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HomeMy WebLinkAbout28876-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT \\vll U Town Hall Southold, N.Y. -D BUILDING PERMIT N C1-r (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 28876 Z Date OCTOBER 30 , 2002 Permission is hereby granted to : BRIARCLIFF (WEXLER) PO BOX 1056 REMSENBURG,NY 11960 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH THREE CAR GARAGE & COVERED FRONT ENTRY AS APPLIED FOR An'e..A.4, I&_ 11 I c( k i at premises located at 470 LAUREL CT LAUREL County Tax Map No. 473889 Section 125 Block 0004 Lot No. 024 . 011 pursuant to application dated OCTOBER 28 , 2002 and approved by the Building Inspector to expire on APRIL 30 , 2004 . Fee $ 2 , 732 . 70 Authorized Signature ORIGINAL Rev. 5/8/02 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. 28876 Z Date OCTOBER 30, 2002 Permission is hereby granted to : BRIARCLIFF (WEXLER) PO BOX 1056 REMSENBURG,NY 11960 for CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH THREE CAR GARAGE COVERED FRONT ENTRY AND UP AS APPLIED FOR at premises located at 470 LAUREL CT LAUREL County Tax Map No. 473889 Section 125 Block 0004 Lot No. 024 . 011 pursuant to application dated OCTOBER 28, 2002 and approved by the Building Inspector to expire on APRIL 30, 2004 . Fee $ 2 , 732 . 70 Authorized Signature ORIGINAL Rev. 5/8/02 r FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) y -------------------------------- FOUNDATION(2ND) � 1 � z � o �y ROUGH FRAMING& H PLUMBING INSULATION PER N.Y. H STATE ENERGY CODE FINAL V C J ADDITIONAL COMMENTS z m t� c9� z c� m d 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy fMe7 ko7- b. Intended use and occupancy­&L& /i ? 3. Nature of work(check which applicable : New Building Addition Alteration Repair Removal n Other Work (Description) 4. Estimated Cost , OBD,, D— '700 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 3 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 sk Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front L y Rear ( Depth Height �2� 3" Number of Stories A- 9. (11� / r 9. Size of lot: Front � �a ��}9 Rear Depth � �O 10. Date pf Purchase Name of Former Owner Bg/�fQCU)C�c . iVASCH 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?YESNO Will excess fill be removed from premises? YES NO, Ae AO)c 105-6 //99 14.Names of Owner of premises if/1D 4(��Address R�is�ititl3v/lct /YX P-one No �3/) Z3S-7600 Name of Architect &;>ARD �95D�iiFTES Address /�00 '-*OW;A9 JoDe No 6 JI szj-q,3cio Name of Contractor�FF,�ScnTr'CoNsneceaTioiy Address �O' "'�''4�"�iA �006 pop r��" Phone No. (6 3/) 464-70 7a 6 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES N0,� * 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_� 14 d c,-D2-D lAt.%E)X 1.C-R WI.11b,being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the C,_7 K) F-Q (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 oZ Q' of 20LL — f .. JWL Public Signature f Applicant JOYCE M.WILKINS Notary public,State of New York No.4952246,Suffolk County Term Expires June 12. Q(5 0 3 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT 2 8 Do you have or need the following,before a� 1 ' ?Y g pp Ymg TOWN HALL Board of Health uea. 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. a$B' 7A je� Check Septic Form N.Y.S.D.E.C. Trustees Examined `d 3-D 20 6 i Contact: Approved 120 Mailto: Uot041217 Weydh#? wt.D. Disapproved a/c @—D-6u . 10'.176 _Rf-W►SEAt w-ke-z NY Phone:(16:? 'S 39-76 00 "q60 Expiration_ 120 Uq AdV Building Inspector APPLICATION FOR BUILDING PERMIT Date /D -A&-b 2. , 20 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. Q (Signature of 4plicant or name,if a corporation) (Mailing address of applicant) State whether applicant is//owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder n r,0&6 Je (C°OAv T2 AK T Ver IV D EE� Name of owner of premises OAejjmc ,/FF 4666=4410-F_ (As 666 SC44i0- (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: 70 ZA MACL <?0aA-,7- 6Z House Number Street Hamlet County Tax Map No. 1000 Section /2,,5- Block____QLot Subdivision ,C.,c U4e1_ !Z&&S Filed Map No. —Lot 16 (Name) TILl3ITI�A �F - -�I- - {- -L- �- Applicant/ Date Owners Naive: Reviewed. /� o Architect/ LL Date Engineer: L , Fo-& 1 Submitted: <<U .)- o a— SCTM #: District: 1,000 Section: xs Block: _ Lot: Project / un p / Subdivision Location: `f70 (..a -t�C- (..��n.�, � ���:�,t., ' Name: Sin&le & separate Required ��t —'— certification: (Yes/No) 1� ,A r Rcy. Req. If Zoning pistricc l� (Lotsize: _CS Actual: I (Lot coverage I'rupos�+� Rey. Z / Req. S/ ' }c / Req. 5`! t (J=rout Pard Ia_Proposed: 15D ) (Side Proposed^ / S'1 [Rear Yard _, � Proposed ) Project Description: 4' AGENCUERMITS Permit REQUIRED FOR REVIE W .A.A_ I;T O YES Number Suffolk County Health Dept. New York State D. E. C. —� Town Trustees Town Zoning Board approval: Town Planning Board approval: Flood Plane Elevation??? Flood Zone: I( eV a -� Lor SUFFOLK COUNTS'DEPARTMENT OF WEALTH SERVICES PERMIT FOR APPROVAL OF C014STPUCTION FOR A - VACAArr SINGLE FAMILY R sloui=0 4LY ye DATE ��IL� $. N0. ��TM� O l .. - set : } � ' APPROVED ' cif �? FORPAA:ttA1Ut1 ©t ,BEZROONIS raARr FROM DATE-OF APPRr:`/Ai EXPIRES T►itEE E �`�`'"�9• e.,ve o � f'e am fmnifw wt/h the STAMDARnS FOR APPROVAL $. AAIB CONSTRUC77 N OF S(AMW'ACE SEWAGE' P '''•. DISPOSAL SYSTEMS FAR ' SLE FAAIIL.Y RESMYCES A and wAl aMlde by be con*lons sel lo/AA M s*p and.on the � � • perrnit la aonsftci. ♦ V 4#iL o, Q SURVEY OF PROPERTY AT MA TTI TUCK TOWN OF SOUTHOLD, N. Y. 00 SUFFOLK COUNTY, N. Y. moo - - n - ��. SAWr 24 2W2 J� Oct. 1, 2042 (CERTAFICA TIONS) }_ �hh OCT. 25, 2002 f revlslon I h y ♦ '`o!► CERT/FAED TOS0'F NEIy �V PEC0IWC ABSTRACT INC. yDip FIRST AMERICAN TITLE NVSL4RANCE COMAP'ANY 0 0 OF NEW YORK ANDREW NEXLER DAIIMEL d NEER t , SHELLEY M9MER RODM+IAN r� ,�'' �T` ► The local of ad ceWok . ANO S� and or front data oafed from olhtts. N.Y.S. L1!tw MO. 49WB NOTES LOT MUIfM>!l RS AUER TO 74AP -Of' LALWEL LAWS 1AECOAK AL i't 0 ON NOED V. 23,E2t?fall AS FLEt NO.107 CLEWS OFFICE (631) 765 - 5020 FAJ( (631) 765 - 17-97 ._ A P. O. BOX 909 ' - Mit TlLAf s�eak� 1230 TRAVELER STREET AMAs MAW A ft SOU TMOL©, N.Y. 11971 02 - 2N