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Home My WebLink About38056-Z TOWN OF SOUTHOLD �g�Ffo(K�o �aa Gy BUILDING DEPARTMENT y TOWN CLERK'S OFFICE "o 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#: 38056 Date: 5/28/2013 Permission is hereby granted to: Plonski, William & Plonski, Nilda 143 Radcliff Dr East Norwich, NY 11732 To: Demolition of 14' x 18' Deck addition as applied for At premises located at: 590 Old Orchard Ln, East Marion SCTM # 473889 Sec/Block/Lot# 31.-6-20 Pursuant to application dated 5/17/2013 and approved by the Building Inspector. To expire on 11/27/2014. Fees: DEMOLITION $175.60 Total: $175.60 Building Inspector TW 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. d Check Septic Form N.Y.S.D.E.C. Trustees C.O.Application Flood Permit Examined 420 Single&Separate EStorm-Water Assessment Form 4 nContact, Approved s ,20_ MAY 17 2013 Disapproved a/c _ pp�� ( BLDG. DEPT. Phone: �((//O _7 eP^ It 110 TOWN OF SOUTHOLD Expiration I 20 -_.-- Building Inspector APPLICATION FOR BUILDING PERMIT Date 120 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 Name of owner of premises 16J/1L I 4✓ /• f�L-0�/S'�f A1J16M Nk,&65,a /DAAe (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 ®/_ ro�� will dAne:q� ��/n�� House Number. Street Hamlet Ck 0 County Tax Map No. 1000 Section Block Lot Subdivision Filed Map No. Lot 41 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 4Z®06 . D_j:rl< b. Intended use and occupancy "r=w'0L / � "e &5L'LC 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated ,Cost �ee (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 constr\i ction: Front Rear Depth Height N, mber of Stories 9. Size of lot: Front ear Depth 10. Date of Purchase Nam`e of Former Owner ti 9 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning la\w, 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? 'k 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�M day of \ ' 20 13 VIC TOTW Notary Public is of IVew lbrk 1!l0.Ol 190696 in Suffolk Co Notary Public CamMsion Expires July 2R. ..n I Signature of Applicant TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET VILLAGE DIST. SUB. LOT NER N ACR. of W TYPE OF BUILDING 2� i VIC,$ v "ES... / SEAS. FARM comm. Cs. MISC. Mkt. Value 1_ c� b I LAND IMP. TOTAL DATE REMARKS 7" _67 00 , '7/1-6 6 :3 6 ff, ?1 v 0 6UR A y 010 0 o q o qf-s'- ko�-sn5 n-ski 1ino' m Z/9-46 , ' 'jr/a f AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Ti I lob]e I Tillable 2 Tillable 3 Voodland swampland FRONTAGE ON WATER 3rushland FRONTAGE ON ROAD J-5" 1V CF-- douse Plot DEPTH Id , 13 BULKHEAD Total DOCK ME NONE u�■niu�i ii�■WEE No NOR on on MEN 0 NEE ON NEE so RUN Al Interior Finish Fire Piace Dorrner i s.rvh�►n.er�� `au�� asu�al7 . P yawl•r i .o SHIMSIV 1►u cl '!?�� J A c?rJ► �D p► A,l fiiF S`G ?'l�l p t • ND,'371+�1A7 NG,;;.�I^N1�wri+<•% S��J/i,PS� ytLrt��/ lr�,�,,,j� �1�� O� ,t{�i '•p ' ' ..ljr 7rll,t+t..'f�?;'A•MY�YiG��L'!1 � n Ti 141 WC"Ai•::::".i';J3'r.'1C�1�� uf / Der, •.a��4:u a�rw v 11 W r . °ii7�:,b0 t��`;iI1::.1r;S GiSiOfY:1 1 ra�v;s G:sw 4.y0s:A�^.s ati'1 ixl 1 •1"LON IYw IMT-f SIM 10 SIB<CI 'AYI HOUY5141 Ova n0A Am DR 14 at'i Nowu iG1�0V�YC►4MlY�L7v QR1�014 - , i i f 7LI/! LSO '00037 1tld" Q + ,,/ OT0/600[a oxx DISK tM CUL M YVA 6V:L'T s6/07/90