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Home My WebLink About35643-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. 35643 Z Date JUNE 14, 2010 Permission is hereby granted to: JOSEPH PETERSEN 85 SILVER COLT RD CUTCHOGUE,NY 11935 for : PARTIAL DEMOLITION OF EXISTING DECK AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 095 pursuant to application dated JUNE Building Inspector to e~ire on DECEMBER 85 SILVER COLT RD CUTCHOGUE Block 0004 Lot No. 018.001 4, 2010 and approved by the 14, 2011. Fee $ 70.00 ORIGINAL Rev. 5/8/02 TOWN OF SOUTHQLD BUILDING DEPARTMENT TOWN HALL ~ SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Exanfined ,20__ Approved ~/[¢, 20f~ Disapproved a/c Expiration 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: /Bu~ector ~-)[~ ~ [~ ~ ~ [~ [IA~ICATION FOR BUILDING PERMIT . ~/ ~~Jl INSTRUCTIONS Date ~1~--~ ,20 /~1 i~iaSccuratel~tt~] !s~l~[~l~,,~a~l~lCl~lg/' b_e co. _~lze~lcYor~Ine~ }~ sbcYh;dypuel~riter or in ink and submitted to the Building Inspector with4 sets of plar b. i qot 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 ttu'oughout 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 l 8 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. /'~'~ . ! ~l~ignature of apphcant or name, ~f a corporation) ~4.~'~ -- (Mailing address of applicant) State whether applicant is owner, lessee, agent, archttect, engineer, general conf~ctor; electrician, plumber o'r~uilder Name of owner of premises (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 No. 1. Location of land on which proposed woj~ will be done:~ , House Number Street Hamlet County Tax Map No. 1000 Sec;ion ~ ~:],.K" Block 0 ~ Lot [00. / SubdivisionO~ ~ t~ l_/t ~ ~'"~~Filed Map No. Lot 2. State'existing use and occupancy of premises and intended use and occ¢4Pancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable)~g Addition Alteration ~pair __Removal (,~DemoFltion~- I,,.'"' Other Work 4. Estimated Cost l'ee - (To be paid ~n filin~ ~l~is a~lication) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 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 Sto'i~ies 8. Dimensions of entire new construction: Front Rear Height Number of Stories ,~ 9. Size of lot: Front Rear Dept~ " 10. Date of Purchase Name of Former Owner Rear Depth 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~ l 3. Will lot be re-graded? YES__ NO ~'/Will excess fill be removed from premises? YES NO__ 14. Names of Owner o f premisesP.12"~O~-~q Address ~'~'~'t~, ~~Phone No. ~!-- ,2~ 7~""4/~J30 Name of Architect Address Phone No Name of Contractor 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 f~here any covenants and restrictions with respect to this property? * YES __ · IF YES, PROVIDE A COPY. NO J STATE OF NEW YORK) SS: . COUNTY OF~ ~ · ~/7-~/'~/~ /"'"/~ ]"~-~ ~ being duly sworn, deposes and says that (s)he is the applicant (Name 6f individual signing contract) tabove named, (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 thinx 20tO , "xNotary Public TOWN OF SOUTHOLD PROPERTY ,RECORD CARD ~ "m ?o~o - ~.~-'- ,/- /?. / DWNER STREET ~,~ VILLAGE DIST. SUB. LOT FORMER'OWNER N E *¢~,~.~ lC/ ~ND IMP. TO~AL DATE R~RKS __._~eod~l~ DEPTH ~ ¢ ~ 3¢ TRIM Foundation CL. ~. Both Basement '~ t'~-'T Floors Ext. Wcdls 'l'ra.x ~ I I Interior Finish Fire Place ~ Heat Type Roof ~a~- Rooms 15t Floor Recreation Room Rooms 2nd Floor Dormer Driveway