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HomeMy WebLinkAbout26572-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. - BUILDING .Y. -BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 26572 Z Date JUNE 13, 2000 Permission is hereby granted to: ANNE A HUBBARD 9 LEGGET RD BRONXVILLE,NY 10708 for s DEMOLITION OF EXISTING BUILDING. at premises located at 40535 CR 48 SOUTHOLD County Tax Map No. 473889 Section 059 Block 0010 Lot No. 002 pursuant to application. dated APRIL 11, 2000 and approved by the Building Inspector. Fee $ 300 . 00 Authorize ignature ORIGINAL Rev. 2/19/98 APR I 1 7_3 BOARD OF HEALTH . . . . . . . . . . . . . . . • FORM NO. 1 3 SETS OF PLANS �36c?-1 . TOWN F S U . . . . . . . . . . . . . - , _ - -- 0 0 THOLD SURVEY . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . �- SOUTHOLD, N.Y. 11971 TEL: 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . . . . . Examined... .. .. ;, 20.... MAIL TO: . . . . . . . . . . . . . . . . . . . . Approved...�.i ....... b P. Permit No. Disapproveda/c .... ....... .................. ................................ ...................................................... _ .. ............ (Buiildiag I •or) APPLICATION FOR BUILDING PERMIT Dare. . . F9,AS . . . . 20.00. INSTRUCTIONS a. This application nest 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 buildingson premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property mast 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. APPLICATION IS 1E[tW MM to the Biu'llding De1jartment for the issuance of a Building Permit pursuant to the Building Zane 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 d�lition, as-herein described. The applicant agrees to caimply siiTh`all applicable,laws, ordinances,, building code, housing code, and regulations, and to admit authorized.inspeetors,on premises and in building for necessary inspections. ' ....... .....I .. ........ ............ ;. : (Signature of applicant„ or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, •lessee; agent•,'architect, engineer, general contractor, electrician, plumber or builde ........lf!!kc ........... - .......... . ..... ..................................................... Name of owner of premises .. Ai6.!�,.Lk�0./�:�?�... .......................................................... (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. .. Plumbers License No. .. Electricians License No. Other Trade's License No. n 1. Location of land on which proposed work will be done.....J\lA : .... ..................................... .........................................................q_,P.(k.................... House Number **** m�l .. �t'l' 11 ll 1 J County Tax Map No. 1000 Section ,C Block ....1. ': .\ . ... . ...... { ....... Lot Subdivision ...................................... Filed Map/No. ; ._-. Lot ....:...e 2. State existing use and occupancy of premises and -intended use and occupany,of;propose Leo ,satnurtion: a. Existing use and occupancy ......✓. c! ” 'r........................ ?3cbSd.¢�'J xv .......... b. Intended use and occupancy ...... .... . ....'.....4...j..Y..4..i.1.l.r..Y............ �•� \u,c.�. twmhum 4phmcallie): New building .. .... .......... Repair ............ Removal ........... Addition Alteration .......... .. Dewlition ..... ..... Other Work ............. . (Description)s ..; at • i. Estimated Cost fee .. ......................... (to be paid on filing this application) i, If dwelling, number of dwelling units ............ umber of dwelling units on each floor ................ Ifgarage, nuaber of.cars ...................................... If business, commercial -or-mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if any: Front................ Rear ............... Depth ................ lleigtmt ......... Number of Stories .......i............ Dimensions` hof same stnmcture with alterations or additions: Front •4.01. �� Rear .. Depth ... ........ ......, ./.. .. P �. .......... Height ............. Number of Stories ... ... Diuensions of entire new construction: Front ................ Rear ...... Depth .............. Height ......................... Number of Stories ..................... Sizeof lot: Front .................... Rear .................... Depth .................... 0. Date of Purchase :0-C,T;1-?1,llft...... Nam of Former Owner ...5tsmow.'.,ctjanmg,w;............. I. Zone or use district in which premises are situated ............................................................... 2. Does proposed construction violate any zoning law, ordinance or regulation: .......J v............. 3. ` Will lot be 'regfaded .................... Will excess fill be removed from premises: YES 4. Names of Owner of premises ........................... Address .............................. Phone No. .............. Name of Architect .................................... Address ............ . ................ Phone No. .............. Name of Contractor .................................... Address ................. ...........Phone No. .............. 5. Is this property within 300 feet of a tidal wetland? * YES .......... NO .., .., *IF YES, SQT11UD TOW Tii[ISIMS PM1IT MAY BE.BEMIRED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ram property lines. Give street and block number or description according to deed, and show street names and indicate -iether interior or corner lot. ppp QED AS NOTED DATE: t 3 vD B.XPARTM 5­7d-e' � ' v0 FEE: 0 0 B'NOTIFY BUILDING T AT 765-1802 9 AM TO 4 PM FOR. THE FOLLOWING INSPECTIONS: 1 FOUNDATION. - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 44. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL. MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR., DESIGN OR CONSTRUCTION,ERRORS CD nlr or ";W Yo w, (UNIT Or ss .... .........being duly sworn, deposes and says that he is the applicant bme of individual signing contract) uve akaned, isLhe .......:.......................................... .. _ _ _ (Contractor, agent, corporate officer, etc.) '. ••' �.•• ••• . said owner or owners, and is duly authorized to PPrform- :;r Ihwve fecformed the said work and to make and file this Fplicar.ia-; that all. statements contained in this application are true to the best.of his knowledge and.belief.; and at the work will be performed in the manner set forth in the application filed therewith. orn to before me this .... ,. day or- --20 ....20.4 . Notary Public T110mfle J.Hu bard (Signature of Applicant) N*w Public,State of Now York No.02HU6991250 Qualmed In Westchester County Commission Expires Sept.30,2000 BUILDING PERMIT REVIEW CHECK LIST Applicant/ Date Owners Name: -1 1 L ✓Le, Reviewed: Architect/ Date Engineer: Submitted: `C t 0-0 SCTM#: District: 1,000 Section: l� Block: G© Lot: JC Project 40-5�J,..;,,S n Subdivision Location: — 4�tC,Lr-t t /l.fX._, Name: Single&separate Required certification: Yes/No) Req. Req. Zoning District: (Lot size: Actual: 1 [Lot coverage Proposed: 1 Req: Rey. Req. [Front Yard Proposed: 1 [Side Yard Proposed: 1 [Rear Yard Proposed: ] Project Description: AGENCY PERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept. New York State D. E. C. Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? ' Flood Zone: . Notes. p v ` lk� . C. --/ OltIN S.tfA 1 1 6 \ ` �Gj ' P ;too L. 1- s d Oti i r \O AO Q 0q- Ar. T OPO -oG 0 o� v G • P t F tr.o= 4 tie �N y . FA. s. FN, otio Joh AREA = 7.845 Aces � AA C,� •sem, y�. a° 0 SURVEY FOR D & D CYCLES �i, CERTIFIED TO, -D 8 D CYCLES, INC. C A T SOUTHOLD o^ FIDELITY NATIONAL TITLE �a��n� INSURANCE COMPANY OF TO WN OF SOUTHOLD VANIA NORTHPENNSL FORK RK NORTH BANK SUFFOLK COUNTY, N.Y. 1000-59- 10- 02 Scale: 1"= 100' July 21, 1993 �Aov Nfwy C, CERTIFICATIONS 7-26-93 • rs� � Prepared in accordance with the minimum Jlli standards for Lille surveys as esloblfshed N. LIC. NO. 4961 by the L.I.A.L.S.. and approved and adopted for such use by The New York Stale Land PECON ' P.C. 0 Title Association. (516. '76 P. V. BOX 9