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Home My WebLink About27032-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. 27032 Z Date JANUARY 26, 2001 Permission is hereby granted to: VIOLA MALEK PO BOX E ROCKY HILL,NJ 08553 for DEMOLITION & REMOVAL OF EXISTING REAR COTTAGE AS SHOWN ON THE ATTACHED SURVEY AS APPLIED FOR. at premises located at 2700 MILL RD PECONIC County Tax Map No. 473889 Section 067 Block 0005 Lot No. 002 pursuant to application dated JANUARY 18, 2001 and approved by the Building Inspector. Fee $ 64 . 80 AAXrizl4d Signature ORIGINAL Rev. 2/19/98 �OL D SMl Ty 'S N 21. 78' 39' w 11V L E T a, 74.97' rn APPROX LO SCREENED ' H PORCH N s FD BLUfMON E CHIMNEY N s� \ S 0.4' 1 STORY COTTAGE O sj 10.7 J LOT 16 P/0 LOT 15 N N/F p Fl TZ SWI TZER REP. 0WNE co coNC. h WALL 1J 7 N WOOD IEP 1 STORY WOOD FRAME RESIDENCE 01 24.9 h Ci L CONC v 15.J' Q'1 0 DRIVEWAY ROOF OVER `� LV Icl- g 14.2' 12.6' O m � O v Z (v N N fv BLuEsmNE S 28. 00' E— 110.90 cm 11E= 220' MON. MILL ROAD SURVEY OF P/0 LO 15 & LOT 16 SURVEYED 24 OCT, 2000 IN FM,{ 860 MAP OF PROPERTY OF BLANCHE T. DICKINSON SCALE 1"--20' FILED JUNE 6, 1926 S1 TUA TE AREA= 17,090.145 SF TAX MAP NO. PECONI C, TOWN OF SOU THOL D OR 1000-067-05-02 SUFFOLK COUNTY, MY 0.392 ACRES SURVEYED FOR : 2700 MILL ROAD LLC GUARANTEES INDICATED HERE ON SHALL RUN SURVEYED BY ONLY TO THE PERSON FOR WHOM THE SURVEY IS PREPARED, AND ON HIS BEHALF TO THE 7111E COMPANY, GOVERNMENTAL AGENCY, STANLEY J. ISAKSEN, JR. LENDING INSTITUTION. 1F LISTED HEREON. AND GUARANTEED TO TO THE ASSIGNEES OF THE LENDING INS77TURON. P.O. BOX 294 GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSPTUIIONS OR SUBSEQUENT OWNERS. NEW . UFFOLK, NY 11956 2700% MILL ROAD LLC , _ PECONIC ABSTRACT CORP UNAUIHO IZEO AL IERA nON OR A00117ON TO 7111S 6.31 T'/ 3 5 4 SURVEY IS A VIOLA 7701V OF SEC RON 7209 OF # 641 - S - 01140 THE NEW YORK STATE EDUCARON LAW. COUNTRY WIDE LENDING I COPIES OF THIS SURVEY MAP NOT BEARING �ICEN4ND'SU YOR THE LAND SURVEYORS EMBOSSED SEAL SHALL NYS L C. N0. 492 NOT BE CONSIDERED TO BE A V.AL10 7RUF COPY 0OR946 BOARD OF ll1:AL:1'll . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS JAM I � 'TOWN OF SOUTHOL.D SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPAR'TME'NT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOII'1'IIOLD, N.Y. 11971 TEL: 765- I002 NOTIFY: CALL .. 1$:... MAIL. To:�:a�rl�� ./1?4 �?/�•SG� Aplyroved...L�»C.��I.., i!'.. Permit No. Q��Q.c.lt � ..7� ....`.,......�/......... Disapproved a/c .................................. ...................................................... ................................ (Ikrilding inspector) APi'L.ICATION FOR BUILDING 1'EItNI,l' ..Qoo/ i NS'TIttiurI ONS a. 'Ibis applicatiorr nust he carpletely filled in by tYpe.writer or in ink aril suhnitted to the Ikrilding Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schechrle. h. Plot plan showing location of lot arxl of ixrildings oxi premises, relationship to adjoining premises or Ixiblic streets or areas, and giving a detailed description of layout: of property must be drrmur on the diagram which is part of this application. c. Ale work covered by this aplilication my not be cccurenced before issuance of Ikrilding Permit. A. Upon approval of this application, the lkjilding Inspector will issue a lkrilding Permit to the applicant. Such permit shall be kept on lire premises available for inspection throrgliont the work. e. Na lxrildiog sliall be occupied or used in wlxole or in part for any prrpose wliatever until a Certificate of. Occupancy shall have been granted lry lire Ikrilding inspector. AI.TLICNI'10N IS 104-USY ME to lire Building, i>epartment for the issuance of a Ikrilding Permit prrsuant to tale Ikrilding 7xxre Ordinance of lire Tam of. Scxutbold, Suffolk Uxnrty, New York, aril other applicable laws, Ordinances or Regulations, for the constnrctiai of lxrildings, ackditions or alterations, or for renwal or (lemolition, as herein (lescribed. 'ilne applicant agrees to carply with all alliltcable laws, ordinaulces, Wilding code, mousing code, aril regulations, and to aduit authorized inspectors on premises arxl in Wilding for necessary inspections. .................. (Sigrknture of apiliicaF, or mime, if a corporation) (K--tiling, xklress of applicant) Slate wl►etl►er applicant is omier, lessee, agent, architect, engineer, general contractor, electrician, plumber or Ixd1der. .................................................................................. Name of owner of premises ....J l"/,.. /........................................ (as ai tine tax roll or latest deed) If applicant is a corporation, signature of duly autlMized officer. ......................................................... (Natiie arxl title of corporate officer) iAIders License No. ......................... I'lcnbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... I. location of land on which proposed work will be (lone- .............. lone.............. 0 C.q 1�q 1 .......................... Ikxrse Street l4nrlet t:cxrnty Tax Kip No. IO(X) Sect ion .(�.G.,7........ Mock ..Q S........ lot .G.2 ......... &nlxlivisicxn ...................................... Filed Mar .... 2. State existing use ani occupancy of premises arxd interxledd use Ond occulrarx'y of proposed coxnstnnction: a. Existing use and occuikrncy ...�$.r..y�r��.../..Crcrn��!>JI ...Q'�lvC./�i. ................................. b. Tnterxlecl use aril occupancy ..asJ.hf„/G....��✓+..4 ... . M.6 6% o..L. rmoT 1. M•►Inre of %A)►k (dieck witidi aih,licnhle): Nco Iktilding . . Atkliticm .. ........ Alteration I(cllu►i t ............ I(ellrw<I I ............. Dent( 1 i L i on .. .... 011ier Wo►k (IleacripCicxl) 1?80nvited U)"a ......................... fee .............................................. (to be lk'lid cm filing this application) :i. 1 f rk.xll l ing, ►xrdter of eA-Ming units ............ ti nl►er of cA.rel I int; units oil enc-11 Floor ... .. ........... 1C garly;e, ►rcnl►er of earn ............... .... ... ... .. ....... . .. . 6. If Itusir►ess, utm ercial or mixed cx:cupancy, specify ru►Lure nrxl exLenL of each type of. use......... ..... ........ 7. Ilinlensions of existing st-toc ores, if nny: 1?rcx►l.. ........ . .. ... hear .. ...... .. ..... I)e ►ll► lluiglrL' ......................... Usiber of Storien . . ....... ........... .. Ilimensicxcs of sane attli:Lure With nlleraticxms or liklitiom: front ............ ... Itenr ............... DeIll h .................... Ileihl►L ... .............. . . . Ringer of Modell .. .... .... ..... Il. I)inK!rlsims of entire oew ccx►st:nv:l.icx►: Frcx►C . ... .. ...... .... (tear Ik'pl.l► .............. Ilcil;l►l.. tAllber of Stories . .. ...... . ... ........ 9. Size of lot: Frcxtl ......... ... .. ...... Itenr .......... . . .. .. .. .. Dept 11 ..... 10. Nile of hirclume ....,/.2-1.00....... Nano! of I'or1rK!r O<•,rx!r ..1''L o r►A. ,,C.Q,��............ 11. 7cxte or use disLl'icL in Adch premises are situate(I ..... ... .......... ..... ............................... . .. .. . .. IZ. Ik)es proponecl coostnx:licxl violate any zcxting law, or(lirkmK:e or vel,ulat.itxl: . ............ ........... 13. Will lot: Ix- Tegrl►rled ............... ..... Will exe:ess Fill Ix! 1-01r,ved frown pionises: YES Nt) 14. Names of. ()~,ner of premises ........................... Aclklrer►s ......... ................ ..... MKx)e No. ....... .. ... Nano! of Architect ............... ..................... Acklress .. .... .../. .........,p........ litorx! Fk). .... . ... . .. Nano! of CotAraclor r�irS..,�4�0.:,,�JG!✓'1...... Acklress 1//..,��•ytC.�/.GCorrrc ..i1x)ne Is this prc)lx!rly Within 3(X1 feet of a tidal 1aeLlnlvI7 .... .. .... tt) .......... *IF YES, St>1111m) '1114N 'Ii20511 IsR tv"I.1' my IIE lu. All(U:I). PLOT DIAGRAM lcx:ale clearly nrxl disl:inca:ly all Ixlildinl;s, c.A►elher existing or prolx)sed, mill ilvileaLe all seL-hac_k dimensions fin► Illolx-rty lines. Give street arxl blcx:k rrnl,er or descriplicm according to deed, nrxt sliow sLreet rumen aril ilvlicnte wl►elher interior or corner loL. a n e..J G 0*1 C a7CP/, ccicjG a //,Gv7T &cS C p�-ncv- G- ,/J voM?\� OF 1`V.W Y((m , (IIAINIY (M' -��t!! CJC/� Sri �fG�•• Jr fVY�.. ..... ....... ... ..lx!inl, duly sworn, delx►,es mill says (it-ithe is the app(icanl (N�r! of imlividunl nil;ning c. . ract) alxwe narrocl, Ik! in IlreC-Gr1�v4 P�(J��.. ......... ... ...... ... ... ............... (fbnl.raalor, agent, corlxrra(e offi(-er, ele.) of Enid owcxlr or owcx!r,, mxl in drily nulhorized to lx!rforlu or hove! lK!rfornred I.he said Wolk aril to nvtke nrxl file lllitr opplkation; thnL all statoneolm co0tairied ill lllis npplic:ation lire t.rtxe to 'lie flet►1: of hin krx,wledge nrxl Ixitief; nrxl Ihe►L the vn►rk Will be perfonncA in the uvunwr set 1'0101 in Ole npplic:nlAotl filed llterewil.l►. `)wotrr to before nr! thin . ... . . ./.y.......da o f �!V 1// l Y. 1�..�r.� . NoLary t'trbl is .�.... EU2ABETH A STATHIS ... . NOTARY PUBUC,StateofNOWY01k (Silp►nlute �ofAlq cnnl.) No.01 ST8008173.Suffolk County Term Expires Jufle 8.20.=1 Z,