Loading...
HomeMy WebLinkAbout26948-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN'T'IL FULL .COMPLET'ION OF THE WORK AUTHORIZED) PERMIT NO. 26948 Z Date NOVEMBER 30, 2000 Permission is hereby granted to: BRIAN MOZER (B. FOX) 2595 PECONIC LANE PECONIC,NY 11958 for DEMOLITION ALTERATION TO A FIRE DAMAGED EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. (THIS PERMIT DOES NOT INCLUDE STRUCTURAL REPAIR) at premises located at 2595 PECONIC LA PECONIC County Tax Map No. 473889 Section 074Block 0005 Lot No. 004 .001 pursuant to application dated NOVEMBER 8, 2000 and approved by the Building Inspector. Fee $ 249 . 00 Authorized Signature COPY Rev. 2/19/98 Nov 8 2000 BOARD .OF HEALTH' . . . . . . . . . . . . . 4 FORM NO. 1 3 SETS OF PLANS . . . . . :: . ... . .. . . BLDG.DEPT QWNOF:SOlTHOLD TOWN OF SOUTHOLD SURVEY. . . . . . . . . . . .... . . .. . . . . . . . BUILDING DEPARTMENT . , CHECK : :. TOWN HALL SEPTIC FORM . . . . . . . . .. . . SOUTHOLD, N.Y. 11971 DEC - .. : . . TEL: 765-1802 TRUSTEES . . . . . . . .. . . . ........ . . . NOTIFY: :,�}. . - CALL O�-� ) .. Ex •- amined. ..�. d..... MAIL.TO: ... . . - - / ��, �?.....,�' 6G. Permit No. 9 fQ I J? . ...................................., Approved...... Disapproved a/c ...................... .... ... ........ ........ ...... (Buiiding Inspec orj ...... "APPLICATION FOR BUILDING PERMIT Date, i . . . . . . . ., 20 Q?� INSTRUCTIONS a. 'Ibis application mist be-completely filled in_by typewriter or. n 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 'my not be tormented 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 HEIHY MALE to the Building Department 'for the issuance of a Building Permit pursuant 'tq' jhe Building Zone Ordu', mnce of the Town of Southold, Suffolk County, New York, 'and other applicable Laws, Ordinances-or Regplations, for the construction of buildings, additions or alterations, or for removal or de clition, 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 Adbuilding for necessary inspections'. c -% ' (Signatujr�e 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 Name of owner of premises .�a. rou,���. iw�1;C?;� ;!C!�..:H`.' -.'.... .. _ ............. .(as on the tax roll or latest deed) If applicant is a r ion, signature of duly authorized officer. . .. . ..............................- -- .. .. . .. . . . (Name and title of corporate officer) Builders License No. Plumbers License No. .. te Electricians License No. Other Trade's License No. ......-..:............ 1. Location of .land on which proposed work will be done........... .......... .... ...... ..... ... - . ..... Z- ........P�e-c �... ?�........... . " - ........ ................. House Number Street Ha&et_-._ Canty Tax Map No. ]000 Section d� ,QQ. Block - Subdivision .... FiledMap.No- Lot. (Name) •R- > 2. State existing use and occupancy of premises_ €4-35"F r`�l✓i °a� B� and•.intended use and1,amrn! a. Existing use and oecupavcy --. lyl._fix . :t%�yI . � C13 Q ..- k 'P-0 b. Intended use and occupancy ......... '\�'..... � �:l 7.:� C .. ?d .. ............. '1" k•.,,Lu.0 .,,. VAJcn kcnecx miiu► appiicalllel: New Building .......... Addition ..... - .. Alteration .......... Repair ....,Removal ............. Demolition ............ Other Work ..... (Descripf on). ...... i. Estimated Cost ........................... fee f} . (to be paid on filing this application) i. If dwelling, number of dwelling units ...::"...... umber of dwelling units on each floor ................. ifgarage, number of cars ........k��........................... i. If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. height . .. ..... ..... Number of Stories ...................... Dimensions of same structure with alterations or-additions. -'Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... I. Dimensions of entire new construction: Front ................ Rear ............... Depth, .............. Height ......................... Nuiber-of Stories. ... .. ....... �. Size of lot:. 'Dont ... .. ........o Rear ..................... Depth c 2 'b of Purchase ....��` .:: .... None of TormerOwner �?fio ... .............. 0. Date I. Zone or use district in which premises are situated ..... 2. Does proposed construction violate any zoning law, ordinance or regulation: ..YA ................� 3. Will lot be regraded .................... 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, SQUIIUD MM TRDS MS.PU IIT MAY BE REQUIRED. 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 number or description according to deed, and show street names and indicate fiether interior or corner lot. � e4AiL t �-to w o[Y\I ( '' NI.TW YQTiK y 1 XXWIY O .......... ...... ...........0. ...........................................being duly sworn, deposes and says that he is the applicant ;Name of individual signing contract) mbove named, I W.^S .R�Qsi_d� . .l..� ..A-►�:'h A�c e..er . 1e is 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 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,appl-ication filed therewith. worn lore me this of/4.vf/'!:.20 } � c ... Notary Publ - ... .. .. ........ _�✓' ---f' ELIZABETHA STATHIS .(Si gnatur..... ...li.cant).. ... NOTARY PUBLIC,State of New York :k No.01 ST6008173;Suffolk County my Tenn Expires June 8,202? ' SRS FIELD INSPECTION REPORT DATE COMMENTS 6� ---- ii cll� FOUNDATION OST) u I � 4 ii Ilm - i FOUNDATION----(2ND)--- II II ii o � ROUGH FRAME & PLUMBING INSULATION PER N. Y. l STATE ENERGY i it CODE ii ii n u n u -------------------------#------- __--------_______________=___________=_____________ � II FINAL __II II ---_---- ------ ADDITIONAL COMMENTS: ---------------------------------------------- ----------------------- 19 pH Q y b H t=J t� ro H ` ' •mow ' 1` •r' .� �� j \ ; 446,49 a r J f'1J• te'E' d1 �t `` � t � `moi APPROVED As NOTED DATE:4 �-- B.P # FEE:, BY' NOTIFY BUILDING D PARTMENT 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 4. 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 'JCUPY" OR L."SE. IS UNLAWFUL WITHOUT CERTIFICATr OF OCCUPANCY lJNDERVJ RTIFICATE EQUIRED s BUILDING PERMIT REVIEW CHECK LIST DATE REVIEWED: ,t /-.go- APPLICANT 3G APPLICANT NAME: Iqo2cA ��� l/1 o x ��os / . � DATE SUBMITTED: SCTM#--- DISTRICT: 1,000 SECTION: BLOCK: 06 LOT: 06`'*,.d 6I PROJECT LOCATIOIx STREET: �-'`SS ���<o� « CITY: SUBDIV. NAME: ARCHITECT/ENGINEER: FAST TRACK: YES o O SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES oR NO NOTES: ZONING: PERMIT ESTIMATE AMOUNT:_$ .00 ZONING DISTRICT: R40, R80, AC, 96 CONFORMING: YES oR NO REQUIRED LOT SIZE: SQFT. WHERE ACTUAL LOT SIZE FROM Ax caRD ACTUAL LOT SIZE:/D 4r� SQFT. REQUIRED REQUIRED REQUIRED FRONT: 'PROPOSED: SIDE YD: '/ ' PROPOSED: '/ REAR: ' PROPOSED: ' LOT COVERAGE: ALLOWED: % EXISTING: sf % NEW: sf % TOTAL: sf % CORNER? YES o WAT ER FRONT? YESoR DESCRIPTION: LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM JAN.1997 100-25. Merger. (A nonconforming at any time after July 1, 1983.) PROJECT DESCRIPTION: ADD ALT ACC OR N/D: ,� �,,—,©�s -4 A40e se—, AGENCY PERMITS REQUIRED FOR REVIEW NEEDED TOWN SPETIC PERMIT: YES or NO SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE:—/—/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO FLOOD COMPLIANCE ZONE: PRE-FIRM 3/18/80 PANEL #: FLOOD ZONE: , NYS ENERGY: YES OR NO GRESS: VENT: LIGHT: NOTES: cet..tee C/// 4 rnc..-► O.-L .tea $ �77c �l< FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR /3 2-6 SF SECOND FLR 132--<3 SF INIT OTHER TOTAL TOTAL: 2-d--.6 SF FEE FEE FEE TOT( _CAO SF)- ( 3C6 SF)=?23 4 O SF X $ =$ +$ — +$ _$ 2-19_ a c) �.r y� BILL FOX GROUNDS MAINTENANCE }} �� "With Good Care" _ , 2000 t DEC,!J December 1, 2000 Mr.Bruno Sernon,Building Inspector Southold Town Hall 53095 Main Road Southold,NY 11971 Re: 2595 Peconic Lane,Peconic;NY Dear Mr. Semon: Pursuant to your telephone message of November 30, 2000 regarding the above captioned premises, to the best of my knowledge the electric and gas services are not activated. Prior to the closing date of the sale of the property, October 31, 2000,Mr. Mozer(the seller) indicated the services were off. Upon my inspection of the house prior to the closing and again on November 1, 2000,I found the gas and electric services to be off and I have not since activated them. Also, as the property contains a well with an electric pump,there is not water service at this time. Thank you for your assistance. Sincerely, V V William F. Fox WFF:jd P O B O X 1 6 0 7 B R I D G E H A M P T O N N Y 1 1 9 3 2 • 2 8 3 8 0 2 5