HomeMy WebLinkAbout42457-Z �gUFFU(�, TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy._• o` 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#: 42457 Date: 3/15/2018
Permission is hereby granted to:
Moulton Jr, William
5250 Rocky Point Rd
PO BOX 152
East Marion, NY 11939
To: Install deer fence in required side and rear yards as applied for.
Replaces BP# 39959
At premises located at:
5250 Rocky Point Rd., East Marion
SCTM # 473889
Sec/Block/Lot# 21.-3-20
Pursuant to application dated 3/15/2018 and approved by the Building Inspector.
To expire on 9/11/2019.
Fees:
PERMIT RENEWAL $75.00
Total: $75.00
Building Inspector
o�guFFo��coTOWN OF SOUTHOLD
BUILDING DEPARTMENT
co co TOWN CLERK'S OFFICE
o . 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#: 39959 Date: 7/17/2015
Permission is hereby granted to:
Moulton Jr, William & Kosch, Heather
5250 Rocky Point Rd
PO BOX 152
East Marion, NY 11939
To: Install deer fence in required side and rear yards as applied for.
At premises located at:
5250 Rocky Point Rd, East Marion
SCTM # 473889
Sec/Block/Lot# 21.-3-20
Pursuant to application dated 7/10/2015 and approved by the Building Inspector.
To expire on 1/15/2017.
Fees:
DEER FENCE $75.00
Total: $75.00
I
B g Inspector
i
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)765-95022 Survey _
SoutholdTown.NorthFork.net PERMIT NO. 3 Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O.Application
Flood Permit
Examined 201 Single&Separate
Storm-Water Assessment Form
Contact:
Approved 20 /-5 Mail to:
Disapproved a/c
Phone:
Expiration 20—L7
�^ 17 1 B lding In ctor
f �� �� L
APPLICATION FOR BUILDING PERMITFfiq Date 20,UL 1O 2015 SJ l tq , � S
INSTRUCTIONS
pplical on MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
BLDCs P 1 psroaccurate of plan to scale.Fee accordingto schedule.
7,,^,!did i1 f•'?1 IQ* !an sit winlocation 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.
(Signa6re of applicant or name,i a corporation)
PO- C80X 15Z , Fq-Sr 1\-V9 D1 e)A)- rte i l�t3�
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
Oj�UhIEf� r IL
Name of of owner of premises 0 e u 1 AM 0• M DVL FDK) �Sg- Qy1 (�GM*04— 1�• ���T
(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. 01A)N'F 2
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
5250 IZPC-14 l D0017- 421N,
EftsT 1`�lA�lonl
c
House Number Street Hamlet
County Tax Map No. 1000 Section Z- Block Lot Z
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Existing use and occupancy S(&IGi' 1=f11y1 1 LU OCCO PANG�I
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition ther or D 6 Ei2 F9 6161 N C;—t
(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 l ' "' Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories
9. Size of lot:Front /2 5 Rear 19 Depth ( �s
10.Date of Purchase 1 B Name of Former Owner 1 C(4,4161— A 1W,4 oq S,4?OS
11.Zone or use district in which premises are situated YY
12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO n
13.Will lot be re-graded?YES NO X Will excess fill be removed from premises?YES NO_
j14.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 �,L
LL OMf�. 1�OL��DYI( v •. a�g' 17 —"/OSCteing duly sworn,deposes and says that(s)he is the applicant
-e (Name of individual signing contract)above named,
Z 3 (S)He is the
O 4) N (Contractor,Agent,Corporate Officer,etc.)
fnZooc
0-16(0 O pj
O o �'�' that al to ements conter or ain ddis duly in this application ca on arorized toe true t the best of erform or have his knowledge formed the ld work and belief;dto make and file and that the work will application;plication;
z'"`DY E aa) performed in the manner set forth in the application filed therewith.
v�s E.u) P PP
O_o-0 U' G Swo before me this /
W.n ID
— o �'a day of
tll
Notary Public Signaturef plicant
0
Z '
APPROVED AS NOTED
DATE: S b.p-4,2-12
FEE: BY:
NOTIFY BUILDING UE'
PARTMIENT AT
765-1802 8AM 1-0 4.PM FOR THE
FOLILCVVING iNSPECTIONS:
1. FOLANDATION - TWO REQUIRED
FOR PO-'--;Rf:-1 1—INCPE1ZE
2. ROUGH
3, 1N-UL A T I C)N
4. FINAL - C(.-;'NSTR-,U'C-'oTi0N MUST
ALL CONSTRUCTIC)IN SHALL MEET THE
REQUIREMENTS OF THE CO'DES OF NEW
YORK STATE. NOT RESPONSOLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
..................... -G-60%9 T-GN RANNIV46 BOARD-,
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RETAINSTORMWATER RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.
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a�17 SU ��co ,TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y 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#: 39959 Date: 7/17/2015
Permission is hereby granted to:
Moulton Jr, William & Kosch, Heather
5250 Rocky Point Rd
PO BOX 152
East Marion, NY 11939
To: Install deer fence in required side and rear yards as applied for.
At premises located at:
5250 Rocky Point Rd, East Marion
SCTM # 473889
Sec/Block/Lot# 21.-3-20
Pursuant to application dated 7/10/2015 and approved by the Building Inspector.
To expire on 1/15/2017.
Fees:
DEER FENCE $75.00
Total: $75.00
/-no
B&4ingInspector
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 C Survey
SoutholdTown.NorthFork.net PERMIT NO. 3 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 I� Mail to:
Disapproved a/c
Phone:
Expiration 20
I'-' B lding In ctor
�FIRn APPLICATION FOR BUILDING PERMIT
1, JUL 1 0 2015 INSTRUCTIONS Date SA a*"' ,20 1�
plicat on MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
3LDCsDo plIns,accurate p of plan to scale.Fee according to schedule.
T V4['4 0 i,. 111w:. �,owing location of lot and of buildings on premises,relationship to adjoining premises or public streets or
r
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.
(Signa a of applicant or name,i a corporation))
P®- Dox
l.5Z , tF/J-ST/jfl1D1 orj
(Mailing address of applicant)
State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder
0W IUL=IZ
Name of owner of premises W l u l AM D VL -DAJ ,-S 9• a lnd
(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. 01A)AJi,7
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
5250 IZoc(e-q PosA[7- ��. EAST- MA-CImi
House Number Street Hamlet
County Tax Map No. 1000 Section Block 15 Lot 2 o
' -Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
Oa-
Existing use and occupancy S1 N C-,LF FA-t,1 1 Lt_.1 0(fGt1 PA ING1{
b. Intended use and occupancy
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition ther V6r L)615,Z E98.161A16-7
(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 -tom '-- Height 1 Number of Stories
8. Dimensions of entire new construction:Front Rear Depth
Height Number of Stories
9. Size of lot:Front If
5 ! Rear 125 , Depth 10s ,
10.Date of Purchase Z l 5 Name of Former Owner
11.Zone or use district in which premises are situated Y
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 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 "l
"being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
Z 3 (S)He is the
O a r- :jo (Contractor,Agent,Corporate Officer,etc.)
.� O N
WO C
a oco0 oc owner owners,
O m o �'• a that all sta et ments ontaineddin this appis duly lication ation areorized to ptrue t the best of his knowerform or have performed ledge Land belief,d work and that the work will ld to make and file this pe application;
-M`"`DYE performed in the manner set forth in the a lication filed therewith.
v�X E� P PP
Z ' �-S O
O o-0 U W Swor�before me this
o 'Q day ofAM
_ -..
0-Z m x (0
Wi5 CY 'I
Notary Public Signature t#pplicant
Z
APPROVED AS NOTED
DATE:
FEE: BY:
NOTIFY BUILDING DEPART'MENT AT
765-1.802
L�v9 TO 410M FOR THE
8 A
FOLLIC"vVAINIG !NSPE;CTiONS:
1. FOUNDATION TWO REQUIRED
FOR
2. 8
3. INSULATION
4. FINIAL iV;UST
Bf-- cr�,kp! Po7m,
ALL CONSTRUCTI'ON SHALL MEET THE
REQUIREMENTS OFTHE CODES OF NEW
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
NEW YORK STATE & TOWN CODES
AS REQUIRED AND CONDITIONS OF
fflnlv8lLuVTmfflTMW0
RETAIN STORM WATER RUNOFF
PURSUANVTO CHAPTER 236
OF THE TOWN CODE.
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