HomeMy WebLinkAbout37800-Z f
�vFFe TOWN OF SOUTHOLD
��o .. BUILDING DEPARTMENT
~� TOWN CLERKS OFFICE
o . SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OPAPPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit#: 37800 Date: -2/11/2013
Permission is hereby granted to:
Jaswal, Saroj
22 Nicole Ct
Bohemia, NY 11716
To: DEMOLITION OF ACCESSORY STRUCTURE 15' X 40' AS APPLIED FOR
At premises located at:
35900 CR 48. Peconic
SCTM # 473889
Sec/Block/Lot# 69.-4-5
Pursuant to application dated 2/8/2013 and approved by the Building Inspector.
To expire on 8/13/2014.
Fees:
DEMOLITION $280.00
Total: $280.00
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) 765-9502 Survey
SoutholdTown.NorthFork.net PERMIT NO. ! Check
Septic Form
N.Y.S.D.E.C.
Trustees
C.O. Application
I r� Flood Permit
Examined (,20 L3 Single& Separate
Storm-Water Assessment Form
Contact:
Approved (( ,20 Mail to: �U
Disapproved a/c
Phone:
Expiration 20
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date o� , 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 a it
authorized inspectors on premises and in building for necessary inspections.
(Signature of applicant or name, if a corporation)
PO •1?)0 XXC4 44 (-Ct 1, � l�
q�f
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of premises Saco ) T • J-0t's W Q,I
(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 propo ed wo k will be done:
�" G Lt VI �C-coy)% C
House umber Str et Hamlet
County Tax Map No. 1000 Section Block �„ Lot
Subdivision Filed Map No. Lot
2. State existing use and occupancy of premises and inter led use and occupancy of proposVonstrLlCtion:
a. Existing use and occupancy `�� nC, • CSso
b. Intended use and occupancy d-Qib1/1.0 0 "C256 Or ` ^ V tj&h r0__
3. Nature of work (check which applicable): 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 40 1 Rear 40 , 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 ,200 Name of Former Owner AA6UPA,h j 1�
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_,�CWill excess fill be removed from prenises? YES NOk
14. Names of Owner of premises�G�-yo 1 VQ�W�� Address Phone No.
Name of Architect -r' Address Phone No
Name of Contractor 11)So I V 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 work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
day of 20
Notary Public Signature of Applicant
�o
SURVEY OF PROPERTY
�, o� , • : �, ,�o SITUATE
C;1 PECONIC
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TOWN OF SOUTHOLD
p •. , c N� 1OgRG1Os SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-69 -04-05
SCALE 1 "=30'
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JANUARY 26, 2012
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PREPARED IN ACCORDANCE WITH THE MINIMUM
STANDARDS FOR TITLE SURVEYS AS ESTABLISHED
BY THE tA.A.L,S.+CAND'APPROVED AND ADOPTED
FOR SUCH\USE'.BY-THE YOR STATE LAND
TITLE jASSOCIATION.Z¢ L!
sn'Ir 7 y
IO IS gOP N.Y.S. Lic. No. 50467
D�9 UNAUTHORIZED ALTERATION OR ADDITION
is TO THIS SURVEY IS A VIOLATION OF Nathan Taft Corwin III
tt SECTION 7209 OF THE NEW YORK STATE
l.r LOS`G EDUCATION LAW. Land Surveyor
00 COPIES OF 'MIS SURVEY MAP NOT BEARING
THE LAND SURVEYOR'S INKED SEAL OR ..//
V+ EMBOSSED SEAL SHALL NOT BE CONSIDERED
•�—� 0+ TO BE A VAUD TRUE COPY.
��y� PO •�O ONLYFTO ICATTESP RSIONTED FOR WHOM THFELSURVEY L RUN Successor To: Stanley Joseph A. IngegnJ. o L.S.L.S.
c.� IS PREPARED, AND ON HIS BEHALF TO THE
C J TITLE LENDING MPANY,lflGOVERNMENTAL ON LISTED HEREON,AND D Title Surveys — Subdivisions — Site Plans — Construction Layout
TUTIONE CERTIFICATIONS RE NOTDITRANSFERABLE.
o� PHONE (631)727-2090 Fax (631)727-1727
JN� OFFICES LOCATED AT MAILING ADDRESS
AND/OR EASEMENTS
S OF RECORD, IF
THE EXISTENCE RIGHT WAYS 1586 Main Road P.O. Box 16
ANY, NOT SHOWN ARE NOT GUARANTEED. Jamesport, New York 11947 Jamesport, New York 11947
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