HomeMy WebLinkAbout31875-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.
31875 Z
Date MARCH
30, 2006
permission is hereby granted to:
T BONANNO
163 SMITH RD
SOUTHOLD,NY 11971
for :
DEMOLITION OF AN EXISTING ACCESSORY GARAGE AS APPLIED FOR
at premises located at
1630 SMITH RD
PECONIC
County Tax Map No. 473889 Section 098
Block 0003
Lot No. 022
pursuant to application dated MARCH
28, 2006 and approved by the
Building Inspector to expire on SEPTEMBER 30, 2007.
Fee $
44.00
1'-1;{~ ~
, Authorized Signature
ORIGINAL
Rev. 5/8/02
L
,lOR 2 0
DOROSKI ELECTRIC, INC.
ElECTRICJ\l. CONTRACTOR
LICENSE .Z941-E
P.O. BOX 781 . CUTCHOGUE. N.Y. 11935
734-7523 4 -/ g -OG
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A "INANC:IAI. CHARGE OF I Ill.'*, PER '-40 (ANNUAl RATE l8'tbl WRl. RIi AOUEOAFtf,t 30 DAYS
Cd W\J6E:60 ~ Bt ....dtJ
!ZSL~ ts::'3t "CJ-l 3Qid
:J-.II :) I aLJ313 I>B:lIDI : WJl:I~
oN' i%..v
FORMER OWNER ~
pIj"J7: wtie <f kJ'
fl ~/ "r' ~ S
/ , ,. ...'" ,>0 f
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600 -
OWNER
RES.
LAND
_ 'to 0
Lf~O
ydO
o 0
AGE
NEW
Form
Tillable
Tillable 2
Tillable, 3
Woodland
Swampland
Brushland
'-
House Plot
Total _ _
( i
9"t - J' - 2-)... TOWN
,
;
M-21PCc
.s '
OF SOUTHOLD HOPERTY RECORD CARD
b ?'O DISTRICT SUB.
7 y
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'c.,..yt.-<
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ACREAGE
, 1 ..Ie
TYPE OF BUILDING
~
L'
~.-,>
W
/\ r"" JAr "
U/, e JI;J i-y l/V66 (i . r..!...
SEAS. # VL
I IND.
Est. Mkt. Value
I CB.
I MISe.
COMM.
FARM
IMP.
TOTAL
DATE
REMARKS
(j()
I
FSr ..2.;)C> D
:;k ,f>O
J- 7 {)O
.J.26d
NORMAL
BUILDING CONDITION
BELOW
ABOVE
FRONTAGE ON WATER
FRONTAGE ON ROAD -IV'!. /9
BULKHEAD
DOCK
Acre
Value Per Acre
Value
-
...,,-
--
"'.._..~._-'-_.- _~,~. .._.,_._______.~u.. .._,_._--_.--_.~
M. Bldg. Foundation
Extension "'J ]15
70 Bosement
Extension .
.J.. J(2. t' - 3.3! Ext. Walls
-
Extension , Fire Place
I
n'j \2y.:z~ ~! _I
, M'\v 300
.. ::: 7!j
.'
Breezeway
Patio
Garage
ci.,D'1-..r'6:.3(,o
sO ,
I 8 0 Driveway
O. B.
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r:
<==13"
hll
I
Irterior Finish
Heat
Porch
Roof Type
Porch
Rooms 1 st Floor
Rooms 2nd Floor
Dormer
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Expiration
,20_
()WJ~
i Building Inspector
BUILDING PERMIT APPLICA nON CHECKLIST
Do you have or need the following, before applying?
Board ofRealth
4 sets of Building Plans
Planoing Board approval
/Survey V /
Check ;./
Septic Form
N.Y.S.D.E.C.
Trustees
Contact:
Mail to: 1Ji:;;u~ B:wA-/JN6
10/!J(VtXJ'D Ae fb /3:,';"(;7>
PhonepT Lcok~ /VI /lf67
51 h f?-&1 - <./1/'/0
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
www.northfork.net/Southoldl
PERMIT NO. JK?j ~
Examined
') 1f> , 20 0 Ip
/}. /)tJ, 20si:L
Approved
Disapproved ale
MAR 28
APPLICATION FOR BUILDING PERMIT
Date
3- 2-8
,20 Db
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
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 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.
APPLICA nON 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
Name of owner of premises ~fVy i SaM botJ4tJIJb .'\PPROV:O :\S ~;JTED
(As on the tax roll or latest deed) .' /. '.. '
If applicant is a corporation, signature of duly authorized officer DATE: 1/"'~/L. Er I', :.JtY 7, r
FEE: '/'1.: . f.-i( -
(Name and title of corporate officer)
NCHi
y BU.L~:
",') e ,!'.\'
C" ,'H, AT
. ~/i i:C;:: THE
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1.
,
2.
..,
3.
4. . ,
'..j ;:"....
',',i~1
1. Location ofland on which proposed work will be done:
L'(
County Tax Map No. 1000 Section
Subdivision
(}('
Block
Filed Map No.
~
.. f.."ET
HamlftEQU E,_,/~ , \.-'. .:,;;: NEW
b~~116~T2~:C~~~~;~S:~~~~~~~
Lot
House Number
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy Ck\-1ll'\b-12.
O-J1A-
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building
Repair Removal 'f- Demolition 'f..-
4. Estimated Cost &-')ov. C/I)
Addition
Other Work
Alteration
(Description)
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 ~ It
Height Number of Stories I
Rear
If'
Depth
'k
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
L~ T>>i=12-
10. Date of Purchase
/17-r-
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-2S:
'.
13. Will lot be re-graded? YES_NO 'f--. Will excess fill be removed from premises? YES_ NO_ .
11. r 0.. ~ 14>70 SSI-lirU.. rl-/) j, _
14. Names of Owner ofpremisesl1Ui4?~ 7 JOtW ~ddress peuMA L ~'1 Phone No. 'iP~175Y~2S 7
Name of Architect Address Phone No
Name of Contractor TIM ~r;;pz..'{ Address ~--hs Ll> M./ 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.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.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on propeliy is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
(Contractor, 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 knowledge and belief; and that the work will be
performed in the manner set forth in the application filed therewith.
Sworn to before me this
day of
20
Signature of Applicant
Notary Public