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HomeMy WebLinkAbout37183-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 #: 37183 Permission is hereby granted to: Dejesus, Beatrice Date: 5/1/2012 To: 21870 Route 25 PO BOX 1088 Cutchogue, NY 11935 demolish existing shed (200 sq. ft.) as applied for At premises located at: 21870 Route 25, Cutchogue SCTM # 473889 Sec/Block/Lot # 109.-1-3 Pursuant to application dated To expire on 10/31/2013. Fees: 5/1/2012 and approved by the Building Inspector. DEMOLITION Total: $167.50 $I67.50 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined ~. 2o/g Approved ~/'~l , 20 }.~ Disapproved a/c Expiration ,20 APR 2 ~ 2012 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the tbllowing, before applying? Board of Health 4 sets of Building Plans Planning Board approval Survey' Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Bulldin= Inspector ~PLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a. This applicatiou MUST be completely filled iu by typewriter or in ink and submitted to the Buildiug Inspector with 4 sets of plans, accurate plot plan to scale. Fee accordiug to scbednle, b. Plot plau showiug location of lot and of buildings ou premises, relationship to adjoining premises or public streets or areas, and waterways. c. The work covered by this applicatkm ntay aot be commenced before issuance of Building Permit. d. Upon approval of this applicatiou, tile Building Inspector will issue a Building Permit to tile 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 ill part for any purpose what so ever until the Buildiag Inspector issues a Certificate of Occupancy. L Every building permit shall expire if the work authorized has not commenced within 12 months after tile date of issuance or has not been completed within 18 months from such date. If no zouing amendments or other regulations affectiag tile property have been euacted ia the interim, the Buildiag luspector may authorize, ia writiag, the extension of the permit for an addition six monlbs. Thereafter, a new permit shall be required. APPLICATION IS HEREBY MADE to the Building Department for tile issuance of a Building Permit pursuaat to the Building Zone Ordinance oftbe Toxin of Sonthold, Suflblk County. New York, and other applicable Laws, Ordinances or Regulations, lbr tile constructiou of bnildiags, additioas, or alterations or for removal or demolition as herein described. The applicant agrees to comply with all applicable laws, ordiuances, buildiug code, housing code, and regulations, and to admit authorized inspectors ou premises and in building for necessary iuspectioas. (Signature of applicant or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder (As ou 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. ~/~}~and On whiqh prOpOs'cd v'~r''¢ will be dOne:''r]_.. ~/'/¥ /t/~/_ d ~FC/7~ ~ ~/~-~' 5/ '" - ltouse Number Street Hamlet County Tax Map No. 1000 Section I0(~ Block / Lot 3 Subdivision 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 Demolition ~v' Other Work Estimated Cost~gTp~,g /; ~'~ Fee 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 If business, commercial or mixed occupancy, specify nature and extent of each type of use. Dimensi°ps°~'existingjst'mctures'ifany:Fr°ntv~t'~/~'~/~L~Rear~ff/~'-'~ ~ Stod~/s' Depth Height _('X pp// i;'x~ Number of Dimensions of same structure with alterations or additions: Front Rear Depth. Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size of lot: Front Rear .Depth 10. Date of Purchase Name of Forn~er Owner 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. Nines of Owner ofpremis (0~' Address~fc//a¢~, ~/. Phone No. 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 * IF YES, SOUTHOLD TO'C/q'q 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. NO 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 · IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF _) beiug duly sworn, deposes anddoiq,tl41~s~[]l~l~l.llbe applicant (Name of individual signing contract) above named, Nota~/Public, Slate of New Yo~ No. 01BU618~50 QualEi~ in ~olk Coun~ , (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 rnanner set forth in the application filed therewith. Sworn to before me this, Notary Pablic TOWN OF $OUTHOLD PROPERTY RECORD CARD OWNER FORMER OWNER STRE~ ZI'~ 7© VILLAGE w DIST. SUB. LOT ACR.~ ~ ES. 2/0 LAND ~.7, ~ (} AGE NEW FARM j Woodland ~ Meadowlond j House,.~ot,..~ Total IMP. NORMAL Ac re TOTAL Y ~aa ,, FARM DATE COMM. CB. MICS. Mkt. Value BUILDING CONDITION B E LOW A B OVE Value Per Acre Vdue FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK COLOR M. Bldg. Exten,sion Extensior~ Extension Foundation Porch I Basement P h iE W II arc I xt. a s - Breezeway Garage Patio Fire Place Total IType Roof Recreation Room Dormer 2--' /¥ o Bath Floors Interior Finish Heat Rooms Ist Floor Dinette BR. Rooms 2nd Floor FIN. B Driveway