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Home My WebLink About38056-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 #: 38056 Date: 5/28/2013 Permission is hereby granted to: Plonski, William & Plonski, Nilda 143 Radcliff Dr East Norwich, NY 11732 To: Demolition of 14' x 18' Deck addition as applied for At premises located at: 590 Old Orchard Ln, East Marion SCTM # 473889 Sec/Block/Lot # 31.-6-20 Pursuant to application dated 5/17/2013 To expire on 11/27/2014. Fees: and approved by the Building Inspector. DEMOLITION Total: $175.60 $175.60 Building Inspector BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 76S-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Approved ,20 Disapproved a/c PERMIT NO. i.i 17 2013 Building Inspector 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 Zontact:~ ~ /9 /q ~ '/) I /~,~ L. I ~U "~ / ~ (~ APPLICATION FOR BUILDING PERMIT Date ,20 INSTRUCTIONS a. l'his 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 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. Fbe 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 tile 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 btfilding 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 tile property have been enacted in the interim, tile 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 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 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 anthorized 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 (As on the tax roll or latest deed) Il' applicant is a corporation, signature of duly attthorized 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 dgme: 3"7o OZ'e,e/ /_Z3 [louse Number Street County Tax Map No. i000 Section Block t~amlet c~- (..7 Lot ~ 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 l uc,~l~ee 5. If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (Description) (To be paid on filing this application) Namber 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 Height Number of Stories Rear 9. Size of lot: Front Rear Depth Rear 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 14. Names of Owner of premises Name of Architect Name of Contractor NO AddressXN Address Address Will excess fill be removed from premises? YES Phone No. Phone No 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. PERM1TS 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 __ · IF YES, PROVIDE A COPY. NO STATE OF NEW YORK) SS: COUNTY OF ) beiug duly sworn, deposes and says that (s)he is tbe applicant (Name of individual signing contract) above named, (S)He is the (Contractor, Agent. Corporate Officer, etc.) of said owaer or owners, and is duly authorized to perform or have performed tbe 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 iu the application filed therewith. Notary Public TOWN OF SOUTHOLD PROPERTY VILLAGE W OWNER ¢~T,~ ,'Id~ FORMER OWNER RECORD CARD J (t~, :ES..... o~- / O SEAS. L. ~ FARM CB. MISC. ACR. SUB. LOT '51 ,, TYPE OF BUILDING ./ MAt. Value LAND IMP. TOTAL DATE AGE I BUILDING CONDBON N~ NORmaL BELOw ABOVE FARM Acre iValue Per Value Acre ¥illable tillable 2 Fillable 3 ~/oodtand J FRONTAGE ON WATER ;wompland ,,.,h~o.~ ~.O.TAGE O. ROAD ~' ~ "~ "'~ BULKHEAD 'ota! DOCK Ext, Walls Extension -~ Fire Place Extension -- Type Roof __~ ~ ~ ~tion Room Porch ~ Breezeway ~ ~ ' ' · O.B. Total ~~ ~ Floors ~'7/-~- K. Heat ~L, /~L/I DR. RoomS Ist Floor BR. -., ~,ooms 2nd Floor FiN. B. 06/7.0/93 13:49 F.~. 516 742 7454 C0~IONWEALTH .~-, CLTIC Rlt0 ~]009/010