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Home My WebLink About26524-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). PERMIT NO. 26524 Z Date M 25, 2000 l Permission is hereby granted to: BARBARA A BERDINA PO BOX 513 LAUREL,NY 119kS for CONSTRUCTION OF A ROOM ADDITION AND SCREENED PORCH AS APPLIED FOR. at premises located at 875 FRANKLINVILLE RD LAUREL County Tax Map No. 4738 9 Section 125 Block 0002 Lot No. 005 pursuant to application dated FEBRUARY 23, 2000 and approved by the Building Inspector. Fee $ 75. 00 D � U Auth r zed Signature ORIGINAL Rev. 2/19/98 FIELD INSPECTION REPORT DATE COMMENTS - ________-_ II II II "0 C=7 FOUNDATION ( 1ST) H� �I I FOUNDATION (2ND) II I ii--------------- TrZ"-- -- - --- - Z" ---------------- -- ROUGH FRAME & i II J PLUMBING i Ji -------------- -u INSULATION PER N. Y. STATE ENERGY ii if C, CODE I �° ii u u II if H II II FINAL I�— --if 11 p ADDITIONAL COMMENTS: PUT 0 0� tj o 0 z - b H 1ci9Q:c �18 - BOARD OF HEALTH . . . . . . . . . . . . . . . -FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . ( ONE Z 83J TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . ' BUILDING DEPARTMENT CHECK . . . . . . . . . L --- ...a ' " TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 ....__._ TEL: 765-1802 NOTIFY: CALL 600.) - �?-- S181C Examined.................., 19.... D``�Jam",/� MAIL TO:J16 S/3. . . . . . . . . d.Approved-5j x..........,'214.... Permit No. ................ D.7s5.. ...................... Disapproved a/c .................................. <� lLt . ...1 ....................................... ............. ...(Wilding•I. tor).••...•• APPLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector w 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 mist be drawn on the diagram which is part of this application. 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 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 whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATICN IS HEREBY NNE 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) ..`.�........... (Mailing address of applicant) State whether applicant is r, lessee, agent, architect, engineer, general contractor, electrician, plumber or buil.dei ............................................./.j............................................................................ Name of owner of premises 3eagiq...A,. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nave and title of corporate officer) Builders License No. ......................... Plumbers License No. ......................... /O Electricians License No. ..................... Other Trade's License No. .................... I. Location of land on which proposed work will be done.............................................................. ....875.......................:�'?.---,t Ja ! e"(.......... �� . : Hou-se Number Street Hamlet County Tax Map No. )000 Section A,5,........ Block ........... Lot .., ............ Subdivision ...................................... Filed Map No. ............... lot ............... (Name) 2. State existing use and occupancy of premises intended use and occupancy of proposed construction: a. Existing use and occupancy (!4.-. £�. /. ................................ b. Intended use and occupancy .... c/d Ir ............1(.. .................................. i. Nature of work (check which applicable): New Building .......... Addition ..v Alteration Repair ............ Removal ............. Derolition ............ Other Work .A--.". ... •(Description) i. Gstiin3ted Cost 5 S�r.:�.!... ..... fee .............................................. (to be paid on filing this application) �. If ckwelling, number of dwelling units .../....... limber of dwelling units on each floor .... ......... Ifgarage, number of cars ...................................... -�. If business, camiercial or mixed occupancy, specify nature and extent of each type of use...... `.............. �. Dimensions of existing structures, if any: Front..k6.:Y....... Rear d'.Q....... Depth ."3T':3......... Height ......................... Number of Stories .-�.................. / Dimensions_of same structure with alterations or additions: Front .4.4:.T. .. Rear Depth ...5�:.,3......... Height .................... Number of Stories ...!4(-AC?...:S'EE .Su�2VE:y Dimensions of entire new construction: Front ...IV.......... Rear ... o........ Depth fe......... Height ........................ Number of Stories ..................... Size of lot: Front ... /Sr.�.�........ Rear ....?:S.r.......QQ.... Depth .0Z.....a9S....E, ot7s 10. Date of Purchase ...�9.7`i�.......... Name of Former Owner .IJ�!��....��tq G;4.Cl................. 11. Zane or use district in which premises are situated ..tO. Psiv EsS.S...............................................!7 12. Does proposed construction violate any zoning law, ordinance or regulation: . ?.................. 13. Will lot be regraded ..MZ.............. Will excess fil be frog premises: YES ND 14. Names of Owner of premisesl��1�4..�:. F 1�Gtll�`} rens L o1�� S.... Name of Architect ... ! P 4R....... Address/-�-- - .4�!?? E�?.� Yhdne No. .............. e �o17 7 . /m...�! _A)r.. PoeN . .IL V Y Me we NName of Contrac 7�= � 90 k?d9eLA!y &JeLArDySMi-0- f S. is anis propertin y *IF YES, SWMMD D TloM Ti3ls1M.S PEMflT MAY BE RE( UED. PLOT DIAGRAM 734- 6q'Fr I,ocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions -rom property lines. Give street and block nimber or description according to deed, and show street names and indicate 4hether interior or corner lot. �E 06 AloTE7 tI ooh De CL -To -Be k me t9 e'J) -MIT. of N;'W 3RKSS, xJl1NIY (JF U 1 ..... .id.A� A��..... .:... AlK�.............being duly sworn, deposes and says that he is the applicant Name of individual signing contract) ,bove named, ,p leis Lhe .......................®(J/l)�/`—.............................................................. (Contractor, agent, corporate officer, etc.) ,f said owner or owners, and is duly authorized to perform or have per.forne-d 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 :hat the work will be performed in the manner set'forth in the application filed therewith. ;worn to b fW me this ...��..........day, of Not Public .... .... p Notary TLdi�j�XAN . ..... ..............110TAR1fNo.Ot6�edNrwVA (Signature of Applicant) Ckfalified in.SutfdkCoUlft � Arm Evw":�latr7h so \ ,1 0 O \ Q 9� eco ,p�9 ZOO�11RE \\ Q Ott > \ C 7 0.o I�J CoJER `N 00 o tJ `fl, \ Z P GpZEbOto co�E \\ I I0I0fa � C RE101 O C. 0. � vIA�� g�Op�gR T y- T,- C1r= A •T 00 VV n7j J I Z a a ,dG 4, 0 1^ V' 11� o� �` spy ` I, ola � �tI�E �.` �vll� 00� P 1� y� d� C5. a1 000 Z5 �\ 0�� a• \$ 5 o O \ `T �7► �JO�p1� SIOf' 0.1 �05 NE CO �v o �A No rE 4lktlJ S a = MONUMENT SUFFOLK COUNTY TAX MAP D/ST. /000 SECT. /25 BL K 2 LOT '5 REVISIONS YOUNG & YOUNG AUG. 25, 1998 400 0STRANDER AVENUE. RIVERHEAD, NEW YO SEPT. II ,1 998 ALDEN W. YOUNG HOWAR - PROFESSIONAL ENGINEER AND LAND SUI LAND SURVEYOR, N,Y.S. LIC. NO. 12846 N.Y.S. Lit SURVEY FOR: TNA;;T R:EE AI TERATAON OR AQOITIQN TO 64RBARA A. BERD/NKA ' Tn;S VRVE� IS A �'iOLAi!ON OF Sf CTION 11J4 OF 1'HL NEW YORK STAIC FDOCATIQN - t LAW. C•iPIEF ';F iHaS SURVC+ MAP NVT OE-AR!•i3 'HE ,ANF :;URVE- OR S INKEC SE AI UR E:M3Q$`,F•-C SF-Ai. SHA! NQ7 6E CGNS!DF RE!? 9L ° 'A'19 ,RU c"jR.: rAT CERT/F/ED TO.• LAUREL BARBARA A. BERD/I \A/WnF NORTH FORK BANK BUILDING PERMIT REVIEW CHECK LIST Applicant/ / Date Owners Name: 8-' , 'a 1� Reviewed: Architect/ Date . Engineer: Submitted: Oz7 SCTM #: �� L3 District: 1.000 Section: '`�5 Block: Lot: 5 Project ubdivision Location: 75 �a.-�kLa ffe- i�o ame: Single&separate Required do certification: (Yes/No) Rey. Req. Zoning District: [Lot size: Actual: ] (Lot coverage Proposed: ] Req. Req. Req. (Front Yard Proposed: (Side Yard Proposed: 1 [Rear Yard Proposed: ] Project Description: 441-m-- AGENCY PETS Permit REQUIRED FOR��EWFOR��EW N1 A. NO YES Number Suffolk County Health Dept. New York State D. E. C. �- Town Trustees Town Zoning Board approval: f Town Planning Board approval: Flood Plane Elevation??? Flood Zone: ,J Notes: