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Home My WebLink About29128-Z �1rd FORM NO. 3 TOWN OF SOUTHOLD JUUU 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. 29128 Z Date JANUARY 27, 2003 Permission is hereby granted to : EDGAR SALVADOR 1200 ALDRICH LANE LAUREL,NY 11952 for CONSTRUCTION OF AN ACCESSORY DECK IN THE REQUIRED REAR YARD AS APPLIED FOR "AS BUILT" NOTE: DECK BUILT PRIOR TO 2003 at premises located at 1200 ALDRICH LA MATT/LAUREL County Tax Map No. 473889 Section 125 Block 0001 Lot No. 002 . 010 pursuant to application dated JANUARY 27, 2003 and approved by the Building Inspector to expire on JULY 27, 2004 . Fee $ 150 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 FIELD INSPECTION REPORT DATE COMLVIENTS' b FOUNDATION(1ST) FOUNDATION(2ND) 'g x - o ROUGH FRAMING& PLUMBING INSULATION PER N. Y. y STATE ENERGY CODE i FINAL r B ADDITIONAL COMMENTS 8- 0 - � O x d B � . INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION C 1 FRAMING [ ] FIREPLACE & CHIMNEY REMARKS: c DATE INSPECTOR /�^� BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ j FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE 8 CHIMNEY REMARKS: w DATE GU �� INSPE R r: TOWN OF SOUTHOLD .�-�/l r S C'` BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT / G 1 _ 7 �N 2 7 4M Do you have or need the following,before applying? TOWN HALL C G ! ! Z r B and of Health SOUTHOLD,NY 11971 3�ets of Building Plans TEL: (631) 765-1802 7 ''---Pianning Board approval FAX: (631)765-9502 -►Survey www. northfork.net/Southold/ PERMIT NO. ,1 / rCheck Septic Form N.Y.S.D.E.C. Trustees Examined ,2005 Contact: Approved '2003 Mail to: Disapproved a/c Phone: Expiration ,200�1 uilding Inspector APPLICATION FOR BUILDING PERMIT Date October 1, 2002 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. EDGAISi~AD@1Ricant or name,if a corporation) , . p k (Mailing address of applic t) TH " State whether applicant is owner; e's ,41;ineer, general ntr or builder OF NANVY' DA BR OWNER Name of owner of remises EDGAR SALVADOR NOTIFY BUILDING DEPARTMENT' �T r 765-1802 S AM TO 4 PM FOR TI1� (As on the tax roll or 1liEak q"INSPECTIONS: If applicant is a corporation, signature of duly authorized officer 1. FOUNDATION - TWO REQUIR'-.0 FOR POURED CONCRETE (Name and title of corporate officer) 3, INSULATION FRAMING A PLUMBih 4 FINAL • CONSTRUCTION MUST Builders License No. BE COMPLETE FOR C.O. Plumbers License No. ALL CONSTRUCTION SHALL MEE, Electricians License No. THE REQUIREMENTS OF THE N.'a; Other Trade's License No. STATE CONSTRUCTION do ENERG`' CODES. NOT RESPONSIBLE FO 3 DESIGN OR CONSTRUCTION ERRORS 1. Location of land on which proposed work will be dorle: House Number Street Hamlet County Tax Map No. 1000 Section k4 Block l Lot 0 '/0 Subdivision Laurel Estates Filed Map No. 7870 Lot 1 (Name) 2. State existing use and occupancy of premises ano intended use and occupancy of proposed construction: a. Existing use and occupancy Single Family Residence b. Intended use and occupancy. Single Family Residence t5 LJ Lit-- 3. Nature of work(check which applicable): New Building Addition' Alteration Repair Removal Demolition Other Work (Description) --4— Estimated Cost — $1 ,000 . 00 Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units one Number of dwelling units on each floor If garage, number of cars one 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. N/A 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories Two (2) 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 100 Ft. Rea. 100 Ft. Depth 400 F t. 18 , 200 William C. Goggins and Jul 10. Date of Purchase Y Name of Former OwnerM. Geejg' 11. Zone or use district in which premises are situated R-80 12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO X ' 13. Will lot be re-graded? YES NO Will excess fill be removed from premises?YES NO X 14. Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NOS * 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 NE f' RKj COUNTY OFM"a'�Tl . ED ., ?a;nRQA $ being duly sworn, deposes and says that(s)he is the applicant (Name of iridivi contract)0ia named, (S)He is the 9wne " : 'i(Cont3ractop,Aigent,Corporate Officer, etc.) 1. ;"I7 i [yy. )6XKLUX , grid i91'01yaut icriiteb to perform or have performed the said work and to make and file this application; that all statem n s jontained in this"*46flon are true to the best of his knowledge and belief; and that the work will be performed in th�ma er set forth}n the�pliAtion filed therewith. Sworn to before this y 1 � 'lR9Ptober , 20" 2 Notary Public z Signature of Applicant DONNA M.PALMER Nmwy public,!fie d New Yak No.01PASOMM t UVW in 8uf*Couch 246-6 <2_ RUQL I�d%I ) r- - I �BJ-I- ,—I-LL17- Applicant/ Date. Owners Name: Reviewed: AZ;' 03 Architect Date Engineer: Submitted: —�s�- �� SCTM M: District: 1.000 Section: ��.`S Block: L Lot: -/D Projeo � � �// Subdivision Location: ��[t7� �JL �Y_att_ — Name: Sin&le & separate Required ) �J certification: (Yes/No) Req. Req, --- Z(ning l)istricClo S20 11,0(size. Actual: 4yD _l (Lot coverage Proposed Req. Req. Req. //�� t� (l wont Pard Proposed: J [Side Yard Proposed: ^ [Rear Yard Lo/ Proposed Project Description: AGENCYJERM TS Permit REQUIRED FOR RTi✓VIEW1_.A_ NO 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: e z � rev +KLi �o'1rS s°fie onsPrvt' 3-*" 1 r Ncrs. '� D�cw n�err • Actvtc.rlrep �f'o ►�ovs�. Z�c ..l9ix5 X� CC.A 4�Gk+1 N C-i --- ----------- ------- _ ------ 1�9x rngv �cion -�Z S-or• .l o °Q P7 ocpq'= V iQ cpp..J DPT >S � ,1,�A"• � � Qot� SV. y 11 o� ?3 s a 0 y c 0. N SURVEY FOR SUFFOLK COUNTY DEPARTMENT OF HEALTH SERYICU ROSCOE PALMER Ell DONNA PALMER OCT. 13,1902 S 1987MICY OWELIINC ONLY LOT 00.1 "LAUREL ESTATES EAST,SECT.1" JULNOV. 22,1906 lIOV.29,191!8 DATEDCT FLS,REF.N0. Sri" �7dL AT LAUREL DATE, FEB.22,19es The sewage difpo{al and waler.119POY ISCOOS IDT this TpWN OF SOUTHOLD SCALE- I":70' kalbn have been Inspected by this Deparlmentan&OfNO. 85-179 other egolAla p!0 laD to ae�e�y, SUFFOLK COUNTY. NEW YORK ,^ J MNMVTNOIAXID AI.Tl11A110NORA0O1ftOM 10 THIS GUARANTEED TOt �i' 3UPVCT 9 A VIOL=Or ACTION Tto$OT THE ROICO MER Chlal of Bures9 of Wastewala tdanagemenl Ncw Toler ffATc cOV.,11OP LAM N COPT[7 of TNI!sIMVIV MOT /[APNO INK LINO E sufvILOR I INNI O PEAL ON INIOUto /{AL!NAIL �p C MOT P[C'"SIDEPtO t0 04 a VAL10 TAUt COP. NOU411ANTEtt IMDICAftV HERON[MALI-IUP O1LT M Jt O HEALTH DEPARTMENT-DATA FOR APPROWIL TO CONSTRUCT TR PERSON FOR WHOM IN IVPYCT IO►IPAPaO =O 4 AND O."IV BEHALF TO INK?Ing COMPAMT,OOVTAM •j •vCANKI/OIrU�ItA1M--..�,�MIyy�M00YNG(OI�FATKM•PMIMtC ►VBLIC� MENIAL AGENCY AMO LCPOIMO Mf TI TVTIOM LISTED p P ""EST TAN MAP ON1111p11.S{C YIOM 'en WICK..91_LOT�,�p- N(NEOM,ANs r0 THE AsiIOMfEK O/TNa LEM DINB N TM[AE ARK NO 00{LLNMS♦ITNIN 100 rt ET Or TMe PRoPCPTI IISTITUTIOK ODARANTEO APE MOT IIWtl/l�lA elE OTNIn THAM THOSE 10411*! "Coto". TO AOO/f10MAl Mf 11TUT10Mf OA fUe3tOVlM .TNt MATEP 711/'/LY AIN SCwft DISMAL 1YfTIM TOR Ton NOIotMC{ 4 DINTA 1 WILL COWONN TO THE STAMOARoo 0f TMt 311/MLM GOVPTY tt►ARf"INT M OINISNCIS SHOWN HtRSOM l OR %SPECIFIC LIMIT ti K RI/f1e TYle erR E NOT T MK FOR 1 fNU190 TO STAlt _UfMT LTH 3r,INIC(!, P"Optp TTSC ALIRIND S OR�ORTTMICEACCr10M OF 119"Cas .000171 401)V nL. YOUNG a YOUNG RRFIEAO,NEWER AYORK E NOTF. it-MONUMENT 0•STAKE ALDEN W.YOUNG,PROFESSIONAL ENGINEER NB0 Iv191CN MAP FRED IN THE OFFICE DF THE CLERK OF ANOLANO SURVEYOR N.Y.S.UCENSE NO.12847 SUFFOLK COUNTY ON APR,4,1985 A!FILE NO.19 TO HOWARD W.YOUNG, LANG SURVEYOR 0. LocAT.rePIIill,LIrL1KmGaNNfTIBCtmooLswlSHOWN wwtoN N.T.S.LICENSENO.45B93 Mt nO.T"KLA OMKPV.TIOMS ANO 00 DATA OMTNMtB"M OTNCPB •"AMM.A fOMf IND.10.0