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Home My WebLink About1000-69.-2-1 ti♦� ti M PLATFORM W O N/F DOROSKI FAMILY LIMITED PARTNERSHIP •.{ ".xfMKE Xyv CRUSHED STONE m^' 9^ I + 3BNa LAND NIF v*% STANLEY AO�I.IC— qY^� G9 DARwb ADW CZUH Wfi• c! tr' r 17 O e mr' IRON A5 6"ARKNNG gL c. F9'Y OTaCE'P2S. r r� y-'�"'""""'.•� M s _060oFPA� �.P. NOTE: G'f?OPERTY LINE SCEN ESTAHLIS HISTORIC RECO DEEDS AND FIE L-+ . E �FOR INTERNAL USE UNLY SITE PLAN USE DETERMINATION "Lln oudtaldTown Planning Board initial, Determination - Date Sent:ja=t �y � — /6 ._ project Name: 14 project Address: A's zo C� � A Suf€oIK County Tax Map No.:fi00Q- �( -�_ 1 Zoning District: Request` —4— tication and supporting docmenat'on'a to (Note: Copy of Building Permit App proposed use or uses should be submitted.) # initial Determination as to whether use is permitted:�,.�� Initial Determination as to whether site plan is ire I r CS r Signature of Buiidin Inspector rtment(P.DReferral: Planning Depa 16 p,.D.Date Received: la i }6— Date of Comment:_ I� — Co meats: ' Stgn at re of planning De tafl Reviewer Final Determinision Date: � Decision: e;.-nfiirP of Rtiildiina lnsnPctor Steel framing. Polycarbonate ends. Roll-Up door. Pre-hung door. Steel framing. Double sliding doors. Shutters. Polycarbonate Version 14-8 �Z 5 j *YEM OEAM \ « zPRUNZ -07 � �K . z %/® \�% —aS. ) USS ) .\ _ _� ~ . . (%QWW--, / ( � Version g4! lb As a last check for square,measure diagonally from the right front to left rear ground post,and from left front to right rear ground post(make all measurements from the outside of the posts).The measure should be equal,although a 1 to 2 inch difference is acceptable. Check your diagonals and make sure you are within 1 to 2 inches of each measurement. 1 � t 1 t � I { # t 1 ! t t Lots ctu �4 tt � t t r � t n t x t i t � 1 {t 4i t \ {t \ f 1 t � t � { 1 FIGURE 8 IATTM MUM LM a�a q��rEn+ao Version 13-11 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 4--sets of Building Plans TEL: (631)765-1802 Planning Board approval FAX:(631)765-9502 SoutholdTown.NorthFork.net PERMIT NO. Check er Septic Form N.Y.S.D.E.C. Trustees (C O'3ApFhcanon ,l F-obd Permit Examined 20— Single&Separate Storm-Water Assessment Form Contact: Approved 20e. Mail to: Pc--J67,s-7,e_1� Disapproved a/c (Videsf4 LI-C- Phone:Phone• �t — t? 3 4 Expiration 20 • � �� Building Inspector L�PLICATION FOR BUILDING PERMIT OCT -7 2016 Date M71 .20_ J� INSTRUCTIONS a.Thies Q ompl filled in by typewriter or in ink and submitted to the Building Inspecto with 4 sets of plan '- .$91�& .Fee according to schedule. — , b.Piot plan showing location o fot and of buildings on premises,re�alaonship to adjoining prem,ses 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 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 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 name,if a corporation) Uldo Gt`191 f4ot4 vsc /-Y tf 9-jo (Mailingaddress of applicant) State whether applicantis o�er,1 see,agent,architect,engineer,general contractor,electrician,plumber or builder Name of owner of premises `T j, L-L–'��- (As on the tax roll or latest deed) a }can is a corporation,signature f duly authorized officer (N . .e and title of eor orate officer) � la f j 'j�vt ktt Buildf j License No. Plum Plumberer s License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done* _ House Number Street Hamlet County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premses wid intended use and occupancy of proposed construction: a. Existing use and occupancy mac, b. Intended use and occupancy It 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work r (Description) 4. Estimated Cost 15 0 07b 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 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 6 — 7. Dimensions of existing structures,if any:Front 3y Rear 30 r Depth 72— Height 2-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 Height Number of Stories }}1 4. Size of lot:Front ° r Rear Depth 10.Date of Purchase NIS Name of Former Owner 11.Zone or use district in which premises are situated 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO l' 13. Will lot be re-graded?YES NO Will excess fill be removed from premises?YES_NOS"_ 14.Names of Owner of premises Address Phone No. 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$SQUIRED. b.Is this property within 300 feet of a tidal vvetland?*YES NO *IF YES,D.E.C.PERMITS MAY BE REQUIRED. r 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. A014- 18.Are there any covenants and restrictions with respect to this property?*YES NO i/' *IF YES,PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF {' being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the �yJ�lc�t� (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 this 7 th day of CG Fy- 20j_(o ACEY L.D Notary�cbllic NOTARY PUBLIC,STATE OF NEW YORK Signa're of App cant NO.01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2L--