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Home My WebLink About26372-Z FORM 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. 26372 Z Date MARCH 3, 2000 Permission is hereby granted to: LEROY COLLINS MAIN ROAD MATTITUCK,NY 11952 for DEMOLITION OF AN EXISTING 22 ' X 24 ' SINGLE FAMILY DWELLING AS APPLIED FOR. at premises located at 9395 MAIN RD MATT/LAUREL County Tax Map No. 473889 Section 122 Block 0006 Lot No. 018 pursuant to application dated MARCH 3, 2000 and approved by the Building Inspector. Fee $ 37 . 80 Authorized Signature ORIGINAL Rev. 2/19/98 BOARD OF HEALTH . . . . . . . . . . . . . . . # ,ei FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . L MAR 3 �� f, �� TOWN 'OF SOUTHOLD SURVEY - - . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . .. . . . . . . . TOWN HALL SEPTIC FORM . . - - . . . . . . . . . . . . . . TC3v'v`i� r'y% i'` i' . SOUTHOLD, .N.Y. -1 1971 �3Uf_0_p TEL: 765-1802 NOTIFY: CALL . . . . . . . . . . . . . . . . . . Examined..................-220.... e2 2 �7 MAIL TO: — _. . . . . . . . . - - - . . . . Approved....3.,:.Z.Z.....,2 ? Permit'No. fro U...oC.. .... .... .r Disapproved a/c .................... .... .. ' �1:. ... .........:............................. .. ...... 2a�, 404G ....... ...... . (Building Inspector) PLICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . . 20. . . . INSTRUCTIONS a. 'this application must be completely filled in by typewriter or in ink and submitted to the Building Inspector wit 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public. streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. r c. The work covered by this application may not be commnce&&before issuance of Building Permit. d. Upon approval of this application, the Building Inspector krill issue a Building Permit to the applicant. Such permit shall be kept on the-premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by,the Building Inspector. APPLICATICN IS UEEEBY MAIC to the Building Department for the issuance of a Building Permit pursuant to the Bolding Zone Ordinance of. the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances-or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. , The applicant agrees to comply with all applicable laws, ordinances, building code,,,housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. .................................................... `(Signature of applicant, orname, if a corporation)- -• • - -- (Mailin -addressofapplicant) g State whether aVicantrY. owner, lessee', agent, architect, engineer, general contractor, electrician, plumber or builder Y: ....................... ...............................: - ....................... .�. Ce-_ Name of owner of premises ... ...Liasthe ......................._....................................... ............ taxtroll or latest deed) If applicant is a corporation, signature of duly authorized officer. ...................................................... (NameAndtitleof corporate officer) Builders License No. ............. . PlumbersLicense No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on whichpr°p° .1/..:4 sed work will be done. :�':�'..W.i.. ........... .1... � ........... .13q�:....... .... ..1.'' .........:............................... .................... House Number Street Hamlet County Tax Map No., 1000 Section ...1•aL 13L9_ .... Block .....6.....:.. Lot -•� ........ Subdivision ........................................ Filed Map:No. ............... Lot ............:.. (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .....:: ............................................................... b. Intended use and occupancy ..................................... _ ..................................... ,1 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ...... Repair ............ Removal ............. Ik3nolition .......... Other Work ................................... 006 (Description) 4. Estinnated Cost ..�1_ fee .............................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .. Number of dwelling units n each floor ..... .......... If garage, number of cars .�� r •� 2 � 6. If business, commercial or minced occupancy, specify nature and extent of each type of use.... 7. Dimensions of existing structures, if any: Front...�:,Z.,_,_•••. Rear ..�.� `•..,-, Depth Height .......1�Q/ C............. Number of Stories ... .................. ......_ Dimensions of same structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Number of Stories ............... 8. Dimensions of entire new construction: Dont ...............'. Rear ............... Depth .............. Height ......................... Number of Stories ..................... 9. Size of lot: Front n/ ....... Rear ................. Depth �j ............. 10. Date of Purchase 40........ Name of Foumer Owner ........�Y'.................... 11. Zone or use district in which premises are situated ............................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................ 13. Will lot be regraded ....... ..... Will excess fill be removed from premises: YES NO c 14. Names of Omer of premises ...... ... Address ....'737.x................... Phone No. ............. Name of Architect .................................... Address .............................. Phone No. ............. Nacre o,17Contractor ................................... Address ...............................Phone No. ............. ti 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO ,...... *Ir YES, SO MIXD ZUWN TRUST]-S PERMIT MAY BE, 9gARED. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensio s from property lines. Give street and block number or description according to deed, and show street names and indic to �lnether interior or corner, lot. ;.r/n.IE OI: MW YORK, SS J00N[Y (A ........................ U ...............^. �. .]......� �.N 5........ < being duly sworn, deposes aril says that he is the applicant ,Name of individual signing contract) above named, leis the ....................... ............................................................. (contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and.belief_; and. lnat the work will be performed in the manner set forth in the application filed therewith. sworn to before me this . _3 .... day oL w.......:--20....... r Notary Public / JOYCE M.WILKINS ...................... Notary Public,State of Newyork Signature of.Appli.cant)• No.4652246,Suffolk County Term Expires June 12, ;; � r) _ �� _ � -'/'PI O�!!!�l OF SOlJTHO�.® PROPERTY RECORD CAR® { OWNER STREET C ' � \, VILLAGE DIST. SUB. LOT Le FORMER OWNER N ,. v E _ S TYPE OF BUILDIN . W.. j RES. G��6) SEAS. VL. FARM COMM. B. MISC. Mkt. Value LAND IMP. TOTAL DATE REMARKS --� z5 +. 6) « _ 67 5 - ct -dam, c.i I AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE FARM Acre Value Per Value Acre Tillable 1 Tillable 2 0 Tillable 3 Woodland Swampland FRONTAGE ON WATER Brushland FRONTAGE ON ROAD 2 House Plot DEPTH BULKHEAD Tota I 77 TOC,DOCK ■MEMOS ■■■■■■Nr■■oMEMO loom MMEMMOR 0 NONE iii■ BM■■■■ ■■ MMM■E!�!■■O■■■■W ON 1 ■MMM■ MMOL■ ...�� ; EMENNE - ■■■■■■■ C0020I1 IMEM■EENZEM■■ ■■MMI■ 1100MM1,15A■■■MSI■MEIN■ EME■■■■ 1,101111 ■■ME■■M ?�■�1�■IEEE■■■■■■■E■ ■■EEM■■ ■■iiE■■■■■■iMM■E■■ wailsFoundation Basement �i�rePlace . .- Rooms 1st Floor •' Recreation ..