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Home My WebLink About28486-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. 28486 Z Date JUNE 21, 2002 Permission is hereby granted to: WILLIAM & ANO BURKHARDT PO BOX 1047 SOUTHOLD,NY 11971 for DEMOLITION OF AN EXISTING ATTATCHED DECK AS APPLIED FOR at premises located at 5610 MAIN BAYVIEW RD SOUTHOLD County Tax Map No. 473889 Section 078 Block 0004 Lot No. 039 pursuant to application dated JUNE 20 , 2002 and approved by the Building Inspector to expire on DECEMBER 21, 2003 . Fee $ 35 . 00 D thori Signature ORIGINAL Rev. 5/8/02 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 3 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 � o6- Survey Z PERMIT NO. Check Ctry X11 PYe- C/o Septic Form 1 .�.i��►�� N.Y.S.D.E.C. Trustees Examined z� ,20 Z Contact: u Approved 6 ,20 Mail to: ?am Disapproved a/c o C Z J l x Phone: oja Q b3 f!g ny/ Expiration _V. Sl— l O Building Inspector (!��—� �� APPLICATION FOR PERMIT Date V , 20 INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 3 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 o pplicant or name,ifc rporation) AP R VEDAS NOTED DA • z Z B.P. ., (Mailing address of applicant) State 3� A ent, rchitect, engineer, general contractor, electrician,plumber or builder 765-1802 9 AM TO 4 PM FOR T FOLLOWING INSPECTIONS: 1. FOUNQDATIONN . TWO OUIRED r Name$f 1-I� Alrul-iNGETE UP/1'L I INSULATION (As on the tax roll or lates deed) If appal La coWNji 6i ur1%LTJ July authorized officer Ro COMELEMFOR C.O. , TIE REQUIREMENTS ofhk THE N.Y. Build ST TE CO TRUCTION & 'ENERGY .b 1A0�''R€8P-ONSIS1E FOR Plum'VMb"RedtNSTRUCTION ERRORS Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: O4 7v) House Number treet Hamlet County Tax Map No. 1000 Section 7 'i" Block Lot, Subdivision Filed Map No. Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a a. Existing use and occupancy F i L b. Intended use and occupancy I fir✓ �T 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work o F (Description) 4. Estimated Cost a o Fee�� 3 S. a"D (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 fes} 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. —- -k6w C : 7. Dimensions of existing structures, if any: Front Rear Depth Height Number of Stories a S Dime i s e structure with alterations or additions: Front 's Pea S� Depth Height Number of Stories _ 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front 2Y,-0 Rear 8-0 Depth 3 1VD o� L� Name of Former Owner /t �l6l 8"ek4,-.Dl 10. Date of Purchase I� 11. Zone or use diftrict In which re ises are situated 5' 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO_V�, 13. Will lot be re-graded? YES—44c- 14. " Oma`- Will excess fill be removed from premises? YES �N+D 13. Will lot be re-graded? YES-4414.Names of Owner of premises VL ° 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 VNO * IF YES, SOUTHOLD TOWN TRUSTEES &D.E.C. PERMITS MAY BE REQUIRED. IV)ft- b. Is this property within 300 feet of a tidal wetland? * YES V'NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. /7f) 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. fl JA 17. If elevation at any point on property is at 10 feet or below, must provide topog Mh- cal.;tdata on surveL.� 1-,q STATE OF NEW YORK) [l 4. ------ COUNTY being duly sworn, deposes�and saysth (s)h is the applicant', (Name of individual sign contract) above named, _. ,. 4: (S)He s the a (Contractor, gen Corporate Officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work andto make and file'this application; that all statements contained in this application are true to the best of his knowledge and belief, and that t e wor will be performed in the manner set forth in the application filed therewith. Sworn to before me t day of 20 O c-- tary Public Signaturef f Applicant JOYCE M.VVILKINS Notary Public,State of New York No.4952246,Suffolk county T,rm Fxp+res..Pune 12, �UCJ3 TOWN OF SOUTHOLD PROPERTY RECORD CAR® OWNER , STREET orij fi VILLAGE DISTRICT SUB. LOT d � � FORMER OWNER N E ACREAGE l�� • �.�.�-� �3 ,:',+ :c...:..�::'�,� S � .a W � TYPE OF BUILDING , a a k CG4 ES. SEAS. VL. FARM Comm. I-ND. CB. I MISC. LAND IMP. TOTAL DATE REMARKS e 6 0 h� AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE Form Acre Value Per Acre Value Tillable 1 Tillable 2 Tillable, 3 Woodland Swampland Brush[and,-- e.r House Plot Tata I 4. \ --- ■■■■��■moi!!■■■■■■■■■■■ r F �- ^+ { Hatt s iv t:dts�`Q►�� y _ psi :�i.-4; ILI 52 �4- 6ILI. :i �4�;• - f;' z2%164 J Q p e4—. r . — —__• -T9ZAVELZ—Z) 411 YED _ Id e~�_ �.J f12 :/'H A t4 + /p �• .�'S��VS�t ��.ti.:':�. _-