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Home My WebLink About28130-Z I FORM NO . 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FU COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28130 Z Date MARCH 12 , 2002 Permission is hereby granted to : MARY BUTZ 24 GARDEN PLACE BROOKLYN,NY 11201 for ALTERATIONS AND ADDITIONS WITH COVERSFRONT PORCH AND DECK ADDITION AS APPLIED FOR at premises located at 2 2 HYATT RD SOUTHOLD County Tax Map No. 473889 ction 050 Block 0001 Lot No. 021 pursuant to applicationated JANUARY 8, 2002 and approved by the Building Inspector. Fee $ 384 . 6A Authorized Signature COPY Rev. 2/19/98 FIELD INSPECTION REPORT DATE COMMENTS ►d FOUNDATION(1ST) y ------------------------------------ C FOUNDATION(2ND) z y, o z ROUGH FRAMING& t� PLUMBING � x r INSULATION PER N.Y. STATE ENERGY CODE _. FINAL ADDITIONAL COMMENTS J z m b N `~ C y O z x I r� l � x e 2. State existing.use and occupancy of premises andinen==== oposed construction: a. Existing use and occupancy y b. Intended use and occupancy --,IrVY►A 3. Nature of work (check which applicable): New Building Addition ✓ Alteration ✓ Repair Removal Demolition Other Work (Description) 4. Estimated Cost �1'S�a Lo 0 o 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 3&iqN" '+ Depth Height �b� Number of Stories Dimensions of same structure with alterations or additions: Frontgo j,R Depth q" Height =Ab Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height / 516 Number of Stories 1 9. Size of lot: Front �•�s�-' Rear 100 - 010 ± Depth 3a ± 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated k - 12. Does proposed construction violate any zoning law, ordinance or regulation: I`(0 13. Will lot be re-graded K6 Will excess fill be removed from premises: YES NO 14. Names of Owner of premise irc f Address ftoM''11X01Phone No. -119-9-9$1 Name of Architect W n Address n 2rr Phone No #7'7=5 7 Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO ✓ • IF YES, SOUTHOLD TOWN TRUSTEES 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 Q� '1R"JMM1 being duly sworn, deposes and says that(s)he is the applicant (Naml of individual signing contract)above named, Cie is the (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. Swo ? efore me thi 'R`— day of 2 L Notary Public Signature of Applicant HELENE D.HORNE Notary Public,State of New York No. 4951354 �:oP� TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIS" BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. i O&Z309 Check Septic Form N.Y.S.D.E.C. Trustees Examined V,20-,0.;?- Contact: Approved 20Q�t Mail to:—OMI =--rT Disapproved a/c Phone: S� 't Building APPLICATION FOR BUILDING PERMIT .3�Do.c�r�.., Date lV1Vi2�iwir� . 200.0-o' 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 ori--premises,relationship to adjoining premises or public streets or areas, and waterways. 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 what-so-ever until a Certificate of Occupanc, is issued 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 code,and regulations, and to admit authorized inspectors on premises and in building for necessary''inspections. (SeVo applicant or name,if a corporation) i bye / �i (Mailin address o pplicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder l Name of owner of premises M hR Y 4BAZ `F .L l AA)c 3ZPrV1T-C,*— (as ori-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 ploposed work will be done: 4 rr Q D 5 o W"L-b House Number Str et Hamlet County Tax Map No. 1000 Section 50 Block 01 Lot a I Subdivision Filed Map No. Lot (Name) Energy Calculations Butz/Ravitch 1/07/02 gross SQ' GROUND FLOOR SQUARE FOOTAGE (new) 513.25 GROUND FLOOR WALLS 632 DOOR(1/2 GLASS) 20.01 WINDOWS ' 159.14 NET WALL FIRST FLOOR 354.11 ROOF 513.25 FIRST FLOOR SF U" RATING 6-3 FLOOR 513 0.045 3 6-1 NET WALL 354 0.0526 41 6-1 GL 159 0.26 -18 6-1 DOOR 20 0.26 -3 6-3 FLOOR 513 0.045 3 TOTAL 26 aED agcy fo e��aT the est of my knowl>? d#��. t�tie#. and Q � I. ti }f� f?CC1�}...1 • ' .•••,.: 1. ' "4i.�'lr +-1ri SWificafions it Eriergy 34'1 OPS F NE`N FAIRWEATHER-BROWN DESIGN ASSOCIATES,INC. P.O.Boz 521 205 Bay Avenue Greenport,N.Y. 11944 631477-9752 (fax)631477-0973 June 11,2003 Southold Town Building Dept. Southold Town Hall Main Road, Southold,N.Y. 11971 Re:permit# 2813OZ For Renovations to Butz/Ravitch Residencs SCTax Map# 1000-50-01-21 Att:Attached please find : • revised plans for the proposed renovations Thank you, Respectfully Submitted, Amy K. artin Permit xpediter, FBDA Inc. , .. i