HomeMy WebLinkAbout23346-z 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)
Date .......ARNrU.5 ....................................... 1996.......
NP 23346 Z
Permission Is hereby granted to;
Arthur H. Axberg, Jr.
..........................................................................................
1 Delaware Rim Dr.
..........................................................................................
Yardley, Pa 19067
..........................................................................................
to ...,,,,,, CONSTRUCT LOW PROFILE RETAINING WALL (6" to 12") AS APPLIED FOR.
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at premises located at..,,,, 3705 CAMP MINEOLA ROAD MATTITUCK, N.Y.
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County Tax Map No. 1000 Section ..........1.2....3.......... Block.........I................ Lot No. ........34..... ..........
96
pursuant to application dated ...............�RIL 5, 19................ and approved by the
Building Inspector.
Fee$..........35..00
�1
.. ......... . . .. .��...............
ding Inspector
Rev. 6/30/80
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Town Hall, 53095 Main Road p • Fax(516)765-1823
P. O. Box 1179 Telephone (516) 765-1802
Southold, New York 11971
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
TO: Zoning Board of Appeals
FROM: Thomas J. Fisher - Senior Building Inspector
DATE: June 3, 1996
RE: Arthur Axbergh - SCTM#1000-123-5-34
Here is a copy of the information contained in Building
Permit #23346-Z dated May 23, 1996 that we have on file
regarding Arthur Axberg's retaining wall.
(� BOARD OF HEALTH
;•,.:�� ,•,� FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . .
j J
OF SOUTHOLD —SURVEY . . . . . . . . . . . . . . . . . . . . . . . .
E 'BUILD, G DEPARTMENT CHECK
APR, «-5 tft'14Y 'r3: . sr . . . . . . . . . . . . . . . . • - - - . . . . .
" WN HALL, 1 1971 SEPTIC FORM . . . . . . . . . . . . . . . . . . .
SLOG.DEPT S6UTI O
{
v TOWN OF SOUTHOL® TEL: 765-1802 NOTIFY:
CALL . . . . . . . . . . . . . . . . . .
Emmined.... rgfa ........ 19.16 MAII. TO: . . . . . . . . . . . . . . . . . . . .
A .....�I.!:S......., 19- -6 Permit No. .;.� ... ....................................
I `� � y
Disapproveda/c .................................. ....................................
......................................................
-(Builnspector). .
g
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . 19. . . .
INSTRUCTIONS
a. This application mist be completely filled in by typewriter or in ink and submitted to the Building Inspector with
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 mist 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.
APPLICATION IS HEREBY MATTE 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 essay :inspections.
...............
:., ....�.:..•. � .................
13^/�,� Si of applicant, , if a corporation)
Mailinngg Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
..............OGtJ,/,.„ ..................................._.._.........................................................
Name of owner of premises ..1:�:C:: l/. i-_ -f�X- ,��.�7...:!-/Z�.........................................
.4
(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 be done... . ... ".. ................
�llw
.......................................................................................................................
House Number Street/ Hamlet
County Tax Map No. 1000 Section ...w.1 a:3....' Block ......'� ...... Lot ......
Subdivision ......... Filed Map No. ............... Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Fisting use and occupancy... ............ ........ .
b. Intended use and occupancy .................................J.---
3. Nature of work (check wlhiclr a14)licable). New Ikuilding .......... Addition Alteration /i
Repa i r ......_..... Renoval ............. Dmx)l i t ion ............ Other WorkAv,n
.��lJ
ption) A-:.- G
�1O feef,�-r....d, . .... .. .......i. LsC lm►�hte<l Cost' ................ ..... .. ... ...to.be paid on -filing this application)
5. If hk4elling, rxidrer of dwelling units ............ liudrer of duelling ►arils on each floor ................
If garage, rxnirer of cars ......................................
G. If1xisiness, mnwrcial or mixed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front............. hear ............... Depth .................
neiglht Mni)er of Stories ......................
Dimensions of same structure wiLh alterations or additions: Front ............... Rear ...............
Depth .................... Ileigl►t .................... Mniner of Stories ...............
B. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
liei&L ......................... Uniner of Stories .....................
9- Size of lot: Front .....^.7.......... Rear .................... Depth ....................
10. Date of Purchase .?� .���-(._•_-... w w of Former Owner ....L`��p�...........................
11. Z.ore or use district in which premises are situated ..............................................................
12. Iknes proposed ccxustruction violate`�h zoning law, ordinance or regulation: ............ ...
►�[ If�41im r� .Yt�i -e C4�
13. Will lot be regraded W L� .. Q Will excess fill be removed frcm pram ses: YES ND
M. Manes of Owner of prenises ........................... Ackiress .............................. Phone No. ...........
Name of Architect .................................... Address .............................. P1►one No. ...........
Nrnre of Contractor .. • ............................ Acklress .. ...........................Phone No. ...........
15. Is this property witlrin300 feet of a tidal wetland? * YES ..v...... NO .
*IF YES, S011IIHD 'IMN 'IMIS M ES PERMIT MAY IC- WG 1111[1).
11I.0'I' DIAGRAM
Tecate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-balk dimensions
from property lines. Give street and block mrhber or description according to deed, and show street names and indicate
%Aiellher .interior or corner lot.
14-1-0
SI'A IE m "V Y(R((,
�� SS
ClllItllY (R? ..... .......
. l/ `.e ...............being duly sworn, deposes mid says that he is the appl icanL
(Mnre of imlividual. signing contract)
alxrve mmied,
IIe in die ..............................Q�'�9QJ�!f..................
................_........................
(Ccmtractor, agent, corporate officer., etc.)
of said canner or owners, aril is duly authorized to perform or have perf-omied the said work and to rmke and file this
application; that all sLaLenents contained in this appl.ic:ation are true to the best of his kwwl.edge and b6l.ief; and
that. Lhe work will. be performed in the mxrnner set forth in the application filed therewith.
.'M n to before rho this Qr,
.......-•---.......(lay o. 9.3 ...
Notaryi'ul ` . ....................`. ...
ROBERT I.SCOTT JR. . . ............ .. ..... .
;NOTARY PUBLIC.Sta N.Y. (Signature of Applicant)
`j4l ..4725089,Suffo Counjy�
�.. ites May 1,19
Term Exp
TITLE NO. S-61524
NEW SUFFOLK AVENUE
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PECONIC BAY
SURVEY FOR /
ARTHUR H. AXBERG, JR.
'13r,4rd- 60/oE A 7NA; i/ 14�s. MATTITUCK a V
CIeEEK Nan 5'c�c'ti' 1hE�clE� TOWN OF SOUTHOL D
SUFFOLK COUNTY, N.Y.
�`S'�If�'.D P�rmnr.:U A�cf✓ar 43r'Xc�
// GUARANTEED TV,
HOME TITLE DIVISION,CHICAGO TITLE
SCALE Ill= 40� INSURANCE COMPANY.
ARTHUR H.AXSERG,JR.
DEC. 15, 1967
LAND SURVEYOR
N.Y.S.LI C.N°.2 s 725
RIVERHEAD N.Y.