HomeMy WebLinkAbout30980-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. 30980 Z Date FEBRUARY 25 , 2005
Permission is hereby granted to:
SWIM KING POOLS
471 RT 25A
ROCKY POINT,NY 11778
for
INSTALLATION OF AN INGROUND SWIMMING POOL IN THE REQUIRED REAR
YARD, FENCED TO CODE
at premises located at 830 NORTH SEA DR SOUTHOLD
County Tax Map No. 473889 Section 054 Block 0005 Lot No. 013
pursuant to application dated FEBRUARY 22 , 2005 and approved by the
Building Inspector to expire on AUGUST 25, 2006 .
Fee $ 150 . 00
Authorized Signature
V o :f) -
PHOT
ORIGINAL
Rev. 5/8/02
FIELD INSPECTION REPORT I DATE COMMENTS
FOUNDATION(1ST)
--------------------------------------
FOUNDATION
--------------------------------FOUNDATION(2ND) -- _- ------ _ - -_ -_ — _- - r
O
dy
ROUGH FRAMING&
PLUMBING
INSULATION PER N.Y. - -
STATE ENERGY CODE -.- -- - _
FINAL
ADDITIONAL COMMENTS
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06
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CO�YN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
3UILDIlVG DEPARTMENT Do you have or need the following,before applying?
COVS�N HALL Board of Health
TOUT$OLA,NX 1X971 3 sets of Building Plans
Planning Board approval
CEL: (631) 7.65-1802
?AX: (631) 765-9502 Survey
PERMEC NO. 200-L
0-L Check
Septic Form
N.Y.S.D.E.C.
' Trustees
;xamined 2 Contact:
roved 20 1 Mail to s ,t�9rn I`1 O
O D S
PrP �— DdC,i.+ �-
)isapproved a/c
Phone:
Jl
expiration 20 ab
r Building Inspector
FEB 2 2 .– -� APPLICATION FOR BUILDING PERMIT
Dat e , 20 5
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or' in ink and submitted to the Building Inspector with'3
ets 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
reas, and waterways.
e. 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
hall 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
;sues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
suance or has not been completed within 18 months from such date.If no zoning amendments or other regulations affecting the
-operty have been enacted in the interim,the Building Inspector may authorize, in writing, the extension of the permit for an
idition 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
uilding Zone Ordinance of the Town of Southold, Suffolk County,New York, and-other applicable Laws, Ordinances or
egulations, for'the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
Tlicant agrees to comply with all applicable laws, ordinances,building code,housing code, and regulations, and to admit
lthori e s �Q s p.X �'es and in building for necessary inspection
ENCLOSE s,
�I �PooLITo c®®E .
QgON
®RE WATER" ®CC
V UpANC� � (Signature of applicant or name, if a corporation)
USE IS U LAWF 4-71 0-+-e 2_61q- P,0 P-4-
L (Mailing address of applicant)
ALL CONSTRUCTION SHALL Wl� OUT CERTIEjC�.
�1� cRi Ea �To �rTflsse° gc c , er, geli1E contractor, electrician, plumber or builder
CODES OF N W YORK STATE. - G
- Annn iter% A n ai^-w
rev v
L. MQ 114V 1 M
2erne of owner of premises .1r\t an at a+h 'SG i.0t1.r+-z. DATE: � 2 �B.P.# 0
(As on the tax roll-or latest de :_ZQ_ � 3Y: 6,JJ =
applicant is a corporation, signature of duly authorized officer NOTIFY BUILDING DEPARTMENT AT
1'I0Rurmlr�RS CERTIFICATE 765-1802 8 AM TO 4 PM FOR THE
(Name and title of corporate officer) bRE®UIRED FOLLOWING INSPLOTIONS:
1. FOUNDATION - TWO REQUIRED
udders License No. FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
�nnbers License No. _ 3. INSULATION
-Ictricians License No.- ,Plo-1 4. FINAL - CON7RUCTION MUST
her Trade's License No. BE COMPLETL FOR C.O.
ALL CONSTRUCTION SHALL MEET THE
Location of land on which proposed work will be done: REQUIREMENTS OF THE CODES OF NEW
j Q OrA1n Seo. Z�Y . So U +C) &ORK-STA �N�OTT RESPONSIBLE FOR
OR CHouse Number Street Hamlet
County Tax Map No. 1000 Section 5Li Block Lot 3
Subdivision Filed Map No. Lot
a. Existing use and occupancy
b. Intended use and occupancy
3., Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work f_oj:&) _
(Description)
4. Estimated Cost Fee
(To be paid on filing this application)
S. 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.
7. 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
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front Rear Depth
10. Date of Purchase 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 V-11"NO Will excess fill be removed from premises?YES NO v` �
14, Names of Owner of premises )ScA,u)ar4z Address 72D 0644,&_1 Phone No. - t45'o0-14
Name of Architect t.e�_.1 C,6 yl Address 116. DbcytjjAVCff Phone No 331- . 1D5
Name of Contractor ck_a� Address 4- ► v4k- hone No. 74Y-9�to O
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO_J�—
'k IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C.PERMITS MAYBE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO i/
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines. . j
17. If elevation at any point on property is at 10 feet or below;mustrQ vide5topographical data ori'survey: --
j ���
STATE OF NEW YORK)
COUNTY OF____-_�
being duly sworn, deposes and says tliat(s)he is the apllcarit
(Name`of-individual signing.contract) above named, L
(S')He1s 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 applicatic
that all statements contained in this application are true to the,best of knowledge and belief; and that the work will be
Performed in the mamler set forth in the application filed therewith.
Sworn to before me thi 11
o� day of 20()6
.'Notary Public S gnature of Applicant
KOLEEK 19, AOB€eKER
NOTARY PUBLIC,STATE OF NEW YORK
No.01 806099540
QUALIFIED IN SUFFOLK COUNTY
MY COMMISSION EXPIRES SEPT.29,20Q
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: 9.3' N6.1'
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SURVEY OF PROPERTY2nd. FLR. DECK
A T ,SO UTHOLD j Pa
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SUFFOLK CO UNT�; N. Y.
1000-54-05-13
SCALE. 1'=30' o —
DECEMBER 22, 2004 3 0
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AREA=37,657 SQ. FT.
v=MONUMENT SET100w
.41 r. �.
®=REBAR SET S34'14'30„W N. Y. 4�1� 618
ANY ALTERATION OR ADD177ON TO THIS SURVEY IS A WOLA77ON N/0/F SMITH CONIC EYORS,
OF SECT70N 7209OF THE NEW YORK STATE EDUCA77ON LAW. (631) 765-5020 FAX ((6J1) 765-1797
EXCEPT AS PER SEC77ON 7209—SUBDIVISION Z ALL CERT7FICA77ONS P.O. BOX 909
HEREON ARE VALID FOR 7HIS MAP AND COPIES THEREOF ONLY IF 1230 TRAVELER STREET
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR 04—313
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y 11971
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NOTES
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SECTION B ?9p_J
WALL SECTION
4.
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