HomeMy WebLinkAbout34583-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. 34583 Z Date APRIL 6, 2009
Permission is hereby granted to:
P~ALPH PARISI & ORS.
17877 SOUNDVIEW AVENUE
SOUTHOLD,NY 11971
for :
DEMOLITION OF AN EXISTING DWELLING FOUND. AS APPLIED FOR PER
TRUSTEES PERMIT #7021
at premises located at
County Tax Map No. 473889 Section 051
pursuant to application dated MARCH
Building Inspector to expire on OCTOBER
17877 SOUNDVIEW AVE
SOUTHOLD
Block 0001 Lot No. 004
27, 2009 and approved by the
6, 2010.
Fee $ 342.70
Authorized Signature
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING DEP~RTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined ~J~ ,20 07
Approved d~/~l~ ,20 Oq
Disapproved a/¢ ?~
Expiration ~o[ I,~ ,20 [0
sets c
PERMIT NO.
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:
MAR 2 7 2009
a. This a,I~I~ST be con
Building Inspector
?PLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
tpletely filled in by typewriter or in ink and submitted to the Building Inspector with 4
;ee 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 pm'pose 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.
(Signature of applicant or name, if a corporation)
(Mailing address of applicant) p,J c.( { t q-//
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameofownerofpremises '-~-e_a~ ~X'c~C~e,-~o[nfx ~('3e-~,ko_O a-
)(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.
Electricians License No.
Other Trade s License
Location of land on which proposed work will be done:
House Number Street
Hamlet
County Tax Map No. 1000 Section 5- \ Block I Lot ~/
Subdivision Filed Map No. Lot
3. Nature of work (check which applicable): New Building
Repair Removal Demolition
4. Estimated Cost #~ au
I VO 0 Fee
State existing use and occupancy of premises and intended use and occupancy of proposed constructi'o~:
a. Existing use and occupancy o
b. Intended use and occupancy o~-,~
Addition Alteration
Other Work
5. If dwelling, number of dwelling units
If garage, number of cars
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front
Height. Number of Stories
Rear Depth
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 ot'lot: Front ! O O. ~ 5 Rear .Depth
I0. Date of Purchase Name of Former Owner
t)eptn
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
14. NamesofOwnerofpremises 'Fe.[l~so~'~-- Address 1-/ ~,~,a_~(5~-, ~ PhoneNo. ~1~-992- /~
Name of Architect Address Phone No
NameofContractor~n r3o~+~, ~l&c ~ Address/3/00~woo&Oc PhoneNo.
15 a. Is this property within 100 feet ufa tidal wetland or a freshwater wetland? *YES ~ NO * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this prope~y within 300 feet of a tidal wetland? * YES ~ NO~ tOC r~ t~ ~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide su~ey, to scale, with accurate foundation plan and dist~ces to prope~y 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)
SS:
COUNTY OF~,{-~011c )
~0~xc~ [~ , I~¢f'- ~0~ being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
CONNIE O. BUNCH
Notary Public.State of New Yorl~
(S)He is the CI~ e,q ~ .... ~..o:~0JB~6.1.8~0_50
(Contractor, Agent, CorpOrate'Officer, etc.) C0mrmssm Exp res April 14,
of s8id 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 this
'2/"'{ day of "~[~'~/~., 20 ~
Notary Public
-
Sign*ature of/~.ppli~nt
BOARD OF SOUTHOLD-TOW31 TRUSTEES
SOUTHOLD, NEW YORK
PERMIT NO. 7021 DATE:
ISSUED TO: TED AS~SANTE~ JOHN DECtCCO & RALPH PARISL
PROPERTY ADDRESS: .1.7877 SOUNDVIETM AVE/,~UE,$OU;THOLD
SC~FM#_51-1-4
AUTHORIZATION
Pursuant to the provisions of Chapter 275 and/or Chagt~,r J~l.l o![~he T0wa Qode of the Town of
.Southol~d.an~d)n aeeor.dance w. ith th.e Resolution of the Board of Trustees adopted at the meeting held on
~, and m cons~deraUon of application fee in the sum of $2 . , aid b ed
~DeciCco & Ral h Parisi and subject' the Tor~ a.A ~- J.2[~ ~fP Y~
ooara oilmstees authorizes and permits the foltiSwing- ~ · ' T ............"
Wetland Permit to construct a 4'x129' stairwav with nlatform~
s. ame]o~at,on as prewously ex,s~g ?airs; demolish and removq
,ounoauoa and undertake construction activities such as ground dis 6 ne$ d
cl~r~g activities associate0 with conswucfion of a new dw~ I cated no ~oser
1~' fr°m crest of bluff~ with the condition of a line, of s~aked:.h~ ,:a~s ~ith silt fen~
is installed along the landward side of the 25' buffer prior to construction, a 25' N~-
~s~anee Buffer is ~ be ma~ained, along the.mst aft~ B~.~i~ a 4' wide access
pa~"10 ~e staks, and as d~ted on the su~ey pr~ar~ ~-~h~ ~. EH/~s Land
~Y0r,:iast dated Janua~ 31; 2009and~.nnd received o~_.~ ~,~ .... ~aao,. ~.~-~ stair
plan printed by EnXCOnsultants, Inc. last d~ted Ap~l Zig g005 and received on
D~ember 26, 2008·
la bY~ maj6tity ot"the saMB6ai-d ~ of this
~-'~-/~-/-4 TOWN OF SOUTHOLD PliOPERTY RECORD CARD
DWNER ~ STREET//-/~ ~'/,~7 VIL~GE DISTRICT SUB.
' S W, ~ ~_.. ~ , , ~PE OF BUILDING
....,~-u s~ w~,~ I~d~ co~.~ I,~.Ic". I~'sc.
~ND IMP, TOTAL / DATE REMARKS
~ oo
NORMAL
BUILDING CONDITION
BELOW
AGE
NEW
Farm Acre Value Per Acre Value
Tillable 1
Tillable 2
Tillable 3
Woodland
Swampland
Brushland
House Plot
ABOVE
Total
LOT
M. Bldg.
Extension
Extension
Extension
Breezewa'
Garage
O.B.
Foundation Bath
Basement Floors
Ext. Walls Interior Finish
Fire Place Heat
Porch Attic
- Porch Rooms 1st Floor
Patio Rooms 2nd Floor
Driveway
.To__w,n of_ Southold
ion, Sed,mentatmn & Storm-Water Run-off ASSESSMENT FORM
RTY LOCATION: $.C.T.M. ~k THE FOLI.OWING ACTIONS MAY REQUIRE THE S["_~_M__!e_ _e!~_N OF A
STORM-WATER~
~' A D~RADINOf DRAINA.GE AND EROSION CONTrOl.
~P.~', ,r~ER B~ ESIGN PROFESSIONAL IN THE STATE OF NEW
.l.tem Number: (NOTE: A Cheek Mar~ (~) for each Question Is Required for a Completa Applicetion)
Yes
,--
1 Will this Pmjent Retain All Storm-Water Run-Off Genemtad by a Two (2"] Inch Rainfall en Site? '~ 7./'"/-'r~-
(This item will include all run-off craated by site clearing and/or construction activities as well as all Site
Improvements and the permanent creation of Impewloee surfaces.)
/
2 Boos ~e Site Plan andka' Survey Show All Proposed Drainage Structures Indlceling Size & Looalion? ~/' r~
This Item shall Include all Proposed Grac~e Changes and Slopes Commlling Surface Watan~owl
L
3 W~[ this ProJent Roqclra any Land Fining, Grading or Excavation whem there is a change to the Natural O L
Existing Grade involving mom than 200 Cubic Yards of Material within any Parcel?
4 Will this Application Require Land Disturbing Activities Encompassing an Area in Excess of r'~
Five Thousand (5,000) Square Feet of Ground Surface?
5 Is there a Natural Water Coume Running through the Site?
Is this Project within the Trustees jurisdiction or within One Hundred (100') feet of a Wetland or Beach? --
6 oneWill there be Site preparation on Existing Grade Slopes which Exceed Fifteen (15) feet of Vertical PJse tOHuedred [100') of Horizontal Distance? D--
7 Will Driveways, Parking Areas or other Impervious Surfaces be Sloped to Direct Storm-Water Run-Off r-'"l
into and/or in the dtrectiou of a Town right-of-way?
V--
8 Wi, this Project Require the Placement of MateriaL. Removal of Vegetation and/or the Construction of r~
any em Within the Town Right-of-Way or Road Shoulder Ama?
(This Item will NOT Include the Installation of Driveway Aprons.)
9 Will this Project Require Site Preparation within the One Hundre(l (100) Year Floodplain of any Waterceurse? E~]~
NOTE: IfAnyAnswer to Questions One through Nine Is Answered with a Check Mark in the Box, a Storm-Water, Grading,
Drainage & Erosion Control Plan Is Required and Must be Submitted for Review Prior to Issuance of Any Building Permitl
EXEMPTION.' Yes No
Does this project meet the minimum standards for classification as an Agricultural Project?
Note: If You Answered Yes to thta Question, a Storm.Water, Grading, Drainage & Erosion Control Plan is NOT Requlmdl y
Notary Public: .............................................................. ~ ..................
FORM - 06/07
STATE OF NEW YOILK,
cou~rv oF ......- .~...~.~.~..... ss
That I, ....~.~.._~..~..~"~'~.~ ........................ De/rig duly sworn, de~s~ ~d ~ys ~at h~she ~ ~e apph~t for Pen~
~d ~t he/she is ~e ......... ~q..~.~..... ...............................................................................................................................
· O~er ancot repr~en~ve of ~e Owner of O~er's, md is duly au~ofized to perform or have perforated
m~e md file ~s appli~fion; ~at ti sm~men~ con.ned in ~is appli~fion are ~e to ~e ~~d ~ef; md
· at ~e' work ~ll be performed in ~e m~ner set fo~ in ~e application filed he~
u0mmissi0n
· ........ ............................ ..... ,
"',~'~i~*'r" .......................
.e, ITUATE~ ~LD
T~ ~:)LtTHOLP
.~,UI~::~K C, Ol,'NT~, N"r'
APPROVED BY
ie~m~o BOARD OF TRUSTEES
T~ Ho~ ~Oo,~old e~,m~,~J~WN OF ,SOUTHOLD
08-26-2005 FL=
DATE ,,~,~'/~' /i o 9
N
FVL
JOHN C. EHLERS LAND SURVEYOR