HomeMy WebLinkAbout24698-zFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
24698 Z Date FEBRUARY 20, 1998
Permission is
hereby granted to:
CHRISTINE HUNT
PO BOX 376
CUTCHOGUE,NY 11935
for :
CONSTRUCT AN ACCESSORY 4 FT. HIGH TRELLIS IN THE FRONT YARD OF A
SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 5700
County Tax Map No. 473889 Section 111
pursuant to application dated FEBRUARY
Building Inspector.
VANSTON RD CUTCHOGUE
Block 0010 Lot No. 013.001
2 1998 and approved by the
Fee $ 35.00
Building Insp~or
ORIGINAL
Rev. 2/19/98
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS .PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 24698 Z Date FEBRUARY 20, 1998
Permission is hereby granted to:
CHRISTINE HUNT
PO BOX 376
CUTCHOGUE,NY 11935
for .
CONSTRUCT AN ACCESSORY 4 FT. HIGH TRELLIS IN THE FRONT YARD OF A
SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 5700 VANSTON RD CUTCHOGUE
County Tax Map No. 473889 Section 111 Block 0010 Lot No. 013 . 001
pursuant to application dated FEBRUARY 2 1998 and approved by the
Building Inspector.
Fee $ 35 . 00
Building Inspe or
ORIGINAL
Rev. 2/19/98
rnrim nrr) -T
t
t'UtVN ()I
II(- H-DING, D1=I'ART-MENT"
T OIVN ( l-,LiZ is S ()f.-T'TCI;
SOUTITOf--17- N.Y.
NOTICE OF I)iSAI'PROVAI_
Date • -"-� -`�-�- - ��_ - l, ! .��. -
I'LFASE TAKE NO. ICI: (hal ymir ipplicntinn rlaiat . . .. . . . _p�� . . . . . . 19
(or herrnii Io . . . l . .:
�j'
601 i Lccn(ion o Property . �/ 1
Coon(y 1 x 14
Mnli No. 1000 Section . . . . . . . _ - . Block h_ . _ . _ . . Lo f
Siri,clivision . . . . . . . . . . . . . . . . . filed Map No. . . . . . . . _ . . - . . . . . Lot No. - - - . . . _ _ . . .,. _ ..'. . .
is rct r•nrd herc^ri(h and tlisnpl„ovcd mi the f(,ilt,�Vinry gro,rnds % _ . . s(Kl.11.
. . .. . . . . . . . . . . . . ... . 5.. . . . . . . . . . . . .,•
A
- - . - . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . . .
.. . - - - - - - ... . • . . . . . . . . . . . . . . . . . . . . . . . _ _ . . . - - . - - • - - .
- - - . .
.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2- - - - - - - - - - - - - - - - - - -
Ott1-i d ng gym; ect_n .
RV -1 /(ln
- (s`c G. Go-/N�w�i !w"O.lJr�i1
.�` }k � L..ra r"��' . � � i�*la+scJcx�"�-7`' ;�'�"ct d'.�'•� . . - � ... �- �.., .
cAr2'7F'
77
44
le
IL
-
.ts'
117 Fi_rk
50
j. • ' %J�.�.f
.� � � _ • ?�`s.✓r,r o F.Svcs rH�"�.A
` `�►+v Yam K s_.:ctna e:1le mot., :/►v'�, vr-s
/ 01-
w. - ... _ ��...K ..45•Y'• :.ha' . 4-N�4i�i�! �I,ti.�AP�!"�'OiM10Vc+�w vow-.� .. r.r-.Lr::-yam•. ./ ��1M'._-�prs�R1�'I��Y�I.....
L a m d .a ' '"a 1-�Pa P d
T
Ir
MM
17
IA
�! �; �� .. �f• Muff. /y-'S�Z F/7-��.�.frl. \.�T"�.:� . p: :�='::; .�' ,•:.•',rj.��,. , p �� .' �, _ Cj.
• . � - � �. � .c..and a Este//4.'i�'►Dorf - .--•;' �� ,f : • ..- - . .
- : : �, � _ /YIP �F'f�i�?OP�'T. �''., '� . � � - . � -= � . •. . � .
F t.
:ANQ'
:o •� cam: . .. • - - - - .. . . : � .
d W. vwn'7&Iy!e�aor
-Now , - la,�:.�.�urve or���
Greerlp"rMo
'i1 N. 7
�` -
765-1802
BUILDING DEFT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUG LBG.
[ ] FOUNDATION 2ND [ ] 1 ULATION
[ ] FRAMING [ FINAL
[ ] FIREPLACE & CHIMNEY
REMARKS:
DATE INSPECTO
' BOARD"OF HEALTH. . . . . . . . . . . . .
FORM NO. ' ] 3,,SETS.OF PLANS . . . . . . . . .•. . . . . .
TOWN OF SOUTHOLD ., SURVEY . . ... . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK *. .- . ... . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . .
SOUTIIOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
CALL '. . . . . . . . . . . . . . . .
Examined.................. 19..... MAIL TO: . . . .'. . . . . . . . . . . . . . . .
Approved.................. 1 ..'.:......................:.........
Disapproved a/c ..� ��. �..: .,: ?,�. U-10H1nM .1uA X-e-,.. ..................
i.+
fr 1d30 'Jal9
......................................................
100
(Building Inspector) a
OCT
APPLICATION FOR BUILDING P
Date: .�.�.. . . . . . 19 .
BLDF-DEPT. .: ' '
SOUTH
INSTRUCTIONS
a. this application mast be-completely filled in by typewriter or in ink and submitted to the Building Inspector wid-
3 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 giving a detailed description of layout of property avast be drawn on the diagram which is part of
this application.
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
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 whatever until a Certificate of
Occupancy shall have been granted by the Building Inspector-
APPLICNrl(V IS HGEtCBY 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 bui,14ing for,necessary inspections.
... . ...... :: 1 ..�:......:..............
(Si ture of applicant, or naime,.if a corporation)
............ ..... ............. ... ....
(Mailing-"address of applicant) .
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.................................. ................................ .... . .......................... ..
Nameof owner of premises ................. ............................ .............................
(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 lard on which proposed work will be done....:................ ....... ............
....? .. .....�...................................................................... ..... . . ...................
louse Number Street� O i( ( f Hamlet 3
County Tax Map No. 1000 . Section ..�Q- .... Block ................ Lot .....Subdivision ........ ......................... Filed Nfap.No. ....I.......... lot. ........
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:`.
a. Existing use.and occupancy .... ....... .. ......�I................. ...
b. Intended use and occupancy .(.� S . .. 7( iUYlS,!:�:!d ......
......
3. Nature of work (check wtud► applicable): 'New Building, . ... _ Addition .......... Alteration . .
Repair .......... Removal".: .. I)enolition. . ....I..... Other Work .....
.. ...
(Description).
4. Estimated Cost !.� fee .... .3s/ .............:........
(to be paid on filing.this application)
S. IF dwelling, number of'dwel,ling units .. Number of (hael.ling twits on each floor ................
If garage, rxmber of,cars . ... ..
6. If husiness, commercial or'mixed occhipancy, specify nature and:extent of each type of use......................
P
7. Dimensions of aist ng;'stivctu=eg; ;i1 any: Front.......... .. Rear . .. .. Depth .................
Height .....l....#µ............ -Number of Stories ....................
f
Dimensions of sane structure with alterations or additions: Front .......... mar ...� . • -�
Depth ..... :. Ilei ............ Number of Stories ..... •• C`i !i
... .. f .. '.. kill !)
�i.�,•7
. ; p Q t
fi. Dimensions of�entire new construction: Front Al l.Q�1. ...... Rear .a�-.S? �f De ?r.. 1�r�# ,t
lleig�hC Number of Stories ..................... •' .d4,!'
9. Size of lot: Front ....................... Rear .................... Depth .....
10. Date of Purchase .................... Nave of lormner .._..._
Owner 1Fya
Il. Zone or use district in which premises are situated ....................... ...................
12. Does proposed construction violate any zoning lase, ordinance or regulation: ........................
13. ` Will lot be regraded ..................... 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. Is.this property within.300 feet of a tidal wetland? * YES .......... NO .......
*IC YES, S01MYHD TU M IMSM9 P 1IT MAY BE WgHRID.
` PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
fran property lines. Give streetiand block number or description according to deed, and show street names and indicate
'wi ether interior or corner lot.,: i "
srl.[E o ri; ,
,s
ODUNtY c � ... ........
: ...........being duly sworn, deposes and says that he is the app].icamht
Mia e'of individual signing contract).
above named,
lieis the .............` Y ........ ..... .................................. ............
(Contractor, agent, corporate•officer, etc.)
of said saner 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 this knowledge"and .belief.; and
that the work will be performed in the manner set forth fin the application filed therewi:tlh. .: ..
Sworn to before me this
-..... �.� . .day f ..
.. .. .
Notary Pn he .. ..............1:::.....1.......
ZORN
LEW (Signature ofApplicant)
MMoa�--�yj .
BOARD OF, HEALTH . . . ... . . . . . . . . . .
t1.,1 'FORM NO:, 1 31; SETS„'OF•�LANS . . . . . . . . ... - - -
TOWN OF SOUTHOLD SURVEY'..`: . . . . . . . . . . . . . . . . . . . . .
BUILDING DEPARTMENT CHECK.: . . . . .. . .. . . . . . . . . . . .
• SEPTIC, FORM . . . . . . . . .
FEB •--2 TOWN HALL . . . . . .
SOUTHOLD, N.Y. 11971
TEL: 765-1802 NOTIFY:
WN DF S UT HOLD '
CALL. I: �14. .
Examined...... . ......... 194 p-. MAIL TO: . . . ... . . . . . . . . . . . . . . .
Apprwed......:X- .., 19 , Permit No. ...............................
Disapproved a/c ........................:. ...... . ....................................
(Building Inspector)
P LICATION FOR BUILDING PERMIT
Date:�� 19. . . .
. ,
INSTRUCTIONS
a. This application must be-coWletely filled in by typewriter or in ink and submitted to the Building Inspector witl
3 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 giving a detailed description of layout of property must be drawn on the diagram which is part of
this application.
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
permit shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in wholentil or in part for any purpose wbatever u a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICMON IS HEREBY RUE 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 ing for,n]jecessary inspections.
. .......
! :.:.. ...........:..............
•(Signature of applicant, or naue,.if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......................................................................wN..:.........::.... : ...................... ..
Nameof owner of premises ............................................................ ...............................
(ason 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. Iocation of land on which proposed work will be done.............................. ...................:..........
.......� ...... Usf .� ............................... ..! -......................
House Number Street Hamlet
County Tax Map No. 1000 . Section ... _ h.... Block .... Lot .
Subdivision .................
:................. Filed Map No. .1............. Lot ................
(Nam)
2. State existing use and occupancy of premise and intended use and occupancy of prbposed ,construction:
a. Existing use and occupancy .. ... ....I. .. U.� ....: .. ...
b. Intended use and occupancy .. �. 6:� (�i III. :; �'lC '�•; S V✓ ��
� V �'LJv" �f ': '��-' �•ry
Ki JC<<`(
3. Nature of work (crack wlirdh applicable): 'New Building
l� ) ng ......_... Addition ....... Alteration
Repair .......... Removal ...... Demolition ............ Other Work .... :...t...................
4. Estimated Cost .. ..{_ ..... fee ........................ i .. ....
'(to be paid on filing this a.�- Ic.Atian4 •.-
5. If draellinS;: ,riuriber of'dwe'lling units ............ ihniber of dwelling omits on each-floor.,''..: , ...- ...-...
Ifgarage, number of,cars.,........................................
6. If business, momiercial or'mi�oed -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 sane structure`•with alterations or additions: Front .................. Rear. ...............
Depth :.::......... ;Ileigtht' !............ Number of Stories•...............
8. Dimensions of entire new•eonstruct-ion:' Front ... �� ll... . .l ... A. Rear �_J. .. Depth :�.. ......
G '
height .............. ,. Number of Stories
9. Size of lot: front ...... Rear ..... ............ Depth
10. hate 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: ........................
13. Will lot 6 re'graded .. ....... Will excess fill be removed from premises: YES NO
14. Names of Owner of premises ....................... Address ..........:................... Phone No_ ..............
Name of Architect ....................... Address .......... ....... ........ Phone No. ..............
Nameof Contractor : .: .. .................... Address ...................... ......Phone No. ..............
15. ' Is this property within•300 feet of a tidal wetland? * YES .......... NJ .......... .
*IF YES, SOLMY D IU1M MISITLS PERMIT MAY BE MQUIRMi .
4`PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give street a6d block number or description according to deed, and show street rhames and indicate
whether interior or corner lot.
Sew su V'ej 0 a C"
SfAll's Or NW YM,
OIY O ....Sv :fo'I�k......... ss
OIIrl
..._ 1`5../.......�.. .... ......................Ibeing duly sworn, deposes and says that he is Cthe applicant
(Name of individual signing contract)
above named,
Ileis the ......... .......�P .. ... .............................................................
(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 ard..belief; and
that the work will be performed In lie manner set forth'in the application filed therewith.
Sworn to before me this........�............day o ..: .19...1Q
Notary Public . . . .. .. ...�. .
; //�
ROBERT) CGIT JR. . (Sig nattire of Applicant)' .
Notary f;ubl�c S` e of Newyork
QuelIN,d'in ufljolk County ,
No 0 4731
Te r m.Expd May 3.1, •,