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Home My WebLink About35933-ZFORM NO. 3 TOWN OF SOUTROLD BUILDING DEPARTMENT Town Hall Southold, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) PEP34IT NO. 35933 Z Date OCTOBER 12, 2010 Permission is hereby granted to: JUDITH D UTTER 3125 GR3%ND AVE MATTITUCK,NY 11952 for : DEMOLITION OF EXISTING SWIMMING POOL AS APPLIED FOR at premises located at County Tax ~p No. 473889 Section 107 pursuant to application dated OCTOBER Building Inspector to expire on APRIL 3125 GRAND AVE MATTITUCK Block 0001 Lot No. 021 6, 2010 and approved by the 12, 2012. Fee $ 100.00 Authorized Signature ORIGINAL Rev. 5/8/02 T(~ OF SOUTHOLD BUILDING DEPARTMENT T 0'~~ HALL SOl THOLD, NW 11971 TEL: (631) 765-1802 FAX: (631) 765-9502 ;v;~v. northfork, net/Southold/ Exanfined Approved Disapproved Wc Expiration .20 PERSIIT NO. BI~LDING PER/VlIT APPLICATION CHECKLIST Do you have o1' need the following, before applying? Board of Health 4 sets of Buildh~g Plans Plamfing Board approval Smwey_ Check Seplic Form N.Y,S,D.E.C. Contact: Mail to: OCT - 6 2,T~O BLDG. DEPT. a;r~¢f~¢~mmi~n MUST t sets of plans, accurale plot plan to s Building Inspector :LPPLICATION FOR BUILDING PERSHT INSTRUCTIONS Date ,20 : completely filled in by ~peaq'iter or h~ i~rk and submitted to the Building Inspector with 3 ale. Fee according to schedtde. b. Plot plan showing location of lot and of buildings on p]emises relationship to acljohfing prenfises or public sn'eets or areas, alld watei~vays. c. The work covered by this applicalion may nol be cmmnenced betbre issuance of Building Pernfit. d. Upon approval of this application, the Building h~spector will issue a Building Pemfit to the applicant. Such a pemfil shall be kept on the prenfises available for inspection fln-ougbout the work. e. No Nfildmg shall be occupied or used in whole or fl~ pan lbr any propose what so ever tmtil the Buil~ng Inspector issues a Certificate of Occupancy. f. Evmj building pemfit shall expire if the work authorized has nol connnenced witNn 12 montlB after lhe ~te of issuance or bas not been completed wilbin 18 monfl~s fi'om such date. If no zonh~g amendments or other reg~flaftons afl~cting the 1)~ope~1y have been enacted in Ibc interim, the Building Inspector may authorize, in wrifing, tl~e extension of the pemfit for an adchtion six months. Thereafter. a new pemfit shall be requh'ed. ~PLICA~ON IS HE,BY N~E Io the Building Depmlment for the issuance of a Building Pemfit pursuant to the Building Zone Ordinance of the Town of Somhold. Suffo~ Cotm~,. New York, and other applicable Laws, ~'dinances or Regulations, for the construction of buildh~gs, additions, or alterations or lbr removal or demolifion as herein described. The applicant a~'ees to comply with all applicable laws, ordinances, building code. housing code. and regtflations, and to aufl~orized htspectors on prenfises and in building 1br necessaw inspections. (Sipmm~f a~plicant or ri&ne, if a co~po]a6on) (Marling ad&'ess of apphcant) State xvhether applicant is owner, lessee, agenl, archilect, engineer, general contractor, eleclrician phunber or builder (As on file tax roll or lalest deed) If applicant is a coq)oralion, signature of duly authorized officer (Name and title of cmporate officer) Builders License No. Plumbers License No. Electhcians License No. Other Trade's License No. 1. Location of land on which proposed wg, rk will be done: gW Honse Number Sl~eel Hamlel Cram, Wax Map No. 1000 Section 1~7'~ Block Ol-~ Subdivision Filed Map No. (Name) Lol Lot 3. Nature of work (check which applicable): New Buildin~ Addition Aheration Repair Removal Estimated Cost If dwelling, nmnber of dwelling units If garage, number of cars Demolition~_~J, Off,er Work ~/51X It~ (Description) Fee (To be paid on filing this application) Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nann'e and extent of each type of use. 7. Dimensions of existing structures, if any: Front Height Number of Stories Rem' 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 Rear Depth 9. Size ofloh Front Rear Depth 10. Date of Purchase Nanle of Forlller Owller 11. Zone or use district in ;vhich prenfises are situated 12. Does proposed construction violate any zoning law, ordinance or regtflation? YES NO 13. Will lot be re-~m'aded? '~qSS __ NO__Will excess fill be removed from prenfises? YES NO t 4. Names of Oxw~er of premises Name of Architect Name of Contractor Address Phone No. Address Phone No Address Phone No. 15 a. Is this properly within 100 feet eta tidal wetland or a fi'eshwaier wetland? *YES * IF 5TS, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQE~RED. b. Is this properly within 300 tee/of a tidal wetland? * h~TS NO * IF YES, D.E.C. PEPd¥IITS MAY BE REQUIRED. NO 16. Provide sm'vey, to scale xvifl~ accm'ate fonndafion plan and dislances to properly lines. 17. If elevation al any point on property is at 10 feet or below, must provide topogral)hical dala on smwey. STATE OF NEW Yeti) SS: COUNTY '~-~J~ ~,, {_1T'~t:~ P-~ being dnly sworn deposes and says lhat (s)he is the applicant (NaS;~e of individual si~ffng contrac0 above named, (Corm'actor. Agent. Cmporate Officer. etc.) ~ :ai4owner e:' c':."nert, and is duly authorized to perform or have performed the said work and to make and file tiffs application: that all statements contained in this application are tree to the best of his knowledge and belief: and that the work vdll be performed in the manner set forth in the application filed therewith. Sworn to before ,ne this 4TI+ dayof (~°---Tt'"% ~ 20 16 Notary hfl~lic / dANIGE M. OLSEN / Not, Bt PuNic, State o~ New'fork { No. 01 0L4527177 - Suffolk Co u nty/'/..~. Commission Expires, March 30, 20_/./ Sig~,6n-e cffApplicant i OWNER TOWN OF SOUTHOLD PROPERTY STREET VILLAGE W RECORD ACR. CARD SUB. LOT SEAS. VL. FAPJ~ cOMM. CB, MISC. Value F BUILDING LAND IMP. AGE NEW FARM Tillable I t'illabIa 2 P~liable 3 Noodland NORMAL TOTAL DATE BUILDING REMARKS Value Per Acre hvomptand J~ushiand FRONTAGE ON WATER. FRONTAGE ON ROAD DEPTH BULKHEAD DOCK X?~- Extension Porch ~.:l~.~t C~ u'¢ y,' p Porch Br~ez~,oy . ,,','/~./ L..~/ !1tl I I I I I M_I;:~:I I ~"~ I I I I I I I t I !-'T", ! ':"I~"I tP.I I I ~/4_! /111'11111111 i I I J,~i'bJ. L4~t I i1~t. r l , I I I I l'Fk~1~ IiFTI i / I I I I I t I' 'l'l I'~'/1~'1'1 '1tll I I 1 t I 1 I I I I I'"l~ 1 I I I I I I t I 1-1 I I I I J 1 I t I I I I .I I ,Os.me.f Fut/ Fio~,s- Type Roof Rooms |st Floor Rooms 2nd Floor Dormer Dr ivev,~y -.-[