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Home My WebLink About29178-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. 29178 Z Date MARCH 3 , 2003 Permission is hereby granted to : MARINA & GEORGE KOKKINOS 435 PECONIC LA PECONIC,NY 11958 for ALTERATION OF DELI TO RETAIL--SALRE� AS-PRtr?G-a.ED--W-I-T$_PLANNING BOARD APPROVALS ` VOID NOT BUILT VOID NOT BUILT �\ at premises locatedat�----2-7-45 PECONIC LA PECONIC County Tax Map No. 473889 Section 074 Block 0005 Lot No. 009 . 002 pursuant to application dated DECEMBER 31, 2002 and approved by the Building Inspector to expire on SEPTEMBER 3 , 2004 . I Fee $ 200 . 00 4! �417 �L y ✓ / Authorized Signature ORIGINAL Rev. 5/8/02 Applicant/ / Date. Owners Name: � r�,c ��c��1Gti, Reviewed: Architect/ Date Engineer: 1'�� rQ., Submitted: SCTM fl: _ 9� District: 1.000 Section: Block: S Lot: Projeo �5 n ' Subdivision Location: Name: Single & separate Required certificatio( : (Yes/No) A) L Req, Rcq, Zoning DistricC F (I of size: Actual: ( 6 d l (Lot coverage (A lo Proposed,tai((/` 1 Req. Req. C;, � Req. (From Yard �_Proposed:�] [Side Yard dJ Proposed: ] [Rear Yard Proposed �) Project Description: �&AL,( AGENCUERMITS Permit REQUIRED FOR REVIEW N.A. NO YES Number Suffolk County Health Dept..9a New York State D. E. C. l� Town Trustees Town Zoning Board approval: Town Planning Board apprq`val: i7 r Flood Plane Elevation??? Flood Zone: da. 51 TOWN OF SOWTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following,before applying TOWN HALL Board of Health SOUTHOLD,NX 11971 3 sets of Building Plans TEL: 765-1802 Survey PERMIT NO. ,�`�� Check Septic Form N.Y.S.D.E.C. Trustees Examined_ U ,20_C!3 Contact:. Approved O 3 20_a3,_ Mail to:�/G'�=)� Disapproved a/c Phone: -7 3 4 - 41 ,? ' 76 _Buildinglispector tP FOR BUILDING PERNIIT 1 "07 D Z Date , 20 :INS RUCTIONS a. This application S' 0�pple,. typewriter or in ink and submitted to the Building Inspector with 3 sets of plans, accurate plot p to cording to schedule. b. Plot plan showing on 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 Pen nit. 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 Occupanc; 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 regulatio and to admit authorized inspectors.on premises and in building for necessary inspections. (Signature of applicant or ,if a corporation) _ po 66v (Mailing address of applicant) State whether applicant is.owner,lessee, agent, archite engineer, general contractor, electrician,plumber or.builder Name of owner of premises Gz 0,2 C (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 propoVC-OA/1 work will be done- K-0 one: K-OL'K1N O.t 6v/Ln n/G G House Ntnmber Street Hamlet County Tax Map No. 1000 Section 7 Block O S Lot / • 2— Subdivision Filed Map No. Lot (Name) 2. State existing use a1id.0WVancy ofpremises and intended usepd occupancy of proposed consfZtion: a. Existing use and occupancy Dr—L l — lf2 E c� b. Intended use and occupancy � /l1. 3. Nature of work.(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost OGd 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 extentof ,each type of use. 7. Dimensions of existing structures,if any:I 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 `- Rear . Depth 10. Date of Purchase Name of Former Owner 11. Zone or use district in-which premises are situated C7 12. Does proposed construction violate any zoning law, ordinance or regulation: /y 13. Will lot be re-graded /V 0 Will excess fill be removed.from premises: YES NO G EovLG f 4 3,>~ WE cav c t,, E 14. Names of Owner of premises .goKc w pS Address PC".y I c. Phone No. _769- ZZ 1 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 • 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 OF being duly swon, deposes.and says that she is the applicant (Name of individual signing contract)above named, (S)He is the AL&* (ContaWr,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 kmowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this of 20 01 o Pub ' Si of AMhcant C JOYCE M.WILKINS Notary Public,State of New York No.4952246,Suffolk Coynty Term Expires June 12, ..a�t)�)