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Home My WebLink About39791-Z7,7 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE og • Sao 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 #: 39791 Date: 5/22/2015 Permission is hereby granted to: Mandery, Robert & Mandery, Christina 18 Roxton Rd Plainview. NY 11803 To: install a deer fence in the required rear yard area as applied for. At premises located at: 210 Shore Ln, Peconic SCTM # 473889 Sec/Block/Lot # 86.-1-4.14 Pursuant to application dated 5/22/2015 To expire on 5/21/2016. Fees: and approved by the Building Inspector. DEER FENCE $75.00 I 10. TOWN OF SOUTHOLD BUILDING DEPARTMENT BUILDING PERMIT APPLICATION CHECKLIST TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net PERMIT NO. Examined .20 Approved , 20 Disapproved a/c Expirat' << � �� , 20 M g 2 2 2015 Building Inspector 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 Contact: sac Mail to: ZIo 2 � f4Ne__ nn ` e-Loyl( II q5� ��lI Phone: G} 17— CcSS j ^IpZD� 1 APPLICATION FOR BUILDING PERMIT INSTRUCTIONS ,V�> S1(0 la�,-�- off, I Date 5 Z , 20 i 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. of a)hplicant or name, if a corporation) 1195 iling address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premisesI`t9 ��c1L j )C►2 (As on ke tax roll or latest deed) If applicant is a corporatl`oli' •sigriature'of duly, authorized officer ".•`� (Name and title,oX corporate officer`} Builders License No --s Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: 2 l Ro ag C,A*j e iDi Z bM t Lr House Number Street Hamlet County Tax Map No. 1000 Section '0 4 Block Lot 40 Subdivision 2. State existing use and occupancy of a. Existing use and occupancy Filed Map No.. Lot and intended use and occupancy of proposed construction: b. Intended use and occupancy eerl be- uL -C 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work -j�vog Iri-6o (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 .Height Number of Stories. NO Rear Depth 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 f !r !i- Name of Former Owner 3-0!-P M0 (101 Z-1 11. Zone or use district in which premises are situated Oir- 0►) l Z 12. Does proposed construction violate any zoning law; ordinance or regulation? YES NO 13. Will lot be re -graded? YES, NO --X Will excess fill be removed from premises? YES NO 14. Names of Owner of premises WIxW- Address Bio S/x -Phone No. q 7 653 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 F ) �j vcfL being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing .contra ) above named, CONNIE D, BUNCH Notary Public, Stele of New York (S)He is the . �wn�t;l/L No. 01BU8186060 Quamw in NAMN County Contractor Agent, Corporate Officer, etc. ( g � � � ) Commie tat Expires April 14, 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 7-15f. day of A4M 20 & Notary Public 4 yok Y SYgI�G SURVEY OF LOT 14 MAP OF RICHMOND SHORES AT PECONIC FILE No. 6873 FILED NOVEMBER 20, 1979 SITUATED 'AT PECONIC TOWN OF SOU.THOLD SUFFOLK COUNTY, NEW YORK S.C. TAX No. 1000-86-01-4.14 SCALE 1"=40' DECEMBER 21, 1999 DECEMBER 6, 2000 ADDED EXISTING CONTOUR LINES OCTOBER 24, 2001 FOUNDATION LOCATION MARCH 15, 2002 FINAL SURVEY AREA = 28,622.81 sq. it. 0.657 ac. �voras: 1. THIS PROPERTY 6 N FLOOD. ZONE K. FLOW ZONE MfORYATION TAKEN FROM: FLOOD INSURANCE RATE YAP Ne. 36103COIG2 O ZDHE X AIZFAS:,DL-EIUMIED To 0E OUISDE 5W -YEAR FiDODPLA CERTMED M. FIRST AYERrAN TIREINSURANCE COMPANY OF NEW YORK TITLE ft. 712-S-01012 CHASE MANHATTAN BANK.. JOSEPH MOIINAIM TMATRI 18.12D ALIFFATIH ORA K* 70 t165 SIAi,t•.Y 6 k NO(A1KM W SEC11N 72090.'. OF THE NEW YORK -STATE EDUGTKM I/d_ COPGS OF iF6 SIAt1iY YAP NOT %R*4 TIE END O&WIY^ SYQD. SFAL OR E]OMSED :SEAL AWL HOT EE lA1KI0E1 ED TO EE A WED TRUE COPY... OFRITIOWAINS ►ICATED Nomm SFVLL FSM rY'103UH 2g?19 1011 =THE "IEY 6 P'Rp'NED, ANDON'HS f1aWF TO 7fE ,IRE LOYPAHY COVE(NFIYTN. A/�1N.Y AFD To THE NSONSES-OF THE iFEIO M AE1% M THE CERM MON THE tNN 7K A6TE- TTFfIN. CEIiRRO010F6 ARE NOf'7RAt@YFA9U THE UTISIF)10E OF f84YIT OF WAYS AND/OR EASEMENTS OF TE OF WAYS ANY..NOY'S1pWNARE"110T Q14RANTEED.