HomeMy WebLinkAbout27590-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)
PERMI NO. 27590 Z Date AUGUST 31, 2001
Permission is hereby granted to:
PHILIPPE MAUCOTEL
PO BOX 455
CUTCHOGUE,NY 11935
for
NEW CONSTRUCTION OF A SECOND FLOOR ADDITION TO AN EXISTING SINGLE
FAMILY DWELLING TO INCLUDE NON HABITABLE SPACE ONLY AS APPLIED FOR.
at premises located at 310 DUCK POND RD CUTCHOGUE
County Tax Map No. 473889 Section 083 Block 0002 Lot No. 019 . 011
pursuant to application dated JUNE 29, 2001 and approved by the
Building Inspector.
Fee $ 150 . 00
Authorized Signature
COPY
Rev. 2/19/98
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Town Hall,53095 Main Road W Fax(631)765-1823
P.O.Box 1179 ,ji Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
January 3 , 2002
Mr. Philippe Maucotel
P.O. Box 455
Cutchogue, N.Y. 11935
Re : Premises Q 310 Duck Pond Rd. Cutchogue,N.Y
Suff . Co. Tax Map #1000-83-2-19 . 11
Dear Mr. Maucotel :
Since you are not going to proceed with the construction
project on the above premises, we are returning herewith your
plans and survey. This building permit has been voided as of
Jan. 2 , 2002 .
If you have any questions or need further assistance, please
to not hesitate to contact this office .
Respectfully,
SO HOLD TO BLDG. DEPT.
Gar J. F sh, /
Y
Bu ' ng Inspector
GJF:gar
(encl)
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�—MAUCOTEL
P.O. Box 455 !
Cutchogue,New York 11935-0455 =
TEL./FAX (631) 734-6931
MOG,O'a
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FIELD INSPECTION REPORT - DATECOMMENTS
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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 11971P a Q' ) y3 sets of Building Plans
TEL: 765-1802Survey � _
PE
Septic Form
N.Y.S.D.E.C.
Trustees
Examined 911-3 --,200/ Contact:
Approved g/-4 I ,20 6 I Mail to:
Disapproved a/c
Phone:2:3 q— 9 3
r ! r! Building Inspector
i APPLICATION FOR BUILDING PERNIIT.
L_J_n Date. Z- , 200 1
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,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 b fO ept 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 Occupancy
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.
(Signature of applicant or name)if a corporation)
�O I- 4 CL)TC_"o N_ ( tGt3S
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder
2
Name of owner of premises A U C C�T =L-
(as
L-(as on 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. I B D
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
1 0 S U C KcP01-i'c> i_ZDv_\® C J C 4 0C9 J
House Number Street Hamlet
County Tax Map No. 1000 Section F,3 Block 02. Lot
Subdivision Filed Map No. Lot
(Name)
7. State existing use and occupancy of premises and intended use and occupancy of proposed constriction:
a. Existing use and occupancy i\
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition �/ Alteration '
Repair Removal Demolition Other Work
(Description)
4. Estimated Cost k Z,00 C Fee
(to be paid on filing this application)
5. If dwelling,number of dwelling units '4 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 7 7• Rear -7 -7. 1 ' Depth 3 4- "7
Height Number of Stories
Diglions ions of same structure with Iterations or additions: Front Rear
r�r� rG�.
Depth Height Number of Stories.
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10.Date of Purchase I c1�R S 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: �-�
13. Will lot be re-graded Will excess fill be removed from premises: YES NO
14.Names of Owner of premises M A u c o7-L-- Address t�oPz> L4-S—";-; Phone No.'l'�>L 6cl 3
Name of Architect Address Phone No
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:
COUNTYOF
MAu �'j l � being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the OW N�l�
(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 toore me thi
oZ 4 day of 200
Notary Public Signature of Appli t
HELENS D.11 'NE
Notary Public, State of New York
Mo.4951384
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SUFFOLK.CO.UNTY H LT PA, ENT
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SINGLE FAMILY DW LItWONL1�'e QP
H.D. REF. NO. o
DATE AN It O"
THE SEWAGE DISPOSAL AND WATER SUPPLY FACILITIES FOR fib!
LOCATION HAVE BEEN INSPECTED BY THIS DEPARTMENT AN 0� •
FOUND TO BE SATI FA DRY. -- -
Chief of W stewater Management'Section
SURVEY FOR
PH/LL/PE MAUGbTEL ✓ucr 29, 19e6
FEB. ?7
,, /986
AT CUTCHOGUE DATE: JULY /0, /985
TOWN OF SOUTHOLD SCALE, / = 50
SUFFOLK COUNTY, NEW YORK NO. 85-6/9
*UNAUTHORIZED ALTERATION OR AODITION TO THIS GUARANTEED T0s
SURVEY IS A VIOLATION OF SECTION 7209 OF THE SOUTHOLD SAVINGS YANK
NEW YORK STATE EDUCATION LAW
*COPIES OF THIS SURVEY NOT BEARING THE LAND
SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL OF He
NOT BE CONSIDERED TO BE A VALID TRUE COPY �(p )M1'
*GUARANTEES INDICATED HEREON SHALL RUN ONLY TO ,
HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE FOS" FOR WHOM THE SURVEY 13 PRCPARAC W 4
AND ON HIS BEHALF 70.THE TITLE COMPANY,GOVERN-
*NEAREST W ■AIN—MI. *SOURCE OF WATER'.PRIVATE—PUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED _
WATER HEREON,AND TO THE ASSIGNEES OF THE LENDING
*SUFF'CQ TAX MAP DWELLINGS
WITHIN 100 FET OF THIS R P RT INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE
OTHERS 'ARE NO OMEHO NS WITHIN 100 FEET OF THIS PROPERTY TO ADDITIONAL INSTITUT.ION6 OR SUBSEQUENT
OTHER THAN THOSE SHOWN HEREON.- OWNERS
III THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE OO DISTANCES SHOWN HEREON FROM PROPERTY LINES
WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EKIfTING STRUCTURES ARE FOR A SPECIFIC
AMU�T+ SERVICES' PURPOSE AND ARE NOT TO BE USED TO ESTABLISH E, G 4a8�3
PROPERTY LINES OR FOR THE ERECTION OF FENCES
ADDRESS fl
'IL` YOUNG 15 YOUNG RIVERHEEAD,NEW YORK
E
NOTE-' ■ + ANONUMENT azSTAlfE ALDEN W.YOUNG,PROFESSIONAL ENGINEER
AND LAND SURVEYOR N.Y.S.LICENSE NO.12845
HOWARD W.YOUNG, LAND SURVEYOR
Al THE LOCATION Of WILL(W),SEPTICTANK(inoce3SP00Lf(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893
ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS
TELEDYNE POST N01779