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Home My WebLink About26192-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. 26192 Z Date NOVEMBER 30~ 1999 Permission is hereby granted to: for : DOROTHY & ORS KOTYLAK 8850 BRIDGE LA CUTCHOGUE~NY 11935 DEMOLITION OF A SMALL UTILITY ROOM AS APPLIED FOR. at premises located at 8850 County Tax Map No. 473889 Section 073 pursuant to application dated OCTOBER Building Inspector. BRIDGE LA CUTCHOGUE Block 0002 Lot No. 004 26 1999 and approved by the Fee $ 15.00 n ture ORIGINAL Rev. 2/19/98 FORH NO. TOI,/N OF SOUTHOLD BUILDING DEPARTt4ENT TO~,~I HALL SOUTHOLD, N.Y. I]97I TEL: 765-1802 Disa~t ov~d a/c .................................. BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORI4 ................... NOTIFY: CALL .................. NAIL TO: .................... ,~,= 0CT 26 ~ APPLICATION FOR BUILDING PERHIT INSTRUCTIONS Date ................ ,19 .... a. 21~is application mint he et~pletely filled in by type~iter or in ink and st~nitted to the Building Inspector ~rlt 3 sets of plmm, scoarate plot plm~ to scale. Fee according to schedule. b. Plot plan ~oaing location of lot and of buildings on premises, relationship to adjoining premises or pablic streets or areas, and giving a detailed description of layer of property ntmt he dr~an on th~ diagr~n ~hich is part of this application. c. lhe work covered by this application may not be ccr~oced before issoaoce of Building Permit. d. Upon approval of this application, the Building Inspector ~ill issue a Building Pemit to the ~plicant. ~ pemit shall be kept on the p~,=.lses available for inspection throughout the work. e. No building shall he occupied or used in ~/aole or in part for mv] purpose ~ahatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATICN IS t~¥ ~ to the Building Department for the isanm~ce of a Building Permit pursuant to the Building Zone Ordinance of the Toan of ~ou~old, ~ffolk County, Ne~ York, and other applicable L~as, Ordin~_es or P, ngulatinos, for the constn~ctian of buildings, additions or alterations, or for r~x~val or demolition, as herein &scribed. 2he applicant agrees to co~ply vith all applicable la~s, ordinances, bui.~ding code, housing code, and regulations, and to ~it authorized inspectors on premises and in building for p~.asary inspections. (8~ture o~/applicant, or na~. if a corporation) · ' ' F/. ,,~p~ State ~nether applicant i8 mr. les~e, agent, architect, engineer, general eontrsc'tor, electrician, plt~her, or builder. ....... ~. w.0...~. ..................................... ~ ................................. ~r~ ~ ~.~ .......... If applicant isa corporation, signature of ~uly anthori/~c-~l officer. ................................................. -/---/.J..~ ~ ~ ~ . ~ ~IREO / ~$~ ..... El~trici~ Li~ ~ ................ k ..... ~-[ / THE REQUIREMENTS OF THE N.Y. ., , X / $TA~ CON$TRUCTION& ENERGY ~r ~ s ~ ~ ................. ~ / CODES. NOT REsPoNSIBLE FOR DESIGN OR CONSTRUCTION ERROaS ~. ~ci~ofZ~i~~n~ ................................. ~ ....... ~ ............ ............ ..... .... ......... ........... ~,~ ~. ~ ~i~ .~g..~S ...... m~ ..0/-°°~ ~ .0~/.'.~. ~ivislm ............... ~. 00 Fil~ 2. State ~sti~ m ~ ~ of ~s ~ int~ m ~ ~ of ~o~ e~st~ti~: a. Nsti~ m ~ ~ ............................................................... b. Intended use and occapansy ............................................................................. 3. Pziture of ~ork (cl~:k ~hich applicable): Ne~ l~uilding~..~ ...... fiddirion .......... Alteration .......... Repair ............ ~l ............. l~liti~ .]~ ..... Otlmr ~ .................................. ~ [ , (~ripti~) (to ~ ~id ~ fili~ this a~li~ti~) / 5. If ~lli~, ~r of ~11i~ ~mirs ...: ........ t~r of ~lling ~its ~ e~ fl~r ................ I~ ~r~e, ~r of cars ........... ~ ........................ 6. If I~i~ss, ~reial or ~ ~, ~i~ ~ture ~ ~ten~ of e~ ~ of ~ .............. ~ ....... 7. Di,mnsi~s of ~i~i~ st~m~s, if ~: ~r .... Z~.~.; .... ~ar .... ~.~,~ .... ~pth .... ZO. ........ Di~i~ of ~m s~e ~th alterar~s or ~r~s: Fret ...... ~ .................. ~p[h .................... ~i~ .................... ~m~r o[ Stories ............... 8. Di~nsi~ of entire ~ ~st~ti~: ~ .............. ~ar ............... ~pO~ .............. [~i~t ......................... ~r of Stories ..................... I0. ~Ee of ~lrdm~ ...... ~. ...................... II. ~ or ~ district iu ~id~ pr~i~s a~ ~i~t~ .............................................................. [2. ~s ~o~ ~t~ti~ violate ~ ~i~ 1~ o~i~e ov ~lati~: ........................ ~. ~ill lot ~ ~ ....... ~ ...... ~ill ~ss till ~ r~ ~ ~s: ~ ~ o[ ~dt~t ........................ ~ ........... ~se .............................. ~ ~ ............... 15. Is fids p~rty~thin ~ [~[ o[ a ti~l~tl~? ~ ~ ...... f ~ ......... PLOT D~AGRAH I~cate clearly and distinctly all buildings, whether existing or proposed, and indicate al! set-back dimensions frc~ property lines, gix~e street and block nmher or description according to deed, and shoa street names and indicate ~hetber interior or conmr lot. ca ... [~t ~ ~ .................... 1~ing duly ~m, ~i~s a~ ~ys ~t he is tl~ ~li~t I~ ~s the .. * .......... q ............................................................ ~ (~ersct~¢ ~t, eOr~rate officer, etc.) of ~id ~r or ~rs, a~ is ~lly ~O~ori~ to ~rfo~ or h~ i~rfo~ ~m ~id ~ ~ to ~ ~ file this a~llcation; ~at all stat~nts c~tai~ in ~is a~llcatlon are t~ to ~e ~st of his ~1~ a~ ~llefl a~ that tt~ ~ will I~ ~rfo~ in tim ~r ~t forth in ~e a~lic~ti~ fil~ t~i~.