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Home My WebLink About26187-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. 26187 Z Date NOVEMBER 29 99 Permission is for : hereby granted to: SARA L HAWKINS 2065 MINNEHAHA BOULEVARD SOUTHOLD~NY 11971 DEMOLITION OF AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at County Tax Map No. 473889 Section 087 pursuant to application dated OCTOBER Building Inspector. 2065 MINNEHAHA BLVD Block 28 99 SOUTHOLD 0003 Lot No. 054 and approved by the Fee $ 365.00 Authorized Signature ORIGINAL Rev. 2/19/98 -FORH NO. TONN OF SOUTUOLD BUILD~N~ DEPARTHF-NT TOI~N HALL SouTHOLD, N.Y. 1197 TEL: 765-1802 l~--~i~ed ................. , 19 .... Disapp~t~ed a/c ............................... . ., Inspector) 'APPLICATION FOR BIIILUING PEP, NIT INSTRUCTIONS BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALL .................. HAIL TO: .................... a. ~his applicatim ~ust be c~letely filled in by typewriter or in ink and su~itted to the l~uilding Inspector w 3 sets of plans, ~-~rate plot plan to scale. Fee ~,~o~ding to schedule. b. Plot plan showing location of lot ~ of buildings o~ premises, relation~ip to adjoining premises or public streets or areas, ~ giving a detailed description of layout of property ~mt be dre~n on the dingrm ~hich is pert of this applicatiee. c. lira ~ork co~ered by this application my not be ccmmneed before issuance of lhilding Pemit. d. Upon approval of this application, the Building Inspector will iasue a Building Permit to the applicant. Such pemit shall be kept on the pe~uises available for inspeetian threughout the ~ork. e. No buildlng shall be occupied or used in ~/aole or in part for any purpose ~ahatever tmtil a Certificate of Oco?~y shall imve been greeted by the Building Inspector. AI~LICATI~I IS ~ ~ ~o the Building Depart~nt for the issum~e of a Building Pe~mlt pursuant to the ~uilding Z~e Ordinance of the To~ of Sonthold, Suffolk County, ~ York, and other applicable L~s, Ordinates or l~-~Eulation-s, for the constnmtion of buildings, additions or alteretions, or for re~o~al or d~oliticn, as herein described. The ~plic~t ~grees to t~.ly with all spplicable ls~a, ordir~ces, building code, housing code, and (l't~iling eddre,~8 of ~llic~t~ .... (as on the t~ roll or late~r deed) If ~plie~t i~ a eorporation~ ~ig~atum of del¥ anthori~d officer. (Na~ a~l title of corporate officer) Euildera License No .......................... Ph~bere Li~e Ro ........ Electricim~s Lit~,~se l/o ...................... Other Tr---t~"s Liresme lib ..................... ]. Ix~cation of land on vhich proposed ~ will be done ...................... ~ ~l~her Street -ty tion ...... ...... £- Subdivision ...................................... Fried ltap 1/o ................l~t ............... 2. State existing use a~i occt~m~ of ~se~ and i~tel~ use and occu~m~ of prolx)sed construction: ~' ~ ~ ~ ~ .... ~.T:.TIz> .... ~-~:.~... ~~t~,.;:'~ ~i.:.q~ ......... ~. ~n~ure o[ ~or~ tc~ock ~ch ~pplmable): ~ ~ildi~ .......... ~i~i~ .......... ~era~i~ .......... ~ir ............ ~1 ............. ~li~i~ ..... ~ ..... Oc~r ~ ........... : ...................... ~timt~ ~st .~,~.~; ............ f~ .............................................. (to W ~id ~ fili~ this a~li~tim) If ~r~e, ~r of ~rs .......... ~ ........................ 6. If ~i~ss, ~ial or ~ ~, ~i~ ~re ~ ~tent o~ e~ ~ of ~ ...................... ~.~i~ o~ ~.~ .~., i~ ~: ~ ...... ~. ..... ~ ...~ ........ ~, ..~ ........... I~i~t ......................... ~r o[ 8torlo~ ..................... Di~mi~ of ~ ~t~m ~th alrerati~ or ~itlm: ~t ............... ~ar ............... ~pth ................... ~i~t .................... ~r o[ 8torie~ 8. Di~n~i~ o[ entire ~ ~t~tlm: ~t................ ~r ............ . . . ~p~ ............ . }~i~r ........................ . ~r of Storie~ .................... . ~. ~ ,~ ~ ~ .... _... ............ ~ ............... ~, ...~/~ ............ I0. ~te of ~dm~ .................... ~ of Four ~r ......... ~....~ ........................ ,~. ~ o~ ~ ~ ~ ~ ~ ~,~ ...~ .......... ~ ..... :~ .............................. 12. ~ ~ ~t~tlm viol~te~ ~i~ 1~, o~i~ m ~lat~m: ...~ ................. 15. I~ fl~i~ p~fldn ~ f~t of a till mtl~ ~ .... ~ .... ~ .......... ~ ~/~ PLOT DIAG~ [~a~e clearly ~ disti~cly all ~ildi~, ~r ~isti~ or p~, ~ i~i~te all ~t~ d~nsi~ ~ ~r~ li~s. Gi~ st~t ~ bl~ ~r or &~riptim ~co~iq ~o ~, ~ ~ strut ~s ~ i~i~te ~r in~erlor or ~r lot. -. ~IY...~~ ..... ...... ..................... ~the ........................................................................................... (~tr~tor, ~ ~rat~ o[[imr, etc.) o[ ~id ~r or ~r~, ~ is ~17 ~t~ri~ to ~r[om or I~ ~rfo~ O~ ~id ~ ~ to ~ ~ file thi~ a~licati~*; ~at ail stat~nts ~tai~ in ~is a~licati~ are t~ to ~ ~st of his ~1~ ~ ~liefi a~ flint ~ ~ ~ill ~ ~r[o~ in tl~ m~r ~t forth in ~ to ~o~ ~ ~is ......................... deposes and says that ~is tJ~e applicant