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Home My WebLink About30352-ZFOPd~ NO, 3 TOWN OF SOUTHOLD BUILDINC DEPARTMENT Town Hall Southold, N.Y. BUII~]ING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN%~!L PULL COMPLETION OF TWE WORK AUTHORIZED) PERMIT NO. 30352 Z Date MAY 25, 2004 Permission is hereby granted to: NLARY JO VERITY RR ~1 30485 MAIN RD CUTCHOGU~,NY 11935 for DEMOLITION OF A~N EXISTING SWIMMING POOL AS APPLIED FOR at premises located at 30485 MAIN RD CUTCIIOGUE County Ta~ Map No. 473889 Section 102 Block 0002 Lot No. 020 pursuant to application dated MAy 20, 2004 and approved by the Building Inspector to expire on NOVE~LBEK 25, 2005. Fee $ 35.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDLNG DEPARTMENT TOWN HALL SOUTIIOLD. NY 11971 TEL: (631) 765-1802 FAX: (63D 765-9502 ~'w. northfork.net/SoutholdJ PERM-IT NO. BUILDING PEkMIT APPLICATION CHECKLIST Board of Health 4 sets of Building Plans Planntilg Bo~d approval ~ --~'~-' ~ Check / Bthlding Inspector APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS a. This application MUST be completely tiLLed in by typewriter or in ink and s ubmilted to the Building Inspector with 3 sets of plana, accurate plot plm~ to scale. Fee according to schedule. b. Plot plan showing location of lot and of btuldmgs on premises, relationship to adjoining premises or public s~rects or areas, and waterways. c. '1 he work covered by th~ apphcetion may not be connnenced before issuance of Building Pe~mft. d. Upon ap~ova[ of th/s application, the BtLLlding Inspector will/ssue a Building Permit to the applicant. Such a permit shall bc kept on thc prcmiscs available for inspcction throughout tlke work. e. No building shall be occupied or used in whole or in part fi~r any imrpose what so ever until ttie Building Inspeetor issues a Certificate of Occupancy. L F~:cry btdlding pcrmil shall cxpfl-c if the work autho~Szed has not commenced wiLLzm 12 months after the date of issumtce or has not been completed within 18 months fi'om such date. If no 7x~lthlg ametldinent.~ or oth~ rcgulaLLons affccting thc properly have been enacted in the interim, the Building Inspector may authorize, in writing, the ex, erosion of LLle pe~anit for an eddition slx months. Thercm~er, a new permit shall be requircd. A2~PLICATION IS HEREBY M_Ai)E to the Building Depm~ment for the issuance of' a Building Permit pars uanl to thc Bull rrm g Zone Ordinance of the To'~m o£ Southold, Suffolk County, New York and ot hca- apphcable La;vs, Ordinances or Reguletmns, for the construction of bnLLthngs, addii[ons, or ~dt era~ons or for removal or demolitinn as her(m described. The applicant agrees to comply with all applicable laws, ordinances, build/ng code, housing codc, and rcgula/ions, and to admit anthorlzcd inspectors on premises and in building for necessary inspections. (Sikmaturc of applicant or name, if a corporation) (Matl~ug address of applieca~t) Stale whether applicant is owner, lessee, agent, architect, e~lgineer, general contractor, electrician, plumber or builder (As on th[~tax..roll or latcst deed) If applicm~t is a corgoration, signature of duly authorized officer "~ (Nmnc mid title of corporate officer) B~tilders License No. Plumbers License No. Electhcians License No. Other Trade's License No. 1. Locarion of land on ,wldch l>rqxl~osed work will be done: Housc Numbcz Street Hamlet Comity Tax Map No. 1000 Section ~ ~ 7}- Block ~ Lot ~ Subdivision Filed Map No. Lot (Name) _45 2. State existing use and occupancy of prcrnises and intended use a~ad occupaucy of proposed ¢on~hetion: a. Existing use and occupancy b. Intended use trod occupan c~ 3. Nature of work (check wh/ch applicable): New Building~ Repair Removal 4. Estimated Cost 5. If dwelling, number o f dwelling units If garage, number of cars Addition Altemt/on Demolition ~_~ ~ Other Work (DesclSption) Fee (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 typc of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Dimensions of same structure with alterations or additions: Front Depth _Height_ 8. D/mensions of entire new con stmction: Front Height Number of Stories 9. Sizc ot'Iot: Front Rear. Number of Stories Rear Depth .Depth Rear, ,, Depth 10. Date of Purchase Name of Fonncr Owner 11. Zone or use district in wbich premises are simatcd 12. Does proposed construction violate day zm~ing law, oldLaauce or regulation? YES NO 13. Will lot be re-graded? YES NO Will excess fill bc removed from premises? YES NO 14. Names of Owner of premises Name of Architect Name of Contractor Address Phone No. Address Phone NO Address Phone No. _ I5 a. Is tb/s property withhx I00 feet ora tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN q~USTEES & D.E.C. PERMITS MAxx' BE REQUIRED. b. Is this property witl~u 300 fcct oI'a tidal wetland? * YES NO * IF YES, D.E,C: PERMITS MAX' BE REQUIRED. NO 16. Provide survey, to scale, wi/h accurate foundation plan and distances to property lincs. 17. If elevation at m~¥ po/mt on property is at 10 feet or below, must provide topograpl'dcal data on sttrvey. STAT~ OF NEW YORK) SS: COUNT'/OF ) (Name of indi,4dual sliming contrac0 able namedlaeing duly sworn, deposes and says that (s)he is the applicam (Contmmor, Ag~ Co,orate O¢c~, ~c.) of sa~d owne~' or owners, and is duly authorized to perform or have pcrka~ed the said work and to make and filc 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 pcu-fonned in the mariner set forth/Il the application filed tlic~cwith.