HomeMy WebLinkAbout31807-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. 31807 Z Date FEBRUARY 23, 2006
Permission is hereby granted to:
CHRISTINE M ZEISLER
39-30 52ND ST APT 4D
WOODSIDE,NY 11377
for :
DEMOLITION OF A SINGLE FAMILY DWELLING AND ACCESSORY SHED AS
APPLIED FOR
at premises located at
County Tax Map No. 473889 Section 050
pursuant to application dated FEBRUARY
Building Inspector to e~ire on AUGUST
680 SOUNDVIEW AVE EXT SOUTHOLD
Block 0004 Lot No. 013
17, 2006 and approved by the
23, 2007.
Fee $ 273.20
Authorized Signature
ORIGINAL
Rev. 5/8/02
Long Island Power Authol~ty
117 Do~tors Path
Riverhead, NY I t~01
P.0[/0~
February 23~
Ms. Christine Zeisler
3930 52 Street,~ Apt. 5B
Woodside, ~ 112~77
RE:
680 Soundview Avenue Ext.
Southold
LIPA Ref. ~ T100597377
Electric Meter #017387328
Dear Ms. Zeisler:
This letter is to advise you that the electric service to the
above referenced premises was removed on February 18, 2006.
If you have any questions, please contact Dianne Danek at (631)
548-7234.
Very truly yours,
Steve Aylward
· Design Engineer
Electric Design & Construction
SA/am
TDTAL P. 01
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL ,
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www. northfork.net/Southold/
Examined )'/~ 3, 20 0 (o
Approved ~/D '_5, 20' f,~
Expiration ,20
iPERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the following~ before applying?
Board of Health
4 sets of Building Plans
Planning Board approval
Survey
Check
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to:
Building Inspector
' ;,"~
d. Upon approval of this application, the Building ~spector will issue a Building Pe~it to the applicant. Such a pe~it
shall be kept on the premises available fbr inspection throughout the work.
e. No building shall be occupied or used in whole or in pag for any pu¢ose what so ever until the Building inspector
issues a Ce~ificate of Occupancy,
f. Evew building pe~it shall expire if the work authorized has not co~enced within 12 months aRer the date of
issuance or has not been completed within 18 months ~om such date. If no zoning amendments or other regulations affbcting the
propc~y have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the pemit for an
addition six months. Therea~er, a new pe~it shall be required.
~PLICATION IS HEREBY M~E to the Building Depa~ment fbr the issuance ora Building Pe~it pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk Co~ty, 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 apphcable laws, ordin~ces, building code, housing code, and re~lafions, and to admit
authorized inspectors on premises and in building for necess~ inspections.
~ess of affpl~t)
State whether applic~t is owner, lessee, agent, ~chitect, engineer, g~eral contractor, electrician, plumber or builder
Name of own~ of prem~Z~
If applic~t is a comoration, si~ature of duly ~~fficer
(Nme and title of co,orate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Street
Section
County Tax Map No. 1000
Subdivision
(Name)
2. RC'.:.; '
4. FtN;,L -' .... :'~' ,~
B: ,':",' ',
.fro 1:'. ; ', ,., c.. "lf~T? ...... ,,2
Block Lot
Filed Map No. Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed oonstruction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal
4. Estimated Cost "~/,~2~ d'--c'-e,, /
5. If dwelling, number of dwelling units
If garage, number of cars ,,v/~
/
Addition Alteration
Demolition ~' Ot~er Work
F~eeJ) We [/' . ? . .: , , o,,, (Description)
(To b~ paid on filing this applicatitix{~
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 of existing structures, if any: Front
Height Number of Stories
Rear
___Depth
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
Rear Depth
9. Size of lot: Front _Rear_
10. DateofPurchase ~7/,.~//~"~..~ _Name of Former Owner
/
11. Zone or use district in which premises are situated
Depth
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO
13. Will lot be re-graded? YES NO Will excess fill be removed fi.om premises? YES NO
14. Names of Owner of premises Address
Name of Architect .......... Address
Name of Contractor Address
_Phonc No.
Phone No
.Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES
* 1F YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 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)
cOUNTY OF{QaA a>t~,v~S: ~,
, ,/~/-~~///~ ._~ ~ ~t~L.~ being duly sworn, deposes and says that (s)he is the applicant
· / (Name/oCdivid4al ~igfiing_ co~tr~ct~ab~ve named, /~ ,:;, ,.,
FC2 AzdWc_._ 7.,r. / / /
/ ; (Cont~~o/t~te Office/r, et~)
of said owner or owners, and is duly authorized to perf~ or have pertom~ed the smd work and to make and file this application:
that all statements contained in this application are tree to the best of his knowledge and beliel2 and that the work will be
perfo~ed in the mmmer set fo~h in the application filed therewith.
Sworn to before me this
~,~ day of ,~ Cc~4a..~b~ 20~' ,. ~
,z No~ry Public ~IAI~ED BESf~,! ' ~2~ure °f/AOPlicant r'' ~
No. 01BE612~ -
qull~ in qu~ns Goun~
~l~l~n Expi~$ Ma~h 28, ~