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Home My WebLink About29838-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL COMPLETION OF THE WORK AUTHORIZED) FULL PERMIT NO. 29838 Z Date OCTOBER 23, 2003 Permission is hereby granted to: TODD JENSEN 819 LINNET STREET GREENPORT,NY 11944 for : DEMOLITION OF AN EXISTING DWELLING AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 048 pursuant to application dated OCTOBER Building Inspector to expire on APRIL Fee $ 71.60 140 LINNET ST GREENPORT Block 0003 Lot No. 003 21, 2003 and approved by the 23, 2005. ~ ~t ho ~ i~j~m~i gna t u re ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ,20 Approved ,20__ Disapproved a~/c Expk~ion ,20 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying? Board of Health 3 sets of Building Plans ¢(~5~Sup~,eyPlamfing Board approval PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees ~ ~ Contact' APPR V= ,% NOTED ' 765-1802 8 x~ O , iOk T~E ----- FOLLOWING 1.~C'JF~LBa~thg lnsp~cto~l~E~ FOP POUREU 2.ROUGH - F~A~ ,~& ~, ~L~NG APP~~OR BUILDING PE~IT 4. FINAL - C~."-j~%N MUST L._ } i BE COMPLF- '"' O. j ALL CCN~¥)~/.~¢~[~d~IEET THE Date ,~-.~'tJc=Wk{~!~--~?,.-~- , 20 O . ,, ~ ....... REQUIRE~~EUO~S OF NEW ...... YO~ S;ATE. NOT RESPCNSIBLE FOR a. I ms appncatzon MUST be comp~et ~ .... ~~~ ~ sub~tted to the Building ~pector with b. Plot pl~ showing locaion of lot and of buildings on presses, relationship to adj oi~ng presses or public streets or ~e~, ~d wate~ays. c. The work covered by t~s applicaion may not be commenced belbre issuance of Building Pemfit. d. Upon approv~ oft~s application, the Building ~spector will issue a Building Pe~t to the applic~t. Such a pe~t slmll be kept on the presses available for inspection t~oughout the work. e. No building sMll be occupied or used in whole or in pa~ ~r any p~ose wha so ever until the Building ~pector issues a Ce~ificae of Occupancy. f. Eveu building pemfit shall expire if the work authorized has not cormnenced within 12 months aker the date of iss~ce or has not been completed witch 18 months from such date. If no zoning amendments or other relations affect~g the prope~y have been enacted in the interim, thc Building h~spcctor may authorize, [n writing, the extension of the pe~t for ~ addition six mo~xths. Thcrca~er, a new pcnmt shall ~e required. ~PLICATION IS HE,BY M~k to the Building Depamncnt lbr the issuance of a Building Pe~t p~sm~t to the Building Zone Ordinance of the Town of Southold, SufIblk Coumy, New York, and other applicable Laws, Ordin~ces or Re~lations, for the construction of buildings, additions, or alterations or ibr removal or demolition as herein deschbed. The applic~t a~ees to comply with all applicable laws, ordinances, building code, housing code, and re~lations, ~d to a~t autho~zed inspectors on presses and in building tbr necessa~ inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State ~vhether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises '~t"'D~ ~"'4~':_~_K~:>~5~,['~J (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. Loc~ion of land on which proposed work will be done: House Number Street Hamlet Lot~L~ Lot County Tax M~p No. 1000 Section ~'~8 Block .~ Subdivision("JlL~c3..~2~l~r 'I'!~UlM~ ~14~-k:?. Filed Map No. (Name) State existing use and occupancy of premises and intended use and o~y of proposed construction: a. Existing use and occupancy ~ I k.J_(~q,3~ ~ t L.L/-~/ t22~E:r,k~[~_, b. Intended use and occupancy~l~C~'X.L.~q:~l~('.Jn&~ ~CC.~-;fn~ },~.,ta~ tto6CE h-" tta4 3. Nature of work (check which applicable): New Building, Addition Repair Removal Demolition p(~ Other Work Estimated Cost ~}'t/.zio_ ~i~c>9OO.C:x:> '{lr~h°iPZ)X .Fee If dwelling, number of dwelling units~ If garage, number of cars Alteration (Description) (To be paid on filing this application) Number ofdwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. -x-o o'x c)o Fa-. 7. Dimensions of existing structures, if any: Front Rear _Depth Height Number of Stories '1 Dimensions of same structure with alterations or additions: Front ~Rear Depth Height. Number of Stories 9. Size of lot: Front 10. Date of Purchase Dimensions of entire new construction: Front Rear .Depth Height Number of Stories Rear_ <-,~0 Depth J/OQ, Name of Former Oxvner '~f~.~rN3~(.~ '~l 11. Zone or use district in which premises are situated ~ 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~/ 13. Will lot be re-graded? YES ~/ NO Will excess fill be removed from premises? YES _,_NO - 14. Names of Owner ofpremises 02. L. Address_ lfDWt0 r. /'. Phone Name of Architect Address Phone No Name of Contractor-'ToJna/) ~ Address. ~i:~-Iw,,~ ~ Phone No. /- 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO V/ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE/~EQUIRED. b. ls this property within 300 feet of a tidal wetland? * YES NO_V * IF YES, D.E.C. PERMITS MAY BE REQUIRED. 16. Provide survey, to scale, xvith accurate foundation plan and distances to property lines. 17. If elevation at any point on property is at l 0 feet or below, must provide topographical data on survey. STATE OF NEW YORK) COUNTY O~: -'~OE2:,'~2~ ~5'"~..1'4 ~_~.. ~ __ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)He is 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 application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be pr~rformed in the manner set forth in the application fil ed therewith. ~kQbefore me this J. ~./}_ f 4.~x~ay of ~.~20 03 Noilly/Pubic - _ Signature of Applicant Veronica F. Cidone Notary Public, State of New¥0rk No: 52-4661406 Qualified in Suffolk Commission Expires Dec.31 ,~:~..'..~ .5UP-.VE¥ OP LOT 6q' PLAN OP p~OPE~TY OF: ®P.:EENPOP-..T O~IVIN® PARK 51TUATE: OI~.:~-NPOI~T TOINN~ 50LYfHOLD 5tlPPOLK C, Ot)NT'¢, NY ~UFFOLK COUNTY TAX ~' 1000-4~-~-~ DIANA TODD d~elling N qO' FE mun ic ipc~ / vocan~ municipc~l NOTES: AXLE FOUNO PIPE POUND 0 AREA = 5,~25 5F OR O.I;~ AC~E5 ®P-.APHIO 5GALE I"= 20' 0 dP FEi 10" 50. , JOHN C. EH~.ERS LAND SURVEYOR 6 EAST MAJN STREET/ N.Y.S. LIC. I~O. 50202 I RIVER!-IEAD, N.Y. 11901 ' ,," 369-8288 Fax 369-828t REF.\XI-Ip server~d~PROS\03-218.pro "