Loading...
HomeMy WebLinkAbout37771-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: 37771 Permission is hereby granted to: Upovac, Denis & Lipovac, Suzana Date: 1123/2013 32-58 37th St Astoria, NY 11103 To: Demolition of existing deck as applied for. At premises located at: 5220 Stillwater Ave, Cutchogue_ SCTM Cf 473889 Sec/Block/Lot Cf 137.-2-14 Pursuant to application dated To expire on 7/25/2014. Fees: 1118/2013 and approved by the Building Inspector. DEMOLITION $251.20 Total: $251.20 TOWN OF SOUTHOLD BUILDING DEPARTMENT TbWN ~IALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork. net ,/ Examined Approved eL '~ ,20 Disapproved 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 APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 thc 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 thc 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 thc 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, housingiouslng coue, a~u regucode, a d regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, ifa corporation) NY it,u3 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bmlde Name of owner of premises I~z ~4~ .5 a~s~ Sit Za,Oo~ (As on the tax roll or la{est 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. I. Location of land on which prop~,sed work will be done: 52.7..o 5-N l l ~ a. 4 o r ,/~1. House Number Street County Tax Map No. 1000 Section Subdivision 15-7 Hamlet c/ Block c~ Lot ?~' Filed Map No. Lot 2;' State existing use and occupancy of premises and inten, ded u, se arid occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Repair Removal Demolition ~ Other Work 4. Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars Fee Alteration (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 8. Dimensions of entire new construction: Front Rear Height Number of Stories .Depth Rear 9. Size of lot: Front Rear Depth 10. Date of Purchase ~/2~oo5 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 ¢/~ill excess fill be removed from premises? YES__ NO 14. Names of Owner ofpremises~ni- *~'~.~ ~o*~Address Name of Architect Address Name of Contractor Address 111o'5, ,/~/, Phone No. 7t~'- 6Z~3 - ~/z_ Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater 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 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(-~o *-~'~ ) ~)~tq~ > ~,.~l Do~)&C~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signihg contract) above named, (S)He is the 0.,3 IOQ ~r (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. Sworn to before me this Notary Public 20 ~ THOMAS R. MAZZOI.A Notary PubLicS ',: of i,:, ~v York Registration # 01 MAS:J77278 Qualified in ©uoen~ County My Commission Lxp,res ~¢i~y 5, 20,L¢. ./ mm , (2) 2X$ PT GIRDER , {21 2X~ PT GIRDER , ~ ~ ' (21 2X~ PT GIRDER ~2X8 LEDt FOUNDATION P~N ~ ~ DECK ~5 ~UILT (P~IOR 2003)