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Home My WebLink About25960-z e FORM NO. 3 �� f TOWN OF SOUTHOLD L IJ\ 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. 25960 Z Date AUGUST 17, 1999 Permission is hereby granted to: CHARLES JOHN CAIN 396 ROCK RD GLEN ROCK,NJ 07452 for CONSTRUCTION OF A SECOND STORY ADDITION AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 3440 . WELLS RD PECONIC County Tax Map No. 473889 Section 086 Block 0001 Lot No. 013 pursuant to application dated MAY 27 1999 and approved by the Building Inspector. Fee $ 185 . 00 —V Authorized Signature r ORIGINAL Rev. 2/19/98 FORM NO. 3 TOWN OF SOUTHOLD �\\� BUILDING DEPARTMENT Town Hall Southold, N.Y. \G BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25960 Z Date AUGUST 17, 1999 Permission is hereby granted to: CHARLES JOHN CAIN 396 ROCK RD GLEN ROCK,NJ 07452 for CONSTRUCTION OF A SECOND STORY ADDITION AND ALTERATIONS TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 3440 WELLS RD PECONIC County Tax Map No. 473889 Section 086 Block 0001 Lot No. 013 pursuant to application dated MAY 27 99 and approved by the Building Inspector. Fee $ 185 .00 Authorized Signature COPY Rev. 2/19/98 IN -ZA4'EE2 \ 2C7!C te,'- c i r � �5; s C VA 7, JI 1 :--)--"VEYE:. FuDP ' 1 AI,MT TLON of AOORIOM N MLS 50EVET K A V1014TIOM OF O TqN 7705 Of T1IE HEW To"STAR �uT,OK uw. Q GUACAINTE�7 S OF TMs SWnn MM HOT EEAEH10 �,.' AND TO `HE NJuT.'i FF <:: �ANKt TRUST�MOAtiY3 yI Ey s U.""''`O4 - AS SURVEYED ;.(O 19`73 AV."iLUE Co". f i.fit r. pIpCATW HET50N s"m tW . /t, J; 1 { �' 1i•-1\..,� { ` ! ` _ TXE swVET ' •rc.v J t:�.• 11 .i L �. - . �•-• y T TO THE Pgooi To&WHOM — - t nEtAtEo.AI<0 all OV Ws EMALT TACT AHO J /V ( ��•"_ (� T SAW,uOVHEIMHTTM AHO - XESEOK n THE ASSLOHIL�OF 7111 Loo"G 06TI. ME HOT TtAHSIfAAllf '`'' ' v��l--1i L�1�y! ��Git:iG� �.CI`.�✓ �� ' �`�� tEtir REE ,.um+„oHs°^! T��f =MOht 1� _ ys <� 2r,\_r. r i r .D INSPECTION REPORT— DATE COMMENTS ----------tee----------- ----------------------- OUKDAT ION ( I ST) N H 3014DATION---=(2ND)==-= _—___--- ----- __ ------- ------------------ — — n N N a _— 'n2 :>aGU FRAME: PLUMBING q u u N gSULATION PER N. Y. w STATE ENERGY N- -h CODE n ti M p u N u n A FINAL N N N xM N p ADDITIONAL COIR ENTS: BOARD OF HEALTH . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY .. . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK .. . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY:��✓t/ CALL Ermined.................. 19.... MAIL TO: .,-?o Approved..--.ffn6e....., 19. ` Pennic No. ... ..... .. Z� Disapprovedarc .................................. ...................(.1..1.3.� ' n LS �� 1 (Building Inspector) � U fnI I LICATION FOR BUILDING PERMIT / � L J U c Date:S . . . . . . . . . . . , 19./. BLDG DEPT. INSTRUCTIONS TObVDJ OF SOOTHOLD a. This application mut be completely filled in by typewriter or in ink and submitted to the Building Inspectc 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 ubich is part this application. c. The work covered by this application may not be tormented before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. :G_ permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whele or in part for a y.purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS d-1F1IM MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Tam of Southold, Suffolk County, New York, and other applicable Lars, 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 regulation, and to admit authorized inspectors on premises and in building for necessary inspections. ftA&�1.� ........................ (Signatureof applicant, our name , ,iff a corporatir & (Mailing address of applicant) State whetber applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluiber or haii ........... �T rr..e,... Jr. �r.......................................................... ............. Name of owner of premises ...l J:..41kd. :�(5E. C/, .hIG...m?...S(!ZgI)..QJ.�S.T-f#.��...........- (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer)) ^^77 Builders License No. .. 4?? 5.f 1....lT. .. PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land an which proposed work will be done........................................................... ...... b.... el15....Rd .....................6 ..................se�:rr.Q........... House Nuiber Street Hamlet Canty Tax Map No. 1000 Section ....9.(e........ Block ......1......... lot ..f�5 .......... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) T. State existing use and occupancy of premises and intended use and occupan7 of proposed construction: a. Existing use and occupancy ..Rom ............................................... b. Intended use and occupan7 a.......J................................. ........................... 1a.utfe UL wvtle tuwtx vaitui a ltcame)• New Wilding Addition k PP ng .......... ... ...... Alteration .... .:.... Repair ............ Remml. ............. Demolition ............ other Work .................................. � // (Description) EstimatedCost . ............. fee .......................................... (to be paid on filing this application) If dwelling, niter of &,ellintg units ....3..... Naber of dwelling units on each floor 3 Ifgarage, mcber of cars ....off............................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... structures v / Dimensions of existi if any: Front.... .p....... Rear ....gi-1..Q... Depth �.� ('� Height [. ..0 ... Rear .......... limber of Stories ..../ Dimensions of same structure with alterations or additions: Front .. a.... Q..Q .. Depth ..... ...... Height ....��Q. 'Q..... Nadler of Stories ...cz:�.... Dimensions of entire new construction: Front .. T7 .0.. Rear ..../. t r. Dep CPQ. Height ...1 4l- .'.<2............. Haber of Stories ..../............... Sizeof lot: Front ..................... Rear .................... Depth .................... ). Date of Purchase 1Y1, co nfra4!.!l A.. Nae of Former Owner .�-�. !?................................. -ZE I. Tine or use district in which premises are situated ....J,..— T..�........................... 2. Does proposed construction violate any zoning law, ordinance or regulation: �?U. ........ 3. Will lot be regraded .....1.`E.Q........ Will excess fill be removed from premises: YES NO i. Names of Owner of premises Addressao�DP..�I� b✓Et'I'??L�.. Phone No. . `/5'�f< Name of Architect ./ !J s°t1n�°?nL ............... Address ....CGtX�Q'.✓.�1?'.A-kA4�L2�.. Phone MJ7:Vi a.+ Nam of Contractor 4' 4C�P..Ve IY................... Address 6)Q00..�rOFsw:a-! !P . �.. j0�hane No. '74.F i. Is this property within 300 feet of a tidal wetland? * YES .......... NO ..✓....... *IF YES, SOfI1 M 1O0 TOSME.S PEIit11T MAY BE PLOT DIAG locate clearly and distinctly all buildi , whether existi or proposed, and indicate all set-back dimensions rom property lines. Give street and block r or description rding to deed, and show street names and indicate .tether interior or comer lot. rA1F. Or NDW WRR, SS IMEY OF ....................... .........U S n.n O /C� �fa( ........................Ueiry; duly sworn, deposes and says that he is the applicant Name of individual signing contract) bove named, els du ry �0 t)�e ....::�._............................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and hat the work will be performed in tine manner set forth in the application filed therewith. worn to before.ne this y _ ............+..-..day of /.. ......19. ... Notary Public HELENE D.HORNE (Signature of Applicant) Notary Public,State of New York No.4961364 Oualified in Suffolk County Commission Expires May 22, l BUILDING PERMIT REVIEW CHECK LIST Applicant/ 004gfe5rli#4 ' I' 1 Date n Owners Name: t^ i Fe Reviewed: /' 6 Q Architect/ Date Engineer: Submitted: SCTM#: District: 1,000 Section: Block: / Lot: `/ 3 Project ® Subdivision MeusLocation: . 7To DAD Name: Single&separate Req uir certification: Ye oCI e9� L� Req. Zoning District: [Lot size: Actual: 4P 55 AGRP 1 [Lot coverage —0 Proposed: 1 Req Req Req. [Front FV[Front Yard y Proposed: [Side Yard 3S Proposed: 1 [Rear Yard 1.5-0 Proposed: ] Project Description: AGENCY PERMITS Permit RREQUIRED FOR REVIEWTom. _ NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: MAP �02 • I Sueoa.-r�j �Cftzfi/ S ,G RSA" D90� �(njhjwvSoWilec2" 0 F � • er �� FtR.sv'" FLeo.. Reawma 3�O 5,F. A00rria& ASR, A=�5 . f 1 ef 00 Sso x 2s I10 ��