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HomeMy WebLinkAbout20868-z FO~ NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN gALL SOUTHOLD, N. ¥. BUILDING PERMIT ('rillS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°-N°. 20858Z Permission is hereby granted to: ..~.~,~ ~.....~.~:~ ~ ............................... .... L.~..~....,~......~ ....... ~ .......... ! ro .C~.>.:~...~ .;C. /ft. ..~.~..~.~.., ..................................... at premises located at ........../...~....~...o,~... .......... .~../...,~...~........~..~.,.~....~.........~...~..: ............................................ ........................................ ...................................... ....................................... County Tax Map No. 1000 Section ...... ~....~... .......... Block ......... ..~./.. ...... Lot No ......X./..:...~.. ...... . .?..?/~o pursuant to application dated ................ ~..-. ............................... , and approved by the Building Inspector. //=uilding Inspector Rev. 6130/80 Board Of $outhold Town Trustees SOUTHOLD, NEW YORK PERMIT NO. ISSUED TO 3829 DATE: May 25, 1990 MARTIN KOSMYNKA Pursuant fo the provisions of Chapter 615 of the Laws of fha State of New York, I .893; and Chapter 404 of the Laws of the State of New York 1952, and the Southold Town Ordinance en- titled "REC~ULATINC~ AND THE PLACINC= OF OBSTRUCTIONS IN 'AND ON TOWN WATERS AND PUBLIC LANDS and the REMOVAL OF SAND, C=RAVEL OR OTHER MATERIALS FROM LANDS UNDER TOWN WATERS;" and in accordance with the Resolution of The Board adopf~'d at a meeting held on May 24 19 90., and in consideration of the sum of $. paid by of ....................... N.Y. and subject to the Terms and Conditions listed on the reverse side hereof, of SouthoJd Town Trustees authorizes and permits the fo~owing: To construct a timber dock consisting of a 4' x 40' fixed elevated (4' above grade) walk; a 3' x 15' hinged ramp; (2) 6' x 16' floats secured by (4) 8" diameter pilings. In addition the applicant is construct a single-family dwelling, deck, sanitary system, drive,II, iff ~v~rdlaSnOceC~ ?l~ef~l~tailed specifications as presented in the originating application. Conditions: a 50' vegetated buffer along creek and installation of of 4~ry wql~ for. d~ci~eway ~ road run-off. IN WITNESS WHEREOF, ~ne sa~a z>oara of lrusfeesh~re- by causes ifs Corporate Seal to be affixed, and these presents fo be subscribed by a majority of the id Board as of this dat.e. TERMS and CONDITIONS The Petmittee IMartin Ifosmynka residing at Pine Tr~e Road~ Peconic~_, NY 11958 N.Y., as part of the consideration ~ot the issuance of lhe Permit does understand and pzesutibe to the fol- lowing: 1. That the said Board of Trustees and the Town of Southold ate released from any and aU damages, or claims for damages, of suits arising directly or indirectly as a result of any oper- ation performed pursuant to this permit, and the said Permittee will, at his or her own expense, defend any and ail such suits initiated by third parties, and the said permitsee assumes full liability with respect there, to, to i the .complete exctosinn of the Board of Trustees of the Town of ~mthold 2. That this Permit is valid for a period of 24 mos. which is considered to be the estimated time required lto complete the work involved, but should circumstances wasram, request for an extension may be made to the Board at a later date. 3. That this Permit should be retained indefinitely, or as long as the said Permittee wishes to maimain the struCtUre or project involved, to provide evidence to anyone concerned that auth- orization was originally obtained. 4. That the work!involved will be subject to the inspection and approval of the Board or its agents, and non-comPliance with the provisions of the originating application, may be cause for revocation of this Permit by resolution of the said Board. 5. That there willi be no unreasonable interference with navigation as a result of the work herein authorized· 6. That there shaii be no interference with the right of the public to pass and repass along the beach between high! and low water marks. 7. That if future ~perations of the Town of Southold require the removal at,d/or aiterations in the lo~ation of the work herein an;horized, or if, in the opinion of the Board of Trustees, the work strall cause unreasonable obstruaaon to free navigation, the said Petmittee will be requited, upon due notice, to remove or alter this work or project herein stated without expenses to the Town of Southold. 8. That the said Board will be notified by the Permlttee oz the completion of the work auth- orized. 9. That the Permittee will obtain all other permits and consents .that may be required mi> plementai to this permit which may be subject to revoke upon failure to obtain same. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~ TOv~I~i c. ,~-~, ~;';,,,~,~.t SOUTHOLD, N.Y. 11971 .............................. TEL.: 765-1803 Examined ..... ?~. ~.'./. ...... , 19 .~.~. Approved ....7~..,~./ 19f.~'.~.mermit No. ~ Disapproved a/c ................................ ., (~ilding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HgALTt{ ......... 3 SETS OF PLA~{S .......... SURVEY ................... NOel FY ~ CALL ................... HAIL TO: 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, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. 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 issued a Building Permit to the applicant. Such permit shall be'kept on the premises available for inspection throughout the wGrk. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. iAPPLICATION 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 ~dmit authorized inspectors on premises and in building for necessary jeB,spectj~ns. ~ ~ J' ............ --' ( ignature of applicant, or name, if a corporation) ·/7. .z.Y... .......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................................... ,... &PPROVED.AS NOTED ...... Name of owner of premises..~/'~ ~ ./../P'~ /(~ ~' ./~. Y (as on'fl(e tax roll or latest NOTIFY BUILDING DEPARTfVIENT AT if applicant is a corporation, signature of duly auth~orized officer. 765-1802 9 AM ~ro it PM FOR THE FOLLOWING INSPECTIONS: (Name and title of corporate officer) 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING Builder's License No ........... ' .......... 3. INSULATION 4. FINAL CONSTRUCTION MUST Humber's License No .......................... BE COMPLETE FOR C.O, ALL CONSTRUCTION SHALL MEET Electrician's, License No ................ ....... THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY Other %ade's License No ...................... CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Location of land on which proposed work will be done IIouse Number Street Hamlet . qf Connty Tax Map No. 1000 Section .................. Block .. · * ........... Lot ................ Subdivision ........................ Filed Map No Lot (Name) State existing use and occupancy of premises and irrtendcd use and occupancy of proposed construction: a. Existing use and occupancy ...... .~...c~./(..g2 .~. f~'. ..... b. Intended u~e and occupancy ....... . .... ~,..~... property lines. Give street and block number or interior or corner lot. Nature of work (check which applicable): New Building ........... Addition .......... Alteration ~ .......... Repair .............. Rem6val .............. Demolition .............. Other Work..F,~.~. ~ .,~... ~ (De.'sc tion) 4. Estimated Cost ..... i ........... Fee, ................ (to be paid on filing this application) 5 Ifd b fd b fd · welling, num er o welling units ............... Num er o welling units on each floor.. · I£ garage, number of cars ................ · · · ·: ......... 6 Ifb si ........................................................ · u ness, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7 Di f ti if F pth · mensions o exis ngstructures, any ront ............... Rear .............. De ....... Height ............... Number of Stories .. .................. ' ' Di f It rio dditi ........................... J ......... mensions o same structure, wi.th a era ns or a ons: Front Depth ..... : He;~ht , · ................ Rear ...... !. ~ ....... ........... ~' ........................ Number of Stori 8 D n i f ti truction: F .... .es i ........ · ~ens ons o en re new cons ront ............... Rear ............... Depth ..... ....... Height ............... Number of Stor/es ................ 9. Size of lot: Front ................ Re ........................................ 10 D of P h ...... ar ..................... Depth . . : · ate urc ase ................. . ....... Name of Former Owner 11. Zone or use district in which pre scs are situated ....... l. t g I .............................................. 12. Does proposed construction rio e .4ny zonin aw, ordinance or regulation: ......... ~ .... 13. Will lot be regraded ......... ; .................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address Phone No. Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimefisions from description according to deed, and show street names and indicate whether ;TATE OF NEW YORK, ?OUNTY OF S.S .......... ' ................. ................ being duly sworn, deposes and says that he is the; applicant (Name of individual signing contract) bore named: : is the ........................ .~ ...... : .................................. (Co actor, age p fficer, ) ............... ' .... ~ ntt nt, cor orate o etc. ' ' ' said owner or owners, and is duly aluthorized to perform or have performed the said work hnd to make and file this ppi:cation; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the manner sdt forth in the application filed therewith. worn to before m~ this .... '' ~~.'.iaY of · ~k-~/j. ........ , 19 .~..~ ' NOtary Publio, State af N~uv--~ .//. ! No. 4951§6-4 ...... ,.. " .... Si n"" ~' '~"'" ~ ~' .... ~''; .... O ' ( g ture. of~pphcant) ualifled In Suffolk County C°mmiss. ion Exioirea May22, 19.,,~ : BUILDER'S NO. ~ THE EXISTENCE OF' RIGHT OF WAYS / ~';$.~' ~ CERTIFIED AND OR/EASEMENTS OF RECORD IF ~ ANY, NOT SHOWN ARE NOT GUARANTEED. UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTI- TUTION, GUARANTEES ARE NOT TRANSFERABLE. TO: ~Tsyt~ ; ~M~TE~F O~U ?HPILsY R~$ I$ ~N Om * :, L~'55~S~ ~ R M TO THE STANDARDS OF THE SUFFOLK COUN~ DEPARTMENT OF H~LTH SERVICES SIGNED SURVEY OF: LOT'/',/-~ Z/A .~' ',~./o ~?rZ~ MAP OF: ,/k,/A..,C,.~, A f,) ,,,,¢'-A /~1'.'¢..~ SITUATED IN: TOWN OF: SUFFOLK COUNTY, NEW YORK. DATE: //~o/¢Z, JOEl NO. ~z-/?/ DIST. SEC. BLK S.C.T.M. NO. 1000 ¢~ / LOT KENNETH H. BECKMAN, L.5;. Surveying and Land Planning 4 Niewood Drive Ridge, New York 11961 ( 16)