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Home My WebLink About38834-Z TOWN OF SOUTHOLD N" BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY ,fir 'ice 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#: 38834 Date: 4/30/2014 Permission is hereby granted to: Giorgi, Alessandro C/O San Simeon by the Sound 61700 Route 48 Greenport, NY 11944 To: Demolish an 8' X 10' shed as applied for At premises located at: 235 Bailey Ave, Greenport SCTM # 473889 Sec/Block/Lot# 34.-4-4 Pursuant to application dated 4/21/2014 and approved by the Building Inspector. To expire on 10/30/2015. Fees: DEMOLITION $124.00 Total: $124.00 Building Inspector TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT , Do you have or heed the following,'before applying? TOWN HALL Board,of Health - SOUTHOLD,NY 11971 4 sets of Building Plans TEL: (631) 765-1802 Planning Board approval FAX: (631) 765-9502 Survey SoutholdTown.NofthFork.net PERMIT NO. Check Septic Form N.Y.S.D.E.C. Trustees Flood Permit Examined 20 Storm-Water Assessment Form ontact: t Approved 20/ Mail to: Disapproved a/c APR ,2 2014 � Phone: C; 20 Expiration - p TrY - �`iOLD Building Inspector APPLICATION FOR BUILDING PERMIT Date 20 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 inspe'ctioii'throughotit 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.sueh date:If no.zQning amendments or other regulations affecting the property have been enacted in the.interim,the Building InspectorattY authorize,in writing,the extension ofilit'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,Nqw 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. J e !a (Signature of appl' or nafifi,if a corporation) P0 BOK Yoa mikdr,,ck- 4�� (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,plumber or builder Name of owner of premises g-�-� ,� I' L2 (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 f land on which 9wilt",oposed work will be done: t/ House Number Street Hamlet County Tax Map No. 1000 Section " Block Lot Subdivision Filed Map No. Lot f 2. State existing use and occupancy of premises dint nded use and occupancy of proposed construction: a. Existing use and occupancy S �� b. Intended use and occupancy 3. Nature of work(check which applicable):New Building Addition Alteration Repair Removal Demolition Other Work (Description) 4. Estimated Cost Fee (To be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use. F��.� 7. Dimension of exisng structures, if any: Front Rear Depth j o Height FLt �,mcl -e Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories 8. Dimensions of entire new construction: Front Rear Depth Height Number of Stories 9. Size of lot: Front - LO (t-t .� Rear —7(') Depth 140 10. Date of Purchase LName'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 NOZ 13. Will lot be re-graded? YES NO_�/Will excess fill be removed from premises?YES NO� 14.Names of Owner of premise €a Address b :.`� {I . Phone No. _ Name of Architect : DM 1.f orb y.. Address ,, .0�;1�� 4 _- Phone No :53—�r Name of Contractor Address " } :,F Phone No. 15 a. Is this property within-100 feet of a tidal vvetland-or a freshwater wetland? *YES' NO * IF YES, SOUT'HOLD TOWN TkbSTBES'&D.E:C. P ITS MAY B REQUIRED. b. Is this property withinJ06 feet of 6' wetland? * Vs `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 NOVL" * IF YES, PROVIDE A COPY. STATE OF NEW YORK) SS: COUNTY OF ) being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, CONNIE D.BUNCH (S)He is the (1 Notary public,Steele of New York (Contractor,Agent,Corporate Officer,etc.) �pryed Suffolk County // Commission Expires April 14,��(P 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 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 — �day of 20 Notary Public Signature of Applicant G O� R R� o 1�0 O G S� O O � �o .p N°WN M. (5yk\r oOP \,40.00,4O'O° %p p \4O • O, 0 �3 m GONG' 0-6 0 pp, or- 6 N,p Np .{ NK r- °�