HomeMy WebLinkAbout29035-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. 29035 Z Date DECEMBER 23 , 2002
Permission is hereby granted to :
HOWARD WOLBERT
PO BOX 280
MATTITUCK,NY 11952
for
CONSTRUCTION OF AN ACCESSORY STORAGE SHED IN THE REQUIRED REAR
YARD AS APPLIED FOR
at premises located at 1590 MILL RD MATTITUCK
County Tax Map No. 473889 Section 106 Block 0010 Lot No. 002 . 001
pursuant to application dated NOVEMBER 13 , 2002 and approved by the
Building Inspector to expire on JUNE 23 , 2004 .
Fee $ 81 . 00
Authorized Signature
ORIGINAL
Rev. 5/8/02
o�*OF SO!/ryol
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Town Hall,53095 Main Road Fax(631)765-9502
P.O. Box 1179 G Q
Telephone(631)765-1802
Southold,New York 11971-0959
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
August 23rd, 2006
Howard Wolbert
P.O. Box 280
Mattituck,N.Y. 11952
RE: 1590 Mill Rd. (Accessory Storage Shed)
SCTM: 106 10 2 1
Dear Mr. Wolbert
Please be advised that your Building Permit#29035 issued December 23`d, 2002 has
expired. According to the Code of the Town of Southold, a Certificate of Occupancy
must be issued prior to use of the structure.
To renew your Building Permit, please submit a fee of$81.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions,please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
pF SOUryolo
Town Hall,53095 Main Road 4 Fax(631)765-9502
P.O. Box 1179 G • Telephone(631)765-1802
Southold,New York 11971-0959 'Q
ly'r4UNT`I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
March 19th, 2007'v
�VV
Howard Wolbert
P.O. Box 280
Mattituck, N.Y. 11952
2"NOTICE
RE: 1590 Mill Rd. (accessory storage shed)
SCTM: 106 10 2 1
Dear Mr. Wolbert,
Please be advised that your Building Permit#29035 issued December 23rd, 2002 has
expired. According to the Code of the Town of Southold, a Certificate of Occupancy
must be issued prior to use of the structure.
To renew your Building Permit,please submit a fee of$81.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions,please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
I
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Owners Nae: 0 .r Reviewed:
Architect/ Date
Engineer: `— Submitted: 4*4 -S'--
SCTM fl: �� la�a
District: 1 000 Section: /0 L Lot: 02_ l
Project Subdivision
Location: —L5 LM a W A ��._ Name:
Sin&le & separate Required
certification: (Yes/No) JIA _
Req. / Rcq.
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AGENCUERMITS Permit .
REQUIRED FOR REVIEW N.A. NO YES Number
Suffolk County Health Dept. ./
New York State D. E. C.
Town Trustees
Town Zoning Board approval:
Town Planning Board approval: T
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TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN IIALL Board of Health
SOUTHOLD,NY 11971 3 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www.northfork.net/Southold/ PERMIT NO. 62 lav 3 S-;:!� Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined a ,206A Contact:
Approved Id 3 3,20'0-` Mail to:
Disapproved a/c
Phone:
Expiration 0 ,20D_I-
Building Inspector
�ry
e' APPLICATION FOR BUILDING PERMIT
Date 6 f ' 20 0a
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.
(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
A01-/ > /S I-AY aAWj6R
Name of owner of premises 011MRW/= AAJ,6> A�eleli9
(As on the tax roll or latest deed)
If applicant is a corpotion, signature of duly authorized officer
(Name and 'tle of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No. �-----
1. Location of land on which proposed wo will bed on
AID
House Number Street Hamlet
County Tax Map No. 1000 Section 10., Block
Subdivision Filed Map No. :LLot
(Name)
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( applicable):check which a :New Building �: Addition Alteration
Repair Removal Demolition Other Work
A( (Description)
4. Estimated Cost �l►' IW19. 0 0 Fee
(To be paid on filing this application)
5. If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars :�2-
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures,if any: Front /0 Rear
/n Depth /6
Height // 4P Number of Stories /
Dimensions of same structure with alterations o[additions: Front d10 Rear &-O
Depth Height /d' Number of Stories
8. Dimensions of entire new construction: Front 020 Rear Depth
Height /-' Number of Stories /
/ Q
9. Size of lot: Front !ego Rear /00 / Depth
10. Date of Purchase Name of Former Owner�l.�J /� /�- �/T�� J li✓�Gn
11. Zone or use district in which premises are situated —"—' • j
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO 1/
13. Will lot be re-graded?YES NO Y Will excess fill be removed from premises?YES NO
r// /
14. Names of Owner of premises i►IkJtA Aty4�Qss ��Phone No.
Name of Architect A'110X4-,'5 Address — Phone No
Name of Contractor �r, 'd, Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO V/
* 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.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the
(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 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.
Swto before me
y of U 20
otary Public Si e of Applicant
LYNDA M.BOHN
NOTARY PUBLIC,State of New York
No.01 806020932
Oualified in Suffolk County
Term Expires March 8,2
s' -
s OCCUPANCY 0 , `s,�
USE IS UNLAWFUL
MTHOUT CERTIFIEii
z
Of OCCUPANCY ; ; c
SEE P fl rA r 1.
fig, --�
IMERVMITERS CERTIFICATE
11 y° VVI 60 C�1 O JAG ._xols-T
5f� � P�,y Won pREQUIRED
--- APR AS NOTED
z -� x 6 u PPS f� P�.r1T� oA a °� ear a 9Q —
(5 --#t FES IT u-NDFR SIDING - ! �--- 2 `Z x _ SWEM&CMFITMENT AT
765-1802 9 AM TO 4 PM FOR THE
� FOLLOWING INSPECTIONS:
(�( SHE�r-T SIDING 1. FOUNDATION - TWO REQUIRED
- -- _ FOR POURED CONCRETE
it
�.. r 4 FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Q --- - Q - ALL CONSTRUCTION SHALL MEET
i THE REQUIREMENTS OF THE N.Y.
Z x 6 T K Ell FCC SILL j STATE CONSTRUCTION i ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
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