HomeMy WebLinkAbout34094-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.
34094 Z
Date AUGUST
7, 2008
permission is hereby granted to:
WILLIAM & ELEANOR J FORTE
1155 HARBOR LANE
CUTCHOGUE,NY 11935
for :
DEMOLITION OF EXISTING ABOVE GROUND SWIMMING POOL
at premises located at
1155 HARBOR LA
CUTCHOGUE
County Tax Map No. 473889 Section 097
Block 0006
Lot No. 012.003
pursuant to application dated AUGUST 6, 2008 and approved by the
Building Inspector to expire on FEBRUARY 7, 2010.
Fee $
70.00
\(~~b~
Authorized Signature
ORIGINAL
Rev. 5/8/02
1
PERMIT NO. "'I) fe'(fb
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.SD.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form_
TOWN OF SOUTHOLD
BUILDING D~PARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.N orthFork.net
Examined
'? \::::L, 20 l) ~
<l\-1f ,20(')~
Approved
Disapproved ale
Contact:
Mail to:
Expiration
OL \-=1, 20n
Phone:
7-.3t/-- 7" 'If)
\{ u:Ju.C:;--'\~ Q~
Building Inspector
r
\1;
APPLICATION FOR BUILDING PERMIT
1 :l
, . J ~ ' \ INSTRUCTIONS
L.l!JJIi=pplioiliiJri M'bS 1 be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 South old, 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.
',ill
"
J'
Date
1\W
,20~
(Signature of applicant or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
I) +;;~(5
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
,
M J-j. JJtj-f/V)
Name of owner of premises
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
I. Location of land on
II
House Number
,
County Tax Map No.1 000 Section
Subdivision
97
Block t:,
Filed Map No.
Lot /J.. ~
Lot
"
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
3. Nature of work (check which applicable): New Building Addition
Repair Removal Demolition ~o L Other Work
Alteration
(Description)
4. Estimated Cost
Fee
5. If dwelling, number of dwelling units
If garage, number of cars
(To be paid on filing this application)
Number of dwelling units on each floor
6. Ifbusiness, commercial or mixed occupancy, specify nature and extent of each type of use.
Rear Ibl Depth_+r
7. Dimensions of existing structures, if any: Front J;) /
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
Height Number of Stories
Rear
Depth
9. Size oflot: 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_ NO_Will excess fill be removed from premises? YES_NO_
Phone No.
Phone No
Phone No.
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address
Address
Address
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_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.
18. Are there any covenants and restrictions with respect to this property? * YES_NO_
* IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OF~S:
W \\ l \Ilm A r=;; ("+ 12- being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
CONNIE D. BUNCH
Notary PubtiC8lState of New York
Nn 01 ~&11IS05O
Qualified in SUfIalk Countv
Commission Expires April 14, :zO~
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 ~~
(.~ dayof ~ 20~
~,..,J h ~ct..
Notary Public
(S)He is the
OlDnefL.
(Contractor, Agent, Corporate Officer, etc.)
df~ j{~
/ Signature of Applicant
I' ;-~.-;.-~~"".......... ~"\:~~
'j'"'' -'_.~~~-"'=- , "
'., ,'~4NF1LIm MAP Q~ . . .
'II "..E'i212 PET..Q C, . ..1.O'tS C:,IlTIiI2l..IN<!.':
" QlNf'OOI2'JflnoM SUFF.CO. D.P,Ir{:"~I"'~'ilJEY~
~.!::t~~ ~ LEVg"';'~G\ia
- ....-.---..----, - t-
I
I
l:r
"
If
,"
~~
d
'1
-~- ....
~~WAl1!ollrtr '
-,', '. ..... QP
L, 0, eY~N, DA7:ibr:"
-'". APPIlDvBo
! I -p.':-YBARs IX'
i e. J (IIESIDE",€)
(~ll': j ~'1
- _ l..! it;S- ,..r\olfLL!
- r ! ....1'l " ~_'
- - - . ~ ;,._~.t-'-
""...." 3 30' - .....,.,_lllO_
- . ,,' "." \
- - -'- - - 8- \ -~__
ui-
!!)
C....,.,. I (Fe ljaril1 @
'f' ~~Ste~l.ING)
, oe.,CE J
'J"~
*'ATEMEN'f OF INTENT. ~
n. SUPI'l. Y AND oawACK D'_L
)I'OR THIS "RlDENeE,. WILL
.. ,TO THE IT "NaMDS OF TIC
~, DEPT, Of' HIAL1I< KIlY'ca$.
---
...":1
-.-'''';':',
.t-.
.._A' ,
..'J
I!I
~.
SU"~,c "..COUNT" DEPT, OF' HEALTH
li.Yr~'11 - FOR AP"ROVAL. 0'
CONS1'ItUCTION ONL V
DA'N: '.
j",:..iF. f!O,'
AM!OYiIJI,
,-
:.
3 ':~~-=':E'T1C I ... _\<~)
'8 ""'''I,'<I<'2''""",l., !i!. .
o! SOYorvh04. ~,' ,;s ",'" _____,,_l5O
"1/) ""'" .
'G ~'I.. t .."" ..,,?~.t;~' "." .,' ;7':, '.', .
ad ""'. ..' _, .
:r;:i "
,:" {"'4<'OO,"
-DaJGN ION~
. '~C1CJ' ~.' PCL,.
IlRlQ . ,,"97 "'~ ',' ~.I&
QWNlUts A/lIOll'" , ,
~,., , tDl.llIlMP...",,,,,.'
-,--~~'7& .
.... ,- ,~)'~ '"
t:EL.~7"7S5
De"""" p,
PRORW&lL
. __...,I
..._ oj
II< ,~
. ~..,"'.....
. > -" "
.;,.-;:;>:-..~. .
-.:-" .)-
tJ
.i
, i
FeCI-
,t
.,_",OCl ,,'
-".,..,;.--
,'18" '-weu.'
,-
I
I' _ .
, IS, WIS:S6:"'~
tror?M. ",,,,.5Tf';:LING)
(
'.
A
~""""'III"""'~
=--::........-
......................
........................ .
-.................
......--...
----"-......
-..-,-...-.......
:.-:=,....~....--.::- '-:
.~'..._-...
'"e.o<..~._...,...... . '
-~~~-:=
"10_ ~'i"
f SCA.LE:sd',o
G). IRON PIPE ~~"1l>
~
i , ~ l, no.x ",",P .DATA'
! ". -"'"" ".""..,. 097:. (.-I!'/O 12.
"",
"""'''' ",
;;'M.. .....:)
',' "AU"'"
......s... I'
." 0
(")0"\:"
{:t~, -sf J.
.~ ,; ,:"'!Ii-
........
.
....ft1..
MAP O~ PI20PERTY
" '"SUI4\(EYEP 1"01'2. .'. .
\,ijLLlAMAfELEANOR J. POQTE
----------" , ---
,;l;[ .
.,nJrCHClGtIt:
row'NDrSOUTIiOLD NoY,
~
'.' Tn'LE NO. \4O-IOee-s
";.~~~,~~;.,,,,,-.
~,' -r. ~"~~'
TB~,""',""
L_LAHD~
GRaa.DItT '..ICW"~
;,
.~7
~..'
.MAP AMEN".~' MAI2. 3!..!22!
'.
~. -
I
I'
i 10
OWlilER
M ;:;rh
FORMER OwNER
,1-.
I
TOWN OF ~O~~LD ."2...Pft]'J
- .... : "f"'o&' ..
~:.,.=.:'_-+" . ..;.".~:~~..:.-.....,..,. -,,' ........
.- .' .-- J
.......... - - --.. .-.. - -..... .
. ....... . .. ~. ''&~
.':ft;r~ - ...., - -~, -::.~.: ~..
.. ,..-~~~-..:::.,
- -'-'~'" .
. - . -: _ .-::',.:b..:.. ....'_~.'
,.J
, d. ~'o.. /--.d.11 ~
N'
q~./.
i.
iRES.
,
i
/1f(J3,J==te'r II A
SE,l,S.
5
. ':,;l4/:::-/St! r - al~p
FARM
LAND
IMP.
TOTAL
<>0
12.1>'0 '~D"
t'~..,,;,-,
.... :))1'2-
l1w~/i"'JI'4c
I~';'
".
",
...~
....~"f:'
Tlllaf?le
Waod~nd
'M~
Hou.e .p~
tatal
FRONTAGE ON WATER ~
FRONTAGE ON ROAD ~
. . ;l..
DEPTH ! c: .j 0' i) '!
. "
BULKHEAD
"'
0:- "-.
.~ ..
~, , J-.. ---. _
f ",
.2..0
,.
F
...._~ .. " l'
.- , . .. ..' ...,'
.., .1l;"'':..' .eo.",,' ':'II.,..~...~.....~.~..'!P':"I'! ,too :.;.~, ~,."oJ.'to;,.'\"""~"'I...~~.,,:.~:~..-,....<CI" "r," . ) "'IIIIl'" --
l"" "._ __n__.
.... ... '. ;
- ." . "'~. ,.' ~. -':: .'
.~.:~~ -f.~" jo~.;.. .,~.. "~:i'.~.;tlti~~~
- . ~. .: "~~ ...~.l." ,.., ,,"'1"';' Q~
. . 1'\ ';,::'1' o:;.~.:.o;"..' ;-~~~~. ,: ' ~ '! ;:.'
..... J-~ ." <l... t, ~ ",:, I'<i~" ':0. . ,(J.~ COLOR TRIM
. .'J'...."..,....~'" .'
: :">~:': '~~l.~X~~ ~ " ,
,- -.
~. 'to .-
'f,,~~.. .- '. - -
t:p.":)~ .. '.:\ ;''- ~::~~ -- -- - .-
.. b&, ~;,-<'<, iJ.df
.. .i::.
.;.-.,.....,. "
......
, .....'
..
e " - -
'"
Iz- , '-.
I~
, I.,,, .~
. .- .~ . . " .. -,"-' ... I.-.~
"- .-. -- .-- -'..-'-- .- --- IV>.
3/9 ,
if / jl;
,
- ., "',
.. ._~.
M. Bldg. . .)-
..
Extwwion 2'&K,lcll <- .\1 12..... 18D~ S~ 14 '2.1'2_
-tit 4- \\0 -
Ex_ion .
-
-~ion 2. "!I- ~ =- \'2. \( (?~ ". :2 4 2.~~ (,.0
Foundation p.r. Bath .. J?,~\\ Dinette ./
Paid! _I '( e.5 ,. tAl.e - \2 . \2..~ ,,st) !tit Basement ~ FIoors- . -- K. '"
. ~\.\
IIon:h i::..1\: 12:'1( ?L1 ... 2.~ , 2-.') 72., Ext. Wqlls ''''''''1\ t.\1iIP Interior Flnliih SII!... LR. ..;
, .
; Fire Place Heat DR.
BrMZ8WCIy '/ES ./
Garage 24 '( '<-4 -- 57(0 It.! 72:-0 trype Roof IWorris ht Floor BR. . 3
-
Patio ','Ul . RlIcreation Room Rooms Ziici'Floor ~ J
0.8. I ",,"l: ",,,,e.,.o.,,, r" .'.~ Dormer Driveway
~- .
fW1l1 .~. ""r.. ..".- 1/,,1\., iJ''(- 7/1113
""'1\.0',",$ '='___t'../ "'if'" tI".1 i/,o,o/. ./()"-"
.--- (,/.98 %~
..
PORM NO. 4
TOWN OP SOOTllOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
lifo, Z-30391
Date, 08/31/0.4
THIS CEll.TIFIBS that the building
ACCESSORY
Location of PJ:O(lerty, 1155
(HOUSE NO.)
County Tax Map Il10 _ 473 889 Section 97
HARBOR LA
(STREET)
Block L-
CUTCHOGUE
(HAMLET)
Lot 12.3
Subdivision
Piled Map Iifo_
Lot Iifo.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JUNE 21, 2004 pursuant to which
Building Permit 1l1o. 30430-Z dated
JUNE 23, 2004
.was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ACCESSORY ABOVE GROmlD SWIMMING POOL IN TIlE REQUIRED REAR YARD "AS
BUILT" AS APPLIED FOR.
The certificate is issued to WILLIAM & ELEANOR J FORTE
(OWNER)
of the aforesaid building.
SUFFOLK COllIlITY DEPAR1'MKIIT 01' HIll\L'm APPROVAL
M/A
BLECTRICAL CEll.TIFI= 1iIO.
2016801
08/06/04
PLllMBBRS CEll.TIPICATION DATED
M/A
~:::;..,~l~..
Rev. 1/81
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMI!NT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
NOI Z-25591
Datel 03/16/98
THIS CERTIFIES that the building
NEW DWELLING
Location of Property: 1155
(HOUSE NO.)
County Tax Map No. 473889 Section 97
HARBOR LA
(STREET)
Block L-
CUTCHOGUE
(HAMLET)
Lot 12.3
subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
fil~ in this office dated
MAY 28, 1996 pursuant to which
Building Permit No. 23593-Z
dated
JULY 17, 1996
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is ONE FAMILY DWELLING WITH ATTACHED 2 CAR GARAGE, REAR DECK & FRONT
COVERED PORCH AS APPLIED FOR & AS PERZBA .4394.
The certificate is issued to WILLIAM & A. ELEANOR J. FORTE
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMI!NT OF HEALTH APPROVAL R10-96-0027
02/25/98
ELECTRICAL CERTIFICATE NO.
N-419743
05/13/97
PLUMBERS CERTIFICATION DATED
07/07/97 HARDY PLUMBING & HEATING
Inspector
Rev. 1/81