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HomeMy WebLinkAbout28917-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. 218917 Z Date NOVEMBER 18, 2002 Permission is hereby granted to: FRANK W & GRACE BURR 15 HOLLIS DRIVE HO HO KUS,NJ 07423 for CONSTRUCTION OF AN ACCESSORY UNHABITABLE, UNHEATED POOL HOUSE AS APPLIED FOR at premises located at PRIVATE RD FISHERS ISLAND County Tax Map No. 473889 Section 007 Block 0002 Lot No. 004 pursuant to application dated NOVEMBER 15, 2002 and approved by the Building Inspector to expire on MAY 18, 2004 . Fee $ 428 . 40 l 1 Au o ized Signature Yogi®y ORIGINAL Rev. 5/8/02 TOWN OF OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health dd SOUTHOLD,NY 11971 3 sets of$uilding Plans TEL: 765-1802 (IJ Survey J PERMIT NO. ��7 Check Septic Form N.Y.S.D.E.0A Trustees 9,k Examined 20 Contact: Approved 20-4::D Mail to: Z&5 CONTRACTING,INC. P.O.BOX 202 Disapproved a/c FISHERS ISLAND, NY 06390 8 Phone: (631) 788-7857 ��- Buil in `Ins2or I ' n ! j' 1';; APPLICATION FOR BUILDING PERMIT �3 .._�° Date 2002 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 a Certificate of Occupancy is issued by the Building Inspector. 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 re ations, to admit authorized inspectors on premises and in building for necessary inspections. ( ignature of acant or name,if a corporation)01 P.O. BOX 20 FISHERS ISLAND, NY 06390 (Mailing address of applicant) State whether applicant is owner,lessee, agent, architect,engineer,general contractor,electrician,plumber or builder GENERAL CONTRACTOR FRANK W.&GRACE BURR Name of owner of premise (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) #13242-HI Builders License No. #554-P Plumbers License No. #4798-E Electricians License No. Other Trade's License No. 1.Location of land on which proposed work will be done: EAST END ROAD FISHERS ISLAND House Number Street Hamlet 007 2 4 County Tax Map No. 1000 Section Block Lot N/A N/A N/A Subdivision Filed Map No. Lot r . . 0 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy W)NF b.Intended use and occupancy POOL HOUSE 3.Nature of work(check which applilcable):New Building * Addition Alteration Repair RemovaL.__Demolition Other Work DECK (Description) 4.Estimated Cost $150.000 Fee $150.00 (to be paid on filing this application) 5.If dwelling,number of dwelling units N/A Number of dwelling units on each floor NIA If garage,number of cars FOR LAWN/POOL EQUIPMENT N/A 6. If business,commercial or mixed occupancy,specify nature and extent of each type of use. 7.Dimensions of existing structures,if any:Front N/A Rear N/A Depth N/A Height N/A Number of stories N/A Dimensions of same structure with alterations or additions: Front N/A Rear N/A Depth N/A Height N/A Number of stories N/A 8. Dimensions of entire new construction: Front -53. '-6" Rear 2.5'-Ar Depth Height 23'ABOVE GRADE Number of stories 1 (y(/BASEMENT/GARAGE BELOWI 9. Size of lot:Front 576.16 Rear 270.29' Depth 429.86' 10.Date of Purchase 11/15/1993 Name of Former Owner ROBERT B.CALHOUN 1.Zone or use district in which premises are situated R -120 2.Does proposed construction violate any zoning law,ordinance or regulation Nn 3.Will lot be re-graded NO Will excess fill be removed from premises: NO FRANK&GRACE P.O. BOX 485 FISHERS ISLAND, NY 4.Names of Owner of premises BURR Address 06390 Phone No.(631)788-7290 Names of Architect Address Phone No P.O. BOX 202 FISHERS ISLAND, NY Names of Contractor: Z&S CONTRACTING. INC.. Address C+6390 Phone No.(6 788-7857 5. Is this property within 100 feet of a tidal wetland?NO *IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey,to scale,with accurate foundation plan and distances to property lines. 7. 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 ) THOMAS.l.SHILLO being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the cn.NTaArmR (Contractor,Agent,Corporate Officer,etc.) If 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. 2 e yo0� Notary Publi nature of Applicant THOMAS F.DOHERTY jR. Netpry Public State of New York No.4806559 Ouallfiea in sutiolk Counly Term Expires 12/31 LA�d si4ow«l "IsT Rous 'p1 o�� 4 saws r P� n Wt� l Gly + IS 41 ACLtSs TO A </ ' A 0 � S of 3 PC 0 �l0 229-7.21 �'y Qr �� \ �• 12- Lo 2- N p0 � � MON. J V. 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