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Home My WebLink About35278-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. 35278 Z Date DECEMBER 31, 2009 Permission is hereby granted to: BRADLEY ANDERSON 3820 SOUTH HARBOR RD SOUTHOLD,NY 11971 for : DEMOLITION OF 18'X 80' BARN AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 075 pursuant to application dated DECEMBER Building Inspector to expire on JUNE 2120 SOUTH HARBOR RD SOUTH/¥~ Block 0007 Lot No. 002 22, 2009 and approved by the 3~, 2011. Fee $ 412.00 Authorized Signature ORIGINAL Rev. 5/8/02 / ,Y J No. 1000-75-07-02 S.C. TAX No. 1000-75-07-03 THE EXI~T£NCE OF' RIGHT OF' WAYS AND/OR EASEMENTS OF' RECORD, Itr TOWN. OF~OUTHOLD BUILDING DEPARTME~NT TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 www. northfork.net/Southold/ Examined ?)~7(~ f, 20 f Approved /'~/¢[, 20~ Disapproved aJc PERMIT NO. J~ ~ fJ ~ 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: Phone: Expiration [* / 3~ , 20// .._...._._,~TOW~, O~ SOUr~O[D , Building Inspector APPLICATION FOR BUILDING PERMIT Date '~) ~_..C1~'~--3~ "2.2---, 200 ~ 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. 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. (Signature of applicant or name, if a corporation) (Mailing address of applicant) · en lneer eneralcon~t~act-~or [l[c~trici3~ State whether applicant is owner, lessee, agent, architect, g' , g , ' ' , plumber or builder ameofownerofpremises P.A-D 6 (As on the tax roll or latest deed) If applicant is a corporation, signat~e_of duly aut,horized officer (Name and title of corporate officer) License NO. Builders Plumbers License No. Electricians License No. Other Trade's License No. Ho~s~eNumber %{20 ,,qj, H/~f~Op,~ ('oxlD Street Hamlet County Tax Map No. 1000 Section Subdivision (Name) Block 0 "7 Filed Map No. Lot Lot 2. State existing use and occupancy of premises and intended use and occupancy of prop0sed.construction: a. Existing use and occupancy b. Intended use and occupancy_ '~ "~_., ~)t~Dq0t..t~l--~D. Nature of work (check which applicable): New Building Repair Removal Demolition Addition Alteration Other Work Estimated Cost 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. /kJ '/fix 7. Dimensions of existing structures, if any: Front t~O Rear ~D Depth Height ! ~ ~ Number of Stories Dimensi~ of same structure with alterations or additions: Front ~ O Rear Depth ~ Height Number of Stories 8. Dimensions~entire new construction: Front Rear Depth Height ~ Number of Stories 9. Size of lot: Front Q. 5C~o 'Z5 t · Rear It ~ct'5-,I Depth I,'2zgB_ -//. 10. DateofPurchase /~>~[t~ WoO Name ofFormer Owner J~A 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO N~ 13. Will lot be re-graded? YES NO '-~ Will excess fill be removed from premises? YES 14. NmnesofOwnerofpremises t~ ~.-P..S',~( Address ~qS~ ~'. t'(A-t~tSot-< PhoneNo. Name of Architect Address Phone No NameofContractor H0 ~/~'T IPO · Address pDh~>c I~'-/ PhoneNo. 15 a. Is this property within 100 feet of a tidal wetland or a keshwater 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. NO >(. 754 - 74 7q- 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 S O '~---T~I2~ ,~ -[D O'U/~ 1~0 ~-~ ~-~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. (S)He is the ~ ~,,J~/_, ~ tx3 k-N~ C-('D ~ · Notary Public, State of New ¥~ (Contractor, Agent, Corporate Officer, etc.) Quah]'l~n"§u'~'~'~o~n~ Commission Expires April 14.20 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 tree 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 ~ ~c-,~ day of~ C~ r¢,~ 20~} Notary Public Signature of Applicant