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28518-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. 28518 Z Date JULY 1, 2002 Permission is hereby granted to: GARRET & MARY P MEADE 2680 PIKE ST MATTITUCK,NY 11952 for DEMOLITION OF AN ACCESSORY BUILDING AS APPLIED FOR at premises located at 2680 PIKE ST MATTITUCK County Tax Map No. 473889 Section 114 Block 0008 Lot No. 003 pursuant to application dated JUNE 27, 2002 and approved by the Building Inspector to expire on JANUARY 1, 2004 . Fee $ 110 . 00 A ignature ORIGINAL Rev. 5/8/02 - - . § -#!!_,'�.,.� _ '0F R i ems 'PI A-1 � ��., `_ �'� °' � � eta°ice' J��`�''``�D' „ `v'NI?is f>-F FEW" ...`s�._ -_—' .—.^" ,g J' I •r`'E '?. ` c�"',� e"'. -g,+- -„•' +gyp! by fi t~^>k�' ,r �' "'"., tw<.; g„. NOTIFY B r+� e�. - � D Yb �w`!�. � '->-.�it r 4<� -..R.:.. s�. � � a P' f� e�• AF, a i_-r„ 1 �h i�-�� o+<... A: 765.1802 ! A11 TO A Phi �� °^� ; ' FOLL01NIiVt3 INSPECTIp >1 � 5 ''�AT r f_'"+ ` `�, s_aCa : 1. FOUNDATION • TWO;' _� _ ,F , FORPOURED i0 Z•l I �< < ROUGAH�ywF } - - . J-4AUTHORIZED ALTERATION OR ADDMOM f I ROUGH UGH/yN - '� :�• - - TO THIS SURVEY 15 A VIOLATION OF _ g' s � � SECTION 7209 OF THE NEW YORK SIATE tt 4, FINAL . CONSTRUOMU am EDUCATION LAW. q 3tt -BE/COMPLETE app i COPIES OF THIS SURVEY MAP NOT BEARIM S ALL CONSTRUCTIOp k UT 1 .� THE LAND SURVEYOR'S IWM SEAL OR { EMBOSSED SEAL SHALL NOT DE CON31DEEED 1[ THE RELIUIRE-JENT`,r� ' TO BE A VALID TRUE COPY. N��� , GUARANTEES INDICATED HEREON SHALL RUN � ' STATE r ©NRUC710N ENEltlTI� I ` „ CODES, ,NOT.-,' + ONLY TO THE PERSON FOR WHOM THE 54iRVEY DESIGNIOp' iESPON81® I_ TI PREPARED, AND OV HIS BEHALF TO THE i {'• /� TITLE COMPANY, GOVERNMENTAL AC•r.1{CY ANL ` / `. LENDING•INSTITUTION LISTED HEREON, AND 7nil 9 1 =J - .: {O-THE ASSIGNEES OF THE LENDING NOVI-` .A I/ - rUTION.GUAR.�MEES ARE NOT TRAKSIUAS, ,` � 1 C,TP)W�f 0N'At INSTITUTIONS OR 5UB5F'Ji p E 1 V, V. I � :-� J_ �{ =fir'. r�:<�• p w} ;.•�.!b�i' .. ._r.,,, �' Mrr'>,y'-rtRli� {/r � f"a is J" { Je. -Et j•' ��'.` Al,�r'=' "=?i. }Y� .r�fptice' - '..�^f-', -_ _. #� 1t` •�s.�_... .__ _._...._. -...,. _Y._.-__"-.--e-a.-__ _ .,-.._.�._._.--�-._----'- i _�_ —. �__-��.___.'- ;`.�s+.,�o- 1.-1�y �as \i--lJ-- 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 Survey PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Examined ,20 Contact: Approved 120 Mail to: Disapproved a/c Phone: Expiration 720 Building Inspector APPLICATION FOR BUILDING PERMIT Date 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 of applicant or name,if a corporation) . AlleK s7 M55 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises /j') (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 proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 1/� 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. Existing use and occupancy F!�/Af � b. Intended use and occupancy 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolition r/ Other Work (Description) 4. Estimated Cost (Jf(�'�UOLU/l) Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units 0/0 Number of dwelling units on each floor If garage, number of cars YH business, commercial or mixed occupancy, specify nature and extent of each type of use. imensions of existing structures, if any: Front Rear Depth eight 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 dl Height Number of Stories 9. Size of lot: Front Rear Depth 10. Date of Purchase Name of Former Owner 1. 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 AIJ'A- E� Address Phone No._29,,-t!�-� 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 MAYBE RE IRED. 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. STATE OF NEW YORK) SS: /�,. COUNTY OF ) k—;, l�'l' m6 ms 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 200cr — No ary Public Signature of Applicant LINDA j.COOPER Notary public.State of ly Y, Rl®.4p22s63,Surk ffolk Ceunty f F119 EKPirem Deca,7+ber 3'i,�s�-CSO 2/ k.- C) Cy --3 TOWN OF SOUTHOLD PROPERTY RECORD CAR -OWNER STREET �6r'1 VILLAGE DIST. SUB. LOT / -FORMER OWNER N / E ACR. S W TYPE OF BUILDING d0 /✓S o N S~ 1 SEAS. VL. FARM COMM. CB. MICS. Mkt. Value 33�c7 LAND IMP: TOTAL "DATE REMARKS J D ✓ 2 /j "� �c n (�v s /r �- 3 lel o f�- 5 AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD. Meadowland DEPTH House Plot BULKHEAD Tote DOCK COLOR ; . TRIM v J ' .y T' F y n air„ 4 �n.w "^° rw,tG t+':� y3f•b J_.YnF"y''i?p+e.a. ,,. rt�y: - p , 9 0� _JL M. Bldg. = 6 �' S,o o v o Extension Extension qsS atC Y 9 - /3 s ; do GQYc, .2 Foundation ' Both. Dinette Porch 3 8 n Basement / Floors. . `^ `z� .. K. ac�f Porch /S L o ,Ext. Walls C-r� ^�_ ', Interior,Finish $!,e�"�, LR. o BAMzewec fa; Y / _ .ry Fire Place Heat Q f DR. GarageX 3 / Type Roof Rooms l st Floor BR. Patio , 0j ecreation Room Rooms 2nd Floor FIN. B 9 �.o Dormer Driveway Total BUILDING PERMIT EXAMINER CHECK LIST DATE REVIEWED: ;–/ )/02 APPLICANT: DATE SUBMITTED:b x/02 SCTM#DISTRICT: 1,000, SECTION: , BLOCK: J , LOT: ti STREET ADDRESS:,?GCITY: SUBDIVISION: " PROJECT DESCRIPTION. __ a _A� ESTIMATED PROJECT COST: ARCHITECT/ENGINEER: FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? --' NOTES: DOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LOTS FROM JAN.1997 100-25.Merger.(A nonconforming at anytime after 7/1/: ZONING DISTRICT: CONFORMING? REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT PROP. FRONT REQ SIDE ACT. SIDE REQ. REARyy PROP. REAR REQ. HEIGHT PROP. HEIGHT WATER FRONT? /J( b DESCRIPTION: PANEL #: FLOOD ZONE: , APPROVALS REQUIRED SUFFOLK COUNTY HEALTH D ES oe16� BED#): DTE:—/—/ PERMIT#:R10- TOWN SEPTIC RECEIPT: Y orb NEW YORK STATE DEC: PRE-DEC 9/1/75 YES o SOUTHOLD TOWN TRUSTEES: YES TOWN ZONING BOARD APPROVAL: YES TOWN PLAN. BOARD APPROVAL: YES Tor —_TOWN HISTORICAL PRE (SPLIA): YES NYS ENERGY: YES OR NO : EGRESS (18 H min.? 4 sq total) VENT(SQ. FT. x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/o Z- , NOTES: FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR: SF SECOND FLOOR: SF OTHER: SF IIT OTHER TOTAL TOTAL: SF FEE FEE FEE 7 �� Ori SFX$ • ��$ 7 +$ +$ _ $ 2. ( SF)- (SF)= SFX$ =$ +$ +$ _$