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Home My WebLink About29704-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. 29704 Z Date SEPTEMBER 5, 2003 Permission is hereby granted to : NANCY & KENNETH STEIN 5 WOODS WITCH LA CHAPPAQUA,NY 10514 for DEMOLITION OF A DECK ADDITION AS APPLIED FOR at premises located at 2535 CEDAR LA EAST MARION County Tax Map No. 473889 Section 037 Block 0004 Lot No. 010 pursuant to application dated SEPTEMBER 4, 2003 and approved by the Building Inspector to expire on MARCH 5, 2005 . Fee $ 107 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD 13171LDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT - 4 2003 Do you have or need the following,before applying? TOWN BALL 1 Board of Health SOUTHOLD, NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. �21 2oK -e Check Septic Form N.Y.S.D.E.C. Trustees Examined 2003 Contact: Approved 2003 Mail to: Disapproved a/c Phone: �/ DO o/ Expiration , 20 O$` q `f 261 7Y06 B ilding Inspector APPLICATION FOR BUILDING PERMIT Date C CJS 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 on premises, relationship to adjoining premises or public streets or areas,2nd waterways. c. The work covered by this application may not be cormnenced 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 lnspcctor ma}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 plicant or name, if a corporation) 0c) (Mailing address of applicant)NYLI N y /0614 State whether applicant is owner, lessee, agent, architect, engineer, general contracttbbPWi r builder DATE: L5L3 B.P.l# p70" -Z ` FEE: le,7 BY: Name of owner of premises 1 �t v (N1- .� Te l ✓\ NOTIFY Al w nING �DEPAR E T 4 — I (As on the tax roll or lat7615460) 8 AM TO 4 PM FOR i HF If applicant is a corporation, signature of duly authorized officer 1 FOLLOWING FOUNDTION INSPECTIONS: REOUIREC (Name and title of corporate officer) FOR POURED CONCRETE 2. ROUGH • FRAMING b PLUMBING 3. INSULATION Builders License No. 4. FINAL • CONSTRUCTION MUST Plumbers License No. BE COMPLETE FOR C.O. Electricians License No. ALL CONSTRUCTION SHALL MEET THE Other Trade's License No. REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR 1. Location of land on which proposed work will be done: ��-- D OR CONSTRUCTION ERRORS. C eA �✓�t— 1� 0.J� Lt (y1 House Number Street Hamlet County Tax Map No. 1000 Section Block Filed Ma dero9➢x3tul e ' Subdivision (st.+�..0 ��CS 1�.�I-�� p No. (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 S 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. 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 S. 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 ,o k DV 11. Zone or use district in which premises are situated 1 t-(V 12. Does proposed construction violate anv zoning law. ordinance or regulation? YES_NO 13. Will lot be re-graded? YES NO /Will excess fill be removed frorn premises? YES—NO 14. Names of Owner of premisese.S1Cw Address L31'CeA (- LQ Phone No. 6 If7l Y10 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 BE REQUIRED. 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 ) KQal,G(„ C• }ct�ti being duly sworn. deposes and says that(s)he is the applicant (Name of indAiidual signing contract) above named, (S)He is the d Lel✓f C1/ (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.dotitained 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 tiled therewith. 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