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Home My WebLink About41591-Z soF�ntXc TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE oy • 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#: 41591 Date: 5/2/2017 Permission is hereby granted to: Fedison, William 3290 Bridge Ln Cutchogue, NY 11935 To: demolish an above-ground swimming pool as applied for. At premises located at: 3290 Bridge Ln, Cutchogue SCTM # 473889 Sec/Block/Lot# 85.-2-19 Pursuant to application dated 4/25/2017 and approved by the Building Inspector. To expire on 11/1/2018. Fees: DEMOLITION $100.00 $100.00 Building nspecto 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) 765-9502 Survey SoutholdTown.NorthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined ,20 Single&Separate Storm-Water Assessment Form p ( Contact: Approved ,20 ` Mail to: --Disapproved a/c " Phone: Expiration ,20 C�� NCEMEM D Building Insp cto ID E -�� N EMEM AP ATION FOR BUILDING PERMIT APR 2 5 2011 FES. TIF BUILDING kIEN-r AT INSTRUCTIONS b -103,02 "AiNo' 4 F ,v FOR, f B> D> GDEPT. FOLLOWING INSPECTIONS: TOWN OF SOUTHOLD 1. FOUNDATION : TWO REQUIRED a. This application MUST be completely filled in by typewriter or in ink and submjj�d to l) LBL9>LdtRgJ�,,L ,Fctor with 4 sets of plans, accurate plot plan to scale. Fee according to schedule. 2. ROUGH - FRAMING & PLUMBING b. Plot plan showing location of lot and of buildings on premises, relationship toSadai�rlgrreymises or public streets or areas, and waterways. 4. FINAL - CONSTRUCTION MUST c. The work covered by this application may not be commenced before issuance offud&gL} R C.0. d. Upon approval of this application,the Building Inspector will issue a Building pLer@-yl\gbhgCapplicajtt ch,gaj��f -lq- shall be kept on the premises available for inspection throughout the work. REQUIREMENTS OF THE CODES OF NEV e.No building shall be occupied or used in whole or in part for any purpose whaT"'.0ve_x,,, Til tli�"eta�d ngflflS ie�etbOR issues a Certificate of Occupancy. DESIGN OR CONSTI;UCTIUN ERRORS. 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. 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 inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 0 Loo)C. , Name of owner of premises FeAI f)n n 1A 1 in + 6C (As ori the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer (Name and title of corporate officer) i",01C` E OF Builders License No. NE`V Y V`_'1` ; !O'l�1� ,! 'C'ODES Plumbers License No. F UIREi�°'-,`r` -�E Electricians License No. SOUT Other Trade's License No. 1. Location of land on which proposed work will be done: v�� "•=° ''' �"i` ' ` ' House Number QStreet —f-Ta—m—l—et m County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable):New Building Addition Alteration Repair Removal -Poo B_ Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 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: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front -_Rear Depth Height Number,'of_Stori6s - ! 8. Dimensions of entire new construction: Front Rear Depth i Height Number of Stories 9. Size of lot: Front Rear Depth ILI- 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 Address 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 OF ) being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)He is the (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 day of 20 Notary Public Signature of Applicant _..._, ._ _ _�_,..,.._._ ..,...s.. ■RJlllwl�wtwwlbwrn.,,t.....____.__ �<,,,•,, •a-Ic.. — - SUFFOLK CO HEALTH DEPT.APPROVAL 'VAC — ^, v - ,� ~f - 67-'ZO-62 .��. I V E YI:D v F 012. H.5 NO 120.0 10 \1 CT N AT THE WA1 _ m tp I SYSTEM: STATEMENT OF INTENT CONFOR m y\� m11 r' I i SUFFOLI THE WATER SUPPLY AND SEWAGE DISPOSAL l�- `1Z !"..'r�!`•: '.Il' Sot)T HOLD �y�• {sly SYSTEMS FOR THIS RESIDENCE WILL f4 CONFORM TO THE STANDARDS OF THE SUFFOLK CO DEPT OF HEALTH SERVICES, SUFFOLI j 1 - SER V I1 (5) APPLICANT CONSTRI DATE, SUFFOLK COUNTY DEPT. OF HEALTH _ 1 H S REF SERVICES FOR APPROVAL OF APPROVI CONSTRUCTION ONLY r DATE _ H S REF.NO a r-so•62 )f IS K' �,nr. J / SUFFZ APPROVED Pool / GJ \ ITT - 110 `a ' 47 \`\ YD' SUFFOLK CO TAX MAP DESIGNATION. OWNERS `tet AL.E 50- DIST. SECT BLOCK PCL ' 1 = 1:)- 85 2 19 c_T+:�•Y� + Ali-EL•!�t'a1=F. OWNERS ADDRESS. B; PT0!,EF4UiC5T r iurS4�2.7GlV I-II,L_,ILi'I 11746 DEE[' L -, 19 F L- Z DEED.L.fvr 1 P. TEST HOLE STAMP 71i,E 14:, c7 :e, r peer,>L..e...•bnr.eawn f.+..n».r et a-trn,.Yvtn.te I c q.-a M1-e.--I nMa n e t-dlj yt li,!•v�r.d r,nM�t t c q ,'•Vu nIVY. bevirlard I= i .+ - .i ' _ _ _ - GW+nw'hd.•,.:At. -�I Li 1!!✓::. � ( - _—_ 3 � tln-2•,t,.n In.•nr - — -- -• SEAL !•._ ala-'v't+YL —'`` Nu-,cC! til c, FtODER ICK VAN T-LLYL,P C r l-•'`l j,r LICENSED LAND SURVEYORS GREENPOR NEW YORK 3. Nature of work(check whichI ' Repair ......, applicable);New Building ..,,,,_ Renioval . Addition ... ....... Alteration ..... ......... Demolition .............. Other Work... 4. Estimated Cc.-. •,3 °O!''' � . ..I:.... Fee (Description) .•. S. If dwelling,number of dwelling units ...... (to be paid on filing this application) If garage,number of cars ...,I.,, Number of dwelling units on each floor...,, 6. If business,commercial or mixed .. .'.'..'''''' 7. Dimensions occupancy,specify nature and extent of each type of use . •'' of existing structures,if any:Front. Height ......... Nu ...... Dimensions of sa tpber of Stories .,,•, Rear .., ,•,,,. ,,,,, Depth ............ ... Depth me structure�Iltth alterations or additions:Front 8. Dimensions............. ............ .Height ........ .. Rear ........ ......... of entire new const #ucti F Number of Stone Height on: Front s ................. Number of Stories , • .''''••• Rear ,,,,' . Depth 9. Size of lot: Front ,1 ��, I 10. Date of Purchase .......... Rear...l Q. ........ .... Depth ....... 11. Zone or use district "'''''''''• Name f Fo p 9..•••••••. I2. Does in which pr�mises are situated,, orlOwner Proposed construction vio ate an ��S,I� '•Z)•• ..' '' 13. Will lot be regraded Y zoning law,ordinance or regulation: V, 14, Name of Owner of premises •ll' Q Will excess fill be removed from Name of �� R� •�)Rjn e ��GhAddress premises: 'Yes No Architect .. ,� 'x?Ro.1 *"Id er fp{�� .Address , C9 ,Phone No. 7, y-50� Name of Contractor . •� ..•. ••••••••• .Phone No. , I5. Is this property within 0 .. ,• •Address . Phone N If e 0 £eet of a tidal wetland? •.. ' '•' •••• . yes, Southold own Trustees pe Yes, No•• ,•,� rmit may be required, PLOT DIAGRAM Locate clearly and distinctly all(buildings, whether existing or proposed, and.indicate all set-back dimensions Afrom property lines.Give street and block interior or corner lot. number or description according to deed,and show street names and indicate whether UNDERWRITERS CMEWIM ICI{ Pool w))) be )o ea:7f ed REQUIRED P105 or MJnvb 1S' -From �r r0 P obe praper�y 1the, anc) Abort � v PIvS Or- nntov6 c/0� Poo 1 �'ron. back of �� ygXray+ I • eat-a,e�e=. �OCCUPANCY OR 15' USE IS UNLAWFL11- DA RAPR9ASNOTED WITHOUT CERT IFY- FEEAl ' sp# IOF OCCUPANCY765-1802 8 AM 70FY D4 PM FOR THE Cfor— /¢D�> FOLLOWING INSPECTIONS: beck, I. FOUIYDAT16N • TWO REQUIRED FOR POURED CONCRETE 2. ROUGH.FRAMING Q�e I Ho 0',-C3, INSULATION &PLUMBING 4. FINAL • CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. r 135 STATE CONSTRUCTION $ ENERGY 3 i 40 ri �� 7Lane STATE OF NEW YORK, R U pg COUNTY o S. 0/'-5 : DoT j 9 ' being duly sworn,deposes and says that he is the applicant (Name of individual signins contract) ' above named. He is the ......OW�}�•• •• �t of said owner ; - (Contractor,agent,corporate officer,etc.) or owners, and is duly juthorized 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 Sworn to beforeme this work will he performed in the manner set forth in the application filed therewith.r i 3 �. .day of. Ch 19:lp� Notary Public, ,,,•,,�, •'''''• ......`..• . . County r' " pig n c,SING Of NIMWk auw"w In rb- h!!(ontrvaJnygi. „' (Signature 0 f applicant)