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HomeMy WebLinkAbout39960-Zrte' TOWN OF SOUTHOLD �g11�FQ(q-EO moo G� BUILDING DEPARTMENT TOWN CLERK'S OFFICE can 0 0 4V 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 #: 39960 Date: 7/20/2015 Permission is hereby granted to: Thompson, Thomas & Thompson, Pamela 7195 Main Bayview Rd Southold. NY 11971 To: Demolish existing accessory shed as applied for. At premises located at: 7195 Main Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot # 78.-7-43 Pursuant to application dated 7/14/2015 To expire on Fees: 1/18/2017. and approved by the Building Inspector. DEMOLITION $188.20 Total: $188.20 -(a., Buildi spector '72 ®F l/ c va 2 ��� TOWN OF SOUTHOLD BUILDING DEPARTMENT 'p' a TOWN CLERK'S OFFICE �p o SOUTHOLD, NY m 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 #: 39960 Date: 7/20/2015 Permission is hereby granted to: Thompson, Thomas & Thompson, Pamela 7195 Main Bayview Rd Southold. NY 11971 To: Demolish existing accessory shed as applied for. At premises located at: 7195 Main Bayview Rd, Southold SCTM # 473889 Sec/Block/Lot # 78.-7-43 Pursuant to application dated 7/14/2015 To expire on 1/18/2017. Fees: and approved by the Building Inspector. DEMOLITION $188.20 Total: $188.20 (C Buildin -ctor TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net Examined , 20� Approved '2015 Disapproved a/c Expiration , 20 1-7 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board,of, Health 4 sets,of.Building Plans Planning Board approval g� aSu PERMIT NO. �_ Check Septic Form MY.S.D:E.C. Trustees C.O. Application Flood Permit Single & Separate JUL 13 Imo' F11U, 1 LD I mn'', f Buildihiiaip6ctor Storm -Water Assessment Form Contact: s 1�ail-to-- RLMCAO Phone: (63 L) •;— UC— s � �( APPLICATION FOR BUILDING PERMIT Date , 2015 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 ofihis application, the Buil'ding'Inspector;wiifis' ue 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 Occup ed'o`r;used in:wliole•or irilpaii 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:.d'ate. If no zoning amendments or other regulations affecting the property have been enacted in the -interim, the Building Inspectonmay authorize, in writing, the extensionof 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 Count' 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, buil ding 'code, housing code; and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. -�-e.�-��-�-- (Signature of applicant or na e, if a corporation) (Mailing a d ess of applicant State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder w� Name of owner of premises / ln;o (As"on'the tax'roll oA 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: House Number County Tax Map No. 1000 Section Lot Subdivision Filed Map No. Lot 2. State existing use and occuparicy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy o1 _ .CA't0 , vie„ Ani Q ) V�s b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal „ ' Demolition Other Work .,,.k. 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 -_ � % (Description) 6. If business, commercial or mined occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front 7-F,1 ` Rear 2- k- l Depth 10, 5 ` Height c ktl Number of Stories c©o 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 ;1 .•r ' :Depth 10. Date of Purchase Name'of°Form'er Owner 11. Zone `or use district ifi which premises are situated" "I ` 12. Does proposed coristr'uction.v>olate any.zoning�law,,6 f4inarice orreil gulation?' YES ` NO F{: ;•i,fEt'�??;...iii n+ - •.� - �' K+' :•�� 13. Will lot be re -graded? YES... NQ Will excess fill be remgyed, from, premises?.YES NO 14. Names of Owner of premises :Ad'dress. , :,E . ',PhoneNo. Name of Architect ;, • AddressF 'PhorieNo, Name of Contractor -Phorie'No.' 15 a. Is this property'with in 100 feet of a tidal wetland ora freshwater wetland? *YES 'NO * IF YES, SOUTHIOLD TOWN TRUSTEES & D.E.C. PERIMTS M"A.Y`BE REQUIRED.` b. Is this property within 300 feet of a tidal wetland? * YES" NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. F.. 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 OF5 T V"eA a jjL\0%Rq-_-�SnA _ ; .being,dulyt sworn, deposes and says that (s)he is the applicant (Name of individual sigking contract) above named, (S)He is the (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 - , day of 1 20� fl Notary Mblicj TRACEY L. DWYER Signature of Apphc NOTARY PUBLIC, STATE OF NEW YORK NO. 01 DW6306900 QUALIFIED IN SUFFOLK COUNTY COMMISSION EXPIRES JUNE 30,2j219 PI C *1442 SBD f�IslO sa, A L��ix' nett o f 0 91 RICA Al '0 A / ,./ � as//'t+r f0• Ike a f. � 2 Z 2' lob �9- • =PIPE ® =STAKE ANY ALTERATION OR ADDITION TO THIS SURVEY 1S A VIOLATION OF SECTION 72109 OF THE NEW YORK STATE EDUCATION LAW EXCEPT AS PER SECTION 7209-SUBDIVISIDN 2 ALL CERTIFICATIONS HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR WHOSE SIGNATURE APPEARS HEREON. 4 C -i AREA=1.0084 acres or 43,-925 S. F. SURVEY OF ePROFL'RTY AT S O Ud HOLD TOWN OF SO UTHOLD SUFFOLK OOU11iTY, NEN YORK 1000-78-07-43 SCALE: 1"-40' MAY 22, 2000 "%WLY U TH ALL CODES OF NEW YORK STATE A TOWN CODES ��REOuIRED AND ��or�c IT�.r�,S OF mlay t i It L` 9j v1 \\ 1'j 6 APPROVED AS NOTED DATE: D I.P. # O FEE: BY:. NOTIFY BUILDING DEPARTMENT AT 765-1802 8 AM TO 4 PM FORT E FOLLOWING INSPECT IONS: 1. FOUNDATION - TWO REQUIRE FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBIN 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEE1 THE REQUIREMENTS OF THE L ODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ER RS. RETAIN STORM I JIATER RUNOFF CERTIFIED TO, PURSUANT TOC iAPTER 236 Thomas D Thompson OF THE TOWN C DE.,. Pamela D. Thompson Horrieside Lending Inc Safe ,Harbor Title Agency, LTD Z t. NEW ND. 4 9618 CDN . of Y' ('631) 7` • `. , p S• AX,('631) 765-1797 P 0. BOX ^` 1230 TRAVELER STREET 100-1901 SOU T HOL D, N.Y. 11971