HomeMy WebLinkAbout27021-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. 27021 Z
Date JANUARY 18 2001
Permission is hereby granted to:
BIG "E" FRAM INC.
ONE JERICHO PLAZA
JERICHO,NY 11753
for :
REMOVAL OF AN EXISTING BARN AS APPLIED FOR.
at premises located at 2675
County Tax Map No. 473889 Section 120
pursuant to application dated JANUARY
Building Inspector.
SOUND AVE MATTITUCK
Block 0002 Lot No. 003.001
9, 2000 and approYed by the
Fee $ 134.00
Rev. 2/19/98
ORIGINAL
STATE OF NEW YORK:
:SS.:
COUNTY OF NEW YORK:
PAMELA W. HUNT, having an office at Big E Farm, Inc. at 6133 Sound
Avenue, Riverhead, N.Y. 11901, being duly sworn, deposes and says:
1. I am the agent of Big E Farm, Inc., which obtained Building Permit 27021 Z
dated January 18, 2001 from the Town of Southold. Big E Farm, Inc. owns the property
at 2675 Sound Avenue, Matfituck, N.Y. 1000-120-2-3.1.
2. Big E Farm, Inc. no longer intends to remove the barn and asks that the
Building Permit be rescinded. The barn has not been moved since the permit was issued.
Pamela W. Hunt
Sworn to before me
July /~, 2001
ubllo, 8tare of
No. 52-4642871
(b~lllfled In Suffolk
re/af~ ~ 8~.
AVENUE
S,18ol7'50"E.
FENCE
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD~ NY 11971
TEL: 765-1802
Examined ,20_.
Approved Il.q,[ ,200[
Disapproved ac
, _ 9nnl :, '
~UII.,DINU FlzKt'vl! 1 At-q-'LIL;A'fION CHECKL][S'
Do you have or need the following, before applyin8
Board of Health
. . 3 sets of Building Plans
Survey_
PERMIT NO.. '. ~t'~Oc~ [ Check
Septic Form
" N.Y,S.D.E.C.
Trustees
Contact:
tor
APPLICATION FOR BUILDING PE~T
Date
INSTRUCTIONS
Mail to:
Phone: q[ - to(o 5
//5" _, 200/
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 sghedule.
b. Plot plan showing location of lot and of buildings ~n'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 a Certificate of Occupan
is issued by the Building Inspector.
APPLICATION IS HEREBY MADE to the BuildingDepartrnent for the issuance cfa Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, SuffolklCounty, New York, and other applicable Laws, Ordinances or
Regulations, for the cbnstruction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable law~, ordinances, building codc, housing code, and regulations, cml to adnfit
authorized inspectors on premises and in building for neces. Sary inspections·
ature of applicant or name, ifa corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Name of owner of p~'emises __
If a/pplicant is a qorporiti, o.q, signature,of duly authorized officer
~J (i'Ve and title ;f~orPor~te 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 doCe:
'' APPROVED AS ~IOTED
~-_~ ) DATE: I-q-ol .B.P., oqgOoq, l_ .
(as 9n ~he tax roll or lates~[~ ;UILDING"g~;A"~M~ AT
765-1802 g AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1, FOUNDATION - ~/VO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4, FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O,
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y,
STATE CONSTRUCTION & ENERGY '
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
./o V /
/ Harhlet
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
/'ZO "Block '2~ Lot ~, I
Filed Map No. Lot
State existing use and occupancy of pr~mises and intended use and occupan.~cy of proposed construction:
b. Intended use and occupancy
Nature of work (check which apphcable) New Budding
Repair Removal ] Demolition
Estimated Cost /7., t,z)~--I Fee
I/!/[//,,z] (to be paid on filing this application)
If
dwelling,
number
of
dwelling
units
Number of dwelling units on each floor
If garage, number of cars i /
If business, commercial or mixed occup, ancy, specify nature and extent of each type of
use.
Addition Alteration
Other Work
(Description)
Dimensions of existing structures, if an'
Height. ,~c/, Numb
Dimensions of same structure with
Depth Heigh
Dimensions of entire new construction
,,: Front '3_ g t 6 ,t Rear
,r of Stori~'~ !
.Depth
alterations or additions: Front
Rear
Number of Stories
Front Rear Depth
Height
Size of lot: Front
0. Date of Purchase_C~/~y97
1. Zone or use district in which premises
2. ages proposect co.9..uxmae2rm violate any
Numl ~er of Stories
Name of Former Owner
e situated. /~ ~
:oning law, ordinance or
3. Will lot be re-graded_
4. Nmmes of Owner of premises
Name of Architect
Name of Contractor
5. Is 4his property within 100 feet of a tidal !
· · YES, SOUTHOLD TOWN
6. Provide survey, to scale, with accurate fo
Depth
regulation:
Will excess fill be removed from premises: YES NO
.Address ,~/.T.~ ~'~o~tag ffttF' PhoneNo. ~'g/ ..~q~'--/d)~'~'
Address Phone No
Address Phone No.
7. If elevation at any point on property is at
vetland? *YES NO /~'
TRUSTEES PERMITS MAY BE REQUItkED
~ndation plan and distances to property lines.
f said owner or owners, and is duly authorized tc
tat all statements contained in this application ar.
erformed in the manner set forth in the applicati(
worn to before me this
.__.~.d,ay of_~amxZO, ax~ 200 ]
' '',
ff ' Not-aw P~blic
APl .:~AIL A, W OKI'lAM
Notary P~bli~, atate of New Yot~(
No. 52-464287¢
Qualified in Suffolk Coun~
(,ommission Exp{res Sept.
110 feet or below, must provide topographical data on survey.
being duly sworn, deposes and says that (s)he is the applicant
nt, Corporate Officer, etc.)
perform or have performed the said work and to make and file this application
~ true to the best of his knowledge and belief; and that the work wiI1 be
n filed therewith.