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Home My WebLink About32876-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) PERMIT NO. 32876 Z Date APRIL 4, 2007 Permission is hereby granted to: J PERETZ 5795 ROCKY POINT RD EAST MARION,NY 11939 for DEMOLITION OF MUD ROOMS (2) & INGROUND SWIMMING POOL AS APPLIED FOR at premises located at 280 ROSENBURG RD EAST MARION County Tax Map No. 473889 Section 021 Block 0001 Lot No. 003 pursuant to application dated MARCH 30, 2007 and approved by the Building Inspector to expire on OCTOBER 4 , 2008 . Fee $ 220 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTH'OD=` - - BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL MAR 3 0 2007 1 Board of Health SOUTHOLD,NY 11971 i 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX:'(631) 765-9502 Survey www. northfork.net/Southold/ PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: / Approved ,20 l7 Mail to: FikuK Uelleil te?C <l Disapproved a/c Phone; Expiration ,20� D Building Inspector APPLICATION FOR BUILDING PERMIT Date 0,3�?0 �L , 20 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 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 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 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 El� c7- Name of owner of premises c2e�SS�E / ��E _2=7' (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: House Number Street HamleNHOOOTPAM J County Tax Map No. 1000 Section 67-2/ Block 621 )"Da11s 141€ Subdivision Filed Map No. ;� - Lo (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .eESll�L�77�L !ry b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition p6VL Other Work (Description) 4. Estimated Cost Fee 4�0c (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 Depth 10. Date of Purchase Name of Former Owner OO/UE7 (/ 1L�CE yl LUU /z,�1 Y/?0'VD 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. STATE OF NEW YORK) SS: COUNTY OF OVI&� 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 '2, day of 20 D Notary Public Signature of Applicant NOTARY PUS STATE HNEIMAVM NO.Malawi LIC QUALIFIED IN SWFOLK COMM MY COMMISSION EXPIRES NOV.,V.SLIP • SURVEY OF DESCRIBED PROPERTY AND PART OF LOT 1 , l® AND LOTS 7,8,9 s �' N �� SUBDIVISON MAP s�s�, �9F 4 V PROPERTY OF MARION G. �s�� AppRo RICHARDSON J �� p XH�` THrS° Soar r SITUATE m LL O �� 'fF r EAST MARION, TOWN OF SOUTHOLD N \ \ OM ?S° N 83•43 o2„E SUFFOLK COUNTY, N.Y. o ^ �`�,S 48.38' SURVEYED FOR: JESSE PERETZ - N 06'47'00"E I - - Fnf# 859 21.6' I L4TE FILED DEC 31, 1927 N 07'36'00"W--_ I T,U 1000-021—01-003 22.1 ' I m N 04°21 '00"E 26'7' OF BLUFF THIS } �:UARANTEED TO: (J 3 �QP JESSE PERETZ r? oArEa COMMONWEALTH LAND TITLE INS CO. cp Qo} � Q (V.I SHED y P SURVEYED: 10 JANUARY 2007 35' 0 O SCALE 1"= 50' N 76'30'00"E LOT 2 m4, 52.25 -AREA = 130,500 S.F. PIPE FOUNO 1 OR z I 2.996 ACRES N 13'30'00"W I PART OF I I 40.00' LOT 1 JI URUTY POLE K I N 7 '00"E S 76'30 00 W 0 N 13'30'00"W .1 131.83' 52.25' 20.00' a I 4 O I WI 00 6.9= 3 O nun I `•/ O POLE LOT 7 WOOD DECK 1 01.4' (y COVERED � OPEN Fv PORCH I ..—..—..—.._.._.._..—.. W/RAJUNG I r cNAN uN f J WOOD FRAME ffg RESIDENCE W � zl i � CELLAR O �—j- LOT 8 I w 0'IO W 1 ; N E 1 00.5' S i WOOD WALKWAY I �9 I o �� I �N.uN>SrENc LOT 9 22.3' 6.3 POED I `10 FRAME N \ UPOLLE /� 9` GARAGE u o I ry I JQ��9 22.1' 1 UNOEf/NE g s r\ n> 2 Po�� rn o d kov Q-00" pfl;yo c Ncw FAG j W & W 6,GT(t 10EGk� o C) PSG N 56'50'00"W 30.3' Do 14.55' Z ro FRAME CONCRETE BLOCK WALL .� BLDG 0`ERye� y o Y' N co PI ES oM'/R PIPE NO FOUND L �O ORNIE UTILITY BLOCK FOUND- UTILITY POLE ATION N/F KANEY POLE OVER OVER LINEINE N V II LL1 STRATMORS RD GUARANTEES INDICATED HERE ON SHALL RUN ONLY TO THE PERSON FOR liVOM THE SURVEY SURVEYED BY IS PREPARED, AND ON HIS BEHALF TO THE TITLE COMPANY, GOVERNMENTAL AGENCY, STANLEY J. ISAKSEN, JR. LENDING INSTITUTION, IF LISTED HEREON, AND P.O. BOX 294 TO THE ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO NEW S 'FFOLK. N.Y. 1956 AD0177ONAL INS77TUT7ONS OR SUBSEQUENT OWNERS. 631 -7 4-5835 UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A NOLATION OF SECTION 7209 OF THE NEI4 YORK STATE EDUCATION LAW. COF%ES OF THIS SURVEY MAP NOT BEARING —T THE LAND SURVEYORS EMBOSSED SEAL SHALL � L,/�l.EENS D LAND RVEI'OR NOT 6E CONSIDERED TO BE A VALID TRUE IV YS L i c. No. 4 273 0 7 R 15 6 3 COPY. a �4 t - / OIL ................ Vol- 1 1 7F r 4 ly`,