HomeMy WebLinkAbout24945-ZFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
24945 Z Date JUNE 10, 1998
Permission is
for :
hereby granted to:
JOHN J JR & WF SENKO
89 PENINSULA BLVD
HEMPSTEAD~NY 11550
THE DEMOLITON OF AN EXISTING COTTAGE AND AN ACCESSORY BUILDING AS
APPLIED FOR. AMENDED TO INCLUDE DEMOLITION OF AN EXISTING DWELLING AND GARAGE AS APPLIED FOR.
at premises located at 52475
County Tax Map No. 473889 Section
pursuant to application dated MAY
Building Inspector.
MAIN RD SOUTHOLD
063
Block 0005 Lot No. 012.001
20 1998 and approved by the
Fee $ 93.20
ADDITIONAL FEE OF $318.20 PAID
ORIGINAL
Rev. 2/19/98
FORH NO. I
TOWN OF SOUTIIOLU
BUILDING DEFARTHENT
TOI~N IIALI.
SOUTIIOI.U~ N.Y. ) 197 I
TEl.: 765-1802
BOARD OF UEALTII ...............
3 SETS OF PLANS ...............
SURVEY ........................
CUECK .........................
SEPTIC FOR~ ...................
NOTI FY:
CALL ..................
HAIl. TO:. .................. ·
APPLICATION FOR BUILDINO PERHXT
INSTRUC'FIONS
n. 'Hals e~licatioo mast Toe conpletely filled in by t~pe~riter or in
b. PloC pl~ d~i~ I~ti~ of lot ~ of ~ildlt~s m ~8, ~lacJ~dp to ~joJni~ p~lMs or ~d)lJc
str~C.~ or ore~, ~ 8ivi~ ~ ~toll~ ~rJ~l~ o[ 1~ o~ pm~rty ~ ~ dr~ ~ tim diem ~*id~ is ~rt of
Ods n~licati~.
c. 'fl~ ~ ~r~ ~ fids n~iicati~ ~y r~ I~ ~ ~fore i8~ o~ ~iidJ~ ~mi~.
d. ~ s~al of fids s~li~i~, ~1~ I~ildi~
e. ~ildi~ droll ~ ~i~ or ~ in~oi~or in ~rt ~r ~ ~t~r~il a~r~iflcate of
~.I~'~ I~ t~ t~ to rl~ ~ildi~ ~rt~nt for ~ is~ of a ~lldi~ ~m[~ ~r~r ~o tl~
Ihildi~ ~ ~i~ of ~ ]~ of ~tl~ld, ~f~oik ~, ~ Yo~, ~ o~l~r a~1i~le l~s, ~i~es or
~lari~, for ~1~ ~r~ci~ of hdldl~, ~i~i~s or altera~i~, or for ~i or ~lki~, ~ ~min
~ri~. ~ applier ~s Co ~ly wl~ sll a~licable
.................................... .................................................................
(~ ~ tim tax mit or
I~ a~tlcm~t is a co~r~ri~, si~e of duly ~l~)ri~l
title of corporste officer)
l~ilders l,ice~se l~b ..........................
Plumbers License ~o ...........
Electrlcia~s License ~ ......................
Ocimr ~'s Li~ ~ .....................
I. I~i~ of 1~ ~ ~i~ p~l ~rkwill ~ ~ .......................................... .. .. ,, ... . ..... ....
Im ~r St~t l~et
/
/
~ivisi~ ...................................... Fii~ ~p ~ ......... ;, ..... I~t ...............
2. State exiati~
a. F~sti~ t~ a~ ~y ............................................................................ ..
b. Inte~ ~ ~ ~ .......................................
PLOT DIAGRAt'I-
l~ate ct~rly nnd dlstl~tly all ~[ldlr~, ~mtlmr ~lsttn8 or pro~)sed, m~d indicate all ~t-back dimnni~n
fr~ i)ro~mrty lJ~s. Glv~ strut nnd block ~r or ~ecrlptJ~ ~in8 to {~. a~ ~ strut ~m$ a~l i~licate
(Nam of i~livi~m[ nj§nj,8
I~ in tl,e ...................................................................................................
(Cx~tractor, ~gc~tt,- corlxarate officer, etc.)
of naid ~er or ~ern, md la ~ly ~tl~rl~ to lerfonn oc h~we i~rfor,~l Ihe ~ld ~rk m~l to nnke m~l file this
:qq)l icnti[~m; tlmt ~tl etate~tt$ ~ttni~ in thin nlq)licnti~ are tn~ to the I~ of hin k~l~e ns~ I~lief~ taxi
thnL tl~ ~rk ~ill ~ ~rf~n~ In tim nnmmr ~t forth in the nl~l. icnti(m fil~ tlmr~iOt.
KEITH ~. SENKO (Silpml t. e of Appl Jem~t)
~TARY PUBLIC, SM;c of N~ Y~
No. 01SE 4~71827
~alified in Nas~u Coun~
~sion ~pir~ SepL aC,