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HomeMy WebLinkAbout26995-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. 26995 Z Date JANUARY 2 , 2001 Permission is hereby granted to : RICHARD D VANBOLT & ORS 198 WARREN ST BROOKLYN,NY 11201 for DEMOLITION OF AN EXISTING SCREENED PORCH ON AN EXISTING ONE FAMILY DWELLING AS APPLIED FOR. at premises located at 110 FLINT ST GREENPORT County Tax Map No. 473889 Section 048 Block 0002 Lot No. 028 pursuant to application dated DECEMBER 29, 2000 and approved by the Building Inspector. Fee $ 15 . 00 Aut orized ignature ORIGINAL Rev. 2/19/98 �,. FORM NO. 3 ' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL:'765-1802 BUILDING PERMIT APPLICATION CHECKLIST: Do you have or need the following,before applying?: Board of Health? 3 sets of Building Plans Survey Check Septic Form N.Y.S.D.E.C. Trustees Exahlined 20 Approved , 20 PERMIT NO. Disapproved a/c Building.inspector U-1 2 9 2000 ` • APPLICATION 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 With 3 sets of plans, accurate plot plan to sale.Tee 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 Inspectof will issue a Building Permit to the applicant. Such a Hermit shall be kepi-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 . APPLICATION 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 constrUetion 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, ho sing co regula ' ns, and to admit authorized itrspectors on pfemises and in building for necessary ins ectio - i (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder 'T Name of owner of premises Qc_� (as on the tax roll or latest deed) If applicant.is a corporation, signature of duly authorized officer (Name and title of corporate officer) Builders License No. Plumbers License No. Electricians License No.• Other Trade's License No. 1. Location r7of land on which proposed work will be done: House Number Street Hamlet County Tax Map No. 1000 Section 6q8 aQ Block O;L,Oo Lot .. 0,-)8. 006 Subdivision Ma P c, cwt L-Filed Map No. 36 S Lot r f (Name) 2. State existing use and occupancy of premises and intended'.use and occupancy of proposed.construction:' a. Existing use and occupancy A-wt, b. Intended use and occupancy S�f` ������ SG��e"` '�� rS�a 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work as sk t,;-A or -:�( scription) 4. Estimated Cost -47aS.. � � Fee, � 15, ©C� (to be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars rJ[A- 6. If business, commercial or mixed occupancy, specify.nature and extent of each type of use. 0, 7. Dimensions of existing structures, if any: Front Rear oP •G Depth as 1 Height Number of Stories Dimensions of same structure with alterations or additions:.Front Rear ' 1 LV g ' Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front JOU Rear Sd Depth 1 10. Date of Purchase Name of Former Owner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: V"J® 13. Will lot be re-graded 00 Wil:excess fill be removed from premises:, YES NO ' Ri1�s. ._1� 1,C'-- N ��- t�tt?j�" srcrS�Ct 14. Names of Owner of premisesRL, � Address t-)� tN Phone No. Name of Architect Address Phone No Name of Contractor Jd�\ `� Address�auAI���+� Phone No, 4L-7 15. Is this property within 300 feet of a tidal wetland? *YES NO • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, indicate scope of project, to scale, with distances to property lines. 17. If elevation at any point on property is at 10 feet of below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OF !:'IE t Jbeing'duly sworn, deposes and says that(s)he is the applicant. (Name of individual signing con et) above named, (S)He is the (Contractor, Agent, Corporate-Officer, etc.) of said owner or owners, and is duly authorized to perform or havd 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 thafthe work will be performed in the manner set forth in the application filed therewith. Sworn t2 re me this _ Z ay of 20 U Notar�Pudic Signature of Applicant CLAIRE L L Notary Nob01GL4879505 York Qualified in Suffolk Co Commission ExPires Dec.S, - I %Ovvreg Ve 3UUMULD PROPERTY RECORD CARD OWNER STREET VILLAGE .DIST 'ST' SUB. LOT rk rd b Vo Y&H ttof (4� 74/k FORMER 0 WNER N E o S W TYPE OF BUILDING ES. SEAS. VL. FARM comm. CB. MICS. Mkt. Value LAND IMP. TOTAL DATE REMARKS 7 L -r2 i o 4e L -Z, Ls a g. 17,9 AGE BUILDING CONDITION IEW NORMAL BELOW ABOVE Aplm Acre Value Per Value Acre lable FRONTAGE ON WATER )odland FRONTAGE ON ROAD !adowland DEPTH if-li use Plot I- BULKHEAD 0( TD CK .......... w.• h ■■■■■■■■ ■■■■■■■■ONE No 0 M No ■■■■■■■■ s;, ■ ■ ■ IA_ ■ ■■■■■■■ ■■■■■ ■ ■■■■■■■■■■E . ; ■■■son■■■■■■■■■■■■■■■■■■■■■ F til ■ ■■■■■■■■■■■■■■■■■■■ ■■■■■■ - �,�;.ye ■�■■■■■■■■■■■■■■MEMO■■■■■■ONE ■■MMM■■■■■ME■■MMWIMEMM■■■ONONE MEN ■■ MIME MEMO Eii�iiAl■■■■ ME MEN ' EO■■IEO■■OM■■O MME ■■■ONNE■O■ E■1N00■MOO■■■N■��� E ■■■M■M■■ME■EOI■MO■EE■E■000■■OO ■■■■■■■■■■■■■■■■■■ONE■■■■■E■E ■■■■■■■■■■■■■■■■■■■■■■■■■E M ed Rooms 1st Floor 'Rooms 2nd Floor • . - Driveway i ;ice; ;' ;��.• �___� � 1 ��'+y"���. �. ':fR!!� �, � ;. •, vat i '!1l �.. . .f»r f 't.1 r 1 � •i ,r.Y,t <Fti.'y,"'�r'•yog,r� ' r Y n —r . rr T`.,:r ad�� 'fJ"�tC * t .d c.�y r."3'ri� S.•T K, 5URYEY`rOE LOT 76 �,4P OFGREENPORT DRIVING PARK" N t� =1LED DEC. I, 1909, FILE No. 369 51TUATE: GREENPORT TOM: SOUTHOL.D w E FOLK COUNT'(, Nr s 911RVEYED 10-16-00 SUFFOLK COUNTY TAX 000-4b-2-2b 'ERTIFIED TO, -ARIO bARRIDO :;OMMO`%gEALTH LAND TITLE IN5URANCE COMPANY S82047'I0"E 50.00' to I 0 7 t' ,. <1 - M ul O IC 2 STORY FRAME HOU E i i N82° = > ' 4710"W 50.00' NOTES MONUMENT FOUND - Il•�ea]S !?� ...... ,i iI AREA = 5,625 5F OR 0.13 AC.RE5 JOHN C. EHLERS LAND SURVEYOR 6 EAST MAIN STREET N.Y.S.LIC.NO.50202' 6RAPH16 SGALE I"= 20' RIVERHEAD,N.Y.11901 �=-�— 369-8288 Fax 369-8287 REF.Wip serve r\d\PROS\20-268a.pro i