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Home My WebLink About42069-Z �g�ffD(,Y 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#: 42069 Date: 10/19/2017 Permission is hereby granted to: Dickerson, Mark 10 Old Stone Ln East Haven, CT 06512 To: construct a deer fence as applied for. At premises located at: 1520 Bray Ave, Laurel SCTM # 473889 Sec/Block/Lot# 126.-7-27 Pursuant to application dated 10/11/2017 and approved by the Building Inspector. To expire on 10/19/2018. Fees: DEER FENCE $75.00 Total: $75.00 Building Inspector 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 Southoldtownny.gov PERMIT NO. -0 (/ Check Septic Form N.Y.S.D.E C. Trustees C.O Application Flood Permit Examined 20 Single&Separate Truss Identification Form Storm-Water Assessment Form Contact: Approved ,20Mail to. Disapproved a/c Phone. Expiration 20_ DBuilding Inspector ----- �+ LICATION FOR BUILDING PERMIT OCT 1 1 2017 Date `.J��L`R- � ,20 INSTRUCTIONS T be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of ii A� Aft-Ito scale.Fee according to schedule. TOWWA Ut W of lot and of buildings on premises,relationship to adjoining premises or public streets or areX,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 s be kept on the premises available for inspection throughout the work PQ e.No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector S�� O G� �• issues a Certificate of Occupancy. `\ GQQ 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-,Tor the Construction of buildings,additions,or alterations or for removal or demolition as herein described.The � ,'@`�vapplicant°agrees to comply with all applicable laws,ordinances,building code,housi g code,and regulations,and to admit a 99 autliorized inspectors.on enuses and r ing for necessary inspections. IZJZ-11 I �6a �• (Signature of applicant or name,if a corporation) (Mailm address of applicant) F(j, --�a��i-Stat�whlether,app'jicant is.Qwner,lessee,agent,architect,engineer,general contractor,electrician,plumber or builder '`2 r:`�`1 „leil :i',11`iriellb(� OVv/�ipIL ct aI a of owner of� remig,e1s �I)A vV 0 k AAS (-X Lt &]%/v n 0:. ;�,, 1h1��Lh• r�ll�'��'�'�'� r i'1 r �. (As on the tax roll or latest deed) 1rlAL�,f`lppCi�ant is;atc HA rat;o`n,ntgn�t�zre of duly authorized officer Cl r"vN -)'of c'oToraxeJofficer) A,JL couildesCLieense.IVo?GiyS' i' r• a .I.:; 3U El Y. EleItr'c>,apspuicenge No. c3ES1GOthe rade's License No. 1. Location of land on which roposed work WK House Number Street Hamlet County Tax Map No. 1000 Section LO Block mF 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 Demolition Other Work L>=F iL L 4. Estimated Cost Fee (Description) (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 Stories 8. Dimensions of entire new construction:Front Rear Depth Height Number of Stories 9. Size of lot:Front ° Rear S-0 Depth 1 .5- 0 10.Date of Purchase 0I Name of Former Owner N to 7�I•t.kisaoN 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 e ill excess fill be removed from premises?YES_NO� 14.Names of Owner of premises OVA Address 5�0 31'k4 Phone No._D? 20C. Name of Architect Address Phone No r 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 ) c V)Q 0" � t VC Ll being duly sworn,deposes and says that(s)he is the applicant (Name—67 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. Sw to fore me t day of 20 LAURA SZKAPIAK ota is Y PUBLIC ature of Applicant my Commission Expires 9116! W wnvr,TCu u}IEs-ZQ 1.9 � elfl'P U C01 AW TAR R 26.7-27 CERTIFIED TO' MARK DIMMMU CHICAGO TITLE zNSUR.ANC$gSRVICSF,.I 1PaLS II'ARGO$AM,Nom, ' gg 1�JQ� � � ►r. : x g,� oJpy:�:• . t G ,• ✓� lV �'P'� � 9 W- ti/ g� 00 d d N ar NORSE r ,yam ti �� R MoN ummvr MuNb n Sm t"f' 0 -9—+� o YJOOD FEN(X LiWo r r W •1� r,�r� +L Aid? w 7.500 8 y.R. .GRAPHIC r nes JOHN C- I tHLER9 LAND 5URVEYOP, f m f Q.MT MA111 MT P.hMUD.N.Y.I loot N Y$,LIC.No.602M 899 H268 Pxr 999.8207 David Quattrucci Subject: Building Permit Application - 1520 Bray Ave Laurel NY Good Morning, I filled this out as best I could. Looking to add an 8' deer fence along the right side of the property from the corner of the house to the rear of the property. If there are any questions, please feel free to contact me at 339 206 2337. Thank you! David Quattr ucci 1