HomeMy WebLinkAbout39295-Z :-� TOWN 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#: 39295 Date: 10/21/2014
Permission is hereby granted to:
Lanza, Heather& Casey, Eugene
2200 Yennecott Dr
Southold, NY 11971
To: Construction of deer fence as applied for.
At premises located at:
2200 Yennecott Dr, Southold
SCTM # 473889
Sec/Block/Lot# 55.-4-32.1
Pursuant to application dated 10/8/2014 and approved by the Building Inspector.
To expire on 10/21/2015.
Fees:
DEER FENCE $75.00
Total: $75.00
r
Buildirig Inspector
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following,before applying?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
Sou tholdTown.NorthFork.net PERMIT NO. �-� �� Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined '20 Single&Separate
Storm-Water Assessment Form
Contact:
Approved —,20 Mail to:
Disapproved a/c
Phone:
Ex
�1.
71—
ector
�i OC T 20 4
PPLICATION FOR BUILDING PERMIT
Date A-o,— ' , 20�
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 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 on premises and in building for necessary inspections.
(Signature of applicant or name,if a 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 �-�Q G��'h tom' LOLKZck-
(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.
1. Location of land on which proposed work will be done:
l/ t
House Number treet Hamlet
County Tax Map No. 1000 Section J�� Block Lot : � �.
Subdivision �t✓►nt t �v-k 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 S w lti ,,,,!jh
b. Intended use and occupancy A,�X,G- X} ,,
3. Nature of work(check which applicable): New Building Addition 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
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
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
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Front 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 NO Will excess fill be removed from premises? YES NO
14. Names of Owner of premises Address 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 NO
* 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.
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 II )
d2C,.V' ,tr l..--hLU 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 Nn 01R1 191A5050
(Contractor,Agent,Corporate Officer,etc.) Qualified in Suffolk County
Commission Expires April 14,2—IG
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.
Sw n t��oppbefore me th'
`-t1n day of _20
L
Notary Public Signature of Applicant
S.C.T.M. NO. DISTRICT: 1000 SECTION: 55 BLOCK: 4 LOT(S)-J7',
a
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YENNECOTT
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APPI Q ED AS NOTED LAND N/F �� n
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DATE: B.P.; f (S "Uvce
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NOT �LD1�,G T AT /
765-1812 8 A TO, 41. PPv� t=OR THE �
LC i IONS: .. _ OF �
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1. FOUN�ATIO11 - TVV0 REQUIRED
A7; -�r S-OF
FOR r'OUF?EU CONCRETE ,, _,
2. ROUGH - FR.r,l:i,PG & PLL'.!w{ING
4. FINAL MUST ---�- - -� -
BE COMPLt `,`L �' . C.O. I In JMVI N n Sl
ALL CONST,.UC i ICAN SH11,L L fj'lEET THE r'�
REQUIREMENTS OF THE CODES OF NEW .. ---' 110 ACJ N V�/
03.0
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONS TI RUCTION ERRORS, THE WATER SUPPLY, WELLS AND CESSPOOL
LOCATIONS SHOWN ARE FROM FIELD OBSERVATIONS
AND OR DATA OBTAINED FROM OTHERS.
AREA: 39,993.32 SQ.FT. or 0.92 ACRES ELEVATION DATUM: ------------------------- .
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY
MAP NOT BEARING THE LAND SURVEYOR'S EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN
ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE 7ITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION
LISTED HEREON, AND TO THE ASSIGNEES OF THE LENDING INSTITUTION, GUARANTEES ARE NOT TRANSFERABLE.
THE OFFSETS OR DIMENSIONS SHOWN HEREON FROM THE PROPERTY LINES TO THE STRUCTURES ARE FOR A SPECIFIC PURPOSE AND USE THEREFORE THEY ARE
NOT INTENDED TO MONUMENT THE PROPERTY LINES OR TO GUIDE THE £RECTION OF FENCES, ADD17IONAL STRUCTURES OR AND OTHER IMPROVEMENTS. EASEMENTS
AND/OR SUBSURFACE STRUCfURES RECORDED OR UNRECORDED ARE NOT GUARANTEED UNLESS PHYSICALLY EVIDENT ON THE PREMISES AT THE TIME OF SURVEY
SURVEY OF: LOT 43 & P/0 LOT 42 INCL. CERTIFIED TO: HEATHER M. LANZA;
MAP OF: YENNECOTT PARK EUGENE J. CASEY;
FILED: OCTOBER 9, 1968 No.5187 FIDELITY NATIONAL TITLE INSURANCE COMPANY;
SITUATED AT: SOUTHOLD WELL FARGO BANK, N.A.;
TOWN OF: SOUTHOLD KENNETH M. WQXCHUK L.S.
SUFFOLK COUNTY, NEW YORK Land Surveying and Design
P.O. Box 3, Mattituck, New York, 11952
FILE # 12-44 SCALE: 1 "=30' DATE: APRIL 30, 2012 PONE (831) 298-1588 FAX (631) 298-1588
N. Y. S. LIC NO. 50227 maintaining the records of Robert J. He easy