HomeMy WebLinkAbout37968-ZSO t,r�o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
s� TOWN CLERK'S OFFICE
y Z
oy • oaf 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 #: 37968 Date: 4/24/2013
Permission is hereby granted to:
Hawkins, Paul & Hawkins, Molly
575 Ackerly Pond Rd
Southold. NY 11971
To: construct an accessory above ground swimming pool, fenced to code as applied for
At premises located at:
435 Glenn Rd. Southold
SCTM # 473889
Sec/Block/Lot # 78.-2-9
Pursuant to application dated
To expire on
Fees:
10/24/2014.
4/15/2013
'\/ 0 �, k
�06
and approved by the Building Inspector.
SWIMMING POOLS - ABOVE -GROUND WITH REQUIRED FENCING $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
TOWN OF SOUTHOLD
�y BUILDING DEPARTMENT
y TOWN CLERK'S OFFICE
oy� • ��� 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 #: 37968 Date: 4/24/2013
Permission is hereby granted to:
Hawkins. Paul & Hawkins. Mol
575 Ackerly Pond Rd
Southold, NY 11971
To: construct an accessory above ground swimming pool, fenced to code as applied for
At premises located at:
435 Glenn Rd, Southold
SCTM # 473889
Sec/Block/Lot # 78.-2-9
Pursuant to application dated
To expire on 10/24/2014.
Fees:
4/15/2013
and approved by the Building Inspector.
SWIMMING POOLS - ABOVE -GROUND WITH REQUIRED FENCING $250.00
CO - SWIMMING POOL $50.00
Total: $300.00
Building Inspector
Form No. 6
TOWN OF SOUTHOLD.
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
Thi,, application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A, For new building or new -use:
1. Final survey of property with accurate'location of all buildings, property lines, streets, and unusual natural or
topographic features.
2, Final Approval from Health Dept. of water supply and sewerage -disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. -Sworn statement from plumber- certifying that the solder used in system contains less than 2110 of 1 % lead. .
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance -from architect or engineer responsible for .the building:
6_ Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to. April 9, 1957) non -conforming uses, or buildings and "pie -existing" land rises:
1 _ Accurate survey of property showing all property lines, streets, building and• unusual natural or topographic
features_
2. A properly completed application and consent to inspect signed -by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certif cafe of Occupancy - New dwelling .$50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building 550.00, Businesses $50.00:
2. Certifcate of Occupancy on Pre -.existing Building - $100.00
3_ Copy of Certificate of.Occupancy - $:25
4. Updated Certificate of Occupancy - $50.00
5_ Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
n
Date. `l7. 1I L
901
New Construction: Old or Pre-existing Building: heck one)
Location of Property: 3� � � (}� uJ :L 1 D 10i
House No. Street Hamlet
Owner or Owners of Property: Q( V1
Suffolk County Tax Map No 1000, Section J% Block _ Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant: p(�,U L11Jll �i► t c��'
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: S S `D • 00
W
Applicant Signature
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Examined r , 20/-3
Approved � , 20 1-3
Disapproved a/c
is V� IJ U
I�
i LAPR 15 2013 ��
BLDG. DEPT.
TOWM OF SOUTHOLD
BUILDING PERMIT APPLICATION CHECKLIST
a Do you have or need the following, before applying?
Board of ftealth
PERMIT NO.Z 1(8'
—�;e
e,
Building Inspector
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
Stone -Water Assessment Form
Contact:
Mail to:
Phone:
APPLICATION FOR BUILDING PERMIT
Date 4j2rj 20j_�
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 Pen -nit 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 pen -nit 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 constrixetion 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 piemis 6 bPuA 6%Tr ,�ssaiy inspections.
t:} USI= IS UNLAWFUL -
� ��� " L.V'"'_ I�I����� �� �`IF, ATI (Signature of applicant or name, if ap�corpora/tion)
ENCLOSE PGOL TO CODE-
0
ODE ! ' � l � n�{1(j
,C
i /l�f� �► I
0iN COMPLETION 'a .� l9 �i_ �� ,s €""6' t.K s ( i g address of a ]c
BEFORE "WATEP' DATE 9 B. P.
#
State whether applicant is owner, lesseNLaag� Ta?,ft- "ts engineer, gener���ontrac`�t` , elec r�ici Armor builder
a 11 NOTIFY BUILDING DEPA�' ''-NT AT
� � 765-1802 8 AM TO 4 F'.! FOR THE
Name of owner of premises
(As on the �
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.
TWG CUIRED
•nnir ,
roll o�laAMING, PlI IlBI"JG.
STRAPPING, ELECTRICAL ,.CAULKING
3. INSULATION
4. FINAL - CONSTRUCTIQN & ELECTRICAL
MUST BE COMPLETE FO, t.b.
ALL CONSTRUCTION SHALL I,!EET THE
REQUIREMENTS OFJHE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERROR&
Loc tion of land on whichprroppoosed woA wi 1 be done:
House .Number Street -1113A2 R)1 k l mlet , R RUNOFF
AIcy watt 10 gJ912 41du9 v,brnt� PURSUANT TO CHAPTER 239
10 ,011 OF -ruc
County Tax Map No. 1000 Section B1be0;M:"',;e`r�:lit 1Z TQ6"DE.
Subdivision Filed Map No. Lot
2. State existing use and occupancy of
a. Existing use and occupancy
b. Intended use and occupancy
C� V V
13 Mature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work0
n (Description)
4. Estimated Cost S I/ W 0 , Fee Oi 56.
(To be paid on filing this application)
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 �j: �o Depth o�
Height Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
SMA
8. Dimensions of entire new construction: Front Rear Dyeptht l
Height Number of Stories
9. Size of lot: Front Rear (t%0 Depth J
10. Date of Purchase l �I i ds Name of Former Owner V � I�il� � i 6 Ll la rd 1
11. Zone or use district in which premises are situated r) `_',U
12. Does proposed construction violate any zon'ng law, ordinance or regulation? YES NO I✓
13. Will lot be re -graded? YES NO Will excess fill be removed from premises? YES NOAZ
14. Names of Owner of premises hnSAddress � 03h-Worck Ur 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 MAYBE
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.
907- i-137,=-3�
17. If elevation at any point on property is at 10 feet or below, must provide topographical data gnsurvey.
18. Are there any covenants and restrictions with respect to this property? * YES NO 'V
IF YES, PROVIDE A COPY.
STATE OF NEW YORK)
SS:
COUNTY OF
7 G Q , (4 c. L,--. lc -. S being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
f
(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
hd4yof20 k3
L1ANA LEA SAEIZER
No Public, State of Now York
,Public:.: o. in 737422 County Signature of A licant
rnmmissiondEXDSeS Oct. olk 120 _ b pp
CERTIFIED TO: PAUL D. HAWKINS JR.
SURVEY OF BETHP A. HAWKINS
LOT 26 ETHPAGE FEDERAL CREDIT UNION
MAP
2000 REAL ESTATE SERVICES ,INC.
MAF OF JOB NO.: 2012-147
WEST CREEK ES TA TES MAP NO.: 3848
SITUATE A T FILED: AUGUST 19,1963
REVISIONS:
lijIlij
SOUTHOLD 0
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK ,
SCTM: DIST. 1000 SE OT 09 y "
15 8 0 15 30 45 60' 75 90 105 120 1355
SCALE: I" = 30' DATE: MAY 1, 2012 .
LOT AREA: 18,647 SQ. FT. = 0.428 ACRE �qT05 '3b'5
OF
W
O
I /
NYT3
EASEMENTAN0. SUBSURFACE
STRUCTURES RECORDED OR
UNRECORDED ARE NOi GUARANTEED
UNLESS WYSICAUYE0DENTATTHE
nME0F5L4NEY.
THEOFFSET (OR DIMENSIONS) SHOWN
HEREONFROMTHESTRLCTURES TO THE
PROPER UNESAREFORASPECIRC
PIIRPOSEAND USEAND THEREFORE
ARENOTINTENDEDTOGM THE
ERECTIONOFFENCES RETAINING
WALLSPOOL$ PATIOS, PUNTING
A S. ADDITIONS TO BUILDINGS
AND ANYOTI/ERCONSTRLCnON.
LNAUTHORISED ALTS PONORADDIRON
M THIS SLWVEYIS A VIOLInON OF
SECTION TTJY OF THENEW YORK STATE
EDWAn—M
COfESOFTHI55MEYMAPNOr6CARING
IHELANO SURVEYORS INKED SELL Q9
EMB055ED SEAL SMALL NOT BE LONSIDEREO
R/BEA VA110 TI7LF LOPY.
1RCAM ...OICATED HERON 5HA4 RUN
ONLYTO THE PERSO " FDRWHOM iNESL'RVEY
ISPREP/RED AN0 ON HISBEHAIf TO nrE
TILECONPANY, GOVERNMENTAL AGENCYAND
LENDINGINSTIIMON LISTED HEREON, AND
..E .'ES
OF THE fF11DING INSn.
TUTION. CERnRCATIONS AAE NOT TRANSFERABLE
TO ADDITIONAL INSTITUMN5 OR SUB5EGLEfT
OWNERS
LICENSE NO. 050363
HANDS ON SURVEYING
26 SILVER BROOK DRIVE N
FLANDERS, NEW YORK w E
11901
TEL: (631)-369-8312 -FAX (631)-369-8313
LOT 45
STOCKADEFENCE OB'N
- FN 4.3'ff—'
S 72°59'30" E 145.71 �D - - rFN.coR
I G.5 EA.rS
SHED 12. 1 '
1�
FN END
f.5'E
-C�HAINL_ENCE
150.00'
GLENN ROAD
FN COR.
V_
LO
J
This certifies that the
bearer is duly
licensed by the
County of Suffolk
Clifford Coleman
DY d.,
SUFFOLK COUNTY DEPARTMENT
OF CONSUMER AFFAIRS
HOMEIMPROVEMENT
CONTRACTOR
LICENSE
xuaE
NATALIE SCHLESINGER
OUSWE99 WNE
SCHLESINGER POOL SERVICES INC
39524-H
D1* n-11
03/07/200
E-RA01N WT 03/01/2014