HomeMy WebLinkAbout24722-ZFORM NO. 3
TOWN OF $OUTHOLD
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. 24722 Z Date FEBRUARY 26~ 1998
Permission is hereby granted to:
A. GOLDEN A/C R BROWN
PO BOX 521
GREENPORT~NY 11944
for :
TO DEMOLISH AND REMOVE ALL DEBRIS FROM THE REMAINS OF A RECENT
FIRE AS APPLIED FOR.
at premises located at 1445 BAY SHORE RD
County Tax Map No. 473889 Section 053
pursuant to application dated FEBRUARY
Building Inspector.
GREENPORT
Block 0004 Lot No. 004
23 1998 and approved by the
Fee $ 175.60
~B '~n~/In/s~ctor
ORIGINAL
Rev. 2/19/98
FORH HO. I
T¢)~IN OF SOUTIIOI.I)
BU]!,I) ING I)EP^RTHENT
· r()~N IIAI.I,
$OWI'IIOI.D, N.Y. 11971
TEl.;
Ib~suined ........ .~.,~ .~..., 19 .?.~.~
AlqnX~vcd ......... ~.~., 19-~0C~. Pe~miL ~) .................
I)i sappix~ved a/c ..................................
AIq'I.1CATION FOP, BIII I.I)ING I'I~.RIIlT
l NITI{UCT IONS
BOARI) OF Ill, Al/I'll ...............
3 SETS Ol/ PLANS ...............
SURVEY ........................
SEI~TI C FORH ...................
HOT 1 FY:
HA 1 I. 'FO: ....................
:' ~ BLDG.
TOWN
l,.te .....'7/.."~- ........
a. 'Jhis applicatio~ ,~mt be c:olq~lelely filled in IJy tyl~,niler or in ink taxi mih~itled to the ~dhling lns~ctor with
3 ~ts of plans, ~curate plol: plan to ~:ale. IF~ according to sch~hde.
b. Plot: plan ~i~ hmati~ of lot m~l oE Ixdldi~n ~ p[csni~, ~elatio~ship to ~joining proui~es or Ixdflic
sit.ts or areas, ~1 givi~ a ~tail~l ~scril)ti~l o~ la~t: of prol~rty .,mt tm dr~sm ~ the dia~n ~*ich is Imrt of
Osi~ aloft icat:i(~.
c. 'lhe ~rk cmer~l I~ this al~licati~l ~,~y ~t I~ c(~m~s~l Imfore iss~mr~e off I~dhli~g Permit.
d. IllX~ a~al of this ol~lication, lira l~dlding lnsl~ctor will ismm a I~dhling Permit lo Ihe a~'lieant.
l~smit ~hall I~ kept ~ tl~ proni~s a~ailable for inSl~Cd(~ Ihr~u~t the
e. ~ I~dldis~ ~mll Im ~mc.pi~l or u~d in ~mte or in lmrL for a~y lX~rl~ ~mtever ~mtil a
APPI.I{~TI(~ IS I~I~IIY ~ to tl~ I~ildi~ l~lmrln~nt For the ism~e of a l~dldi~ Pen.it D~mnt to the
I~dldi~ ~ Onlil~e of tim '1~ of ~ll~ht, ~fffolk l~mty, ~ York, m~ olher applicable l~s, Onlismmes or
I~ulati~m, for I1~ tx~mt~ti~ of I~dhli~, ~liti~m or alte~ati~m~ or for row~val or ~mlition, ~ I~reln
~m:~il~l. 'lira appliean~ agr~s Io cruddy wilh all alff~licable l~s, ordinm~es, h~ihlir~ c~, I~ming c~1% m~l
.... ..................
I
State s~tlelher applicant is tx,~ser, lessee, aget ,~'~ar(:lsi
(ns c~l 11~ Itl~ zoll or latest deol) ~
1 I: al~,l leant is a corlx,~at:i~m. sig~atur~ of ,hdy mal~,ri~l officer. ~1~ ~ ~ ~ ~ ~ ~ ~
(N~.t~t a,sl title of COSlx>rate officer) I ~ - ~ i
......................... s, ~;u~k. C~ ~
l'h~d~rs I.icen~ ~o .......................... $[ ~ ~
ALL CO~~ ~ ~
I~lectric;m~s L]cen~ ~ ...................... THE REQUIREMEN~ OF ~E N.~.
STATE CONS~U~ION & ENER~
GLInt 'lY~s LJcen~ ~ .....................
co s. Nm .ES O SmC; ;O.
..... ...... ..... ........ .... .........
~dMi~isi{~ ...................................... Fi I~xl ~q~ ~ ................ lt~E ...............
(~me)
2. Stale exist' il~ t}~ alii ~t:Ul~a~:y of inonises mM inte~k~l tree a~tl ~:(a;l~ji~y of i}rolx)ml c(sml:tuct;ion:
a. Existi,~ ,,m, a,~l ¢x:o,l~a,~:y ...... ~., ..............................................................
([4ail iuI; ~klress of appl leant:)
elqgioeer, ge.e~al cont:raclof, electri£ian, ph~s/)er'or'.l~dlder.
~,l~l)l i(:nl.i<nq tirol: ~,11 e~ator~.l. (:(),~[ai~m(I i. Ihi~ .iqH lent lo. ~.e IH~ to the I~nl: <)~ hi. k~x~loll~e taxi I~1 ier[ .,.I
Ihnl the ~.k will I~ I~rf(.n~l i. Ihe .~..~r *mt forth h~ the .ppi i(:al:i(). Ii led t l~tc~{Ih.
JOYCE M. WILl(INS
Notary Public, State of New Yolk
No. 4952246, Suffolk Coun~
Term Expires June 12. 1.~-~
I
(.:}i[~qlal Ille of ^ppi il'mil )