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Home My WebLink About25767-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. i BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25767 Z Date JUNE 1, 1999 Permission is hereby granted to: RALPH & JILL D PASSARO 405 HARVEST LA MATTITUCK,NY 11952 for s CONSTRUCTION OF AN ACCESSORY ABOVE GROUND SWIMMING POOL WITH FENCE TO CODE IN THE REQUIRED REAR Y�RD AS APPLIED FOR. at premises located at 40 /HARVEST LA MATTITUCK County Tax Map No. 473889 Be ion 120 Block 0003 Lot No. 008.030 pursuant to application da ed MAY 3 99 and approved by the Building Inspector. Fee $ 50.0 /�O I Authori ed ign Q — RDA- G, ' � COPY Rev. 2/19/98 U� :LD INSPECTION REPORT DATE C01IIIENTS <aaaaofsalaasaaaaaaaaaa�aiaia:�asaasssassaa:s:ssaa:ssssaiasaaaaaaaaaaa:saassssss N N H (� JNDAT ION ( 1ST) N I 7NDATION (2ND) n u UGH FRAME & PLUMBING N 1 u N N (SU[<ATION PER N. Y. STATE ENERGY N H CODE u— n N -II i I � N FINAL N N PFJ ADDITIONAL COMMENTS: � C CG x 1 ria -------------- b H ' 0 ' r BOARD OF HEALTH . .. ... . . .. . . . . . 3 PA FORM N0. I 3 SETS OF PLANS .. ... .. . . . . . . .. TOWN OF SOUTHOLD SURVEY .. .. .. . . . . .. .. ... . . . . . . . BLDG.DEPT. BUILDING DEPARTMENT CHECK . .. .... .. . . . . . ... .. . . . . . . TOWN OF SQUTHOLSITOWN HALL SEPTIC FORM . . .. . . . .. . .... . . . . . . SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . .. . . ./- ... Examined...�' ....... 19.x'.' r MAIL TO: . . - Approved. .........., 19 Q! Permit No. .�f.�............. ................................... Disapproved a/c .................................. ................................... ...................................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date. . . . .. . . . . . . . . . .. 19. . . . INSTRUCTIONS a. This application must be completely.filled in by typewriter or in ink and submitted to the Building Inspector v 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 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. APPLICUICN IS HEREBY R E to the Building Department for the issuance of a Building Permit pursuant to the LIxilding Zone Orth* 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. �•,•t]. . Y _ , ..................................................... (Signature of applicant, or name, if a corporation) A::a yQ�S..�l ..✓. Si.L.�O M d.MWc i (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde .....Q.w N .................................................................................................... Name of owner of premises .�Ll e L!�:¢�.�L tz.....t.A ........................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Nam and title of corporate officer) Builders License No. ......................... Plumbers License NO. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done................... .............................. ........... ............... . ......... .............................................. );louse Number Street Haslet County Tax Map No. 1000 Section ..�:�.d......... Block . ............ Tzt ...(J..::�O .... Subdivision M/A� 0 f,, A�P� ;�........... Filed Map No. .. �d U...... Lot .... 2. State e3risting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................. .................................................... ... b. Intended use and occupancy ......Ii Y...J::::.:......................................................... 3. Mature of Work (check which applicable): New Building .......... Addition .I:....... Alteration W A.A `'f c « .M Repair ............ Removal ............. Demolition ............ Other Work ............... :............... (Description) i. Estimated Cost ........ fee .............................................. } (to be paid on filing this •applicatiocr)a. - -----.- i. If dwelling, number of dwelling units " I .... ....... Kimber of dwelling units on each floor ................ Ifgarage, number of cars ...................................... i. If business, commercial or mixed occupancy, specify nature and extent of each type of use............. ........ �. Dimensions of existing structures, if any: Front...y 1.......... Rear ..,7.1......... Depth �.... ...... Height ...0.✓.................. Number of Stories ..P................... Dimensions of same structure with alterations or additions: Front ..Y!......... Rear �. gh ... Number of Stories .�....... Depth ....�.............. Hai t ..-2 y.......... ..... I. Dimensions of entire new construction: Front ................ Rear ............... Depth .............. Height ......................... Number of Stories ..................... �. Size of lot: Front ..441`............ Rear .... a .,��......... Depth ..�..........:..... 10. Date of Purchase ��J ......... Name of Former Owner ........................................ II. Zone or use district in which premises are situated ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded .................... Will excess fill be removed from premises: YES ND 14. Names of Owner of premises R� ! f.J�� :..�/fr��9Qn. Address ....0......................... Phone No.A Name of Architect .................................... Address .............................. Phone No. ............. Name of Contractor ................................... Address ...............................Phone No. ............. ;5. Is this property within 300 feet of a tidal wetland? *1 YES .......... NO .......... *IF YES, SWITIOID 1Q61 MUSHES PE1WT MAY BE RF7(xTIRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set—back dimensions Tan property lines. Give street and block rnmber or description according to deed, and show street names and indicate Whether interior or corner lot.`- Q Z R { 1� VA DATE: "IMMEDIATELY" FEE: �� L =�-"`'"�'`� ENCLOSE POOLTO CON NOTIFY BUILDING h'AR1 h: C�1T k UPON COMKEMIN 765-1802 9 AM TO 4 PM FOR THL BEFORE"VMWTER" FOLLOWING INSPECTIONS: 1 FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION UNDERWRITERS CERTIFICATE 4. FINAL - CONSTRUCTION MUS-f REQUIRED BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEE I THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS TA1T•, Or N31 YORK, SS OMIT Or ....................... .........RR k6 ...�A S� ......................being duly sworn, deposes and says that he is the applicant Name of individual signing contract) bove named, eis the ............ .................... ............................................................ (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 list the work will be performed in the manner set forth in the application filed therewith. worn to before me this 00, .... ... ...day of ...........19..Q 9.. Notary Public .. ......... .. .�-Y.............. . ... .. .......... .............. HELENE D. HORNE (Signature of Applicant) Notary Public,State of New York Qualified In Suffolk County Commission Expires May 22, 19 _. � ,, NQUSE I ` I' UNDE2 CONST (VAC. i . .. ........ �� HARVEST LANE 125.0 -3S8 TO,CQT-OFF AT FA2MV EU i20, x,.1019`30'1:. _. � f N Q 30U TO &001_ r Q iN �---_ --------- iv1 2�S'I'o►ZY � � . l 185 TO WELL !42_ N Boz N ( VAC. ) i 'JAC. �.,C�c1fi.L 1 V� I 3 LLJ 'o THE li C7 - 2. E, E _ o CTS ?,.T.' 2 REVISED P20P. LINE, t4' S-t(Q 'V '/ 125.4 _ 5,69`3?' C :It.Eo MAP) 125.01 >. INAME cHAr>,EDTEES pc jAM1r*iULc� At-' . r'9. 1995 ') Ir ►VUJAW S►C I VAC. ,on �ainv