HomeMy WebLinkAbout28152-Z FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 28152 Z Date MARCH 8 , 2002
Permission is hereby granted to:
`r.
JEANNE P HAMILTON
27 CAMPO AVENUE
SELDEN,NY 11784
for .
CONSTRUCTION OF A 10 X 12 SHED IN THE REQUIRED REAR YARD AS
APPLIED FOR
at premises located at 965 GABRIELLA CT MATTITUCK
County Tax Map No. 473889 Section 108 Block 0004 Lot No. 007 . 038
pursuant to application dated MARCH 6, 2002 and approved by the
Building Inspector.
Fee $ 75 . 00
� 6i b
Au orized Signature
ORIGINAL
Rev. 2/19/98
BOARD OF HEALTH . . . . . . . . . . . . . . .
-FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . .. . . . . . . . . . . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
Examined....'. 20..L.?
MAIL TO: . . . . . . . . . . . . . . . . . . . .
..........
Approved.......-. ...... LA Permit Llt
.... ...................................
Disapproveda/c .................................. ...................................
........1-..... ................ .......
777',- 7 ..
. . .
16 2W ........... ..
(Building In. -tor)
MR
APPLICATION FOR BUILDING PERMIT.
W DC . V' �!-17
Date P 0Xt 20.QA.
INSTRUCTIONS
a. 'Ibis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wi
3 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 giving a detailed description of layout of property mist be drawn on the diagram which is part of
this application.
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
permit shall be kept on thepremisesavailable for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATION IS HEREBY K61E 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 f , removal or demolition, as herein
described. The applicant agrees to comply with all applicable la ordinances,0 ;:ilding code, housing code, and
regulations, and to admit authorized inspectors on premises - r,
diDg 0 swsary tions.
�a
�a..............
Signature of applican or name, if a corporation)
7S101
(Mailing address of applicant)
State whether applicant'is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
....0.[U.Y.A?r..........................................................................................................
Name of owner of premises
(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. .........................
Plumbers License No. .........................
Electricians License No. .....................
Other Trade's License No. ....................
i. QUA
I. Location of land on which proposed work will be done.... .... ...................................................
I
......... .. .....
� (( ................I............................................................
.. .. .
House Number ' Street Hamlet
County Tax Map No. 1000 Section Block ...0.1.......... Lot .......:... 7'.�y
I . 41 411. Map No. ............... Lot ...............
Subdivision ...
Name)
2. State existing use and occupancy of prremises and i ended use and occupancy of proposed construction:
�Jdjn(e_
Existing use and occupancy ..
a. ...... ...............................................
b. Intended use and occupancy ........ ....Qq!,
afd4 WWCM
*MV63-40"Ve r4 bahlowO
M
!. Roture of cork (dmedc wlmidm applicable): New Building .......... Addition ......... Alteration
Repair ............ Removal ............. Demolition ............ Other Work
l � .(Description)•
Estimated Cost ,l�lS; .. fee .. ..
•� X ......�................. . ......
(to be paid on filing this application)
If dwelling, number of dwelling units !`�. .... Number of dwelling units on each floor ......!�! ....
Ifgarage, number of cars ..........�.� .....................
If business, commercial or mixed occupancy, specify nature and extent of each type of use.....N., .,•„
Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
i.leight ......................... Number of Stories ......................
Dimensions of same structure with alterations or additions: Front Rear
Depth .................... Height .................... Number of Stories .....................,1........
Dimensions of entire new construction: Front .....R........ Rear ..! .1......... Depth ..............
lleiot .. Number of Stories
Size of lot: Front ...,...� .'........ Rear ......).JoX71
......... Depth ...
0. Date of Rmrdiase .. .�.� 1p�D ... Name of Former Owner .. 1.�., ... ,f(/� (1; ..
I. Zone or use district in which premises are situated
2. Does proposed construction violate any zoning law, ordinance or regulation: ..,n Q.........•,,,,•„•,
3. Will lot be regraded ..... (1�............
QWiil�l� ss fill be rammed firm premises:
YES ��/'� NO
4 Names of Owner of premi Al�Qn1]t•.r: C►4�1L\l .l�1 L�L�CT..l:1.(t( �Pftdcie`-.No.
• stihes .. ... Address
Name of Ardmitect ....J.I.�.�:. ....................... Address ..............................
Name of Contractor ..... .�P........................... Address ................ ........... Phone No. .............
... .Phone No. .............
5. is this property within 300 feet of a tidal wetland? * YES .......... NO .. •
*IF YES, SO[Allr[D MM 1i�1SMS p0WT MAY BE ....
PLOT DIAGRAM
locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
ran property lines. Give street and block number or description according to deed, and show street nacos and indicate
hether interior or corner lot
At MIX . 1 " MY
tole, (x. ww lluc//
t .��- .... . ... S
3MlY (T.
............ueir% duly sworn, deposes aril s that he is -t
f� say l w applicant
`lane of individual signing contract)
)ove m a med,
istime ..................................... ./. .......................................
(Contractor, agent, corporate officer, .)etc . ......
F said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
ppl.ication; that'. all statements contained in this application are true to the best of his knowledge and belief; and
imat the work will be performed in the manner set forth in the application filed therewith.
,corn to 17foorre�me this
Notary Public ... r.........
BOA► ( 'gnature•of.Applicant)
Cnrmmriaim►rr tbpirs UA 2%
1
t
-71
is �I
Jeanne P. Hamilton
965 Gabriella Court
Mattituck, New York 11952
March 1, 2002
Town of Southold Building Department
Town Hall
P.O. Box 1179
Southold, New York 11971
Re: Application for a shed
To Whom it May Concern:
Enclosed herewith please find my application for a building permit. I would like to place a
10' x 12' shed on my property as marked on the accompanying survey. As per my
conversation with your office, I have also enclosed a copy of the shed, which will be
purchased from Kaufold's Country Sheds and Gazebos in Ridge.
The shed will be used to store my tractor mower and attachments, garden tools, etc. The
location of the shed as indicated on the survey will be at the rear of the property, well
within the Town's prescribed setback requirements.
Should you have any questions concerning the enclosed, please do not hesitate to contact
me during the day at (631) 727-4989. 1 thank you for your consideration of this
application.
ery truly y u ,
eanne P. Hamilton
/jph
enclosure(s)
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST) � y
------------------------------------
FOUNDATION(2ND) con
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ROUGH FRAMING& �
PLUMBING
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INSULATION PER N.Y.
STATE ENERGY CODE
FINAL w
ADDITIONAL COMMENTS
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PLOT. AREA d ArqS, ^•^`._.�
DATFEE: _L = .�
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NOTIFY BUILpiN
765-1802 9 Alli Ti",
FOLLOWING
1. FOUNhA:"�1c
FOR POURED
2. ROUGH
3. INSULATION
4 FINAL LEOTE FOR�C 0.1u,4 .
BE COMP
ALL CONSTRUCTION SHALL EET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENE Gy
CODES. NOT RES��E R RS LOT xl LOT xo
DESIGN OR CONST VACAMI «4 •NT vAeANr
[1/511106 AL"ej
NJb W�IAd'YAwINYd:
GABRIELLA COURT
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ntr«nova!IOTA+1411111014 REFER TO VIA, C.I.OATUN.
T4 E7alTOles Cr NMI Or WAYS AMC/01 [AIENCNT!OF RECOII01 r ANY,MOTH AI1[�ypT aAA«N1Eco, r.".
TVI VAmT WAS Tt1�ARL0 W A4:OARbANCE�IR1'ME E1nsTINO CO OF Fmcn6a FDIC AMp RK'AI AOOPtlD.RY
AMOOAT101!/OYI OONAL IAMO lrJR Y S �.'.� •!l i;i t ,. Tt.• K .
ANY AVERATION OR AOO114*4 TO TMl 9URVET IN A MOIJIPON CnON 7201 OF Twit NEW TOYAYE E0�CA7ICN G_Yfi, iURYE.Y;;'
YAP NOT SEAAIMO TNL LANO 8YAvRTO4'1 WkrP IEA OR [NROSSCO ,ACAAL!HALL NOT
1 RE UWSISIYOEEIAIuu TO At A VAUO iRUuL1 st.d',,•
IM
is 1Pi4TlwTWA �ti a,°KNA n TM+u'R �ME�oN�0 9EN A ARVALLAOE K NOT � "w�/,Ob AMR N1Al Ao'�0a Y oe a L MEI N
ANO To TYII ASI1CNCEI a THE IJLNt>SN41 I+mTuTION. acRnncAa p AR[Nai TNAN6/CII go AoanaNAt �iTu)R�K T u. "it. M ouNE A
surrOLK COUNTY TAX MA4` OIST.1000 sigel.tee MLN.os %aT: qY f.t BU.
WAP N01 ao+a
PATIO OCTOGE d. this '. ', ' '. �.• `4�"4"'a".,w�+"''�.' Q SEW t0
O -BEH dEN� R
LOT t• `' t ' AY 9• f
MAP OF ELIJAH'S LANE ECTION 2 y •1+
LocA710N4 M&TTITucK ' '' �N. RS: ar
TF.
GTB
TowN OF SOUTHOIo, euFFo4.M COUNTY. NE rotors $U,R EYOR5 (i No, DAg'J1�J
SURVEYED: MARCH 21 , 1907 PREPAREM NOVEMIER, 1946 tisFp LT+xO�
4 RAST.MAIN 9T.:
sem. E11T1T1Cp TO: JEANNE HAMILTON BLOC LOCATION; 3/11/9 II,N,1T, 1 Ty70!
' IJ 10 COyuNTT NATIONALL SANK REVI 1 1/fl0.` !LLPr1ir
�'�p}
pOR TITLC AOENGT s IF, 2). 47 --OKAY
FILE Nd: 97-143 4X 47E�-OJ61
SCALE'.
w•rluallTM'��"'
0 -H Lb?TE b9T9 3 llIl �:f0gN H 3A W0 t,9 T T 00—T T—`_111-IBJ
j r
Shown with optional cupola, flower boxes Shown with optional flower boxes and ramp
and ramp
aiu
Shown with optional cupola and weather-
vane Shown with optional cupola
k'
" g
Quaker Porch Barn Quaker Porch Barn
Shown with optional Dutch trim, side porch rail, Shown with optional cupola, flower
cupola, weathervane and flower box boxes, painted deck and side porch rail
ION-
• 10 -