HomeMy WebLinkAbout29304-Z FORM NO. 3 01D
BUILDING
TOWN OF SOUTHOLD U
BUILDING DEPARTMENT I
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 29304 Z Date NOVEMBER 13 , 2003
Permission is hereby granted to:
MICHAEL ANERELLA
184-38 ABERDEEN RD
JAMAICA ESTATES,NY 11432
for
ALTERATIONS AND ADDITION TO AN EXISTING SEASONAL DWELLING AS
APPLIED FOR. THIS PERMIT REPLACES BP#25801 .
at premises located at 855 PINE NECK RD SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0005 Lot No. 033
pursuant to application dated APRIL 16, 2003 and approved by the
Building Inspector to expire on MAY 13 , 2005 .
Fee $ 150 . 00
Authori ed Signa re
COPY
Rev. 5/8/02
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
-tS2 4614
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 25801 Z Date JUNE 15, 1999
Permission is hereby granted to:
MICHAEL ANERELLA
184-38 ABERDEEN RD
JAMAICA ESTATES NY 11432
for
WINDOW ALTERATIONS AND BATHROOM ALTERATIONS FOR SEASONAL DWELLING
AS APPLIED FOR Amended to include alteration h addition to an existing seasonal dwelling
as applied for.
at premises located at 855 PINE NECK RD SOUTHOLD
County Tax Map No. 473889 Section 070 Block 0005 Lot No. 033
pursuant to application dated APRIL 23 1999 and approved by the
Building Inspector.
Fee $ 75 .00
Additional fee of $75.00 for amendment. _
Authori Signatu
ORIGINAL
Rev. 2/19/98
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FORM NO. 1 3-SETS OF .PLANS 4. ... ... . .. .. . .
TOWN OF SOUTHOLD SUVE ... .. .. .... . ....... . . . . . ..
BUILDING DEPARTMENT CHECK ... .... ..... . ... ... . . . . . .
TOWN HALL SEPTIC FORM . ...... . . ...... .. . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY: //�� _ n
CALL 3q 7 %7d.q - (u!' 'k
Examined ..� ., 19.,E.j a�3oy � MAIL To: . . . . .. . . . .
.... �. ., ... Permit No. .. ........... w ............
1131 e3
Dia/c .....I....... ................... `. ....................
.. ....................
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(Building r)
APPLICATION FOR BUILDING PERMIT
_.._.1 Dat ..
.,
INSTRUCTIONS
a. this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector vi
3 sr_ts of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings an premises, relationship to adjoining premises or public
streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
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
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 whatever until a Certificate of
Occupancy shall have been granted 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
regulations, and to admit authorized inspectors on premises and in building for necessary inspections.
( •gnature of applicant, or name, if a corporation)
...................................................
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer,*general contractor, electrician, pluuber or builde-
.................. :� . ........................................................................
Name of owner of premises .........'.1� .......................................................
(as on the tax roll or latest deed)
1
If applicant is a corporation, signature of duly authorized officer.
(Name aid title of corporate officer)
Builders License No. .........................
Plumbers License NO. .........................
Electricians License No. .....................
Other Trade's License ND. ....................
1. Incation of land on which
�proposed
Awork will be done..............................................................
..... J. .7...................!!I!!�r.!`! :)L..�22�-p.............................................................
House Number Street Hamlet
County Tax Map No. 1000 Section .....7.s ....... Block ........�...... Lot ..�1..........
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 ........ .. ... ' .. ............................
ANY ALTERATION OR AVa7DV TO THS"VEY/S A MMA TM
SECTION
T AS��FOR IM MAP Abp *Q0
�,ME NEW YOW STATE 91X A LAW
1�
SIVA OR VAS WARR 7W WK�7 OF TW SURVEYOR
WMM S1 M MW APPEARS MDMOYM.
ADDITIAVALLY TO OOhftY KM SAD LAM THE TERM ALTERED BY'
Awr 9E USED BY ANY AHD ALL SLRVEYORS UTLRM A COPY
OF ANOTMN SURVE'YOR'S l{AP. TERMS SMM AS WECTW AN
T--To-DATE'ARE NOT N COIPLUNCE wITH THE LAM.
AREA = 12017 ac.
The local/ons of wells and cesspools
shown hereon are from field observations
and or from data obtained from others. ✓O
l=/wAr wM Ma SMAVARDS FOR APPROVAL
AAD CONSTRIiCMN OF"9MALE SEN'A6E
AISPOSAL SYSTEMS FOR SA/6iLE FAME RESMMS
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CERTIFIED T0*
ROBYN CANNAR/ATO ANERELLA
ISUTTON LAND SERVICES, INC.
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SURVEY OF PROPERTY
AT SOUTHOLD
TOWN OF SOUTHOLD
3 SUFFOLK COUNTY NY
1000 - 70 - 05 - Sig
SCALE 1" = 50'
W OCT. 1, 1998
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P. 0. 80
1230
TRA V TREET
SOUTHOLD, N.Y. 11971
. 98 - 315
184-38 Aberdeen Road
Jamaica Estates, NY 11432
January 29, 2004
Mr. Michael Verity
Building Department
Town of Southold
Town Hall
Southold, NY 11971
Re: Permit Number 29304Z
Dear Mr. Verity:
Please be advised that effective January 30, 2004, I will transfer ownership of the
property (855 Pine Neck Road, Southold,NY) for which the above referenced permit has
been issued, to Anna Andrews-Acker, P.O. Box 429, Shoreham,NY 11786. Therefore, as of
that date I request that your permit be transferred to Ms. Andrews-Acker accordingly.
Sincerely,
L
Michael D. Anerella
SO!/jyol
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Town Hall,53095 Main Road Fax(631)765-9502
P.O.Box 1179 G Telephone(631)765-1802
Southold,New York 11971-0959
COU ,�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
June 20th 2006
Anna Acker
P.O. Box 429
Shoreham, N.Y. 11786
RE: 855 Pine Neck Road
SCTM# 070 0005 033
Dear Mr. Acker,
Please be advised that your Building Permit#29304 issued Nov. 13th, 2003 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit,please submit a fee of$150.00 at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.