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Home My WebLink About29374-ZFORM 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. 29374 Z Date MAY 14, 2003 Permission is hereby granted to: TOWN OF SOUTHOLD 53095 MAIN RD SOUTHOLD,NY 11971 for : DEMOLITION, REMOVAL AND RELOCATION OF AN EXISTING FRAMED BARN AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 061 pursuant to application dated MAY Building Inspector to exq~ire on NOVEMBER Fee $ 92.15 52875 MAIN RD SOUTHOLD Block 0001 Lot No. 005 5, 2003 and approved bythe 14, 2004. Authorized Signature ORIGINAL Rev. 5/8/02 Fax (516) 765~ 1823 Telephone (516) 765 - 1800 Town Hall, 53095 Main Road P.O. Box 1179 Southold, New York 11971 SOUTHOLD TOWN LANDMARK PRESERVATION COMMISSION TO: FROM: DATE: RE: Southold Town Building Department Southold Town Landmark Pres. Comm. - Herb Adler, Jr. May 13, 2003 Barn on Southold Town property at 52875 Main Rd., Southold Tax Map #61-1-5, SPLIA No. $D653 With respect to the disassembly and planned re-erection elsewhere of the barn presently located at the above address, the Commission herewith approves the same. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ~5 ]1~ ,20 ~ Approved __ ~1'~ __, 20 ~> Disapproved a/c Expiration ,20 PERMIT NO. BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 3 sets of Building Plans Planning Board approval Survey_ Check Septic Form N.Y.S.D.E.C. Trustees Contact: Mail to: Phone: ~'?~R ~" -Y~'0 }) Building Inspector /~PPLICATION 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, l~ee 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. ~o~./Sq-ocD /q-tj;rm~.4~. 5 cc c e= Fy ' (Signature of applicant or name, if a corporation) (Mail~g ad~l~e'ss o~' applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ~,q'Ot/r~ If al~gli~ant is, a~ corporation, si~gnature of duly authorized officer (Name and titl~ of c~rporate offi-cer) Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. (As on the tax roll or latest deed) 1. Location of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section Subdivision -- (Name) Block cO { Lot Filed Map No. ~ Lot 2. State existing use and occupancy of premises and intended use and occupancy of proposed constmctipn: a. Existing use and occupancy b. Intended use and occupancy Repair Removal Estimated Cost 5. If dwelling, number of dwelling units If garage, number of cars J 3. Nature of work (check which applicable): New Building Addition Alteration Demolition ~ Other Work (Description) (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. 7. Dimensions of existing structures, if any: Front ~ O~ Height [~ t Number of Stories Dimensions of same structure with~:~mt~rl'~-~dditions: Front Depth ..-Mare~ght. Number of Stories 8. Dimensions of entire new construct~ Rear Height . ~'l~lumb~ 9. Size of lot: Front ...~..---'~ear .Depth 10. Date of Purchase 4/'/'8/O~ Name of Former Owner Depth Rear 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 Name of Architect Name of Contractor 7", t-,qv8c~,~ 1 __ NO ~ Will excess fill be removed from premises? YES__ 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 X * IF YES, D.E.C. PERMITS MAY BE REQUIRED. Addr e s s 3-4-~ ? 3'-/t{ MX) t~0 Address Phone No Address [ldAOIM~ t~tl]~/~ PhoneNo. q2, c~ ~ ~ig.~-"' 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 ) ~.,'ff,4~ /~. /~O.,~ ,: ~~t~7- ~7- 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.)~z~,~ ' ' ,~, - 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 tree 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 0'"-, dayof /QO &-~j 200.ff ~ ~ lqotary P/ublic / Signature of Applicant FOR POURED ~ 2. ROUGH - FRA~ 3. INSULAT/ON 4. FINAL - CONS1 I~E COMPLETE ALL CONSTRUCTI REQUIREMENTS ( YORK STATE, N( DES~N OR APPROVED AS NOTED o^T~../i~j3 a,.#'~'~ ¥~- NOTIFY BUILDINg' DEPARTMENT A~ 76~1~2 8AM TO 4PM FO THE F~LOWlNG INSPECTIONS: 1. F~ND~~ "TWO REQU lEO ;ONCRETE lNG & PLUI BI~ RuC~N.M ~T ~ FOR C.O. coHALL ME~ ~E, o~s~w ~T RE~N$ ~BLE FOR EL 35.3' EL 35.8' N 60'aB'BO' £ , ,,N 60°22'~0' ----C I34,90' EL 36.5' CONCRETE F EL // / 1000-'61-0i-05 05'D E STY. FR, H~E. FIRST FLOOR £LEV~TI~N=381 '1 60'38'10' 136,1P' M~IN