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HomeMy WebLinkAbout28815-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. 28815 Z Date OCTOBER 9, 2002 Permission is hereby granted to: GERALD R LANG 220 OAK STREET CUTCHOGUE,NY 11935 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH TWO CAR GARAGE UNDER AND COVERED FRONT ENTRY AS APPLIED FOR at premises located at 600 WUNNEWETA RD CUTCHOGUE County Tax Map No. 473889 Section 104 Block 0011 Lot No. 013 pursuant to application dated SEPTEMBER 17, 2002 and approved by the Building Inspector to expire on APRIL 9, 2004 . Fee $ 1, 270 .20 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF,SIJUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 _ Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined q& 20 �� Contact: Approved 10 T 200 Mail to: Disapproved a/c Phone: Expiration ,20 O l Building Inspector APPLICATION FOR BUILDING PERMIT Date (C— —3c) , 2002— INSTRUCTIONS 0O2.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 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 what so ever until the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim,the Building Inspector may authorize, in writing,the extension of the permit for an addition six months. Thereafter, a new permit shall be required. 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,ikfcorporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises �4_L> £ 4 3C9(3,f31 ei L.,4& G (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. 1. Location of land on which proposed work will be done: CeloNA cd&'r,+ gU C." Tc IVO G G House Number Street Hamlet County Tax Map No. 1000 Section f G Y Block // Lot_._ /3 Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ,S 3. Nature of work(check which applicable):New Building v Addition Alteration. Repair Removal Demolition Other Work (Description) 4. Estimated Cost 2, O ® Fee (To be paid on filing this application) 5. If dwelling,number of dwelling units 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. Depth , 7. Dimensions of existing structures,if any: Front Rear De p Height Number of Stories 2 Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear ��� Depth Height .3 Number of Stories 9. Size of lot: Front /00 Rear Depth 10. Date of Purchase /��"�9=©C'� 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? YES NO 13. Will lot be re-graded?YES NO ✓Will excess fill be removed from premises? YES NO 14.Names of Owner of premises 60�9,-X t-J> 640-'4 Address 2 ao OA"-' s--r' Phone No. 909' —?G Y,S� ' Name of Afchitect E 1L'4SWvEM Address3�2T_%�� Fphone No Name of Contractor l G� LAAJ 4 Address 22 _:sT--Phone No. Q'd' 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO c/ * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO * IF YES, D.E.C. 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: COUNTY OF &V Z-.,-,fN 4, L&C✓✓E k ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 to before me this day of 20� otary YubTic Signature of Applic JOYCE M.WILKINS Notary Public,State of New York No.4952246,Suffolk my Term Expires June 12,Cogo D FIELD INSPECTION REPORT DATE COMMENTS b FOUNDATION(1ST) y C FOUNDATION(2ND) z _ O H ROUGH FRANMG& PLUMBING INSULATION PER N.Y. STATE ENERGY CODE c FINAL ADDITIONAL COMMENTS 0 Z m ti O z x 1 � d ►may U- 1 L IIS 11T�`T�r�f T'T D T�'c IT TJ WT �T T T-i"IT i I c r r _ 17 Applicant/ Date Owners Name: `t , Reviewed: /v 4 L Architect/ Date Engineer: _ a-4-r, k , Submitted: SCTM #: �/ District: 1 000 Sectjon: /d T Block: Lot: 13 Project Subdivision Location: —�— Name: Sin&le& separate Required certification: Yes/No 1 n Req. / Req. i/,Zoning0istricc '(y (I,ot sizc: _ Actual:- " 3, l (Lot coverage Prorx)sed Req. r Req. r-t r , Req. / )r' (f=ront Yard f L Proposed: _) (Side Yard J- � Proposed: (Rear Yard Ab Proposed 1 7 J J Project Description: LJ1 C-a._ AGENCWERMITS 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: L Flood Plane Elevation??? Flood Zone: _ Notes: BROADWATERS ROAD SURVEY OF LOT 297 AMENDED MAP A OF NASSAU POINT �+► OWNED BY NASSAU POINT CLUB PROPERTIES, Inc. FILE No. 156 FILED AUGUST 16, 1922 N E SITUATED AT o � � µ NASSAU POINT OWN T OF SOUTH LD ,. O SUFFOLK COUNTY, NEW YORK Pl � � � � � S.C. TAX No. 1000-104-11-13 LO ��N E D8 vn.1 SCALE 1"=40' JUNE 8. 2000 �\ fa"�pL1• / i p� JULY 13, 2000 ADDED TOPOGRAPHICAL. SURVEY N cmc p G �►�{ SEPTEMBER 14, 2000 ADDED PROPOSED WATER SERVICE 03 J SEPTEMBER 19, 2002 ADDED PROPOSED HOUSE 'o 92e O CT 0. \ \ \ AREA = 36,033.07 sq. ff. ap \ 0.827 ac. ` Orya - - r>� �5 \ ,� �•. \c �� X11 � ��� � r �• r 0 TEST HOLE DATA 12Y1 N�0 .ALINE`'121 6\ p-� \ !TEST HOLE DUG BY ON I2. 2000) ,r. wow Sow Lama wow LWW NAND SM LO 120 - .- -_ v \ ,79 A \A \V 96 _ .... .. - 'rte dF atE " 122 . \ �'1 \ -zC� rwc waw Esc 10 curse arw a� 6 ���'"-- itz.3 N _ --.--•-.-._-_-._ ._.. ._ .. . . .. Lo / ,24- ._. ..- . .. ._.. ; tjk � m 128 27 TT. _ 1N THE MINIM 716EgDWRJSHED ADOPTED ARLAND LO'f a� GUARANTEED T0: s r; / - PECONIC ABSTRACT, Inc. t Qtr �o !y ' /; - -W- ---139 FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK O��, JERAR. LANG X31 _ - -140 �d1 \ BOBBIE KAYE LANG i l' - morgs, r 1. ELEVATIONS ARE INITE 1ENCED TO AN ASSUMED DATUM 0fl11. O- i' NpY MIM CUMATIOM ME WOW THIM 10 FLJ 0 1370/ // O' COSTING CONTOUR UNES ARE SHOWN THIM- - -130- - - A.� ,o0, /; 51 ,►0 2. YNMOY $0, TANK CAPACIM FOR! A 1 TO 4 NEDR0011 HOIKE IS 1,000 GALLONS. N.Y.S. Uc. No. 40M J 6 1 TANK: S' LONG, 4'-3' WOE. i'-7' DEEP UI0AITHO IM ALTERATION OR ADDITION 6 3. MINIMUM LEAOINIG SYSTEM FOR A I M 4 BEDROOM HOUSE IS 300 p H SIDEWALL AIKA. 10 THIS aIRVEr 5 A VIOLATION OF SD 1 POOL; 12' DEEP. Lr db. OF THE NEW YORK STATE C PROPOSED EXPANSION POOL COPIES OF TMS MIP NOT ITEARINC Jos h A. kVegno ® THE' A �.'�EC OR Land Surveyor LIIOOiS£D>FAL SILL NOT LLE CONSIDERED PROPOSED LEACIMC POOL lO iE A IDEA TRUE COPY. ® g RUN WIN: TAMC ARDPQV�EENTHE SY0�� NDowaENALF70� 4. THE LOCATION OF WELLS AIM CESSPOOLS SHOWN HEREON ARE FROM FIELD w"COMPAW.oormiAmm AGENCY No rMe Swveya - &bdAwm - SAb Plans - C.or &Lwtbn Lgad y0 f NDMOK AND 5. zomm�Dt$F CTRis ATA*-40. -40 ANIED FROM OTFIEIIS. 70 THEU9114100illFlS Oi AMIE L NSS 1- 6W1R01G ENVELOP[ S[1�AG(E ARE FOR ANON-coNioRMNG LOT 7U11ON. "IM NOT PHONE (631)727-2090 Fox (631)727-1727 f �d WITH A LAT AREA OF 20.000 .O. If. To 39.M p. A. THE EIOSTC" OF 11" OF WAYS AND/OR EAEEIJDM OF RECORD, IF QfFKES LOCATED AT AIICIIJG ADD1�35 ANY, NOT SHOWN ARE NOT OLIARANTEED. 1360 ROANOKE AVENUE P.O. Box 1931 RNQOIEAD, Now York 11901 Mwrfioad, Now York 11901-0965