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Home My WebLink About30709-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUILDING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 30709 Z Date OCTOBER 19, 2004 Permission is hereby granted to: LORR3kINE C FRIEDRICHS NEW ORLEANS LA, 70130 for : DEMOLITION OF EXISTING ADDITION AS APPLIED FOR at premises located at ETTRICK ST FISHERS ISLAND County Tax Map No. 473889 Section 009 Block 0012 Lot No. 005 pursuant to application dated SEPTEMBER 28, 2004 and approved by the Building Inspector to expire on APRIL 19, 2006. Fee S 64.40 ~~,/; ~/~ , ORIGINAL Rev. 5/8/02 aUILOI~C PERmT'EXX~iNER cH~;i~LIST APPLICANT: SCTM# DISTRICT: L000, SECTION: __ __, BLOCK: ADDRESS: CITY: DATE REVIEWED: / /04 DATE SUBMITTED: / /04 _, LOT: __ SUBDIVISION: ZONING DISTRICT: CONFORMING? BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR N BP __-Z / C/0 Z- , INFO / BP -Z / C/0 Z- , INTO BP -Z / C/0 Z- , INFO / BP __-Z / C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED NOTES: LOT~ 40,0008F -10~-24. Lot reeognition.(CREATED befor~ June 30, 1983), UNDERSIZBD LOTS PROM JAN.1997 100-25. Merg~r.(A nonconforming tt any time afar 7/ REQ. LOT SIZE: REQ. FRONT REQ. REAR ACT. LOTS~E: PROP. FRONT PROP. REAR __ REQ. LOT COV.. REQ SIDE REQ. HEIGHT ACT. LOT COV. ACT. SDE PROP. HEIGHT PROJECT DESCRIPTION: ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: WATERFRONT?. DESCktPTION: PANEL # .A/'. PROV, ,ALS REOvm~o SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED #): DTE: TOWN SEPTIC RECEIPT: Y or N NEW YORK STATE DEC: ~ YES or NO SOUTHOLD TOWN TRUSTgES: YES or NO TOWN ZONING BOAI~D APPROVAL: YES or NO TOWN PLAN. BOARD/APPROVAL: YES or NO TOWN HISTORICAE(PRE (SPLIA): YES or NO FLOOD ZONE:. / / PERMIT #: DTE: / / PERMIT #: DTE: / / PERMIT #: DTE: / ./ .. PEI~MIT #: DTE: I /v[~RMIT #; / NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): YES or NO NOTES: FEESTRUCTURE:FOUNDATION: I. {__~[~s~=)- ( 2. ( .sF)- £ SF)- ( F[RSTFLOOR: SECOND FLOOR: OTHER: TOTAL: SF SF SF SF 3.( ~'v~ SF)= SF)= SF)~ 1NIT t~ SF FEE SF X $ =$ +$ +$ OTHER FEE SF X $ =$ +$ +$ FINAL TOTAL: $ TOTAL FEE NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRAPHIC DESIGN CRITERIA: Ground Snow Load: 45 Weathering: Severe__ Design Temp: 11 __ Frost Depth: 36" __ Ice Shield Underlay: YES __ USE/OCCUPANCY CLASSIFICATION: HEIGHT/FIRE AREA: TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED/PRESCRIPTIVE FULL FRAMING DESIGN ELEMENTS: Y,q'q H~ADERS: Y/N WALL STUDS: YfN CEH,ING JOISTS: YfN FLOOR JOISTS: Y/N LUMBER SPECIES AND GRADE: DESIGN LOAD CALCULATIONS: Y/N LIVE: Y/N DI~ Y/N SNOW: YfN SEISMIC: Y/N wn, ow SC.EDULE: E,~SS 5.7 S.F.: Y/N EI:GHT 8°,/0: Y/N /CENT 4%: Y/N NAILING/CONSTRUCTION SCHEDULE: YfN MEANS OF EGRESS: Y/N PLUMBING RISER DIAGRAM: Y/N LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N TRUSS DESIGN: Y/N CERTIFICATION: Y/N ENERGY CALCS: Y/N TOTAL COMPLIENCE? Y/N (RETURN TO PAGE ONE) Wind Speed: 120MPH__ Seismic Design Category: B __ Termite: M-H __ Decay: S-M Flood Hazards: GIRDERS: YfN ROOF RAFTERS: YfN WIND: Y/N TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL , SOUTHOLD, NY 11971 TEL: 765-1~02 Approved I o/1o/ ,20 Disapproved BUILDING PERMiT APPLICATION CHECKLIS~ Do you have or need the following, before applying Board of Health 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: .2'g~ ~t~ Phone: P~PPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS ,20 0 a. Tiffs 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 Occupanc 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 here(n described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit author/zed inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) ~(~3~0 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises (as on the tax roll or latest deed) If a~s a co~orat.~9.fi,~s3gnature of. duly authorized officer / (Nme ~ title of co~or~e officer) Builders License No. / 3 ~td /¢. _~. Plumbers License No. Electricians License No. Other Trade s License No. 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block /~ Lot ~ FiledMapNo. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing useandoccupancy .. ,,,c;~ ~.~,~ b. Intended useandoccupancy ~'t~,fi~ ~,~/~r * 3. Nature of work (check which applicable): New Building Repair Removal Demolition X Estimated Cost Fee If dwelling, number of dwelling units If garage, number of cars Addition Other Work Alteration (Description) (to be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Re~ Dep~ Dimensions of same structure with alterations or additions: Front Rear Depth. Height. Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 1 I. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: 13. Will lot be re-graded 14. Names of OWner of premises ~-~rr,'~/v~-- ,~,~t~ Address ~tr~ Name of Architect Address Name of Contractor ,Z,~,5 ~,dr~ J4d~.. Address~.V. ff~, 15. Is this property within 100 feet of a tidal wetland? *YES NO · IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED Will excess fill be removed from premises: YES NO Phone No. ~,?/-7~c~' Phone No Phone No. F,.,Y/- ?oeo 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 ~o~r~,~ ~. ~'//0 being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the ~e,,~r~ ~,~., (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 · ~7~ :ign~ture of Applicant 12,~.. LOT AREA= 0,58:1: ACRES ~/-SEFllC SYSTEM COTTAGE N/~ JOHN W. IdETTLER, III COOR01NATE DISTANCES ARE MEASURED FROM U.,S. COAST &: GEODETIC SURVEY TRIANGULATION STATION "PROS" 2.) TAX REFERENCE: DISTRICT I000, SECTION OOg. BLOCK 12. LOT 5 SU RVE~ MAP PREPARED FOR JOSEPH MAYBIN GORE FRtEDRICHS LORRAINE CAFFERY FRIEDRICHS N/F ~ ~ JOHN W. MET~. III 40 20 o 4o C.~PH~C SCALE ~N FEET REVISIONS DATE, I ,, CESCRIPTION DATE: jUNE 16,_ !999,, , SHEET 1 OF ~ ETrRICK STREET FISHERS ISLAND, NEW YORK CHANDLER, PALMER ~ KIN(3