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HomeMy WebLinkAbout29727-Z FORM NO. 3 TOWN OF BUILDING DEPARTMENT Town Hall Southold, N.Y. NnT �ul �i BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 29727 Z Date SEPTEMBER 12 , 2003 Permission is hereby granted to: EFFIE L MOORE PO BOX 515 CUTCHOGUE,NY 11935 for SCREENED PORCH ADDITION TO AN EXISTING SINGLE FAMILY DWELLING ONLY AS APPLIED FOR PER DEC AND TRUSTEES APPROVAL WITH FLOOD PERMIT. at premises located at 50 OAK RD NEW SUFFOLK County Tax Map No. 473889 Section 117 Block 0002 Lot No. 001 pursuant to application dated SEPTEMBER 10 , 2003 and approved by the Building Inspector to expire on MAR412 , r Fee $ 250 . 00 ature ORIGINAL Rev. 5/8/02 OF SOpjy�6 TOWN OF SOUTHOLD BUILDING DEPT. 765-1802 INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION REMARKS: DATE 3 INSPECTOR ✓� � FIELD. DATE CON�'S „ . FOUNDATION(IST) . • C FOUNDATION(2ND) M rA 'ROUGH FSG& PLUNIMG H INSULATION PER N.Y. STATE ENERGY CODE "] i FINAL ADDMONAL CON11 n, I � n o- y h9 I V WIN VV JVU IHVLU bURIVEN U rhXM1l AFFLlUA11UN l:rihl KL1J BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health 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. Check ✓ Septic Form N.Y.S.D.E.C. Trustees ✓ Examined I t2 ,20 3 Contact: Approved ,20 Mail to: Disapproved a/c Phone: LL=��f'D� Expiration �'y ,20 1 } Build' g In4pector APPLICATION FOR BUILDING PERMIT Date q/,� , 20 00 -r 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. (Signa of applicant or name,if a corporation) OW/V k©AD Cep rc#0 70t (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Alm#_trcT Name of owner of premises /g' y /)7CV/0F (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. AVVVC Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: .moo © D�� �ICIU C>Ff,D House Number Street Hamlet County Tax Map No. 1000 Section // Block �02 Lot 0/ Subdivision Filed Map No. Lot (Name) r 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /9�1006F b. Intended use and occupancy (?� 3. Nature of work(check which applicable):New Building Addition t/ Alteration V Repair Removal Demolition Other Work (Description) 4. Estimated Cost �o 060, Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 6/C Number of dwelling units on each floor If garage, number of cars AMIE- mey 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front o:)4 /Tr Rear 0 Depth Height a2 §_ FT, Number of Stories /f Dimensions of same structure with alterations or additions: Front 86 Ar Rear /y% Depth 40 All Height 125' kr' Number of Stories / 8. Dimensions of entire new construction: Front /o� lir Rear fol If Depth Height / �r Ar Number of Stories QUG 9. Size of lot: Front_ -70 lT ReDepth Z20 Ar. 10. Date of Purchase Name of Former Owner (MUW MOO)te ' 11. Zone or use district in which premises are situated 0e_*0 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ✓ 13. Will lot be re-graded? YES NO /Will excess fill be removed from premises? YES NO 14. Names of Owner of premises dWP-6y/7MOOo& Address,A/B,ll dA�'OCK Phone No. -<o/R5 Name of Architect e!'fj 0 &7S Address Cel MHO 6Uu Phone No -(o Eg Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES V NO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMIT§ MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES ✓✓ NO * 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) e�,rr '/S\S: COUNTY OFA lir C ffluetS being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the <reoT - - - (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 day of 2003 Notary Public Signature of Applicant PATRICIA RICHARDS Notary Publlo, State of New York No. 01 816042467 QUAliltild in Suffolk County i46 on Expires May 30, 209 -65 o LK AT , EW SUFF0 SURVEY OF PROPERTY � OF s 4 " LD, k , k 1000-117-02-01 JAN 6, 2OW r FC ASPHALTol yt �? x 28.2 S �! Z3• 3,�T, ��� ti k o4 »Ar �X AREAjw27,612 S.F. P �'Uvsig NEW cY09 y •+�'`� Y. *L N0. 4 £18 EC I S , ANY ALIM77ON OR A0017ION TO THIS SURVEY IS A VIOLATION (631) l -5v0 � FA-X 1) 765-1797 OF SECTION 7209W THE NEW YORK STATE EDUCATION LAW. P.0. B �� 49 EXCEPT AS 'PER SECTION 7209-SUMMSION 2 ALL CERMCA TIONS HMON ARE VAUD MR THIS MAP Alm COPIES THEREOF CWLY IF 1230 SAID MAP OR CORES BEAR THE A"ESSED SEAL OF THE SURWYOR ■=MONUMENT SOUTHOLD, 71 02`_'_353 SI J w AIRS ia�i/ZL\V A i4A%Lfli1 i AiL i1 tZyy\Away Vix l'j VAS."A..71 r DATE REVIEWED: �i is /03 APPLICANT: t�� ��c�ol�� DATE SUBMITTED: It ho /03 SCTM#DISTRICT: 1,000, SECTION: I I ,BLOCK:�, LOT: �_SUBDIVISION: ►-SIA ADDRESS: 6-0 yAv_ 2n CITY: KL fY'oca_ZONING DISTRICT: — _CONFORMING?d/ BUILDING PERMITS OPEN/EXPIRED: PRE CO: Y OR(s) BP -Z/C/0 Z- , INFO /'BP -Z/C/0 Z- , INFO BP -Z/C/0 Z- , INFO /BP -Z/C/0 Z- , INFO SINGLE & SEPARATE CERTIFICATION-REQUIRED A/q —NOTES: LOTS 40,0000-100-24,Lot recognition.(CREATED before June 30, 1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at anytime aft( REQ. LOT SIZE: — ACT. LOT SIZE: 3 696REQ. LOT COV. ; ACT. LOT COV. REQ. FRONT PROP. FRONT 51 REQ SIDE ACT. SIDE REQ. REAR 0-0 PROP. REAR ✓ REQ. REIGHT PROP. HEIGHT o nL'1 ( �a Dec T,-rvsis PROJECT DESCRIPTION: Pofch �1ddt`�or� F_loo ��na " ESTIMATED PROJECT COST: 4 6t>V —HITMT/ENGINEER: �Sun_s qa WATER FRONT? A* DESCRIPTION: PANEL # FLOOD ZONE9T APPROVALS REQUIRED SUFFOLI{COUNTY HEALTH D + T: YES of ED #): DTE: / /_ PERMIT#: TOWN SEPTIC RECEIPT: Y NEW YORI{STATE DEC: PR -DEC 9/1/7 DTE: 12�)'/3 PERMIT #: SOUTHOLD TOWN TRUSTEES: DTE: /g2/ 3 PERMIT #: TOWN ZONING BOARD APPROVAL: YrS fr �i� DTE: / / PERMIT #: TOWN PLAN. BOARD APPROVAL: YES oDTE: / / PERMIT #:TOWN HISTORICAL PRE (SPLIA): YES o NEW YORK STATE CODE COMPLIANCE (SEE PAGE 2): E or NO NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF INIT OTHER TOTAL TOTAL: a SF FEE FEE FEE 1 ( —SF)- ( SF)= SFX $ =$ +$ +$ = $ �5 v I`C_ 2. ( SF)- C_SF)= SFX $ =$ +$ +$ = $ /00 3. (--_—_SF)- ( SF)= SFX $ =$ +$ _ FINAL T TAL: $O9-5 NEW YORK STATE CODE COMPLIANCE CHECKLIST CLIMATIC/GEOGRA- 11C DESIGN CRITERIA: j Ground Snow Load: 45 Wind Speed: 120MPH / Seismic Design Category:B ✓ Weathering: Severe ✓ Frost Depth: 36" ✓ Termite:M-H ✓Decay: S-M Design Temp: 11__,,/ Ice Shield Underlay: YES Flood Hazards: A USE/OCCUPANCY CLASSIFICATION` HEIGHT/FIRE AREA: / TYPE OF CONSTRUCTION: DESIGN CRITERIA: ENGINEERED SCRH!T�5 71 AA A t=P11 FULL FRAMING DESIGN ELEMEN HEADERS: Y/N WALL STUDS: Y/N GIRDERS: Y/N CEILING JOISTS: Y/N FLOOR JOISTS: Y/N ROOF RAFTERS: Y/N LUMBER SPECIES AND GRADE: Y/N / DESIGN LOAD CALCULATIONS: Y/N / LIVE: Y/N DEAD: Y/N SNOW: YIN SEISMIC: Y/N `'MND: Y/N WINDOW AND DOOR SCHEDULE: V-**� MISSLE TEST RE,QUIREMENTS: Y/N EGRESS 5.7 S.F.: Y/N LIGHT 8%: Y/N VENT 4%: Y/N j NAILING/CONSTRUCTION SCHEDULE: Y/N MEANS OF EGRESS: Y/N ✓ PLUMBING RISER DIAGRAM: Y/N f" /Ac LOCATION OF FIRE PROTECTION EQUIPMENT: Y/N /V A TRUSS DESIGN: Y/N P I CERTIFICATION: Y/N ry ENERGY CALCS: Y/N N A' TOTAL COMPLIENCE /N (RETURN TO PAGE ONE)