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40147-Z
TOWN OF SOUTHOLD cpGy:, BUILDING DEPARTMENT -} TOWN CLERK'S OFFICE oy o.1/ 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#: 40147 Date: 10/5/2015 Permission is hereby granted to: Planamento, Nicholas PO BOX 605 Mattituck, NY 11952 To: erect a deer fence as applied for. At premises located at: 7160 Horton Ln,Southold SCTM # 473889 Sec/Block/Lot# 54.-3-12 Pursuant to application dated 9/29/2015 and approved by the Building Inspector. To expire on 10/4/2016. Fees: DEER FENCE $75.00 Total: $75.00 Building Inspector 1 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following)before applying? TOWN HALL '' •Board 6t:Health ' SOUTHOLD, NY 11971 — — 4•sets of Building Plans TEL: (631) 765-1802S Planning Board approval I. , FAX: (631) 765-9502 - - �r r Survey' I SoutholdTown.NorthFork.net PERMIT NO. `T Check • __ r Septic'Form I' - 'I ,,-, , _ I .., . N.Y.S.D.E':C.' -- I __ Trustees f; ,I — _ C.O.Application Dr--_______'-'sep:2` I �� Flood Permit IExamined_1(t_' ' S ,20' '' l `� Single&SeparateI� Li I, Storm-Water Assessment Form�‘ Contact: - ' .' ' ' ( '- Approved - ,20 7BLDG7-- -' r� k �k9�- 1\611fol \akAyLA 1 \i cum Imell - r Disapproved a/c ____. '�;I"�,T•. �.�, ��=� C�1 � •�� S. Phone: �kLkR -01-13 Expiration ,20 I , . . � �; . , ,, , ' r- ' ' ` ' ` Building Inspector= • - -'i'" - APPLICATION.FOR:BUIL-DING'PERMIT' •• '" jDate , 20 '� INSTRUCTIONS--- " a. This application MUST be completely'filled in by`typigriter'or iii ink-and_submitted to the Building II spector with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. b.Plot plan showing location of lot and of buildings':on-premises;'relationship to adjoining premises.or pl blic streets or areas, and waterways. c. The work covered by this application.may,pot,b,e cop cppmenced,tieforecipsuangq of,Building Permit: d. Upon a royal of this application,the Builain Ins' ectorwill i sue aBBuildin 'Permit to the a `licant. Such a permit P PP PP � g P• g PP shall be kept on the premises,availaKe,•for;inspection throughout•t4e work. , - •' t":,- e.No building shall be occupied k use$in whole or in pait'i'orr"any-Purpose what so ever until the Building Inspector issues a Certificate of Occupancy. •• I , - f. Every building permit,shall expire if the world authorizectclhas_tfofcommenced 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 have been enacted in the•irit'erim,-the BuildingIns ectorima"authorize--in writing,-the,the extension of the p permit for an property 1? Y � g p addition six months. Thereafter, a new permit shall be required. APPLICATION IS HEREBY'MADE:to:the'B,uil'diiig,Depa tmentfor the issuance of a Building Permitpursuant to the Building Zone Ordinance of the'To • wn,of Spi thold;,Suff li<c Cpuxiiy;New York;arid'ether'applicable Laws,}Qrdinances,or Regulations, for the construction of buildings,additions, or alterations 0r4for removal on demolition as herein described. The applicant agrees to comply with all applicable laws, ordinances,building;cod'e Thou g'Ode;and regulations;'and to admit authorized inspectors on premises and in building for necessary inspectio . • i, ' -" • ' 1,,= \, ((:A (Signature of applicant or name,if a corporation) ';1 \--Go `� 1 n . rr It Al,1� S Dint i 4U��101dt' Nailing'.addres's'of applicant)Nj 11941 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder • °Writ/ - I Name of owner of premises g v,} , j. .e.p, fcti4ovvI relf • (As"on the tax ro_1l,or•latest deed)i • , ; , • ' If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) i, 5 ' - - !, i' . ' Builders License No. • Plumbers'License No. ' ' , -I' '• ' ' •' " ' • `I' '' ' Electricians License'No. f' Other Trade's License No. • 1, Location of land on whi h proposed work will be done: p ) n House Number Street ��''jm,,/,I ' Hamlet County Tax Map No. 1000 Section r Block ,.•©„ . r, ; Lot 1 '/-4., ,i.".-1;?l,::.,,C:'1i Jjri',,) Subdivision Filed Map No. Lot 2. State existing use and occupancy of'prem'ises and int ded use and occupancy of proposed construction: a. Existing use and,occupancy Sri 4e , t1 f� S,'ct cQ— ,,, .. , b. Intended use'arid-occupancy t( u l t, , . , , , 3. Nature of work(check whi.ehtapplicable):New Building --- - Addition Alt ration Repair Removal, Demolition Other Work ,(n C ti C .e �p (Descriptio 4. Estimated Cost '( Fee (To be paid on filing this application) 5. If dwelling, number of, 7dwelling units Number of dwell •I•g.\units on each floor If garage, number'of cars' • ' .n ':, 6c' , ": 6. If business, commercial or rnixed,occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front Rear Depth Height ' N'tamber of Stories Dimensions of same structure with alterations or additions: Front 'Rear Depth Height it.:7_,_;r,4 .r:;:,,. -fi Number of Stories 8. Dimensions of entire new construction:Front\:A,,., +>la, - .,11 :.•, ,4Rea..,' . , ,,.,': Depth Height Number of'Stories " • ' n 9. Size of lot: Front 10 Q Rear . ;,CL)V1,,,,rt,: . • , Deph I • 1 ,(0QQ 10. Date of Purchase_7i!1 Name of Former ,. Owner ' �,'Q is.1 ii` 4ocif • ;, 1 I. Zone or use district in which premises are situated"' "'Z �.. . '•:.,., ' ,'" , , , 12. Does proposed construction'Iv1iolate any,zoning law;"Iordiriaipe'dr regulation?;YES-, :' NQ 13+ Will lot be re-graded? - -g YES NO Will excess`f11=be�r�moved'from;;premises? YES NO u, , 14. Names of Owner of premises . .r.l.,.• . :, .A,ddress li,. - ., , _ . :Phone`No., Name of Architect, ; : .�, .: ;L`'„'•'IAd'dress' ;''.'r,,.‘i '',-:11,i,''.',. -,Phone No Name of Contractor . •I '-'.',:ii;; -Addfess= . ?,,I'''.:-.)-,':i,--'- • Phone No.' 15 a. Is this propertyt within I00;feet of•a,tidal wetland,or.ahfrdshv,iater;•�vetland?(*,YES• -'NO' ' US * IF YES, SOUTHOLD TOWN TRTEES;&?D:F C�- ;PERRMITS'?I4A:,1'Y`>BErREQUIRED. • • • b. is this property within 300 feet of a tidal,wetldrid7.*IVES•"'I, • Na - * IF YES, D:E.C. PERMITS 1VIAY'BE REQUIRED.`; "( . (r) - �6. Provide survey, to scale, with accurate.foundation plan and distances to property lines. 17. If elevation at any point oh property i's--at 10 feet or below, must provide topographical data on survey. 18. Are there any covenants and-.restrictions with respect to this property? * YES N *'IF YES, PROVIDE A COPY. r STATE OF NEW YORK) • ' SS: . C LINTY OF - _ sk 1 dkakA , a In a MA 1.\e"--) ..being,duly,s�voxn, deposes and says that(s)he is the applicant (Name of i di idual igning contract)above named;• • ' ,, ;: : �, i , (S)He is the OtA)17 ,,; (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 7,8 day of - ( ( (_ 20 2167.--- 1 k ' ' • , . , Jipiacj ., . , Notary blic TRACCY NOTARY PUBLIC,STATE OF NE YO” �, gnature of Applicant NO.01 13W6306900;•• , QUAMMISUNTY' COSSION LIFIED EXPIRESINFFOLK JUNECOU30, \ r\c.�tIc ' () � bta`41c� o� C P � �t_)`1Ch `' 1 l t"It ,1 ) . ck rt c �� 1 �r � �6,E.E'TGLC� Ike n \ o, c.�.2 < c ����• l 0* 1.n t 4 .Q"s . 6 ,-14/24167101/04 — — /0000 f __ CP® n drZ d ` ( tr i . l od,9, c -e . +aim su'Yeyr%a vwtabon of p, Soden 7208 of 1 ON3wVont SaltoA; , t, Ed.toabon law iCi 1 _ ti Copes d tit S. �p bKn+g �- — .7._-_---,' ___ 44 , . emmbossed sed 1 ra ba contdKb ~ ^nn land adraanoill Wed a."' r toboa dMN tttl�. 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