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Home My WebLink About39478-ZPermit #: 39478 TOWN 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) Permission is hereby granted to: Souravlis, Hrisovalantis & Souravlis, Ana 21-36 38th St Astoria, NY 11105 To: Demolition of an accessory shed as applied for. At premises located at: 820 Sigsbee Rd, Laurel SCTM # 473889 Sec/Block/Lot # 143.-1-10 Pursuant to application dated To expire on 7/9/2016. Fees: 12/29/2014 Date: 1/812015 and approved by the Building Inspector. DEMOLITION $176.80 Tntnl P 17F R(1 Building Inspector TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST BUILDING DEPARTMENT Do you have or need the following, before applying? TOWN HALL SOUTHOLD, NY 11971 TEL: (631) 765-1802 FAX: (631) 765-9502�� So u tholdTown.NorthFork. net PERMIT NO. Examined , 20 1� Approved _,20 Disapproved a/c DEC 2 9 2014 BLDG. DEPT. TOWN OF SOUTNOLD Building Board of Health 4 sets of Building Plans Planning Board approval Survey Check Septic Form N.Y.S.D.E.C. Trustees C.O. Application Flood Permit Single & Separate Storm -Water Assessment Form Contact: Mail Phone: APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Date 20 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 oriii'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, an to admit authorized inspectors on premises and in building for necessary inspections. ( ignature of applicant or �na e, if a 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 r S-0 \/ s So') r- Gl l,. (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. of land on which proposed work 1 be done: d .Si SSZPC' A House Number ,lIckAl.yk Hamlet County Tax Map No. 1000 Section 143 Block Lot �� Subdivision 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 Buildir Repair Removal Demolition 4. Estimated Cost �Fee Addition Alteration _Other Work (Description) I (To be paid on filing this application) 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. 7. Dimensions of existing structures; if any: Front Rear Depth Height Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth Height Number of Stories ?; Dimensions of entire new construction: Front Rear . Depth Height Number of Stories - 9. Size of lot: Front Rear Depth 10. Date of Purchase' 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 14. Names of Owner of premises .....:.. .........._,.a, Address : _:.. _. _ ..: • , 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 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 NO * 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, (S)He is the (Contractor, Agent, Corporate Officer, etc.) 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. S',orn too pefore this G C1.`IJ►1 day of 20 Notary Public Not ublic, State of New Y01K Signature of Applicant No. 01 BU6185050 Qualified in Suffolk County Commission Expires April 14, 2_U) ( Existing Shed Demolition There is an existing shed which will be removed and disposed of on the property at 820 Sigsbee Road Mattituck New York 11952. Waste and disposal by Mattituck Environmental 800 Wickham Ave Mattituck New York 11952. Shed dimensions are 16.3 by 16.2. H.Souravlis