HomeMy WebLinkAbout29782-ZFORM 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. 29782 Z
Date OCTOBER 3, 2003
Permission is hereby granted to:
JAMES & LAURA MANNETTI
6206 SUGAR HILL DR
HOUSTON,TX 77057
for :
DEMOLITION OF A AN EXISTING SEASONAL RESIDENCE (744 SQUARE FEET)
AS APPLIED FOR
at premises located at OFF AVE B
County Tax Map No. 473889 Section 006 Block
pursuant to application dated SEPTEMBER 29, 2003
FISHERS ISLAND
0002 Lot No. 020
and approved by the
Building Inspector to expire on APRIL
Fee $ 101.60
3, 2005.
ORIGINAL
Rev. 5/8/02
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (63I) 765-9502
www. north fork.net/Southold/
PERMIT NO.
Approved__
Disapproved a/c
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following, before applying?
Board of Health
3 sets of Building Pkans
planning Board approval
Check
Septic Form
APPLICATION FOR BUILDING PERMIT '
INSTRUCTIONS Date ~///
a. This application MUST be completely filled in by typewriter or in ink and submiRed to the Building Inspector v~ith 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 befoie i~suance of Building Pemtit.
d. Upon approval of this apphcation, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shah be kc-pt on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any pm'pose what so ever untit the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 momhs aRer the date of
issuance or has not been completed within 18 months fi-om such date. [f no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in w~iting, 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 ora Building Permit pursuant to the
Building Zone Ordinance o f the Tow~ o f Southold, Suffolk County, New York, and other app[icabla Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for ten,oval or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, ha~sing code, and regulations, and to admit
authorlzed inspectors on premises and in building for necessag, inspeedons. /
~ ( Signature of apl~licant or name, if.~n~nm~
(Mai~g address o f appl/can
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
Nameo£ownerofpremises '~'~//~g '9~ ,L~o[~/~
(As on the mx 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.
I. Location .o f land on which prJ~posed work .~i11 lflpg .dfkn~g:
House Number Street F~arhlet /
County Tax Map No. 1000 Section ~O, Block 0~,~. Lot
Subdivision Filed Map No. Lot
(Name)
,06
o,).o.
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Imendeduse and occupancy ~-~ ~/~-)~,~]T-{
3. Nature of work (check which apphc~abte): New Building ,~ Addition
Repair Removal ~,/ Demolition ~ Other Work
5. I f dwelling, number o f dwelling units
If garage, number of cars
Alteration
(Description)
(To be paid on filingthisapplication)
Number ofdwellingunitson each floor
6. [f business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front r-grg. / Rear c~a0- / Depth
Height J C~/ Number of Stories- ]
Dimensions of same structure with alterations or additions: Front Rear
Depth. .Height
8. Dimensions of entire new construction: Front
Height Number of Stories
9. S eof]o. Pront '76 / Rear 75
Number of Stories
Rear
Depth
.Depth
10. Date of Purchase I /~F NameofFormerOwner. k/ALE,
I 1. Zone or use district in which premises are situated ~/~'/o-]--/g&- L_
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO V
13. Will lot be re-graded? YES lt//NO Will ex,cass fill be removed from premises? YES'NO_
Name of Contractor Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEPS & D.E.C. PERMITS MAY BE ~,I~QUIRED.
b. Is this property within 300 feet of a tidal wetland? * YES NO
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to propeay lines.
17. [f elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF
,~/cJ-,r~ ~/t~ i~t~/e~/~ ~" 7~r being duly sworn, deposes and says that (s)he is the applicant
(S)He i¢iati~ ° f in~°intact) above named,
(Contractor, Agent, Corporate Officer, etc.)
of said owner or o~cners, and is duly authorized Io perform or have performed the said work and to make and file this application;
that all statements contained in this application are rose 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.
Notmy Public
'~-.-- - ~m. Exp. ~.-L j
Si-gna{ute 6 f'Applicant
~E ,JR.
N/F
DONALD E. VIOLA
MEYER
N 5,569.[6
W 1~108.79
RONALD ~ MARY ANN RODD
N B7'OO'30'E ~
Area = 7,745 s.f.
Owell i n c.J
foundOtion
Dwelling
L
N/F GUISEPPE ~ROSEMARY
F. RIPANTI
/
N/F ANTHONY MARSHALL
WILLIAM R.
RUTH H.
BLOETHE
[-INE BEARING D
3 S B7'OO'30"W