HomeMy WebLinkAbout34349-ZFORM 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. 34349 Z Date DECEMBER 15, 2008
Permission is hereby granted to:
ALFRED & MARY KNAPP
PO BOX 443
PECONIC,NY 11958
for :
DEMOLITION OF ACCY DETACHED ONE CAR GARAGE AS APPLIED FOR
at premises located at 3175 SOUNDVIEW AVE PECONIC
County Tax Map No. 473889 Section 068 Block 0001 Lot No. 011
pursuant to application dated D_ECEMBE__R 10, 2008 and~by the
i~illing Inspeci~510 expire On JUNE / _~
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown. NorthFork.net
Examined ., 20
Approved ,20___
Disapproved aJc
Expiration ,20__
PERMIT NO.
~DL~. DEPT,
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.S.D.E.C.
Trustees
Flood Permit
Storm-Water Assessment Form
Contact:
Mail to:
Phone: ~:t~j- _ j~fff ,9
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date ,20
INSTRUCTIONS
a. This application MUST 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 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. ,n ~ , ,
- Aig~na~ure of*alj~p[icant or name, it~orporation)O'~''
(Mailing address of applicant) [
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises '~xLff (9 (0
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 whichproposed work will be done:
House Number Street
County Tax MLJp~o. 1~;0 ~ection & ~>
Subdivision
FOLLOWING INSPECTIONS:
1. FOUNDATION. TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3, INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C,O.
ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
YORK STATE. NOT RESPONSIBJ_~, FO_R_
Block / Lot II
Filed~ Map No. Lot
State existing use and occupancy of premiseq
a. Existing use and occupancy ]
b. Intended use and occupancy
and intended use and occupancy of proposed construction:
Nature of work (check which applicable): New Building
Repair Removal Demolition
Estimated Cost 4 [~'- {._.)0 Fee
If dwelling, number of dwelling units
If garage, number of cars d
Addition Alteration
Other Work
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
If business, commercial or mixed occupancy, specify nature and extent of each type of use.
Dimensions of existing structures, if any: Front Rear
Height ! ~_ ,r~_~- Number of Stories ~
Dimensions of same structure with alterations or additions: Front
Depth. Height. Number of Stories
Rear
10. Date of Purchase C/ I ~'-! 6 ~
Dimensions of entire new construction: Front Rear
Height Number of Stories
Rear /~1 'ff~ Depth
Name of Former Owner ~.~'(-0
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES__
Depth
NO f
13. Will lot be re-graded? YES__
14. Names of Owner of I$r~Thses
Name of Architect
Name of Contractor
NO ~Will excess fill be removed from premises? YES__ NO__
~4~,-~ i~/¥Address~t'~ q ~xx~ O, ¢ Phone No. ") (~ ~'%~ 3-",i~ (..)
t 'Address Phone No
Address Phone No.
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 f
· IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
COUNTY OFS[) (~L- [~-~:
I q~ L, ~B,t. 1'212) being duly swom, deposes and says that (s)he is the applicant
(Iqfin~e of individu&l ~igni~g ~contract) above named,
(S)He is the ~'~.k,'r~..~~
(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 tree 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 th& , ~ _~
~ D JCl- day of!) Cq~ ~ I~'V' 20 O~
' ' NoW~u~hc MELANIE DOROSKI
NOTARY PUBUC, State of New Yo~
No. 01D04634870
Oualifiefl in SuffolkOoun~., ~ } ~
~ls~on ~ir~ Sept~ ~, ~
Sig~ of~pplicant 'V
N47"O9'40'W
S47'09'40'E
N/O/F ALFRED & MARY KNAPP
SURVEY
OF PROPERTY
A T PECONIC
TO~fN OF SOUTHOLD
SUFFOLK COU~TY, N.Y.
1000-68-0i-ll
SCALE: 1~50'
FEBRUARY 2G, 2008
UL
N /O,/F
ALICE BENNETT FAMILY
ALICE BENNETT QUALIFIED PERSONAL. RESIDENCE
CERTIFIED TO~
UNLIMITED ABSTRACT COMPANY
ALFRED KNAPP
MARY KNAPP
COMMO'NW~-Ar TH L'AND~~ ~7~ITLE dNSE]RANCE COMPANY
AREA=3.7851 ACRES
TO TIE LINES
ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION
OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW.
EXCEPT AS PER SECTION 7209-SU~TDIVISION 2. ALL CERTIFICATIONS
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF
SAID MAP OR COP/ES BEAR THE IMPRESSED SEAL OF THE SURVEYOR
f~c~CONIC
{631) 765-~
INa 49618
31) 765-1797
P, O. BOX 909
1230 TRAVELER STREET
SOUTHOLD, N.Y, 11971