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HomeMy WebLinkAbout34886-Z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT ND Town Hall Southold, N.Y. �L& BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 34886 Z Date JULY 23 , 2009 Permission is hereby granted to: STANLEY ANDREOU 5255 ROCKY POT RD E MARION,NY for INSTALLATION OF AN ABOVE GROUND SWIMMING POOL, FENCED TO CODE at premises located at 5255 ROCKY POINT RD EAST MARION County Tax Map No. 473889 Section 021 Block 0001 Lot No. 008 pursuant to application dated JULY 13, 2009 and approved by the Building ,Inspector to expire on JANUARY 23 , 2011 . Fee $ 250 . 00 Authorized Signature ORIGINAL Rev. 5/8/02 f _ r FIELD INSPECTION REPORT DATE COMMENTS FOUNDATION(1ST) y C FOUNDATION(2ND) • z o V� ROUGH FRAMING& PLUMBING O INSULATION PER N.Y. STATE ENERGY CODE Zia Alf FINAL ADDITIONAL COMMENTS O z m LA O z W C TOWN OF SOUTHOLD BUILDING Pi4RMIT 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 SoutholdTown.NorthFork.net PERMIT NO. Check S o •o p Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 7 � ,J 200 Storm-Water Assessment Form Contact: Approved 20 Mail to:, Disapproved a/c Expiration A3, 120 DBuilding Inspector JUL 13 2009 APPLICATION FOR BUILDING PERMIT BLDG.DEPT. Date f , 200 TOWN OF SOUTHOLD 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 pen-nit 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. VIIAU 't'�ELY"' ALL CONSTRL!CTION SHALL (Signature of applicant or name,if a corporation) ENCLOSE TO CODE MEET TL{E RECuI -IL-IME:NTS OF THE UPON COMPLETION CODES-OF NEIiV YORK STA "BEFORE"aIUAT,ER" (Mailing address of applicant) State whether applicant is owner, lessee, agent, ar 1 contractor,&P k p"ar uilder t DATE:-�� FEE Name of owner of premises l ah Is' IM UIL {I � (As n the tax roll/or lates � ° ° "'E If applicant is a corporation, signature of d authorized officer WING IIJSk'�=CT CCkJ U6�, �I��° (�R I. FOUNDATION TTWOO R REQUIRED FOR POURED C0 {CRETE (Name and title of corporate office ) 2. ROUGH '- FRAMING & PLUMBiNG S-E IS UNLAWFUL 3. INSULATION Builders License No. WITH I IT C 4. FINAL - CONSTRUCTION MUST Plumbers License No. non% TIFICATE BE COMP.ID'E,. FOR �.�. Electricians License No. Y ALL MEET THE REQUIR�-V :YS OF.T�E C DES OF NEW Other Trade's License No. YORK `j"YE. NO I" NEVOfU :;I;iLE FOR ESIGN rIR CON'S-TnUCTIGN—LRRORS. 1. Location o lan on which ropo'sed work w'll bed e: _ = v House Number qtreet Hamlet County Tax Map No. 1000 Section Z;11_r Block / Lot Subdivision Filed Map No. ' Lot 46 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 (Des iption) 4. Estimated Cost Fee (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 � yl� iil Dimensions of same structure with alterations or additions: Front i? l ? Rear Depth Height Number of Stories`; PPOU r, .fill, 8. Dimensions of entire new construction: Front Rear a Depth.-, Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase 1p 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 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. 3-TMMi: 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 pr,Q�erty? * YES NO IF YES, PROVIDE A COPY. '' `'`'' `'''}''�t§` llr'jf44�'� STATE OF NEW YORK) a SS: COUNTY OF G t being duly sworn, deposes and says that(s)he is the applicant hn A r ame of individual signing contract) above named, (S)He is the (Contractor, Agent, Corporate..O.ficer,etc;)'-- .`..;�s' of said owner or owners and is duly authorized to perform or have'performed th'e`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. KHALID M.CHAUDHARY Sworn to before-me this - Notary Public,state of New York / _ � No.o1 CH6164382 day of U 1— 20 U Qualified in 5u,olk County Commission Expire April 16,201 Notary P blic Signature dAbplicant 'OWN'OF SOUTHOLD BUILDING P�9RMIT APPLICATION CHECKLIST, ;UILDING DEPARTMENT Do you have or need the following,before applying" 'OWN HALL 'Board of Health OUTHOLD,NY 11971. 4 sets of Building Plans 'EL: (631) 765-1802 Planning Board approval 'AX: (631) 765-9502 Survey outholdTown.NorthFork.net PERMIT NO.. a 0 Check .'S 0 •d 1) Septic Form N.Y.S.D..t.C. Trustees Flood Permit :xamined 7 __1 20 09 Storm-Water Assessment Form . ` Contact: al kpproved 1)- ,20� Mail to: )isapproved a/c Phone:!S4/— U/ 'expiration luJ � U V � D Building Inspector �(J[, 1 3 2009 APPLICATION FOR BUILDING.PERMIT Date 20 BLDG.DEPT. TOWN OF SOUTHOLD INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 ,ets of plans, accurate plot plan to scale.Fee.accbrding to schedule.: b.Plot plan showing location of lot and of buildings on premises,relationship to.adjoining premises or public streets or ireas, 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 >hall 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) "IMUk Y. ALL CONSTRUCTION.SHALL ENCLOSE L TO CODE MEET TH.E R.EPU'l�G�-Y;LNTS OF THE UPON COMPLETION CODES OF_NEVV YORK STA I (Mailing address of applicant) BFFORE..VATER" State whether applicant is owner, lessee, agent; ar; F IR R ` 1 contractor; Tizilder 4 �\ a DATEJ1 8.P. V M. FEE• W BY Name of owner of premises I GAG) CS' I UIL 11 Pelt e (As n the tax col or lates "'� WING INSHECTIONS: If applicant is a corporation, signature of d&CUPMCY-OR authorized officer 1. FOUNDATION TWO REQUIRED FOR.POURED. CONCRETE (Name and title of corporate office ) 2. ROUGH:= FRAMING & PLUMBING USE IS UNLAWFUL 3. INSULATION Builders License No. WITN0I i �Q 4: FINAL -'CONSTRUCTION MUSTIT (` Plumbers License No. TIFICATF BE GOMP�.EI'E.:FOR -C.9. E ALL CON�"i Rl::t."' Electricians License No. OF : >Hf:f:. MEET THE Y REQUIRLAh"'<;,:"i'S .OF THE. OF NEW . Other Trade's License No:. YORI< `3T f E.. NU f kESd()t 011LE FOR ESIGt, riR: C01YSFhUCTIU1v f;RRORS. 1. Location of land on which nropdwdwork,P b e d e: K_ House Number &treet Hamlet County Tax Map No. 1000 Section Block / `. 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 (10 4. Estimated Cost �_ Fee (Des ption) (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 Lie th� Height Number of Stories Dimensions of same structure with alterations or additions: Front !; Rear Depth Height Numb.e.r of St 6 his' f1 4 R "4 A .8. Dimensions of entire new construction: Front Rear :....., .,.,. 4� . .. Height Number of Stories „ '- ;,,. _ �...�.......�.,..,. ._.+�-{i : 9. Size of lot:Front Rear. Depth 10. Date of Purchase Name of Fortner Owner fink 11. Zone.or use district in which premises are situated 12. Does proposed construction violate.any zoning law, ordinance or regulation? YES T 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. Naive 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 30.0 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. ri r 17. If elevation at any point.on property is at 10 feet-or below,must provide topographical data on survey ;- _. °1 :i AVV': is 18. Are there any covenants and restrictions with respect to th�sopQ� * YES NO IF YES,PROVIDE A COPY. �I;il' ;,.:._ :. RJ.,i N.Y.i STATE OF NEW YORK) SS1. COUNTY OF . / Y be duly sworn, deposes and says that-(s)he is the applicant acne of individual signing.contract) above named, ;�.• :,•, "• (S)He is-the (Contractor, Agent,Corpoxate..OfProer,"' tc ;\ I of said owner or owners,and-is duly"authorized to perform or have p"eirformed the s�id work and to make and file this application; that all stateiments.eontained 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 iii-the application filed.therewith KHALID M.CHAUDHARY Sworn to-before iAe this Notary public,State of New York day,of l) 1 2009 No.01 GH6164382 Qualified in Su olk County ' Commission Expire. April 16,20 Notary P blic Signature otAbrilicant Addition .�...".... A lterat on .......... 3. Nature of work(check which applicable):New Building .. ......... Other Work............... Removal .. Demolition (Deception) Repair ...... dl � ................ ..�°. }$ � ©.0.... .............. Fee ....• .. be Paid On Ming this application) . 4. Estimated Cost Number of dwelling units on each floor............. 5. If dwelling,number of dwelling'units ........•.................. ............................ . If garage,number of cars ................. a of use ............ ......... 6. If business,commercial or mixed occupancy,specify nature and exteentaof each type .... Depth..... ........ 7. Dimensions of existing structures,if any:Front• .... ....... ...... .......... . Height ...........Number of Stories .. ,. ...... Rear ........ alterations or additions:Front f Stories Dimensione structure w}th al ...Number P ....... peps • l. ..........Depth .+ `.t .Height . �• �; .Dep ... imensions ofpenr�eljnew�nstfuction:Front .. ( ..1....... Rear : ..... Q f .. .Feight ..I-- .L, ...... er o o es ... •..... .Nun}b f 5t ri .1PA .. Front ..........,. Rear:• .. Size of to ... .... ; 9 t. :,..:.........::Nadine _ _ ...... _ _ _ .. ., rrner :�e , Depth of Purchase k . Date _. arc tta't�"".�.......... ....... _ ' a, p .. is ct s �.19...;• . orre` ruse 1 viordinance or reg+rhattoa. �No construction violate any zoning a , ses ' oC 12. Does Proposed •�� ,Will excess fill be removed �t���� gg(Q7 13. Will lot be regraded .. r.. .•.. ........ Rl�k.'�: Rp��,`13lione o�3��`f�i-R3 7 _ tv4r11'�1D.1Q1lAddessd�.. 'PhoneNo. . 14. Name of Owner.of:premises `` Address ....... .. Name of Architect .......................... .Address .........:..........Phone No. ....... Name of contractor .........I.............. : PLOT DIAGRAM iorproposed and lndieate t-back dimensions from to dI 'shioVv'street dames and indicate whether Locate clearly and_distincblr all,buildings,r whether ezaccor d .�:: property lines.Give street and block' or description according interior or corner lot. W a" toq.x6 _ _.,. ••1` I • SHGO E ,fin E j(l 5'Ta +, z }}oust r' ,r _ i : - - m RD. ` R6CXy �c�lNr f i low.o M STATE OF NEW YORK, t d .. - . . ... can poses and says that he a ppli e (Name of individual signing contract): above named. e .. . He is the ................... �. (Contractor,agent,corporate officer,etc.) file this the said work and to make of said owner or owners,and is duly authorized applperform or have icatlon are true to the pest of his knowled8 and belief;and that the application.that all statements contam work will be performed in the mannei set forth in the application filed therewith. 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