HomeMy WebLinkAbout26856-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. 26856 Z Date OCTOBER 20, 2000
Permission is hereby granted to:
BENIGNO DEJESUS
806 LINNET STREET
GREENPORT,NY 11944
for
DEMOLITION OF FIRE DAMAGED SINGLE FAMILY RESIDENCE DOWN TO
FOUNDATION AS APPLIED FOR. NOTE: REQUIRES CONSTRUCTION PLANS & SPECIFICATIONS BEFORE
REBUILDING.
at premises located at 395- A/K/A 806 LINNET ST. GREENPORT
County Tax Map No. 473889 Section 048 Block 0002 Lot No. 037
pursuant to application dated SEPTEMBER 20, 2000 and approved by the
Building Inspector.
Fee $ 166 . 10
Authorized Signature
ORIGINAL
Rev. 2/19/98
RohvxN bo
`� � 4°.4 BOARD OF HEALTH . . . . . . . . . . . . . . .
FORM NO. 1 3 SETS OF PLANS
] TOWN OF SOUTHOLD SURVEY
SEP Z O ?n no, ` ?BUILDING DEPARTMENT CHECK . . . . . .. . . . . . . . . . . . . . . . . . .
TOWN HALL SEPTIC FORM
E�I'Dr,.DLE i.��. SOUTHOLD, N.Y. 11971 DEC .. . -
.. . . . . . . . .. .. ... . ... . .
'I`Ob11N OF SU!il"FlGLi) � TEL: 765-1802 TRUSTEES . . ����SC>S"
NOTIFY:
CALL . .'I&13 :: gY11:42
Examined... 16)/. ...... 2:.-0. MAIL TO: . :,�-0_r A�I d5 6k.
Approved..... e ....., ,-C3�d Permit No. � �. .. n:f.. : ........
Disapproveda/c .................................. ..... .....................
................................................ .. .
. .. ......... .�--......
(
Building Inspector
APPLICATION FOR BUILDING PERMIT
Date. . . . . . . . . . . . . . . . 2G. . . .
INSTRUCTIONS
a. 'This application must be caupletely filled in by typewriter or in ink and submitted to the Building Inspector wi
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.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall bekept 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.
APPLICE1rION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building 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 r finances, building code, housing code, and
regulations, and to admit authorized inspectors on premises and iniltl'ng for necessary ins tons.
...................(Si uie of licant, o name, if a corporation)
..... ........ 0.
(Mailing address of applicant)
u'l �.,, ...,, .„,. ,.q ..-: cL'j •ll„� lar ,..�
-• n. m!'1 �'i 't S'� F
State whether applicant is_owi> r, lessee;;sen agnt, architect, engineer,'general contractor, electrician, pltmber or builder
.........�( .. Y ... .................................................................
Nameof owner of Premises;. .,..�. r.h ...N[ ....... ..................................................
Ghie; tax rpll,br latest deed)
-
If applicant-is- :coipor`ation''sij nature'ao duly`audh rized officer.
=
- 'I CA a
(Name and title ofTe9rporate off '
Builders License No.. .............. ....
Plumbers License No. .........................
Electricians License No. ........r.7.............
Other Trade's License No. � !.3 ...1�.�
1. Iocation of land on which proposed work will be done..............................................................
... ��........ .i ��.�- .�5 �
............................................. ... ........................
House Number Street Hamlet ”
County Tax Map No. 1000 Section ... .®.......... Block ...<.......... Ivt .3 .....---..
Subdivision ...................................... Filed Map.No. ............... Lot ...............
(Nam)
2. State existing use and occupancy ofpremises and intended7,0,q�.e
and occupancy of'proposed construction:
f
a. Existing use and occupancy ... .�� �.�.�...j 4?W ..........................................
b. Intended use and occupancy ... �.� .��`f .. 4.��.� s. � .....5;r;.�;:tir;r1�,t'f•�, ":;�:pJ'.... .......
b
3. Nature of work (check wbid► applicable): New Building ....... Addition .......... Alteratior. ..........
Repair ............ Removal ............. Demolition X......... Other Work .................................
Q (Description)
4. Estimated Cost ...(J JQ t........... fee ..............................................
nn nnL (to be paid on filing this application)
5. If chaelling, number of dwelling units .-D�1 .... Umber of dwelling units on each floor ... ........ -
If garage, number of cars .......`. .......................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use......................
7. Dimensions of existing structures, if any: Front................ Rear ............... Depth .................
Beight ......................... Number of Stories ...C)Aj:�_............
Dimensions of same structure with alterations or additions: Front ............... Rear ...............
Depth .................... Height .................... Number of Stories ...............
8. Dimensions of entire new construction: Front ................ Rear ............... Depth ..............
Height ... Nuhiher of Stories .....................
9. Size of lot: Front .. f....... v-r -1,�,L .L
.� ... Rear ....� ............ Deptth ! ......
10. Date of Purchase ..................... Name of Former Owner ........................................
II. Zone or use district in which premises are situated ...............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: .. Q.................
13. Will lot be regraded .................../.�. Will excess fill be remwed /from pr ses: YES /&W
14. Names of Owner of premises tP.�21. ®. � �.�i.S.... Address Fok.l!�m,!I�! ��:
Name of Architect ... ... .j Address ..............................;�
;L.
n Phone No,
Name of Contractor `:!f P� � �C .. , 114 Address40!�'.P: l •�- .. .Phone ,Al y
.•�;J�l
15. Is this property within 300 feet of a tidal tland? * YES .......... .... I��79
we
*IF YES, SWfI D TM TRUSIFLS PERMIT MAY BE REI�TIRID. �..
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions
from property lines. Give street and block number or description according to deed, and show street nares and indicate
whether interior or corner lot.
&F 0eS:—j1WXe,0
crre4r e'�jGe/.2e � Q,-f:5 /•hsA ,D�c r il+•►y �rCo'�S?
In WxF>: 0 cc
A- Ge i/LiTj�s 3�pl+P LUa i� � m M W Z W WO
�W W W
0 =W J W
Ul
-XIL WO
m Z
O w Z
LL- Z
QQ O Z
NV6
O� 8 NLLrW �C� WZ� ® zaZOW Z� � � W � U0— C!3 ma ? ZCLa) 0Z0 O
w
�.wlr- Or. DHwYM, ��° 0000 �� W `wwt�7
SS �� ��, W � ►nJU. u. ae -Zu. m � WIOW
) U[1IT (A ?.�.? C7[-lL.... � V) g� w O m O
..�P�I n o ��s
.... ........................ .•............_......being dul.y'sworth, delx)ses and says that he is the applicant
�Nahe of individual signing contract)
above named,
leis the .. ................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
hpplication; that all statements contained in this application are true to the best of his knowledge and belief; and
_hat the work will be performed in the manner set forth in the application filed therewith.
worn to before me this
CCD
---- _ o ( .�
2.:Notary P ....ul ...................
......
ELIZABETH A STATHIS (Si lune o- .13.c .
NOTARY PUBLIC,State of New York
No.01 ST6008173,Suffolk County
Tern Expires June 8,20-C.2-:
OF
���!�.,-.!
}' ; F$Ny'°N'F.iek>c a ,t �= �r (t - • .0 (t I1 ���� ,�:...3 { •.J' 3- t 1..� -l•.,. Ik l�
ti
rsa��-t'clr
r t +6�0,e?'t; w';� Baa •M1.X X.r
r
Yr t
Jf51
sir t, :i tS v;nr O
l �r nr'nn o1 �� „r V 4 'P
of'fie Now ywk Stati- A ?�
r`h5r*r. Yr C'Jc&tion Uw.
Oapies of fhla sumoy map not bearing i " r
:he land Suryeyor's inked seal OL '• � •
embossed seal shall not be considered
htz r s {1 to be a valid true copy, Zp Q� �ry� 1 i
Guarantees indicated hereon shall run V
- Z•" only to the person for whom the survey
LL is prepared,and on his behalf to the
r
cat, j title company,governmental-agency and
lending institution listed hereon arW
t zc ti +1 • to the assignees of the lending Invd-
tution.Guarantees are not transferable
� t to additional institutions or subsequent
+{a }r owners.
`rr T,
Lj
i 'AF
1
y
Irk-
F"I
A
p/�
oZw...�1•;41G �V
t Q t �'•y .
h�A.
1
�o. ,• M i_. f taw.. F `M ! n,..t
�rFY F. 1
4L <
BUILDING PERMIT REVIEW CHECK LIST
DATE REVIEWED: /o /tea
APPLICANT NAME: DATE SUBMITTED:—/—/—
PROJECT
UBMITTED / /PROJECT LOCATION
STREET: CITY: SUBDIV. NAME:
ARCHITECT/ENGINEER: 01430--,UFAST TRACK: YES or<0
SCTM# --- DISTRICT: 1,000 SECTION: 'f,9' BLOCK: ,2 LOT:
ZONING:
ZONING DISTRICT: R40, R80, AC, CONFORMING: YES OR NO REQUIRED LOT SIZE: SQFT.
WHERE ACTUAL LOT SIZE FROM? - �j e , ACTUAL LOT SIZE: SQFT.
REQ. REQ. REQ.
FRONT: 'PROPOSED: SIDE YD: '/ ' PROPOSED: '/ REAR: 'PROPOSED: '
LOT COVERAGE: ALLOWED: % EXISTING: sf % NEW: sf % TOTAL: sf %
CORNER? YES o N WAT ER FRONT? YES oR NO DESCRIPTION:
SINGLE & SEPARATE CERTIFICATION-REQUIRED: YES o NO OTES:
LOTS 40,000SF --100-24. Lot recognition. (CREATED before June 30, 1983), UNDERSIZED LOTS FROM
JAN.1997 100-25. Merger. (A nonconforming at anytime after July 1, 1983.)
PROJECT DESCRIPTION: ADDALT,ACC OR wD: &,,, , 0,4/L ^e c
AGENCY PERMITS REQUIRED FOR REVIEW
NEEDE
TOWN SPETIC PERMIT: YES o
SUFFOLK COUNTY HEALTH DEPT: YES or O (BED #): DTE: / / PERMIT#:R10-
NEW YORK STATE DEC: YES or
SOUTHOLD TOWN TRUSTEES: YES o
TOWN ZONING BOARD APPROVAL: YES or
TOWN PLAN. BOARD APPROVAL: YES or O
FLOOD COMPLIANCE ZONE: P1; U. FLOOD ZOhT
NYS ENERGY: YES OR EGRESS: VENT: LIGHT:
NOTES:
/6/O /11,14 cine 7`o v'Jrrs2aG1.] $/ 'p r C oevte
` f
( -� /,-' a /ate G _S'
/14 rl 'w Xe as • a
FEE STRUCTURE: FOUNDATION: SF
FIRST FLOOR // SF,/- ry ,
SECOND FLR SF INIT OTHER TOTAL
TOTAL: /&// SF FEE FEE FEE
OT( j $✓/ SF)- 6 SF)= /s // SFX $ to /C)+$_/ 6,—+$ 0.r = /'��• %�