HomeMy WebLinkAbout40643-Z ,t,,-004 ; TOWN OF SOUTHOLD
X0`9 k BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
oy o� SOUTHOLD, NY
ti�ol a
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#: 40643 Date: 4/26/2016
Permission is hereby granted to:
Jarusiewic, Mary
705 Hummel Ave
"PO BOX 472
Southold, NY 11971
To: demolish an existing barn as applied for.
At premises located at:
705 Hummel Ave., Southold
SCTM # 473889
Sec/Block/Lot# 63.-2-21
Pursuant to application dated 4/19/2016 and approved by the Building Inspector.
To expire on 10/26/2017.
Fees:
DEMOLITION $238.60
Total: $238.60
Building Inspector
TOWN OF SOUTHOLD ' BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENTDo you have or need the following before applying?
TOWN HALL " '' :f Board of Health
SOUTHOLD, NY 1197-1 4 sets of Building Plans ; '
TEL: (631) 765-1802 Planning Board approval I
FAX: (631)765-9502 - - L Survey I
SoutholdTown.NorthFork.net PERMIT NO. �✓ , 3 M Check
_ '''"' 'Septic'Form'
;, .,,- , :,i ; .3 N.Y.S.D.E:C.' „
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Trustees
' ECEu_v� C.O.Application
Flood Permit i'
Examined •,20` r Single&Separate
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APR <<'R; Storm-Water AssessmenYiForm
ntact jv„,me___ �j , dti"
Approved- __ ,-(0,2� 8 1 : }—•; l ��
Disapproved a/c `
h 1 S,.UTHOLD ' ' ((,3-l `1 Lei-a Sia
- ' __ one: U3/ . .5J— & i09 6
Expiration ,20 l l ; 0 ' BeK 7
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APPLICATION=FOR BU):.':I IN.G PERMIT' " '
=a,
; Rate , 20
:— r INSTRUCTIONS---
a. This application MUST be completely•filled in by`typewite'rtor'iifinktarid.submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing.location of lot and of buildings.on premises;:relatronslup to adjoining•premises or public streets or
areas, and waterways. - - I
c. The work covered.by this a pplication,mayinot,be commenced,befoxe;issuance of.Building Permit. i
d. Upon approval of this application,the Building Inspector will issue a BuildingpPermit to the applicant; Such a permit
shall be kept on the premises,availabje.for inspection•throughout tl}e work. , , - • :• i .
e.No building shall be occupiecl"dr use$in'Bole or in pai or any purpose what'so ever until the Building Inspector
issues a Certificate of Occupancy. } .
f. Every building permit shall expire if the world authorizes 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 affecting the
property have been enacted i`n the-interim,the Building•Inspectonmy authorize, in writing,the extension of the permit for an
addition six months.Thereafter, a new permit shall be required. I
APPLICATION IS HEREBY"MADE:torthq°B,uildirigDepartmentfpr the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the'Town,of•Sput-hold Sil4f)h County;New Xor'k;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;cod'e;ihousing'cod'e,'and fegulatiods; and to admit
authorized inspectors on premises and in building for necessary inspections.
t
(Signature of applicant or name,if a corporation)
I
Mailing.address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, pluri'ber or builder
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Name of owner of premises, any, .,`�J ( 5i,e, 1 I Ci
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(As'on the tax roll,or•latest-deed)- . . .• , .j
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer) '^
Builders License No.
Plumbers License No. ' , S''' ' h "" '", - ' .
Electricians License-No. ``. ‘ -
I
Other Trade's License No. S
_:1 Of,_; ) i . 'ti. i
1. Location of land on which proposed wo k'will:be.dorie:,'; '' {' °' .
7b5 Pum ASK,,:: ,::-,-i ,. . SOJ\h0Id /197/
House Number Street - .:":'` ' .,;-,i-- :',: "'{-';''.'`' 10,• Hamlet
County Tax Map No. 1000 Section (e:0
Block Lot A I
Subdivision Filed Map No. Lot
,
2. State existing use and ooripancy,of premises and intended use and occupancy of pro osed cons uction
a. Existing use and oocuparicy a C C.P�FY L ,rA[ —}-� ( . Q `>,. -
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b. Intended use'and'ocdupancy 4, ,
3. Nature of work(check which!applicabl- . iew :u .g - - -- Ad.' •:• Alteration
Repair Removal, Demolition ► 0 6't er Work
' `se7..; ►s v° : .. 0.. (Description)
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4. Estimated Cost - L '4' �'�` '12 11 V s
digse paid on f,lin: is application) , ,
5. If dwelling, number of dwelling unitsv,‘,111
u ,be•e o'f Vain!! _ .s -.ch-floor
If garage,'number of cars ' • s `� �} .
•
6. If b. iness, commercial or mixed_occupancy, speoirati.RIMant of each type of use.
/
_7. Dimensi..s of existing structures, if any: Front RA Rear c I f Depth 'a I
Heigh ' Number of Stories I
Dimensions of s me structure with alterations ora e' ions: Front 'Rear
Depth • Height ,(2, i,.,: Number of Stories _
8. Dimensions of entire new`construction:,Fro• •/ k,j!a .rr , `."-Rear , ',':;a:a,x' Depth
Height Nu ►-'r of Stories
•
9. Size of lot: Front - Ad Rear 4. I. ,.a;,4: . • ,Depth
10. Date'of Purchase Na 'e'of Forinei:,.Qvyner ' ,. I . - , •
.
•
11. Zone or use .• rict in-which'premises are,situate .. -
12. Does proposed construction',violate any,zoning�law;; ordiriax ce'or regulation,?,;;YES', ' NO ,/
13. Will lot be re-graded? YES NO .Will excess fill'be^r rnoved;fr'om;;premis'e`s?•YES - 'NO
14. Names of•Owner of premises . „ , , •4 , :A.ddress :_,,. . .. Phone�No.
Name of,Architect : . • _
, .. ,:_ _-,'. ',;,"4Ad'dress..:, , _•',1; _,,,.-','4, ,Phone No .
Name of Contractor • • - • ',:is=; 'A'ddress=
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APR 2 0 2016 ______
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BUILDING DEPT. All
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TOWN 4,-
OF SOUTHOLD
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70 5 ' Illit-r 1'I Me( ,i-u-C
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/ ., , TOWN OF SOUTHOLD PROPERTY RECORD CARD
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OWNER STREET -----/ ,--)z,,..; VILLAGE DIST. SUB. LOT
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FORMER OWNER _ , N ,V, -E ACR. p
1\10 li u -T A ru 51(1/0 1 (--- ...?-.74;i:,.,1„:4,-. ...,,q--,.;',17:.,,,yi. . , 13 6 ti 1.:?.., ' 7 54
j . ,s, 1 TYPE OF BUILDING
S-c-7.5:e,p Inkyk_ Fera in aocl 3 fus\aAck—AL-L-c--1"---,--,_e_ cF4-c,
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' REy 1 ! SEAS. VL. FARM COMM. CB. MICS. Mkt. Value
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LAND : IMP. TOTAL DATE REMARKS
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11(411 -I- )I 4)5or 6 30--0 Ktisieco,'ci -C-7.sf -1-,e) , -5 rust etuie,' tv/C:
...s---e, 0 1 ...? , 4, ,--:, ,..* .5 7- 0 P 1/, •-:3/A,‘tiif(.2j/ i P8 ii 0 g fi4: 3LP
3 5-av --6‘-d--0 1/. ,3// /i 7--- —7//q /1/ £P# 36,6te 40, 1,0i dows .
119i/3-2-ii-711 p7iCi-nt u,51,to lc- -1-b Pittl2baYd -
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AGE / - BUILDING CONDITION
NEW NORMAL BELOW ABOVE
FARM Acre Value Per Value
Acre
Tillable FRONTAGE ON WATER
Woodland ' FRONTAGE ON ROAD 4 7-7 ' it
Meadowland DEPTH
House Plot BULKHEAD
Total DOCK
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+ a r` d"4 sfir wsc' + a '�„�."�- ,,;. .
63.-2-21 4/11
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M. Bldg. al,�" - -' .
� . - , - ryes,•° . !
Extension I /s':t / 6 . ,.. v r,)_ g , a _\.14-0 , 4 7.37 . I i =
Extension I
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Extension I • • - -
Foundationn N N . Bath !Dinette
b 1 Basement - Floors K.Porcn ;- XJ. i /c -r.., fy
re, 1.-- c.-
Porch i��1 z . ,a ., /..- 6' 6 .1..,4) / �„^ Ext. Walls Interior Finish LR.
Breezeway Fire Place Heat DR.
Garage Type Roof Rooms 1st Floor - BR.
Patio Recreation Room ' Rooms 2nd Floor FIN. B
0. B. Dormer Driveway
Total 1 .,9 7 7 , 41 77 - - . - -
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