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Home My WebLink About37245-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT (�/! 2 ' TOWN CLERK'S OFFICE oy . IPA 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#: 37245 Date: 5/24/2012 Permission is hereby granted to: Galante, Carlo & Galante, Anne 21 Grant St Copiague, NY 11726 To: Demolish an inground swimming pool as applied for; At premises located at: 515 Mayflower Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 107.-8-22 Pursuant to application dated 5/18/2012 and approved by the Building Inspector. To expire on 11/23/2013. Fees: DEMOLITION $100.00 Total: $100.00 Building Inspector 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 Planning Board approval FAX: (631) 765-9502a (�� Survey SoutholdTown.NorthFork.net PERMIT NO. �' l ` Check Septic Form (f,' (� U N.Y.S.D.E.C. lUr 15 Trustees C.O.Application .� Flood Permit Examined � 2,q,2011_ MAY 18 2012 Single&Separate ` Storm-Water Assessment Form BLDG,DEPT. Contact: TOWN OF SOUTHOLD Approved ,201� Mail to: Disapproved a/c Phone Expiration ,20 Building Inspector �. J APPLICATION FOR BUILDING PERMIT 'VDate , 20 /2- 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. 1-11, 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 wort: 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 anyarpose 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 a erein d 'bed. The applicant agrees to comply with all applicable laws, ordinances, building code, hou 'ng ode, and re ul ioi , and o admit authorized inspectors on premises and in building for necessary inspections. ignature of applicant o name, if a core ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of 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. (_ _ l,, r p (} y-fc—" "� � � Wnv d-cSSCJ.rvi.r2..�-1�e3C 1. Location of land on which proposed ork will be d ne: j �&41 House Number Streeet 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 ap icab ): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 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 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 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) 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 worl<will be performed in the mariner'sei forth in the application filed therewith. Sworn to before me- this -7�, 7 day of /iL 20 LAURA SEEBACH Notary Public,Staie of New Y ck No.p1SE6212g41 QudW in Suf. Co Notary Public Expires Signature of Apphradt