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Home My WebLink About27402-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. 27402 Z Date JUNE 15, 2001 Permission is hereby granted to: CAROL ZEBROSKI SAVAGE WOODCHUCK HOLLOW LANE WADING RIVER,NY 11792 for DEMOLITION OF TWO ACCESSORY STRUCTURES IN DISREPAIR AS SHOWN ON THE ATTACHED SURVEY. at premises located at 38220 CR 48 PECONIC County Tax Map No. 473889 Section 069 Block 0002 Lot No. 002 pursuant to application dated JUNE 11, 2001 and approved by the Building Inspector. Fee $ 70 . 00 Au i d Signature ORIGINAL Rev. 2/19/98 TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying? TOWN HALL Board of Health SOUTHOLD,NY 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. 7�� Check Septic Form N.Y.S.D.E.C. Trustees Examined �y r jT,s ,20 Contact: Approved G 1 /� ,20_QL Mail to: Disapproved a/c Phone: Buil Ins (ector APPLICATION FOR BUILDING PERMIT Date 6 // , 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 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 waterways. 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 a 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 what-so-ever until a Certificate of Occupancy is issued 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 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 or name,if a corporation) V Y2_ o� lW ra , � h ,�/ Pe-Z�l � (Mailing address of applicant) //"�5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises C it Z��osle9 sa-ci rsZo, Gy�/// „S . Z.e�- x,6,1 i (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 of land on which proposed work will be done: House Number Street Hamlet .5, ?1_PA County Tax Map No. 1000 Section �j Block Z Lot:' Zr �;,rz;S!J l Subdivision Filed Map No. (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 ;_ 3. Nature of work(check which applicable): New Building Addition Alteration Repair Removal Demolitions Other Work (Description) 4. Estimated Cost Fee (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 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 Height Number of Stories 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 Number of Stories / 9. Size of lot: Front 12,1 Rear 12-1 Depth I3 J 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: 13. Will lot be re-graded iZ a Will excess fill be removed from premises: YES NO 14.Names of Owner of premises Address Phone No. Name of Architect Address Phone No Name of Contractor Address Phone No. 15. Is this property within 100 feet of a tidal wetland? *YES NO t-`- • IF YES, SOUTHOLD TOWN TRUSTEES PERMITS MAY BE REQUIRED 16. Provide survey, to scale, with accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey. STATE OF NEW YORK) SS: COUNTY OFE t� S4'� /`.S 1CL w Z4,Z j no G ',7-LUf<_ being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)He is the Cd h`T r�Q�� Ve�Z�-1 e e— (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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to efore me this day of 20(?L X c5zaZZ2;i�2w Nkotdf'ry Public Signature of Applicant KAREN J. HAGEN NOTARY PUBLIC,State of New York No. 02HA4927029 Qualified in Suffolk County Commission Expires March 21, 20 TOWNS OFSOUTHOLD PROPERTY RECORD CARD OWNER STREET r' r ( ' VILLAGE DIST. SUB. LOT CC.0�o ZCi_ (/ 3C. Q VY 11_ ' f.f Y C teu" FORMER OWNER :; E r`' ACR. tom-, , `^ i-•, � r 7 � o , �S� r �S` W TYPE OF BUILDING 'J Z. ro (RES SEAS. VL. FARM COMM. CB. MICS. Mkt. Value LAND IMP: TOTAL DATE REMARKS 3 a �o y7 442 - L l 9. " 5 9- ros k' sIn 170vo �J-s `7Qo 32 0D '7 OL i AGE BUILDING CONDITION NEW NORMAL BELOW ABOVE. FARM Acre Value' Per Value Acre Tillable FRONTAGE ON WATER Woodland FRONTAGE ON ROAD ` Meadowland DEPTH I House Pot BULKHEAD v v Total DOCK t. I . • x,anfs3 Jig��'_P uy r „3+ Y h*14 , mom OMMOMEN MOON mommom rh, �a � , �� F, n Fr t 's ,fir j ■■■■■■■■■■■■■■■■■■■■■ rfi` ■■■■■■ r a t ilT <11 1 ur aC NEON■■■■■NEON■■MEMO■■ MENEM 4 a fig' lIs r {ps r_ e ®■MMM■■■NNEON MN■NN■MOON ■■■■■ mom MEMMIMMINIME ME VN , t MEN ENO ■■■■�io�■�w�7■■■■■■ %. 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Z fc��5t % e Ntr N� Z 76 , "A m �r 1�' 39� S�• �La � •� O' x 8 , SURVEY OF PROPERTY AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NY o ; 1000 - 69 - 02 - 02 121.00' SMA Y 25,'200�' SPS K� S. 7e.°604, w ROAD �RTH p�E OF N N S� F� Y.'S. LIC, NO. 496/8 EC 1W ;S ORS, P.C. (631) 76 - 5020 FAX (63/) 765 - 1797" P. 0. BOX 909 AREA =. 19,126 SQ. ft. 1230 TRAVELER STREET SOUTHOLD, N.Y. 1/97/ " 01 - 150