HomeMy WebLinkAbout42903-Z S�FFotK TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
o + 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#: 42903 Date: 7/30/2018
Permission is hereby granted to:
Sharples, William
77 White St Apt 3
New York, NY 10013
To: construct deer fence as applied for.
At premises located at:
31545 Old Main Rd., Orient
SCTM # 473889
Sec/Block/Lot# 14.-2-3.4
Pursuant to application dated 7/23/2018 and approved by the Building Inspector.
To expire on 1/30/2020.
Fees:
DEER FENCE $75.00
Total: $75.00
B ' in pector
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 Plate Board approval
FAX: (631)765-9502J� Survey
Southoldtownny.gov PERMIT NO. vz _2�_ Check
Septic Form
N.Y.S.D.E.C.
Trustees
C_0_Application
LM
DFlood Permit
Examined 20 v Single&Separate
DD Truss Identification Form
J U L 2 3 2018 Storm-Water Assessment Form
contact
Approved CJU 20 $jJjg,DIN0 DEPT. Mail to: Y/�J} /AE
Disapproved a/c Tcffr%W I-�� - 1 OLD
Phone:
Expiration ® 20
Inspector
APPLICATION FOR BUILDING PERMIT
Date �Ly oZ3 120/61/"
INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or in ink 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
areas,and ys-
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 auffionzed 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) 119V
State whether applicant is owner,lessee, agent, architect,engineer, general contractor, electrician,plumber or builder
Cif/ EG
Name of owner of premises 4Z-I" 19,0 rew&w
(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. Location of land on which proposed work will he bone:
D1-v l /�/ Rb 00/zf&,v`7_
House Number Street Hamlet
County Tax Map No. 1000 Section Block OZ 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 �S/ GLS `A /L y �22F,S/�CIt� AG
b. Intended use and occupancy /p C#AA14X'
3. Nature of work(check which applicable):New Building Addition Alteration
Repair Removal Demolition Other Work DEER j!�1VCI11/G
4. Estimated Cost Fee
7131� (Description)
(To be paid on filing this application)
If dwelling,number of dwelling units Number of dwelling units on each floor
If garage, number of cars
\ If business,commercial or mixed occupancy,specify nature and extent of each type of use.
'9N\ 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
Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9� Size of lot:Front Rear Depth
1 .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 BF,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.
there 18. Are ere any covenants and restrictions with respect to this property? * YES NO y
* IF YES,PROVIDE A COPY,
STATE OF NEW YORK)
,`Dc- LSS:
COUNTY OFSAo-j
ISI 1 d o— �—e C_" being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)He is the
(Contractk,Agen 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 20j8_ '
�J TRACEY L. DWYER
BLIC,STATE OF NE
Notary Pub i NO.01DW630690o gignature of Applicant
QUALIFIED IN SUFFOLK COUNTY
COMMISSION EXPIRES JUNE 30,200,
LOT N1460S®Rim TO'YAP Cr PCTr,$EXHr
FXM N In affuU:cowr aERx's amcr
N °N JAM.M•1978 AS FNE Na 5979 SURVEY OF PROPERTY
AT ORIENT
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
1000-14-02--9.4
SCALL'I'— 90'
s8P7EY8ER 15 1014
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OMPLY WIT F 'A ODES OF
NEW YORK STAJf—_& T CODES
AS REQUIRED AI ,§OND 4 S OF
In i
POL AR R NED AS NOTED
`ra•'�Ji.
POLE° DATE:
FEE: - D BY:
NOTIFY BUILDING DEPAR T AT
1"02 .8 AM TO 4 PM FOR THE
�L'LOWING INSPECTIONS:
4--FOUNDATION -f�, OREQUIRED
FOR POUREDtCRETE
WMLLALCOREN SHARF ES d am\ q2. ROUGH -'FRAMING & PLUMBING
STEWART TITLE 1N CE COMPANY , 3. INSULATION
TRW REPUBLIC SAM
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
AREA= 99+966 SO. FT. AL CONSTRUCTION SHALL MEET THE
cR P_295 ACRES n �D �aSs REQ EMENTS OF THE CODES OF NEW
YORK S TE. W
ANv ALTFRAacw Oe AOA'a0ll Ta Tws sar�r u A ma,uxN I r L 89618
SEOROV F1090P T1C NEW Tear srarE m°aaar uW �We! n DESIGN 0 M
NOT C `CONST 797
12jo TRAVELER rsou7xoLa xr. 14-100
RUNOFF
PURSUANT TO CHAPTER 236
OF THE TOWN CODE.