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Home My WebLink About31231-ZF~RM 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. 31231 Z Date JUNE 28, 2005 Permission is hereby granted to: PAUL & MARGARET RADICH PO BOX 362 SOUTHOLD,NY 11971 for : DEMOLITION OF EXISTING PORCH AS APPLIED FOR ONLY at premises located at 51170 MAIN RD SOUTHOLD County Tax Map No. 473889 Section 070 Block 0002 Lot No. 006 pursuant to application dated JUNE 28, 2005 and approved by the Building Inspector to expire on DECEMBER 28, 2006. Fee $ 35.00 ~ .- -Authyi zed '~gnature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL - SOUTHOLD, NY l19ql TEL: (631) 765-1802 BUILDING PERMIT APPLICATION CHECKLIST Do you have or need the following, before applying'? Board of Health 4 sets of Building Plans planmng Board approval FAX: (631) 765-9502 ,7 ,~ Survey ~w~v. northfork.¥17Southold/ PERMIT NO. ,D L~ -3/~ Check / Septic~o~ . / / ~.y.s.~.~.c. ~/~.~ / / Trustees Examined /j~ )~ ,20 ~ Contact: Approved Z'/~ ~ .20 ~~ .... ~.~ Mailto: / ' ,~ ', ', ~PPLICATION FOR BUILD~G PE~T-- a~Th~s a~ ~9~t~ion MUST be completely filled ~ by t~ewfiter or ~ i~ ~d submitted to the Bulldog hspector with 4 sets of pla~ a~fate plot pl~ to scale. Fee according to schedule. b. P~ plan showing location of lot ~d of bulldogs on premises, relations~p to adjo~g premises or public streets or areas, and wate~vays. c. ~e work covered by this application may not be co~enced before issu~ce of Bufld~g Pe~it. d. Upon approval of this application, the Building ~spector will issue a Building Pemit to the applic~t. Such a pemit shall be kept on the premises available for inspection t~oughout the work. e. No building shall be occupied or used in whole or h pan for ~y pu~ose what so ever ~til the Building hspector issues a Certificate of Occupancy. f. Eveo' building pe~it shall expire if the work authorized has not co~enced witch 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning mendments or other re~lations affect~g the prope~y have been enacted in the ~tedm, the Building ~spector may authohze, in writing, the extension of the pe~it for an addition six months. Thereafter, a new pemt shall be requked. ~PLICATION IS HE,BY M~E to the Bulldog Dep~ment for the issum~ce of a Bulldog Pe~it pursuit to the Building Zone Ordin~ce of the Town of Southold, Suffolk County, New York, ~d other applicable Laws, Ord~ces or Re~lations, for the construction of buildings, additions, or ahemtions or for removal or demolition as herein descried. The applicant agrees to comply with all applicable laws, ordin~ces, building code, housing code, ~d regulations, ~d to admit authorized inspectors on premises ~d in building for necess~ inspections. (Sigmmre of applicant or name, if a co~oration) (Mail~g address of applicant) l 7t State whether applic~t is owner, lessee, agent, ~chitect, en~neer, general contractor, elec~ci~, plumber or builder Nameofownerofpremises H (As on ~e tax roll or latest deed) If applicant is a co~oration, si~at~e of duly authorized officer (Name and title of corporate officer) Builders £icense No. Plumbers License No. Electricians License No. Other Trade's License No. 1. Location of land on which proposed work will be done: ~'~ 70 /~:n House Number Street Hamlet County Tax Map No. 1000 Section 7~) Block ~-- Subdivision ]>~c>po~4-,4 pre -~,~¢~ ( }o4q ~"X, Filed Map No. Lot Lot State existing use and occupancy of premtses and intended use and ta:cupancy n ,' proposed construction: ' ' ,'-. \ ' ~t~ a. Existing use and occupa~cv F~Stck¢,~_- 2 _~-~ =2 t /~t~-,[~ ~., b. Intended use and occupancy__ Nature of work (check which applicablel: New Building _. Repair xX Removal Demolition 4. Estimated Cost ~ 2~C,OC9 Fee (To be paid on filing this al)plication} 5. If dwelling, number of dwelling units 2- Number of dwelling antis on each floor If garage, number of cars R/A, Addition ~% Alteration Other W,)rk t Dcscripti on 6. If business, commercial or rnixed occupancy, specify nature and extent of each type of use. IxA/] 7. Dimensions ofexisting structures, ifany:Front 1~[-=/'5~(,,'' Rear t~( = t';'6" Depth Height fzp= i'5' ~ [z'=12%"Number of Stories ¢ P = ~ ({ ¢' - ~ Dimensions of same structure with alterations or additions: Front Depth FP ~ ~ ' 1'~ I::= 15~ Height_ 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Sizeoflot: Front '75~ ' Rear 7q3'. 5-q ~ Depth '~L<I ~'C t_ 10. DateofPurchase ]~, ~ Name ofFonner Owner ~c.ct~c ~-"-~Y)lC M __(,12~,[a£rt-~) l 1. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning lax,,,, ordinance or regulation? YES . NO 13. Will lot be re-graded? YES NO ,,~ Will excess fill be removed from premises? YES NO X 14. NamesofOwnerofpremises }'M,/~qDICH .Address (~0"5' [~p.s~L (~0PhoneNn. /(?'~ _,2.',~' ~'-~ NameofArchitect /..a.~r¢.m:_¢ F-ct*Bt'Il Address F> O, IG..2. G('pt-' PhoneNo q77 NameofContractor_ 5¢-~,f, (Uct&bav,dJt '~ddress ~01G7-'5 ,~C:L PhoneNo. '7&~_'~-c3..2~2 ~ ~4:>be~t ( vchcc,,~ 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO * IF YES, SOUTHOED TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet of a tidal wetland'7 * YES NO * 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 10 feet or below, must provide topographical data on survey. ]'~] .4 STATE OF NEW YORK) SS: COUNTYOF $~ff'~ k) 146 lc.r, (' otb, t-a~ being duly sworn, deposes and says that ts)he is the applicant (Name of individual signing contract) above named, (S)Heisthe 6L~ 0~.'~ ( C[O-x~'-2[ G~) .... (Contractor, Agenff Corporate Officer, etc. ) of said owner or o~vners, and is duly authorized to perform or have pertbrmed 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 betbre me this 2-6*" dayof rvx ~;t 20o5 John M. Judge NOTARY PUBLIC, State of New York No. 01JU6059400 Qualified In Suffolk County Commission Expires May29, 20 O ? Signature of Applicant ON .Z0/(~t251(~ ?001405 q'VO6r