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Home My WebLink About33882-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. 33882 Z Date MAY 8, 2008 Permission is hereby granted to: PATRICK ADIPIETRO PO BOX 192 PECONIC,NY 11958 for : DEMOLITION OF AN EXISTING BARN AS APPLIED FOR at premises located at 2980 PECONIC LA PECONIC County Tax Map No. 473889 Section 074 Block 0003 Lot No. 016 pursuant to application dated MAY 5, 2008 and approved by_ the Building Inspector to expire on NOVEMBER 8, 2009.~J Fee S 292.60 ~~~ ~! ~.~/_// o zed S~[gnature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown.NorthFork.net 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 Flood Permit Storm-Water Assessment Form ........... :i'T,:' ' -.~ Buil~ting Inspe 5r ~ APPLICATION FOR BUILDING PERMIT Date INSTRUCTIONS Mail to: Phone: ,20 O~ - .a'~'T"Ng~b~ilc~i~ 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 befbre 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. 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 Southold, 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. '/~ a~re of a[::~a corporation, (M~filing address of applicd'nt) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, Name of owner of premises .: :~,~ ~i (As on the 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. 1. Location ofland..p~which l~roposed work will be done: House Number Street County Tax Map No. 1000 Section '"fi J7/-- Subdivision Block -- Filed Map No. - - 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /~'e .5iff~r,~/,- b. Intended use and occupancy ~$,' O e,,~0 ~ 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition J Other Work Estimated Cost :~ ~ c.~r) ~ Fee If dwelling, number of dwelling units If garage, number of cars _ (Description) (To be paid on filing this application) 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 ofexisting structures, if any: Front ~4tO f~ Rear '~C? lC- .Depth ~ .~, Height ~ ff'/~- Numberof Stories / Dimensions of same structure with alterations or additions: Front Depth. Height Number of Stories Rear 8. Dimensions of entire new construction: Front Rear .Depth Height Number of Stories 9. Size of lot: Front / ~o~ /~f7- Rear ~ ~ ~ ff~- Depth 4'L tCi~ ~'~7~- lO. DateofUurchase/~/ /7~/~ Name ofFormer Owner L/? o~>~ 11. Zone or use district in which premises are situated ./~.,)0/~// 5'//0d'5~ f 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. Nines of Owner ofpremtse(~L ~ Addres~ 0> :fl Ilql: Phone No.6 [-7:~' q/lC Name of Architect Address ~ Phone No Name of Contractor Address Phone No. 15 a. Is this prope~y within 100 feet of a tidal wetl~d or a freshwater wetland? *YES NO ~ * IF YES, SOUTHOLD TO~ TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this properly 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. 18. Are there any covenants and restrictions with respect to this property? * YES NO ~ · IF YES, PROVIDE A COPY. STATE OF NEW YORK) 0 f7 a, ss: COUNTY OF ~J~) ~D }Z?44 ~ 'i F)i O~4'Y~ being duly sworn, deposes and (Name of individfial signing contract) above named, Jj~He is the says that ~he is the applicant (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 applicatiom 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,