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HomeMy WebLinkAbout40870-Z o�g�Dl,��,o TOWN OF SOUTHOLD �� �y BUILDING DEPARTMENT y 2 TOWN CLERK'S OFFICE o • � SOUTHOLD, NY y,��l � �ap! 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#: 40870 Date: 8/1/2016 Permission is hereby granted to: Terry Judith T Family Trust 600 Highwood Rd Southold, NY 11971 To: demolish existing accessory horse shed as applied for. At premises located at: 585 Private Rd #21, Southold SCTM #473889 Sec/Block/Lot# 78.-9-37 Pursuant to application dated 7/25/2016 and approved by the Building Inspector. To expire on 1/31/2018. Fees: - DEMOLITION $146.20 Total: $146.20 Bui ' ing Inspec r� TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT � Do you ave or need the following,before applying? TOWN HALL ' ` � d of Health SOUTHOLD,NY 11971 . , , 4 sets of Building Plans � TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 r � Qrvey SoutholdTown.NorthFork.net PERMIT NO. � Check Septic Form N.Y.S.D.E.C. �, Trustees ' C.O.Application f ) _ D ���D�� Flood Permit Examined ,20 � � D Single&Separate --r-F- Storm-Water Assessment Form Jkll. 2 5 2016 Contact: �a�, � o e Approved ,20 � �Ole a�� Disapproved a/c $jjEL,D1N('`iDF�PT• �'�'�� .. '�y611�j UF SOTJTHULD Phone: ��(��%►$�� Expiration ,20 Bui ng In ector APPLICATION FOR BUILDING PERMIT ' � Date � o , 20�� INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector witl� 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 worlc 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 months 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 permit for an addition six months. Thereafter,a new permit shall be required. APPLICAT�ION 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 inspections. �� ( ' nat of ' � , a - ,..� � � . (Mailing a dress f applicant) `�c�� � � State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ���t'��/P�s , Name of owner of premises ���o � 9G" �,(,��r`�i � �/�/e � (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 ,o:'�'��� � ' �,'�" ,��, . . . _ _ ._,., , :r ,. „ .- 1. Location of land'on="`�hich propo`s'ed�wo'k'wi�e;�ione: ��� c� - :";• -,i- -�r ,,�.,. � House um r ,Street�. ,�,���'9 J���'9 Hamlet . (�t�°���'�°� ¢ �7'�:�L►�� /eiP�.''/— - � . County Tax Map No. 1000 Section �� Block � Lot �� ,,�c�,olt-� j• ���e�y�7�5�9 ��—'9,3� . Subdivision Filed Map No. Lot _ � 2. State existing use and occupancy of premises and intended use and occupancy of opo onstr iction: a. Existing use and occupancy � b. Intended use and occupancy C 3. Nature of work check which a licable : New Buildin Addition �"Alteration � pp ) Repair Removal emolition Other Work ° (Description) � Estimated Cost �` =`�^���� �°"'��;�- •.. Y :.. � �M �'.'•l `sdf�.�e.�����.E�;;'j c��paid on filing this application) � , � If dwelling, number of dwellin ' s �.'� Number of dw ' u�z�s�on each floor ' If garage, number of c ��� • ;> > �,.;t � � "��A,',v t� J .5��yo ..r � If business, comme/rc1' mixed occu , specify nature and each type of use. / � y�~r•.rythh �'"'.�h.S.1A.1.��9`L� �r f�.(6i..<<:w L'{a✓Ad rd�f.ti a.t•�-a e1 T�?`� 4 7. Dimensions of existing structures, if any: Front Rear-R� Depth � (' Height Number of Stories Dimension o same struc r�re � Iterations or additions: Front Rear Depth � � Heig ) u� x � �, Number of Stories ��Dimensions of entire cons ction: Front Rear Depth Height • � Number of Stories ��� Size of lot: Front Rear Depth �1�Q Date of Purchase Name of Former Owner c � Zone or use district in which premises are situated ��S �,((/�/` �,_ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO .V Will excess fill be removed from premises? YES NO � . v � ��{� 1�2�J� �� �D� /1��i��� 14. Names of Owner of premises�t� � � �� uAddress r i �hbne�o. /–�O – � Name o -e�'rt��t— Address Phone No Name o actor 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,�EQUIRED. b. Is this property within 300 feet of a tidal wetland? * YES NO_� * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. rovide 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 V * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF � • i ,�f � r �/' � c� ,�CL�r ! �'i /� / tP�t'�� ��D�° � /U � � � being duly sworn, depo es and says that(s)he is the applicant (Name o individual signing con ract) above named, � � (S)He is tlie ,�/�(�/dQl��v �(,�Jjj�/��,� (Contractor,Agent, Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to mal<e and file this application; that all statements contained in this application are true to the best of his knowledge��f�a8�1 �he worl<will be performed in the manner set forth in the application filed therewith. N07ARY PUBLIC,STATE OF NEW YORK NO.01 DW6306900 Sworn to before me this QUALIFIED IN SUFFOLK COUNTY 5� day of� 2Q� COMMISSION EXPIRES JUNE 30,2� . � .� . . � � �{� , � Notary P lic ignature of Applicant ' - , , ' � - ' ' , � , . ' , ^a`.i . �-, �. \ � '. } �—/ �� � � � ������ �������� ������ ���� �� /e:� � � � ?�-� �.�s� Yv�. �, OWNER � STREET � � VILLAGE DIST. SUB. LO ��tc�-����";�" ,� ��.t�-t`��� ,�-- ��. �� ' �" . _ �FORMER OWNE.� � �, � �,�,�,�� e . E � f � � � A�CR. �� 0 � l� -�'i �, �` ��F.�.�,c ,:��...� b f�p� . � S W , ' TYPE OF BUILDING � � �•���t��a a "�7.J�.�5'e,��:.�rs! " �� � �t/� /� RES. SEAS. VL. ��� FARM COMM. CB. MICS. Mkt. Value _ LAND IMP. TOTAL DATE REMARKS - - - , , - ` �'�' � � � /1��� � ./�,P...�.� ..� �°-��...��.�,�L.-:.�:. - -� -� , - . . . . �... 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