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HomeMy WebLinkAbout34471-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34471 Z Date MARCH 3, 2009 Permission is hereby granted to: MAE C MAURI 4 ALDEN LANE PORT WASHINGTON,NY 11050 for : DEMOLITION OF EXISTING DECK AS APPLIED FOR. at premises located at 1070 CRITTEN LA SOUTHOLD County Tax Map No. 473889 Section 070 Block 0012 Lot No. 009.002 pursuant to application dated FEBRUARY 25, 2009 and approved by the Building Inspector to expire on SEPTEMBER 3, 2010. Fee $ 70.00 Authorized Signature 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 Approved ~_'~ BUILDING PERMIT APPLICATION CHECKLIST Building Inspector Do you have or need the following, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey_ Check Septic Form Trustees Flood Permit Storm-Water Assessment Form Mail to: Phone: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date 20__ 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 puq>ose 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 fi-om 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. Therealler, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for the issuance ora 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 buil~l~g for necessar~'l~pections. J '7 '~'--" (Signature o f applican'ro~'na~n e, ifa corporation) - (Mailing address of apphcant) / · '"7~ DATE:_ Name of owner of premises (As on the tax roll[~t~s~ d~°-e~UIpI' n _~ If applicant is a corporation, signature of duly authorized officer 765-1502 8 AM '~O 4 PM FOil THE FOLLOWING INSPEC'TIONS: (Name and title o£corporatc officer) 1. FOUNDATION - TWO REQUIRED Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on wh~c,h propgsed work will be done: Ho[:s; Nfum"'ber "~ 'St['e[/ ...... County Tax Map No. 1000 Section Subdivision '70 FOR POURED C©NCRETE 2. ROUGH - FRAM;NG & PLUMBING 3. INSULATION 4. FINAL - CONSTRL}CT!ON MUST BE COMPLETE FOR C,O. o ~4~:~TRUCTION SHALL MEET T~HE -~ ~,t['~r~,l~l~',c,~!~'~ n~ T~ nor)ES OF Nc.W ESPONSI LE FOil Block DI[S~ OR CLOo~dSTR~TI~ ~RRORS. Filed Map No. 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 Alteration Repair Removal ~~ Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Numbar of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, speci~ nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height. Number of Stories Rear Dimensions of same structure with alterations or additions: Front Depth Height. Number of Stories 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front Rear .Depth 10. Date of Purchase ~'/e~0~q 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 ~ Depth Rear ~/'/~,- Depth 13. Will lot be re-graded? YES__ NO __ Will excess fill be removed from premises? YES__ NO__ 14. Names of Owner of premises~t~ ,/~ ttt, lt't Address Phone No. Name of Architect __ , ~d,/t'~ Address --/ PhoneNo. ame of Contractor~ Address ~Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO 3~ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE I~EQUIRED. 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 k,~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH (S)He is the Notary..PubI. j.c~..S.~_ .te_~ _Ngw York (Contractor, Agent, Corporate Officer, etc.) no. u.touo.t~ouDo Qualified in Suffo k County Commission [l~llires g0ri114 20/.3,. of said owner or owners, and is duly authorized to perform or have performed the said work and to make andtlle this apphc~iti'dn;,~ 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. Sumrn to before me this_ '~'~ dayof ~5~2)Z~.&O~--~ 20~ Notary Public Signature of Applicant File Edil View Toolbaf Window Help ...~..j! 170.-12-9.2 'l~89S~Ulh~,ld Acl~e R/S:1 School: $°uihold H~i~ Hah "e~Y~ 1 F~mil~ R~ L~nd ~V: i700 Slate: ~ Cede: , 1.050- Cd: Dw~¢~ @~Q Lite Use Owner Type: Ready ~ S [a~rllI S.C.T.M. NO. DISTRICT: 1000 SECTION: 70 BLOCK: 12 LOT(S): 9,2 EL 51.7 ,0"~ 'bt 65'55 MON FD O/L 48,8 PP ROOF OVER CONE. PORCH "%% o,g SHED .32,3 CL 50.31 S 63°~'0'30" IN THE WATER SUPPLY, WELLS AND CESSPOOL LOCATIONS SHOWN ARE FROM FIELD O~SERVATIONS ANO OR OATA OaTAINEO FROM OTH£RS. ~,REA: 41,585.8 S.F. OR 0.95 ACRES ELEVATION DATUM: ASSUMED UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STAT~ EDUCATION LAW. COPIES OF THIS SURVEY MAP NOT 8EARING THE LAND SURVEYOR'S EMSOSS£D SEAL SHALL NOT 8E CONSIDERED TO 8E A VALID TRUE COPX GUARANTEES INDICATED HEREON SHALL RUN ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE. THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR ,4 SPECIFIC PURPOSE AND USE THEREFORE THEY ARE NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE ERECTION OF FENCES, ADDITIONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY SURVEY OF: DESCRIBED PROPER'P~ MAP OF: FILED: SITUATED AT: SOUTHOLD TOW~ OF: SOUTHOLD SUFFOLK COUNTY, NEW YORK FILE # 28--,33 SCALE: 1"=30' DATE: APRIL 22, 2008 N. Y. $. LIC NO, 50227 CERTIFIED TO: THOMAS MAURI; MAE MAURI; KENNETH M. WOYCHUK L.S. Land Surveying and DesiLm P.O. Box 3, MatUtuck, New York, 11952 P~ol%'~ (661) ~'08-1688 FAX (631) 208-1688