HomeMy WebLinkAbout40578-Z -- TOWN OF SOUTHOLD
/'oSU�Fo4�oa BUILDING DEPARTMENT
VPrp_
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#: 40578 Date: 3/29/2016
Permission is hereby granted to:
Weaver Family Trust
2150 The Long Way
East Marion, NY 11939
To: install a deer fence as applied for.
At premises located at:
2150 The Long Way, East Marion
SCTM # 473889
Sec/Block/Lot# 30.-2-125
Pursuant to application dated 3/25/2016 and approved by the Building Inspector.
To expire on 3/29/2017.
Fees:
DEER FENCE - $75.00
...1: $75.00
Building n :- o -
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) 765-9502Survey
SoutholdTown.NorthFork.net PERMIT NO. 40 Check
Septic Form
N.Y.S.D.E.C.
. Trustees
C.O.Application
Flood Permit
Examined ,20 ! raczovg Single&Separate
Storm-Water Assessment Form
2_, \� T VAR 2 5 2016
Contact: '� �y i ,.
Approved ,20
Mail- / (c r/► �// l
Disapproved a/c SIMUDINGIDEPIt
f
'0' it i:- i.i,,r 4;:4., Phone: G3 I f )-7 G(40 2—
Expiration -" ,20
Building nspector
APPROVED AS NOTED APPLICATION FOR BUILDIN G PERMIT
DATEA2_', 1 ( . B.P.# UJ _ Date ab-
, 20/‘:,
FEE: , -_____ BY: INSTRUCTIONS
NOTIFY BUILDING DEPARTMENT AT
765al.alliisPa0MicT2iofi 1N'll_IWP'FbR)&mpletely filled in by.typewriter or in ink and submitted to the Building Inspector with 4
sets g i gi,INgcd SeFl b 'barn to scale. Fee according to schedule.
1. FI 1! Ti shJ�ji'igFo@afiFo'nlbf lot and of buildings on premises, relationship to adjoining premises or public streets or
areas a�gRwa&W I�.CONCHETE ,
. . TIle wo Iv�ere l b®y�m s application may not be commenced before issuance of Building Permit.
3. Ii��S %TQC
p n pp�roval of this application,the Building Inspector will issue a Building Permit•to the applicant. Such a permit
F ' qty ,TP l��iaokva�ii abs inspectiong
shall rr� IC �� �rs a e for throughout the work.
eBe OolawPa" iii iag�d pccgp'ec1 or used in whole or in part for any purpose what so ever until the Building Inspector
issu
ALLFF tJCSAMtc (HE
E� kit,Ga„sore,„„xt
l e `�e if the work authorized has not commenced within 12 months after the date ofYO Kle/ E�u I nl' d`�- '1
issuti�c-�l �! e n�t Ng elp e e y.�t rH 8 months from such date.'If no zoning amendments or other regulations affecting the
property nye 'Veen enacted in 1"ie 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 inspecti s.
l'i e ()EaL
(Signature of applicant or name, if a corporation)
r,2/5-6 76—LW dcz ,
/htqljjk(Mailingddress ofplian
1173?
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber j
uilder
(1)
Name of owner of premises Pht I I ( 0,6 �d 1 + C • e VQ/
(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 i''
Electricia iaiceris'e';No. "'`' .
Other„Trad&s'License,No.: , '
_ ,3-, ,.' ; _,'v :; .
1. Location of la.a on which pro•osed work will be done: f) /� Q' f
J. LTi 1. • ._ L! , Lf 1 . •
S l v o
House Number ' treet Hamlet .
County Tax Map No. 1000 Section 0 31 /1
� Block 0 �--- Lot I L/.—J
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and intended used occupancy of�proposed construction:
a. Existing use and occupancy r�� 1 V�'�C e 0 (o �,�
b. Intended use and occupancy • 7
3. Nature of work (check which applicable): New Building Addition V Alteration
Repair Removal Demolition Other Work
----• (Description)
4. Estimated Cost ",, et!Pf �( 6 P�b paid on filing this application)
5. If dwelling, number of dwelling units � Number of dwelling tot on each floor
If garage, number of cars 3.�
6. If business, commercial or mixed occupancy, specify at ems exte `ll 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 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 Name of Former Owner •
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation?YES NO
13. Will lot be re-graded? YES NO Will excess fill,be removed from premises? YES NO
14. Names of Owner of premises Address Phone No.
Name of Architect Ad'dress - ` 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 OF5'\ J
-Darlene, - U1ka. ( being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the Ot Qn-P r
(Contractor,Agent, Corporate Officer, etc.)
TRACEY L. DWYER
of said owner or owners, and is duly authorized to perform or have performed the said work andN® itrt3B r i. OPlalt cpK
that all statements contained in this application are true to the best of his kn.. •• ;dge and belief; and that tlRliO' w1
performed in the manner set forth in the application filed therewith. QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,2N
Sworn to before me this . •
5-1-1 day of 5)(--,in 20 149 / - ,I /
C Notary Public Signature of Applicant
BUILDER'S JOB NO. TITLE NO.
TOTAL PLOT AREA: 22,110 ± S.F. REV' DATE ITEM
N0.
1. 12/28/05 HOUSE CHANGE
•
2 03/16/06 HOUSE CHANGE
3 6/2/06 UNDER CONSTRUCTION
4. 7/24/06 FINAL SURVEY
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® MONUMENT ��p��
C STAKE
SUFFOLK COUNTY TAX MAP DIST:1000 SECT:030 BLK:02 LOT: 125 ,� _� � �'t'' \
%, -, , , .
MAP NO: 6266 DATE: JUNE 1 1, 1975 1
SEI--ISE DT ``` + .. a
LOT 49 t. t' -� {IIA
SMITH �F.,x p
MAP OF PEBBLE BEACH FARMS PC w. d i.
ELEVATIONS SHOWN HEREON REFER TO N G V D \f'`''X O• I /A::-'
LOCATION: EAST MARION ENGINEERS THE EXISTENCE OF RIGHT OF WAYS AND/OR EASEMENTS OF RECORD, IF ANY, NOT SHOYJ 'F]OiRGI ARAN•1t:E-0.../ s '
TOWN OF SOUTHOLD, SUFFOLK COUNTY, NEW YORK ARCHITECTS THIS SURVEY WAS PREPARED IN ACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR D SU[ MORS A OPTED BY THE NEW YORK STATE
SURVEYORS ASSOCIATION OF PROFESSIONAL LAND SURVEYORS
SURVEYED: MAY 7, 2005
244 EAST MAIN ST. ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. COPIES OF THIS SURVEY •
CERTIFIED TO: PHILLIP R. WEAVER & DARLENE CARLSON WEAVER MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY NO OFFICIAL OF
S SHALL .
AMERICAN HOME MORTGAGE ISAOA, ATItv1. • PATCHOGUE, N.Y. 1 1772 ACTHICEPT OR APPROVE ANY S STATE, OR OF ANY IPLANS OR SPECTY, COUNTY, IFICATIONSLTHAT ARE THEREIN,AGE CHARGED
STAMPED 1�CERTH TIFICATIONS INDICATED HEREON E ENFORCEMENT OF LAWS, RSHALL CRUN ES OONLY R GTOATHE NPERSON
SUNRISE ASTRACT, LLC. (631) 475-0349 FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED HEREON •
SCALE: 1 " = 40' FILE NO: 05-288 •
FAX 475-0361 AND TO THE ASSIGNEES OF THE LENDING INSTITUTION CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS