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Home My WebLink About37399-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 Cf: 37399 Permission is hereby granted to: Mollica, Peter & Mollica, Diane 50 Schooner Dr Southold, NY 11971 Date: 7/26/2012 To: demolish an existing deck as applied for At premises located at: 50 Schooner Dr., Southold SCTM # 473889 Sec/Block/Lot # 79.-4-2 Pursuant to application dated To expire on 1/25/2014. Fees: 7/16/2012 and approved bythe Building Inspector. SiNGLE FAMILY DWELLiNG - ADDITION OR ALTERATION Total: $100.00 $100.00 Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.nct Exa,nined .... ?/~', 20 i ~ Approved 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 C.O. Application Flood Permit Single & Separate Storm-Water Assessment Form Contact: Mail to: Phone: Building Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS 7/J ~ ,20/z- a. This application MUST be completely filled in by typewriter or in ink and submitted to tile Building Inspector with 4 sets of plans, accurate plot plan to scale. Fee accordiug 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 Bailding Permit to the applicant. Such a permit shall be kept on the premises available for iuspection 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 Occupaocy. f. Every building permit shall expire if the work aathorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. [f 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 addiliou six months. Thereafter, a new permit shall be reqaired. APPLICATION IS HEREBY MADE to the Building Department Ibr the issuance ora 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 tile construction of buildings, additions, or alterations or for removal or demolition as herein described. Tile 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, ifa 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 -r>4' '~gt ~ 25/0/~t' /'~othr c': (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. Location of land on which proposed work will be done: ttouse Number Street Hamlet County Tax Map No. 1000 Section ~9 Block z~- Lot 2- 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 Repair Removal Demolition '~' 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work Fee (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 Rear 8. Dimensions of entire new construction: Front Rear Height Number of Stories 9. Size of lot: Front Rear .Depth .Depth 10. Date of Purchase Name of Former 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. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this property within 100 feet cfa tidal wetland or a freshxvater wetland? *YES__ * 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. NO 16. Provide survey, to scale, with accurate tbundation 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 ) being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public, State of New York (S)He is the No. 01BU6185050 (Contractor, Agent, Corporate Officer, etc.) , Oualitled in Suffolk County Commission Expires April 14, 2 ~_~o 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. Sworn to before me this day of Notary Public ~ Signature of Applicant o o [00,0 j