HomeMy WebLinkAbout25900-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. 25900 Z Date JULY 26~ 99
Permission is hereby granted to:
PECONIC BAY WINERY
PO BOX 818
CUTCHOGUE~NY 11935
for :
DEMOLITION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 5205
County Tax Map No. 473889 Section 095
pursuant to application dated JULY
Building Inspector.
OREGON RD
Block
22 99
MATTITUCK
0001 Lot No. 002
and approved by the
Fee $ 67.80
ORIGINAL
Rev. 2/19/98
FORH NO. I
T(}~4N OF SOUTIIOLD
BUf 1,I)I NC I)EPARTHENT
TOt4N IIALI,
SOUTIIOI.D, N.Y. 11971
TEl.: 765-1802
I)i ~ a/c ..................................
SURVEY ........................
CIIECK .........................
Sl~, PT ~ C FORH ...................
HA~L TO: ....................
i~ ~PI~I-IC^'I'ION FOR BUII.I)TNC PEItH1T
3 ~ts of plans, nc~rnte plot plan to ~nle. F~ aeco~ling to ~l~,le.
b. Plot plan d~i~ l~ati~ of lo~ n~ of l~dldh~ ~ prmi~s, rela~Jon~Hp to ~joining pr~i~ or ~Jbl
struts or areas, nmi givi~ n <~tnil~l &~:ripti~ of In~t of pro~rty m~st I~ drm~ ~ I:l~ dingran O~ich is [}3ri:
this al~l icatia~.
c. '11~ ~ c~r~ ~ this a~flicati~ my ~>t I~ c{~m~l I~fore is~mme of b~ildi~ Pemit.
d. 1Jim a~al of this al~li~ti~, tl~ l~dhli~ Ins~ctor will is~ a ~tilding Pemit to Ihe applicant.
i~mit ~mll I~ kept ~ tl~ ~i~s ~vnilnble For i.sl~ti*~ thr~aq~alt the ~rk.
e. ~ I~lldb~l ~mll I~ ~rcupi~l or u~l in ~le or in lmrt for n.y i~.'~ dmt~er until n (~rtlflcale of
~o~.~y ~,alt Is~ I~n grant~ by fl~ lllildi~g Ins~tor.
A~I.I(~'I'I(~ IS I~I~IIY ~g to tlw I~Hhling l~[mrt.~.t for the is~me of a ltHhllng ~mlt ¢~rmm.t to Ihe
I~Hhllr~ F~ Ordimq~e of tl~ ~ of ~tl~>ld, ~ffolk Cmty, ~ York, taxi olher n~llcable l~s, ~dirm~es or
I~datims, for tl~ ~st~tim off I~dldbgs, ~itims or sltersti~m, or For r~sl or ~lttion, ss I~rein
{}scril~. ~1~ ~ffplicant ~s to co~l? with all ~Iicable l~s, ordi~es, l~lildi~ c~, ~slng c{~le,
re~dati~m, m~ to ~it a~tl~rlr~l in~mtors 0~ ~ims hal in IxHhli~ f~ ~ces~ry
....... ~:~:: ........ : . ~.
(~il ir~ ~blre~s of al~l leant)
State ~}ether applicant is o~_r, lessee, agent, architect, enl;i.eer,
(' ' '' >
I~ n~)licant is a c~rnti{m, si~tt,re of duly m,tl~*ri~l officer.
title of corparnte officer)
¸.mW
THE RBOUlRIMENTI Of T)IE N.Y.
STATE ~ONSTRUCTION & ENERGY
lhHlders Licens~ No ..........................
l)h~bers Licen~ No ..........................
Electricians Licerum ~ ......................
Other ~'s Licen~ ~) ..................... ~-- / ~C~D~ 8ES~NSI~E FOR
(~)
I0.
II.
12.
13.
It*.
15.
1~4t.te ul: ~J~k (d~'ck ~hid~ alqdicahle): I%~ I~fihling .......... ~klki~ .......... Alteradon ..........
If lalaigmaa, ~m~rcial or mi~l ~q~t~y, s~ci~ ~h,re md ~tent of eadt ty~ of u~ ......................
I)i.~nai~8 of ~iati~ atn~turea, if any: Fr~t ................ ~ar ............... I~pth .................
I~i~t ......................... ~admr of Stories .....................
~ or u~ diatrict in M~id~ p~i~s are s~t~t~l ..............................................................
~ prOl~l ~mt~ti~ violate any ~ing 1~, ordi~e or regulad~: ........................
~.~ of Ardfitect .................................... ~here .............................. ~ ~ ..............
Pi.OT I)IAGIIAH
lo-cate clearly and dietinc£1y all buil(linsa, ulmtlmr existing or propored, and i[xlicate all ret-back dimensions
fro. i)roperty lirea. Gixne etreet and hlock raid)er or deseriptica~ according I:o deed. and d~ street ru~tes and indicate
.... Ix.~inl~ duly .s~)r., (lelx)ses a~kl r~ys thor he ~s tim apl)l i(:ant
((k}lll:la~; (:orlx)rnl:e officer, eh:. )
olY ~;aicl c~r or ~rs, ntd is chJly outhori~l Io lerfoo, or have i~rl;onl~l lira soi(I ~)rk aid to
~a~ Pu~l~ ~tate of ~Y~