The URL can be used to link to this page

Home My WebLink About35565-ZFORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. (THIS BUII/)ING PERMIT PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 35565 Z Date MAY 18, 2010 Permission is hereby granted to: JOYCE OLSON 235 W 76TH STREET NEW YORK, NY 10023 for : DEMOLITION OF AN EXISTING SHED AS APPLIED FOR at premises located at County Tax Map No. 473889 Section 098 pursuant to application dated MAY Building Inspector to expire on NOVEMBER 160 SMITH RD PECONIC Block 0003 Lot No. 038 3, 2010 and approved by the 18, 2011. Fee $ 70.00 Authorized Signature ORIGINAL Rev. 5/8/02 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL' SOUTH(~LD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 SoutholdTown. NorthFork.net Examined Approved (I 1~20 I O Disapproved a/c Expiration PERMIT NO. > 5 ~-~ % 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 Contact: Phone: ~ ~ ~ ~ ~ ~ ~1~ Building Inspector ~'~ LICATION FOR BUILDING PERM1T AY - 3 2010 Date ,20 IO INSTRUCTIONS BLDG. DEPI. This appli~ ~e ccmTk ely filled in by typewriter or in ink and submitted to the Building Inspector with 4 sets of ,la~ccurate 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 wate~ays. c. The work covered by this application may not be commenced before issuance of Building Pemit. d. Upon approval of this application, the Building Inspector will issue a Building Pe~it to the applicant. Such a pe~it shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pa~ for any pu¢ose what so ever until the Building ~spector issues a Ce~ificate of Occupancy. f. Eve~ building pemit 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 intehm, the Building Inspector may authohze, in writing, the extension of the pemit for an addition six months. Thereafter, a new pe~it shall be required. ~PLICATION IS HEREBY M~E to the Building Depamnent for the issuance of a Building Pemit 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 deschbed. The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa~ inspections.~ (~~~ ~~~ ~ · - of pp,,cant qb (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises '~O'q CC OlSO}q (As on the tax roll or latest deed) 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 of land on which p, roposed work will be dore: House Number Street Hamlet County Tax Map SOl IQ.~00 Section Subdivision ~/~{> ~: fld01')lA/~ .~_CJ~_ Block (~,,~ Filed Map No. ff_~l Lot O,~7 Lot \gl State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~qCOraq~ ~he~ -Oa~,x 47~v~t~'0rx · b. Intended use and occupancy 3. Nature of work (check which applicable): New Building_ Demolition y" 4. Fee 5. Repair Removal Estimated Cost If dwelling, number of dwelling units If garage, number of cars Addition Alteration Other Work (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. X7. 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 X9. Sizeoflot: Front Rear ×10. Date of Purchase Name of Former Owner Rear .Depth .Depth ~. ~ 11. Zone or use district in which premises are situated ] 2. Does proposed construction violate any zoning law, ordinance or regulation? YES NO 13. Will lot be re-graded? YES NO v/ Will excess fill be removed from premises? YES __ NO__ 14. NamesofOwnerofpremises '~6'~Ce OISon Address b!q N'a IOO~Z Phone No. ~/~ qgq-~q7 Name of Architect Address ' ~ Phone No Name of Contractor Address Phone No. 15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES * IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED. b. Is this property within 300 feet cfa tidal wetland? * YES NO * IF YES, D.E.C. PERMITS MAY BE REQUIRED. NO v/ x 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 · IF YES, PROVIDE A COPY. NO c/' STATE OF NEW YORK) < .CNs: COUNTY OF--~ t \ ~ being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, CONNIE D. BUNCH Notary Public.State of New Yon~ (S)He is the Nn mmmmqn~n (Contractor, Agent, Corporate Officer, etc.) ~ Oualifie~l~,~[~l"k-(~o'unty ~.~ u0mmission Expires Apd114,20; oL 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. Notary Publi~ '~ Signature of Applicant m MAp OF