HomeMy WebLinkAbout36231-ZTOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 36231 Date: 3/9/2011
Permission is hereby granted to:
Pindar Vineyards LLC
591-A Bicycle Path
Port Jefferson Sta, NY 11776
To:
Removal of existing farm building as applied for
At premises located at:
37645 Route 25, Peconic
SCTM # 473889
Sec/Block/Lot # 85.-2-15
Pursuant to application dated
To expire on 31812012.
Fees:
2/2212011
and approved by the Building Inspector.
DEMOLITION
Total:
$I00.00
$100.00
Building Inspector
TOWN OF SOIdTHOLD
BUILDING 'DEPARTMENT
TOWN HALL
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
SoutholdTown.NorthFork.net
Disapproved a/c
Expiration
PERMIT NO.
BUILDING PERMIT APPLICATION CHECKLIST
Do you have or need the fbllowing, betbre 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:
Mail to:
' Building Inspector
ICATION FOR BUILDING PERMIT
Date
..... INSTRUCTIONS
a. This application MUST be completely filled in by typewriter or m 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 ac[joining 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 v~riting, 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 ofbuildings~ additions, or alterations or lbr removal or dem~olition as h~ein described. The
applicant agrees to comply with all applicable laws, ordinances, building code,.)3~g ,_ct°'del and regulati/~s, and to admit
authorized inspectors on premises and in building lbr necessary inspections.X' ~d.~ '~/J~~__~ ,...] ~
I (Sit,hate'-re of applicant or name, ifa 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 e. todo4'u. i')am ia q0 S
(As on the tax roll or latest deed)
If applici~n,t is a co~oration, si~ature of duly authorized officer
(Name and title of co,orate officer)
Builders LicenseNo.
Plumbers License No.
Electricians License No.
Other Trade's License No.
Location of land on wl3ich propo~sed wqrk wil~.~e done:.
House Number Street
Hamlet
County Tax Map No. 1000 Section
Subdivision
lO00
Filed Map No.
,-:. , ~ Lot
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy
b. Intended use and occupancy
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal )q, Demolition Other Work
Estimated Cost S ~00. O0
If dwelling, number of dwelling units
If garage, number of cars
Fee
(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 of existing structures, if any: Front ~ 0 t Rear ~ 0 ~ _Depth
Height I t~ ~ Number of Stories
Dimensions of same structure with alterations or additions: Front
Depth Height Number of Stories
Rear
8. Dimensions of entire new construction: Front Rear
Height Number of Stories
Depth
9. Size of lot: Front Rear Depth
10. Date of Purchase I q °t 0
Name of Former Owner
11. Zone or use district in which premises are situated
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 from premises? YES__ NO
,,_ , ~ ,~_ Por'l' ff',iq: gR, a~o~
14. Names of Owner of premises 0ieeoao'hiS Pamia,,~ddress Sql I~ ,oi c,lctt r~-r', Phone No.
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 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 Ibundation 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 ~
STATE OF NF~,W YORK)
COUNTY OF2 0 ~ ~S~._
~1 vltt&l- 9o.,~_,.¢,.,.~ e~ ,., being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(Contractor, AgenL Co~Jorate Offer, etc.)
of said owner or owners, and is duly authorized to pertbrm 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 t~belbre me this/~ , }// ,t
~t /~ dayof ~L~ 20 [~ ~/
Nota~ u ~ Publi~ S~m ofN~ Y~
No. 01LI611~
~llficd h S~olk C~
I Signature of Applicant