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Home My WebLink About25286-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. 25286 Z Date OCTOBER 27 98 Permission for : is hereby granted to: JOHN G & WF SMITH TOWN HARBOR LA SOUTHOLD~NY 11971 DEMOLITION OF AN EXISTING SINGLE FAMILY DWELLING WHICH HAS BEEN DAMAGED BY FIRE. at premises located at County Tax Map No. 473889 Section 063 pursuant to application dated OCTOBER Building Inspector. 465 TOWN HARBOR LA Block 26 98 SOUTHOLD 0004 Lot No. 007 and approved by the Fee $ 121.70 BuildingVIns~ ORIGINAL Rev. 2/19/98 TO~N OF SOUTHOLD BUILDING DEPAETHENT TOI~N HALL SOUT~OLD, N.Y. 1197 ! TEL: 765- ]802 APPLICATION FOR BUILDING PERHIT SURVEY ........................ CHECK ......................... SEPTIC FORt4 ................... NOTIFY: CALL .... HAlL TO: .................... Date ................ ,19 .... INSTRUCTIONS a. 'll~is agplieaticm 3 ~ts of pl~, ~ate plot pl~ ~ ~ale. F~ ~i~ to ~le. b. Plot pl~ ~ l=tim of lot ~ of ~ildi~ m ~s, ~lati~ip to ~joini~ pr~s or ~lic struts or ~e~, u~ givi~ a ~tail~ ~ri~im of last of pm~ ~t ~ ~ m ~ diem ~i~ is ~ of ais a~liatim. c. 'Hm ~ ~ ~ ~is a~li~tim ~ mt ~ ~ ~fore isle of ~ildi~ ~t. d. ~t ~11 ~ ~pt m ~ ~ms ~ail~le ~r i~tim fi~t ~ ~. e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~t~r mtil a ~rtificate of ~ ~11 ~ ~ ~mt~ by ~ ~ldi~ I~tor. ~I~ IS ~t ~ to t~ ~ildi~ ~nt for ~ ism of a hildi~ ~t ~t to t~ ~ildi~ ~lati~, for ~ mt~tim of ~ildi~, ~iti~ or alterati~, or for ~al or ~liti~, ~ ~in ~ri~. ~i~, ~ ~o ~ ~i~ i~or~ ~ ~ ~ i~ ~i~!~ ~or~*~ ~i~*. (Si~e of ~li~, or ~ , if~?~i~) State ~m~r ........................... 7--- >:~ .... : .....:~;~8 ........................... ~ .... : ................................ ~ o~ ~ o~ ,i~ ~. ~.~..~...Ae~....ii 1~:~,,~...~0.=5 .............................. '" (Nam 'and title of corpot-at&'olih'tt~l,)3'~ - .174I: 1~ ~il~rs Li~ ~ .............. .:{~!......i~:~ Pl~rs Li~ ~ .............. ~ ...... ki,';) El~trici~ Li~ ~. t~ ) :i ~ Other Trade's License No ..................... 1. loc~tion of lm-~l on ~ich ~ ~ork ~aill he &me .............................................................. Comaty Tax ~ No. 1000 Secticm ................ Block ............. lot ............. Sulxlivisio~ ...................................... Filed Nap No ............. Lot . (~) 2. State existing use and occupancy of pr~i~ 'ses/'N ~/and ,intended use and occupancy of proposed ccamtmeti~m: a. Existing use and occup~'y ....... .'.~:f..t~...e~../.L..t~ .............. ; ....................................... b. ...... ...................................... 3. blature of ~ork (check ~hich applicable): ~ Buildi ..... A&lition .......... Alterat~[~i[.~ ....... Repair ............ l~e~al ............. Remalition .~. ......... Other ~ork .................. ''~...~ ............. Estimated Cost. ... .. . .......... fee ... ............................................. (to be paid on filing this application) If d~elling, nt~ber of d~elling ~mits ............ K1~x~er of duelling ~mits on each floor ................ If garage, amber of ears ...................................... If Ixminess, eumercial or MM occupancy, sTeeify nature and extent of each type of use ...................... Dimensions of existing stxa~tures, if any: Proot ................ Rear ............... Hepth ................. Ileight ......................... klmber of Stories ...................... Dimer~ions of sam structure ~ith alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Ixtmber of Stories ............... 8. Dimensions of entire ne~ onnstruetion: Irzont ................ Rear ............... Depth .............. Height ......................... Ixl~ber of Stories ..................... 9. Size of lot: Front .................... Rear .................... Heptl~ .................... 10. Date of Purdmse ..................... Rare of Former O~ner ........................................ ! I. Zone or use district in ~hieh pi~=aiaes are situated .............................................................. 12. Does proposed mtruetion violate any zoning la~, ordinance or regulation: ........................ I3. ~/ill lot be regraded .................... Nill e~ess fill be removed fr~n premises: ~S 16. lqm~s of O~ner of pce~ises ........................... Address .............................. Phone Ixlo ............... Name of Ardfitact .................................. .. Address .............................. Phone ~ ............... Na~ of Contractor ................................... Address ............................... H~one ~ ............... 15. ls this p~operty within 300 feet of a tidal wetland? * YES .......... NC) .......... PLOT DIAgRAH l~cate clearly and distinctly all buildings, vhetber existing or proposed, and indicate all set-back dimensions f~m property lines, give street and block amber or description according to deed, and sho~ street nares and indicate dnether interior or corner lot. lie is the ..... ~ual signing contract) 7~6-'1~02 ~ AM 10 4 PM FOR CrHE FOU,,~MNG INEIW=CTIONS: I FOI,IIII)ATION - I~NO REQUIRED 2. ROUEN - FRAMING · PLUMBING 4. FINAL o CONSTRUCTION MUST BE COMPLETE FOR C.Q ALL CON~I'RUCTION SHALL MEET THE REQUIREMENTS OF THE NY. STATE COI~TRUCTION & ENERGY CODES. N~I' RESPONSIBLE FOR DESIGN OR ~ONSTRUCTION ERRORS duly s~rn, deposes and says that he is tho appl. ica~t (Contractor, agent, corporate officer, etc.) of said o~er or o~mers, and is duly authorized to perform or have perfo~ed the ~aid ~rk mgl to rmRe and file this application; that all state, eats contained in this application are true to the best of his kr~ledge and beliefl and that the ~rk will be performed in the raanner set forth in tee application filed tberewith. ( acura of Applicant) SUP~x/tE¥ 0t= SI TU~TE.. SOUTHOLID TOINN 0t= SOUTHOLID SUFFOLK COUNT~, bit GERTIFIED TO~ -JOHN ~. SMITH MAUF~-E--~N SMITH SUt~X4EYEO 08-2~-q8 SUFF:OLt( C, OUNT'( TAX ~* I000- 6B- 4- ~ MAIN ROADf- S.R. #25 NOTES: · MONUMENT FOUND 0 PIPE FOUNE2 x ×-× ldl~dE t=ENGE AREA = 11,821 ~ 0t~ 0.2~ AGt~.ES ~R. APHIC SC, ALE I"= 30' JOHN C EHLERS LAND SURVEYOR B EAST NAZN STREET RIVERHEAD, N.Y 359-8288 Fax 369 B287 N.Y S LIC. NO 50202 REFERENCE # 98 0232