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Home My WebLink About31904-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. 31904 Z Date APRIL 12, 2006 Permission is hereby granted to: CATHERINE KONSTANTINIDES PO BOX 488 MATTITUCK,NY 11952 for : DEMOLITION OF EXISTING INGROUND SWIMMING POOL AS APPLIED FOR at premises located at 300 SUNSET DR MATTI TUCK County Tax Map No. 473889 Section 106 Block 0007 Lot No. 044 pursuant to application dated APRIL 10, 2006 and approved by the Building Inspector to expire on OCTOBER 12, 2007. Fee $ 35.00 &-~ ClJJL f Authorized Signature ORIGINAL Rev. 5/8/02 3/tfc1-?: 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: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www.northfork.net/Southold/ PERMIT NO. Examined Jj /IY, 20~ APproved-~20D V Disapproved ale Mail to: fD/(J, 20 01 Phone: 7/ 7' Z 8 z. ... 71.( Z ( Expiration ~ Building Inspector JR I 0 APPLICATION FOR BUILDING PERMIT Date 3 3/ . , 20.t2.G.- INSTRUCTIONS a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4 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 before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit sr ~ 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 the Building Inspector issues a Certificate of Occupancy. f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the property have been enacted in the interim, the Building Inspector may authorize, in writing, 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 of a Building Permit pursuant to the Building Zone Ordinance of the Town of South old, 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 regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder OLd ^ <'" .r- APpr;QVED AS t~:,)TED ~ It 4M ~/qc '"2 . AT~ i b 8. . Ii cO T Name of owner of premises a:f-her/ l1e Ko......s~L.V\"9,~ c, f'~ (As on the tax roll or latestrdeed)... ...,) -. ' ~ .... -..." ;.-- .....~.... fiT If applicant is a corporation, signature of duly authorized officer :::'0' . , "THE' 765.i802 E' '. 10 4 !',.', ,un - 0- (Name and title of corporate officer) A prJ L c.o",A- l-S r.-~' , ,...".".,n ':- ""--1,'-.,\:<:"_. ':""" "".,"'~' r:: Builders License No. Plumbers License No. Electricians License No. Other Trade's License No. P. ~ ~),-l;!\18it~G 2. '. 3, it;,' 4, FitJAL . C, . ',!:Xl MUST 8E COMPeL:t, FOR C..J, ALL CONS11',G,~:'':'': SHALL MEET THE P' 'I "Q!=I,'F'11S OF TH".~~::J[S OF NEW I . .. or "'E,;;:-ONSI8LE FOR HamPerJ?~~"':~Sr~:';UC' N CPR()R~ 1. Location ofland on which proposed work will be done: Z '-l '-l 0 St-.n V) I ~N R.. d House Number Street , County Tax Map No. 1000 Section Subdivision 10,,", B1Qck Filed Map No, 7 Lot 'i 7.-) 8 B q Lot '1'-\ IDh.-7-4"t (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Other Work Alteration C'lCWlO( ;t-.""l eoo ( (Description) 4. Estimated Cost Fee 5. If dwelling, number of dwelling units If garage, number of cars (To be paid on filing this application) Number of dwelling units on each floor 6. Ifbusiness, 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 Depth Rear Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Height Number of Stories Rear Depth 9. Size oflot: Front _Rear Depth 10. Date of Purchase _Name of Former Owner II. Zone or use district in which premises are situated .... 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO - - ~ 13. Will lot bere-graded? YES_NO_ Will excess fill be removed from premises? YES_NO_ 14. Names of Owner of premises_ Name of Architect Name of Contractor Address Address Address Phone No. Phone No Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES _NO _ * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.e. 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. 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 G...<Jettl", ) Cbi:he.-I'" III e..- /<c:w1-" \-n vlf-,',,'j t' kbeing duly sworn, deposes and says that (s)he is the applicant (Name of individual sighing contract) above named, (S)He is the (Contractor, Agent, Corporate Officer, etc.) of said owner or 8'''Rim, and is duly authorized to perform or have performed the said work and to make and file tlUs 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 before me tlUs \-t.J-k day of 20 0 k. &%2~ Signature of Applicant N Y J J:1.>---- ARNOUO COLORADO Notary Public - State '01 New Vork NO. OlC04977185 Qualified in Queens County My Commission Expire" 01-28-2007 -~-",-<~~.\,,:,~~ . \\~~ . . ; -.y' k'" v{ ;~\~, ,~ 1,0"" " ~~0"o ") ,{ ~ ""oF,.:' " r, t<.~: ~.---' ; ,.I' . 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