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Home My WebLink About36944-ZTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 36944 Date: 1/26/2012 Permission is hereby granted to: Burns, Roseann PO BOX 261 New Suffolk, NY 11956 To: Construction of an Accessory Building; Shed, 10' X 12', as applied for. At premises located at: 4370 New Suffolk Rd, New Suffolk SCTM # 473889 Sec/Block/Lot # 110.-8-29 Pursuant to application dated To expire on 7/27/2013. Fees: 111812012 and approved by the Building Inspector. CO - ACCESSORY BUILDING ALTERATION OF ACCESSORY BUILDINGS Total: $50.00 $148.00 $198.00 Building Inspector FOUNDATION (Is'r) FOUNDATION . ~OUOH ~0 ~S~ ~ N. Y. STA~ EN~ CODE ~D~ION~ CO~S ~ ~fl:tALL ~¢()~HOLD, NY 11971 ' ;~EL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net PERMIT NO. Examined / - Approved_ 20 Expiration 20 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: ~..~1'~---~ Phone: Building Inspector I ? ; TiON O II ,Jb,}l 1'] 2~)'~?- ~L7'~/ Date '/'1 ,201'7 ~ ~.~ INSTRUCTIONS ~y filled in by typewriter or in ink and submitted to the Building Inspector with 4 T} 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 pe~Tnit shall expire if the work authorized has not commenced within 12 months a~er 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 aherations 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 ap-'~ican~ or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~22, o~-~. -jt:~t~td x~Z2>O f:~ l'-l~ (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. u Electricians License No. ~, Other Trade's License No. '~ Location of land on which proposed work will be done: 4-%'?0 ~-~ '~o~-c--~v~-~-- ~.xv~2 House Number Street Hamlet County Tax Map No. 1000 Section Subdivision Filed Map No. Lot Lot State existing use and occupancy ofpr~mises and intended use and occupancy of proposed ' ~ constmctmn: x~, a. Existing use and occupancy ~ r4~l_.~ ~1 t--~? [2)vVl~il-~.ld G, b. Intended use and occupancy Nature of work (check which applicable): New Building Repair Removal Demolition Estimated Cost ~O DOe If dwelling, number of dwelling units If garage, number of cars Addition t/ Alteration Other Work ~ ~15~:O (Description) Fee (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 ~ Rear ~ .Depth '~ Height I,¢~' Number of Stories I Dimensions of same structure with alterations or additions: Front ~ ~ Rear %~r Depth ~D'~> ~ Height. ~ ~5 Number of Stories ~ 8. Dimensions of entire new construction: Front Rear Height ~ -2~ Number of Stories 9. Size oflot: Front 100 Rear ~0 ~' Depth 10. Date of Purchase ~OO4- Name of Former Owner TL=12-1i3~ 1 I. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES__ NO X, 13. Will lot be re-graded? YES NOXtq, Will excess fill be removed from premises? YES %, NO 14. Names of Owner of premises'12o--~ Name of Architect Name of Contractor Address Address Address Phone No. Phone No '~.g -~::~-~ 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 'x * 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 · IF YES, PROVIDE A COPY. NO ~< STATE OF NEW YORK) SS: COUNTY OF ) .I"') t_~ I```3 ~ ~ I.- ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the t -I'-~---.(~'T''''- (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. Swomto before me this -- O 20 } , /' !" ... ~'x,%.t~ GYNiHIA J. KESSL~FI ,.,. .... . . ~'~orary ax: ~]gnarure oz^ppncam / ~o Notary Public, State of New York ~' No. 01 KE5006684 ~BU!LDING PERMIT EXAMINER CHECKLIST Applicant: Architect/~a~am~: ~ SCTM#1oDO--{IO- g- ,~ Property Address: Subdivision 'Date Submitted: [- [ 7-,/$1~ Date Reviewed: Estimated Cost: ~_5-0 Zone: ~-~a Conforming? City: ~-~-~Pre COs? Building Permits (Open/Expired): BP -Z / C/0 Z-__ Info: BP__ -Z / C/0 Z- __, Info: BP -Z / C/0 Z- Single & Separate Search Required? Y o~)Determination: REQ. Lot Size: ACT. Lot Size: /~') 0 BP -Z / C/0 Z- , Info: BP__-Z / C/0 Z- , Info: __ ~Q. ~t Coy. ao% ACT: ~t'Cov. REQ. Front ACT. Front REQ Side ACT. Side 1KEQ. Rear ' PROP. Rear -- REQ. Height. 3~'/ ACT. Height RlF.~t. Be'c8 $1b~.5 ,, A CT Project Description. c~n.~~ ~ ~r~ . Waterfront? Y o ~' ' ' ' ' ' If yes, water body: ~h stance: ADDITIONAL APPROVALS REQUIRED pktlt4S(q-) 51674~b~ .~,n/_KO OP-,,~q.¥~p, SII'~ PLAN Suffolk County Health: Y or N - If yes, *Bed#: *Date: / / *Permit: Town Septic: ~ If no, certification required: Y or N Received: Y or N By: NYS DEC: ea~-o~cgnns Y or N - Date: / I Permit #: or NJ Letter - Notes: Southold Trustees: Y or N ~ Date: / / Permit #: or NJ Letter - Notes: Southold ZBA: Y or N - Date: / / Permit #: - Notes: Southoid Planning: Y Or N - Date: :/__/__ Permit #: - Notes: Town Landmark C of A: Y or N DTE: / Notes: ' / *NYS CODE.~_ompliance (page 2): Y or N Fee Structure: b we t.d Foundation: SF First Floor: SF Second Floor: SF Other: SF Total: SF Calculation:/- +(~ ~/-L-]I/C_~+ Initial Fee: $ dditional Fee ( ): $ c o 3-0, oo X -? ! · NEW YORK STATE & TOWN CODES AS REQUIRED ~ CGNDiTiGN$ OF .~ -SQ~D TOWN Z~ ~ I 7, SOUTHO~LANNING BOARD APPROVED AS NOTED L r- ~ ~U". DiNG DEPARTMENT AT-- · Mq TO 4 PM FOR THE-F:~. , ,, ~PECTIONS: -- i ~ , )N - TWO REQUIRED ~ ~----~----~-' ~ED CONCRETE .~ - FRAMING, PLUMBING, 4 EINAL - CONSTRUCTION & ELECTRIC~ ~UST BE COMPL~E FOR C.O. ~ ALL CONSTRUCTION S~LL MEET ~E,