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HomeMy WebLinkAbout35204-Z FORM NO. 3 TOWN OF SOUTHOLD VI v I I~ BUILDING DEPARTMENT ^ I Town Hall I//~~ 11 l Southold, N.Y. ~~L~ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35204 Z Date DECEMBER 8, 2009 Permission is hereby granted to: PAULETTE SATUR MUELLER 3705 ALVAHS LA CUTCHOGUE,NY 11935 for CONSTRUCTION OF A COMMERCIAL AGRICULTURE BUILDING (FOUNDATION) AS APPLIED FOR PER PLANNING BD. APPROVAL 3~~~~ to ~'~C~ ~l /9-,~ . at premises located at 3705 ALVAHS LA CUTCHOGUE County Tax Map No. 473889 Section 101 Block 0002 Lot No. 024.005 pursuant to application dated NOVEMBER 30, 2009 and approved by the Building Inspector to expire on ,7UNE 8, 2011. Fee $ 250.00 G Authorized Signature ORIGINAL Rev. 5/8/02 s FIELD INSPECTION REPORT DATE COMMENTS N. V1 FOUNDATION (IST) ~ FOUNDATION (2ND) ll~' o Jy ROUGH FRAMING & ~ PLUMBING ~ "j INSULATION PER N. Y. H STATE ENERGY CODE FINAL C-J ADDTTIONAL COMMENTS S 1 O 2 rn ~A I ~X z 2 d TOWN,OF SOUTH ~ ~ ~ ~JI BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPAR Do you have or need the following, before applying'? TOWN HALL Board of Health SOUTHOLD, NY 11 NOV 3 0 2009 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631)765-9502 B ~.UEpL Survey SoutholdTown.North ork.net TOW ~ 3 ~ Check Septic Form N.Y.S.D.E.C. Trustees f Flond Permit Examined G ~ X , 20~` Storm-Water Assessment Form Contact: .Approved~6~i7 , 20~ Mail to:~G°~ - L.1 h \ Disapproved a/c _ Phone: S 1 - " 3 Ct,t~ Expua ~ 20 ~ _ j ~1" Ot~r~ ~F ~ Building Inspector APPLICATION FOR BUILDING PERMIT Date , 20 INSTRUCTIONS a. This application MUST be complotely 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 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 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 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 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 authorized inspectors nn premises and in building for necessary inspections. ~O,~Fa..~..a,1Lc (Signature of applicant or name, if a corporation) 3 7os Ac.vPys' [.a.~ ut~u-wc...~ n~~' (Mailing address of applicant) ~ j ~/,33- State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises {~.-~~.-.~-i.w~'^°~-~"~-~ a~~Q ~~-~u-~C. ~40'~"- (As on the tax roll or latest deed) If applicant ' a o oration, ~~nature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. l . Location of land on which proposed work will be done: "~"~oS ~p~yaH3 ~rJE C.~c.~oGa-tom House Number Street Hamlet County Tax Map No. 1000 Section ~O 1 Bloc), a- Lot a y Subdivision Filed Map No. Lot ~ C + ii i I; ,~1, f _ 2. State existing use and occupancy of premises and intended ~~e~and occupancy of proposed gonstruction: a. Existing use and occupancy t.... .r ! i b. Intended use and occupancy 6A ~d2 ~lpKby 5 ~ OF ~E7'W!3 t,....f _ r ~r 3. Nature of work (check which applicable): New Building ? .4dditiori. - _ 1 Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost ~ Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor ~ ~f garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. Gil c.ucsly~ ray tNc` ~J 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories ` Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories r 8. Dimensions of entire new construction: Front ~C>7.67 + a•2.33r Rear .~'jo•67 ~ra~.33 Depth 7a67 it ~{0~.~3 Height 3S Number of Stories ~ ~ ~ i 9. Size of lot: Front °2 ~¢3 Rear ~`I 'Depth. a 3/a 10. Date of Purchase fl ~ ~ 1 `I9 ~ Name of Former Owner ~ R U,$ C O ,S ly 11. Zone or use district in which premises are situated l4~- !7 L S'i'p-t ~ 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 ? PAUr.~,~cs~ S,rn,2 3ZoS Ac-~/Atts ~ 14. Names of Owner of premises ~ ~ MuEu-EA,pddress G.~t+oG-~t~ Phone No. ~3 I -Z 3`~-y a.19 Name of Architect Address Phone No Name of Contractor S.S GGi Eno ~'NC. Address /w3J~S/~r? A~Phone No. 631- 7 ~ ~ (3/oy T~ NY (i-74T 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 j.EQUIRED. b. Is this property within 300 feet of a tidal wetland? *YES NO * 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 NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) S COUNTY OF ,~G~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is the zi~yY/ (Contractor, Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized [o 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 p ~7~" day of d 20 O~'- / k ~ Notary Public Notary Public, State Of NewYoAt Signature of Applicant Na,31-4970341 tlualffied In Suffolk County Commission Expires February 4, 20 f L Town o~ Sau~l~old Erosion Sedimentation ~ Stonnii- ~ ~ ~ Water Run-.off /tSSESSMENT FORM YF PaopeRtY LOCATpN; - S.C.T.Y: fi ~ - ~g ACTT NS MAY R@gpIRE.T{rS 8U ~Eb© ~ ot~t s.~ C p ~ - A.. .C ttanNumber (NOTE: AChedrMmkf+I)faeacht~esaonlsRequiredroracanpiatenppacetbn) Yes No. 1 ww gas Pm)act Rata~l al storm-wafer atawlftnedby a nw ~ lnd, r:eh~aa a, arcs? - - - ` /J~ (lids ham xMl•include all nuroRpatr~ by sl0s-alepuarg errNorcertatructlon~adMdes eawea:as ap sae Imprgvetttents and the Penrrenerrfa~tlon.dtaipervbrte slrfeoes..) 2 floes ihe.SitePlan anNa Stwey~3how Aa Proposed Stnap+res Irtdkxang Stag 61-oeaaonT ~ a This ttem stiert krcluile au Proposed. grarJe p~geS-eHd Stopes,tbnboayg gudace watetl-'IeWt 3 war this Project Require en? Lana-Filtlng; ~Mt9 a E~uaivauon where ti>e,eia a . Fidsting grade Invdving more than 20UCulic Yard's of fltatedei within any. Parce17~~ to-the Naltxat - d WiN tuts Appnoation Require LarW 1>~stuurbing AatlWUep Enrwryrassing an Area in Ertceu of ~ - . Five Thousand (5,000) Square Feetof.titound Surtaoe7 ~ - I`V Ja - ~ j is (here a Natural Water Course Waning.OUaugh jhe Sae? - ~ _ / Is this Project-wiadn We Tnrstees judsdkilorr or wihin One Fluntlred.(100•).(aeE of a Weaand ar Beach? ]L/ s Will there be Site preparation on Ertisfing grads Sbpes wNch Exceed Fiaeen (15) feet of VerticalRise to ~ ~ / One Hundred (ttaY) of Hor¢on1a1 Distance? - V 7 l>ra Driveways, Paddng Areas or.afher Impervious Surfaces be Sloped td_Dired $ItlrF11-Water Run-00 into and/or in the direction of a Town d~taf-way? VVV Wdl [his Project Requlre.ihe Placement of Materiel; Removal oI Vegetation endlocgie_ Conslrudion of ? any Item Wahin the Town. Righl~of-Wayor Road Shoulder Area? - ~I (This item will NOT include Ehelnsta11a0on:of ISriveway Aprons.) , 9 Will this Protect Require Site Prepereaori whin the One Hundred{100)'Year Floodplain of any Waterceurse9 ~ NOTE: If AnygnswerQO puastlons One thtorigh Nthe Is Answered whh a Check Mark in the edx, a Storm-Waterr grading, - - Drainage & Erosion Control Plan is Required and Must be.Srrbmftted for Review pAorto Issuance of Arry Building Permit) EXEMPTIgN7 - Does this - Yes No^ prajed meet the minimum stantlards for deesi&;aapt es en Agdcirlksal Project? - -Note: tf Yov Answered Yes (o tfis Question, a 8torm.Vya(er, l3rading, OAinege 6~Erosbn Control PWn Is:NOT Required) • i// SCATS OF NEW YORK, ~ O1 jNTY OF~~,J ~!:~.1.:/ SS ITrat I; ..~'li"-"r;'..'.;~.-nau ooaerrenq d berrrg duly sworn deposes and says that he/she is.the applirxr,t for Permit, . Md that he/she is the ~ t*/»t> ~ ~ J LL C . (owner Ca161ldo6 !bed, Curparete Oaov ercl Jwner and/or reprxsentative of the Owner of Owner's, and rs dufq atudrorued to perform or have performed the said wotlc and to Hake and Fie this application;, that all statemerrfs conta~ed in-this application are tare to the best of his knowledge and be6e~ and hat rile work wdl be performed in the manner set forth in the aPPGcafioh fried herewith: iworTE W before me th!ss _ ~.7 day of " , 20..1.1. ''K+v2_.~ Cheryl ff(eM omry Public ,.„.i(q_~(yPublic State Of RewYbfk No. 3~'=d97U34 T........ Cualified In Suffolk County (agnewed Alf - ®6/07