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Home My WebLink About1000-74.-3-16.1 TOWN OF SOUTHOLD FORM NO. 3 NOTICE OF DISAPPROVAL DATE: June 9, 2011 TO: Robert Adipietro P O Box 192 Peconic, NY 11958 Please take notice that your application dated June 3, 2011 For alteration of a dwelling to a Boarding House at Location of property: 2980 Peconic La., Peconic, NY County Tax Map No. 1000 - Section 74 Block 3 Lot 16.1 Is returned herewith and disapproved on the following grounds: Pursuant to Article X Section 280-45,(B) Site Plan approval from the Southold Town Planning Board is required. The use is permitted by special exception by the Board of Appeals. Authorized Signature CC: file, Planning Bd, L3A Note to Applicant: Any change or deviation to the above referenced application, may require further review by the Southold Town Building Department. TOWN OF SOUI ( BLIILDINC``ERMIT APPLICATION CHECKLIST BUILDING DEP "c, 0,-v, Do yuu have or need the following;before applying? TOWN HALL Board ofHealth . SOUTHOLD,NY 1 JUN -3 2011 4 sets of Building Plans,_, TEL: (631)765-1 O�2 Planning Board approval FAX: (631)765-9102 Survey iltD .a SoutholdTown.N rthFo. rk. lu GF'4$ IT NO Check Septic Form N,Y,S37.E.C, Trustees Flood Permit Examined 20 Single&'Separate Storm-Water Assessment Form Contact: Approved 20 MaiI to: Disapproved aJe al' Phone: Expiratian ,20 Building Inspector APPLICATION FOR BUILDING PERMIT Date & 20 �. INSTRUCTIONS a.This application MUST be completely filled in by typewriter or in inl<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 I reas,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,montlis 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 pen-nit 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 CCLI tv,NCW Yffl-k,arid'otl er applicable'Laws,Ordinances or Regulations,for the construction of buildings,additions,or alterations or iori'emoval'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. (Signature of applicant or re,if a corporation} (Mailing address of app i)'can State whether applicant is owner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder N F < t Name of owner of premises t v ( .1 .. (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, 1. Locatiq of land on v h proposed wor,° will be done: 8 C7 tea': . tC: I C , /\,/ G _ House Number Street ._.�— ..... Hamlet County Tax Ma No. 11100 Section Block Lot . Subdivision Bee Ef — 1-kg I Filed Map No.11103 Lot 2. State existing use and occupancy of premises arld intended use and occupancy of proposed construction: a. Existing use and occupancy l ID b. Intended use and occupancy 3. Nature of work(check which applicable):New Building __ Addition Alteration Repair Removal DemolitionOther Work _ (Description) 4. Estimated Cost Fee— — - (To be paid on filing this application) S. If dwelling,number of dwelling units f 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: Frontj� Rear.. Depth -7 Height a` _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 —µ 9. Size of lot:Front Rear &l Depth ;2-061 ' 10.Date of Purchase 19 -7 � Name of Former Owner 11.Zone or use district in which premises are situated "° 5 l SSS 12.Does proposed construction violate any zoning law,ordinance or regulation?YES NO 13.Will lot be re-graded?YES®NO�WiII excess fill be removed from premises?YES NO 14.Names of Owner of pemises a. i p+e /V Address� vr�< T'hcane.Na,r i/ 76:)- l J(fl Name of Architect .Address -� Phone No Name of Contractor c� a Address, Phone No. 15 a. Is this property within 100 feet of tidal wetland or a freshwater wetland?*YES NO IF YES,SOUTHOLD TOWN TRUSTEES & D.E.C.PERMITS MAY BE REQUIRED. b.Is thm s 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 U I being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the ontr ( actor,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 app I is at io-n-fled,tlmerew ith. Sr before me this day of 11 20 No ubl°c mature of App t MW an Wfwk 6a�V w.aawr�a�«�rf, � 0A oy N tt �yAy�V �.. �.�Clp" 9 o N Festa. \uVV�'~ a`fig / SURVEY OF A PROPERTY � � ��p��, AT PECONtC ti,oTOWN OF SOUTHOLD ✓� ``l' \ SUFFOLK COUNTY, N.Y. 1000-74-as-P10 16 vJ Scale: Y`=40' Feb. 2,2010 00, AREA-=20,229 sq.ftc ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW. 1�=� / ��9C EHCEPT AS PER SECTION 7209-SUBDIVISION 2,ALL CERHFICA77ON LOT NUMBERS ARE REFERENCED TO'STANDARD SUBDIVISION N 49618 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY FOR THE PROPERTY OF ROBERT ANP,PATRICK ADIPIETRO" � / iF SAN MAP OR COPIES REAM 7'FIE IMPRESSED SEAL OF THE P. DNIC SU - ,..,�. SURVEYOR WHOSE SIGNATURE APPEARS HEREON. (6311 765-50 7B65-1797' A a.BOX 909 TRAVELER STREET---- SOUTHODN03-217