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HomeMy WebLinkAbout27738-Z FORM NO. 3 /r r TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMIS UNTIL FULL COMPLETION OF THE WORK AUTHORI D) PERMIT NO. 27738 Z Date SEPTEMBER 27, 2001 Permission is hereby granted to: RICHARD F HALE ' PO BOX 227 FISHERS IS ,NY 06390 for r' DEMOLITION OF AN ACCESSORY GARAGE STRUCTURE AS APPLIED FOR r at premises located at %�. THE GLOAMING FISHERS ISLAND County Tax Map No. 473.889 Section 010 Block 0009 Lot No. 008 T Y pursuant to applicat on dated JUNE 5, 2001 and approved by the Building Inspector, Fee $ -5 . 00 ' U Author zed Siggature F J-_ ORIGINAL Rev. 2/19/98 la 3-C1 OG s� Town Hs \(f�.( . Fax(631)765-1823 P Telephone(631)765-1802 Southold,P DEPARTMENT LO O SOUTHOLD Nov. Richard F Hale 6 PO Box 227 , , f �C Fishers Island, NY 06390 RE: The Gloaming, 1000-10-9-8 Demolition permit #27738 . +� / to Dear Mr. Hale : On September 27, 2001, we issued a Demol ' on mit for you accessory garage. There is a balance d of $20 . to pay for `S this permit . Ci ( S OL---5 � f If you have any questions, please call us at -765-1802 . Sincerely, ! Southold Town Building Dept . � 5 BUILDING PERMIT EXAMINER CHECK LIST a??-3q-e7 DATE REVIEWED: `? 0`7101 DATE SUBMITTED: /K/01 APPLICANT NAME• SCTM# DISTRICT: 1,000 SECTION: BLOCK: LOT STREET: CITY: SUBDIV. NAME: 'j:)PROJECT DESCRIPTION: L- 0-F- ARCHITECT/ENGINEER: FAST TRACK? SINGLE & SEPARATE CERTIFICATION-REQUIRED? NOTES: LOTS 40,000SF-100-24.Lot recognition.(CREATED before June 30,1983),UNDERSIZED LATS FROM JAN.1997 100-25.Merger.(A nonconfomvng at any time after 7/1/83) ZONING DISTRICT: CONFORMING? REQ. LOT SIZE: ACT. LOT SIZE: REQ. LOT COV. ACT. LOT COV. REQ. FRONT PROP.FRONT REQ SIDE ACT. SIDE REQ. REAR PROP. REAR WATER FRONT? DESCRIPTION: PANEL #: FLOOD ZONE: , AGENCY PERMITS REQUIRED FOR REVIEW APPROVALS REOUIRED: SUFFOLK COUNTY HEALTH DEPT: YES or NO, (BED#): DTE:—/—/ PERMIT#:R10- NEW YORK STATE DEC: PRE-DEC 9/1/75 YES or NO SOUTHOLD TOWN TRUSTEES: YES or NO TOWN ZONING BOARD APPROVAL: YES or NO TOWN PLAN. BOARD APPROVAL: YES or NO TOWN HISTORICAL PRE (SPLIA): YES or NO NYS ENERGY: YES OR NO EGRESS (18 H min.?4 sq total) VENT (SQ.FT. x 4%) LIGHT (SQ. FT. x 8%) BUILDING PERMITS OPEN/EXPIRED: BP -Z/C/0 Z- , HAVE PRE CO'S : Y OR N BP -Z/C/0 Z- , NOTES: /V -/ v w I 17-,K-V — FEE STRUCTURE: FOUNDATION: SF FIRST FLOOR : SF SECOND FLR SF INIT OTHER TOTAL TOTAL: SF FEE FEE FEE OT( SF)- (__SF)= SFX$ =$ +$ +$ _$ NOTE : COOKDIMTE DItiTAWCPS ACE MEASUKED FROM VS. G0,6.ST &MD GEODETIC 5UVVEY TKIWGtjL4T ON STATI ON to Pw,!5w% J � C E �A A .� t,,�or1• Ti 16A 0 aw oe r t 1 1D �. AA a I'00- a $ off. I oa►� H� a � �Zo� 1q OF MEW , . kq• o e t� m . T 1�► `' 4 I' PL AM Or P 1COPE KTY TO SE SAND So CD�1YE E© To tjcHAAKD A L► �l} A• H:aLE ay e�iraTl�O Te . *acow�,c A ST1C�.cT,Yr.1c. , F15HE:IM t5LAAD kJ.EW YMK ��cti�r:ac�aR •..ao ���c►,�s•taAt..r � TKg cow�st��ctsT `.�C+�L-E: �.�y_t� :F'�'. '_ So►K1iC A+r4W ' W.Ulo*- coNtr�.*1Y , k.A. CHaUDLE P_.4L E 1 C �u I�cco�ppq.+�ca W WT14 •r#A* MIMIkAvnir w1vVV)E4-4 . CD1J F(fT)GU'T ST/0�1t0 AR�7 S loot T 1T 1..8 S u tC„Vt�Y S o t! TKR. MWW YOlt1< 'STAT fa• LAtdf-') T tTti--W- AYPICI L S D 1 Malt A.SS ocI AT�at`1 .y�.{ �1UN ► i12N I v VV 114 ter auu l rivl,L MU1LIJIN .i!'t XMI I AeeL1C;AT1UN C;HEC;KLiS 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: 765-1802 Survey PERMIT NO. -77545 2:; Check Septic Form N.Y.S.D.E.C. Trustees Examined y ,20 Contact: Approved_ ,20 Mail to: Disapproved a c_ Phone: A� Buildin specto APPLICATION FOR BUILDING PERMIT Date `j UAJ C- !S— , 200/ 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 through.out'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 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'a'Iterations 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) �.,/. d 3"�o State whether applicant is owner, lessee, agent, architect,engineer, general contractor, electrician, plumber or builder Name of owner of premises 01;�/r (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: /`J i He ErLC��-► ��6- •' �.iS f�Ft�2 S �'SL.��✓ House Number Street Hamlet AD �c-C� 1 L-O T Z. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy- .. W b. Intended use and occupancy �-57_P Ay �2)aw i. Nature of work (check which applicable): New Building _Addition Alteration Repair Removal Demolition—X Other Work (Description) 1. Estimated Cost/ i1� i/7— M�/S�Z-t= Fee 41s—.06 ��p S rr (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 If business, commercial or mixed occupancy, specify nature and extent of each type of use. 6 PrIc 9- C Dimensions of , if any: Front /O Rear. �d Depth �y/ Height ,� 9 Number of Stories / Dimensions of same structure with tions or additions: Front /d Rear ! �� Depth o Height ^t Number of Stories Dimensions of entire new construction: Front Rear Depth Height Number of Stories Size of lot: Front Rear Depth 0. Date of Purchase Name of Former Owner_ 16 2%;4 14 1. Zone or use district in which premises are situated 2. Does proposed construction violate any zoning law, ordinance or regulation: N v r-- 3. Will lot be re-graded �f S Will excess fill be removed from premises: NO 4. Names of Owner of premises k ft�J � /� 3e ZZ.`Z ess X Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 5. Is this property within 100 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 6. Provide survey, to scale, with accurate foundation plan and distances to property lines. 7..If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. TATE OF NEW YORK). 'OUNTY OF —� H71 ct7�__ being duly swom, deposes and says that(s)he is a applicant (Name of individual signing contract)above named, 3)He is the #}.v% (Contractor, Agent,Corporate Officer, etc.) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; iat all statements contained in this application are true to the best of his knowledge and belief, and that the work will be -rformed in the manner set forth in the application filed therewith. wo fore mes �1 of UM t 2040 Notary Public Signature of Applicant TH®f�Aii� DtR'1'�Jl�t Will Public SM0�4,�i4f Now York N0.4606659 puciltioo in SBtgo k Term Exp