HomeMy WebLinkAbout30175-ZFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold,
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
30175 Z Date MARCH 18, 2004
Permzsszon is hereby granted
DANIEL & TINA FINNE
120 CENTER ST
GREENPORT,NY 11944
for :
DEMOLITION OF 3kW EXISTING STRUCTUP~E AS APPLIED FOR
at premises located at 1020 SEVENTH ST GREENPORT
County Tax Map No. 473889 Section 048 Block 0002 Lot No. 040
pursuant to application dated MARCH 11, 2004 and approved by the
BUilding Inspector to expire on SEPTEMBER 18, 2005.
Fee $ 35.00
Authorized Signature
Rev. 5/8/02
ORIGINAL
Officers
MAYOR
DAViD E. KAPELL
(631) 477-3000
TRUSTEES
WILLIAM J. MILLS RI
GEOKGEW. HUBBARD
GAlL F, nORTON
BRADLEy B. BURNS
March 17, 2004
TO:
Town r~£ S outhold
Building Department
FROM: Greenport Utilities
William Swiskey
To Whom It May Concern
The electrical service to 301 ? Street,
2004 at the request of D, Finne, owner.
Respectfully,
William Swiskey
236 THIRD STREET
GREENPORT, NEW YORK 11944
Greenport, New York has been removed as of March 17.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOW~ HALL
SOU~I~HOLD, NY 11971
T~EL: (631) 765-1802
FAX: (631) 765-9502
ww~v. northfork, net/Southold/
Approved ~/)f' ,20 O~
Disapproved a/c
Expiration -- ~ .~, 20 ~
BUILD~ PEILMIT AVPLICATION CHECKLIST
Do you have or need the following, before appl~ying?
Board of Health
3 sets ofBuildrng Plans
Plann/ng Board approval
Survey
Check
Sevtio om '.. "
N.Y.S.D'.E'~C.~
Trustees
Contact:
Mall to:
~'hone: O'?~-- ?7~vt0
~ding Inspector
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
,20 0.5/.
a. This application MUST be completely filled in by typewriter or in ink anc submitted to the Building Inspector wtth 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on prermses, relationship to adjoining premises or public streets or
and waterways.
c. The work covered by this application may not be commenced before issuarfce of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
available for inspection throughout the work.
e. No buildLng shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
_" fi Every building permit shall expire if the work author/zed has not commenced wittfm 12 months after the date of
,~ or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
pr~eerty have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter. a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permi~ pursuant to the
Build/ag 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
auth°rizedinspect°rs°npremisesandinbuildingf°rnecessmT~nspecti°ns' ~d '~.~/,...~.~,,.,~
(S~gnamre of applicant or name, if a corporation)
CMailing address of applicant)
applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nmne of owner of premises
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officeO
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on which proposed woe will be done:
House Number Street
County Tax Map No. 1000 Section
Subdivision
(Name)
Block oo-
Filed Map No.
State existing use and occupancy of premises and intended us,e and occupancy of proposed construction:
a. Existing use and occupancy __ff,),~,/f.z~ .//~,~/?, ~arr~/g,//;~.,
b. Intended use and occupancy
Nature of work (check which applicable): New Bui]ding
Repair Removal Demolition
Estimated Cost Fee
If dwelling, number of dwelling units
If garage, number of cars
Addition Alteration
Other Work
(Description)
(To be paid on filing this application)
Number of dwelling units on each floor
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions ofexisting structures, ifany:Front /,~, /d' Rear /~/c(/~ Depth
Height. Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth. Height Number of Stories
Rear
8. Dimensions of entire new construction: Front
Height Number of Stories
9. Size oflot: Front ~'/>/'- ; Rear '"~-
Rear Depth
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? YES NO
13. Will lot be re-graded? YES__ NO /XWill excess fill be removed from premises? YES
14. Names of Owner of premises
Name of Architect
Name of Contractor
Address Phone No.
Address Phone No
Address Phone No.
NO
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES
* IF YES. SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property with'm 300 feet of a tidal wetland? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
NO
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)
C ........ .J~,r~.~SS:
/k~ff~ g ~/~//'b'J'-e being duly sworn, deposes and says that (s,he is the applicant
~me of indihdual si~ng conWact) above rimed,
(S)He is the
(Contractor, Agent, Corporate Officer, etc.)
of said owner or owners, and is duly attthorized 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 before me tkis
/ ~ day of~
/ Nota~ Public
20 aC/
SignatUre of Applicant
LOT 58
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FLINT STIlE. ET
OISAPPROVAL
N
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s
JOHN C. EHLERS LAND SURVEYOR
6 EAST MAIN STREET N.Y.S. LIC. NO. 50202
R1VERI-IEAD, N.Y'. 11901
369-8288 Fax 369-8287 REF.\~Ip serve~dXPROS\03-130.pro
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