
P.O.Box 1179 • �� Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 30, 2003
Leda Brundage
122 Willow Street
Garden City,NY 11530
To Whom It May Concern:
Please take notice that we are returning your building permit amendment for construction
of an accessory garage at 1125 Mason Drive, Cutchogue,NY, SCTM# 104-5-35.
Because the design of the garage has changed,we must void the old permit(which is
scheduled to expire on July 16, 2003) and a new permit application(enclosed)must be
filed with this office. In addition, the new plans must meet the requirements of the current
New York State Building Code. The plans you have submitted do not appear to meet the
current building code.
In addition, the plans you have submitted were not properly sealed and signed by your
architect. Each page of each set must be stamped and signed by a New York State
licensed architect or engineer.
We are sorry for an inconvenience this may cause. Please feel free to re-submit the
application when you have address the above referenced issues. If you have any
questions,please feel free to contact this office at (631) 765-1802 between the hours of
8:00 a.m. and 4:00 p.m.
J
urs,
CC: File
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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 3 acts of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631)765-9502 Survey
PERMIT NO.Q1-$ Check
Septic Form
N.Y.S.DX.C.
Trustees
Examined 20 contact:
Approved 20__Z� Mau to:
Disapproved a/
Phone:
Expiration / e 20
_07/
Buildm Inspector
1 APPLICATION FOR BUILDING PERMIT
Date' 200.
INSTRUCTIONS
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 onpremises,relationship to adjoining premises or public streets or
areas, and waterways.
c. The wQvk 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 daze.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 of applicant or fiakne,if a corporation)
I as U C9-ch
(Mailing address of applicant)
State whether applicant is owner,lessee, agent, architect,engineer, general contractor, electrician,plumber or builder
Name of owner of premises L2a4 PO 0\06ne
(A s_ 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.
1. Location of land on which proposed work will be done:
11.25 bR%�e , �}
House Number Street Hamlet
County Tax Map No. 1000 Section C��{ Block S Lot 3v
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 (J `
b. Intended use and occarpancy
3 Nature of work(check which applicable): New Building Addition Alteration
Repair .Removal Demolition Other Work
(Description)
4. Estimated Cost 4 t 0 , 0y 0 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 One- CaK
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
Dimensions of entire new construction: Front Rear 0\®`K Depth to
Height 6oe,,0Q S Number of Stories 1
9. Size of lot: Front 5 (� ' Rear IS!'t Depth
10. Date of Purchase '9194 Name of Former Owner D(J-U/ifS CA-r\ct EvOe*g e. -T2""�
11. Zone or use district in which premises are situated S`� L K 1 WTCktUy&
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded?YES NO VWill excess fill be removed from premises?YES Nov
iaaW;IV6,Aj Sr
4 Names of Owner of premises 14, d� ��Address c-7t e-i-)c-,-v c i Phone No.
Name of Architect Address Phone No �-
Name of Contractor >. ,'1 Address Phone No. ;� . ` 63 T-59 q- 4569
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES_ 11?y 6-�1 CKod
* IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C.PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO_L,!:n�
* 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 S�
.Lec1A (br(Tjbft-E' being duly sworn,deposes and says that(s)he is the applicant
(Name of individual si contract)above named,
(S)He is the a-LONCA-
(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.
Sword to before me this
day of 20 v-1,
L/'Idtary Public Signalfire of Applicant
JOYCE M.WILKINS
Notary Public,State of New York
No.4952246,Suffolk County
Term Expires June 12, av 0 3