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HomeMy WebLinkAbout3788-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING pERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 3788 Z Permission is hereby granted to: .... ............................ ...... ~...........~.~ .~..~:........~.X~. ................... : ....... ................................................................ at premises located at ..~...~..;.~~.,:~.:~.-.... ~.~.~.~.;~ ......................... ;....'....,;.;.~ ...... ......................... · ~ ............ - ...... ~nd approved, by, the pursu~n¢ to applic<~tion doted ............. Building Inspector. ' Rider* which may be used with Standard NYBTU Form 8041, rev. 11/78 S('IIEDUI.E fi. (Description of P~emises) At.K that certatn p~ot, piece or parcel of lind. with the bulldinss nad improvements thereon erected, situ- of 3~fo~ and ~a~e of ~ ~o~ ~ ~io~arly ~no~ and demig ~ted mm ~d by the lo~ ~m. ~ntF Five ~ ~n~y~ix (~ ~ 26 on a oe~a~ ~p entitled '~p of P~y of ~one R~l~y Co~ ~mtion, O~cho~. ~ Yo~ ~eo&ion 1" ~ed Nove~er T2th, 1930 and filed ~ the office of the Cle~ of ~ 0omty of 8~fo~ on ~ce~er ~, 1930 as ~ by ~he ~p No. ~)~, TOOETH~I~ ~rith a fr~e a~i ~obs~r~eted right of .~y ove~ ~d ~n Flee~d ~d ~d ~ ~ ~o~and ~e~ss on foo~ ~ anal, or ~hiolea to t~ b~ah at ~ ~, together ~th the ri~t and pri~le~e of ~ for ~g_~sen t~ ~ of ~e beach at ~t C~ ~eh liee ~a~erAy or a ~lnt ~ by a ce~ b~h ~,~ on ~ld b~e~ ~A~ ~ of ~ to the ~e off ~td bee successo~ and assi~. TOQ~H~R ~lth ~he right to ~he u~e of the right of ~ay EUGENE ~RSEX as mho~m o~ Nap of l~lee~oot Oove a~ 0utohogue. 3uffolk County, N.lo dated April 19~8~ l.~gI~ No ~A?~P~ L.S. O~?ER BAT, SUBJECT to any state of facts an accurate survey may sho The Seller will provide a Certificate of Occupancy from the Southold Town Building Department for the garage, which is presently on the premises. BUILDING DEPARTMENT SOUTHOLD, N. Y. (Buildin~ Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b, Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is part of this application, 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 permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shell be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o 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 oil applicable laws, ordinences,~ffi~ding code, housing code,,~.and renqulations. (Signature of applicant, or nome, if o corporation) ' (Address of applicant) ......~'/}'~ & ~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... ............................................................................................. Nome of owner of premises~ ~~4 ~g&~Xe;'~ 2/OB* If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) )iO . - 1. kocation of land on whlch proposed work will be done, Map No.: ...~..~.~.C../ ..~....f~.~..~'~otNo.:..~,.C~.,~...g... Street and Number .. ~ ....................................... ~ ........ ; ......... .~...~. .............. 7~ r ~ ~_ o ~) Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~J 0 )~J(~ b. Intended use and occupancy ............................. ,..~...~.,..~.....~,..¢*..~.. ........... ..~.....~.. .................................................... J 3. Nature of work (check which applicable): New Building ....... ..~'...... Addition .................. Altera.tion .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe, ........................................ 4. Estimated Cost ....................... % ............................... rea ...................................................................................... (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 ............................ 7. Dimensions of existing structures, if any: Front ............. ~;.. Rear .............. ~.:...' .......... Depth .....'.~'.~;:7. ...... Height .............. ~...'~.. ..... Number of Stories "~-' Dimensions of same structure with a.lterations or additions: Front ................. ~ ............. Rear ......... ~ .......... Depth ................................ Height ......... ~ ............ Number of Stories ........... .~..: ................ ........ ~,.~. ............ Depth '......~....~.. ............ 8. Dimensions of entire new construction: Front ...... ~.~.[ ..................... Rear / Height ...... Z.¥. ........ Number of Stories ..............O ....... ;¢. ............................................. ;, ............................................ 9. Size of lot' Front .......... /...'q...O..../. ..... Rear ...... ¢..~...O...L.. Depth ... /......~...O.. ...... 10. Date of Purchase ..... ~..q..(~.,....'~...~.7..,/..~.~..~...'· .......... Nome of Former Owner ...~..~..¢...'~....q.,./.~..'...~....~.../.¢..~...~. .... 11. Zone or use district in which premises are situated ............................ .~.... .................................................................. 12. Does proposed construction violate any zonirtg law, orr, Jinonce or regulation? ................. .~......0. .................................. Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .................................................... Address ............................. ~.,.t .......... Phone No .......... . ........... PLOT DIAGRAM I Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, end show street names an~ whether interior or corner lot. STATE OF NEW YORK, ] c c c ,Y OF .......... ...~./..,~¢,~:'~......~~"--"' ........................... being duly sworn, deposes and soys that he is the applicant (Name of individual signing applicaHon) above named. 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. Sworn~to before me th~ ~ ~ ~ ~ No,aw Pub,¢~ ....... ~*~..~..Z~./~ ~ounty (Signature of applicant, FOI~M NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT . , TOWN CLERK'S OFFICE ~ SOUTHOLD, N. Y. Exomined .............. ~. .................... , 19.. APPLICATION FOR BUILDING PERMI.~T?//' ,~/, ~.:/~,~-~,/~// Dote ............................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot p~an showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of thie application. c. The work coyered 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 permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. 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,~bdilding code, housing code, and regulations. ....... ................. ................................................ (Signature of applicant, or name, if a corporation) .......................... '~'~;~ss of oppl'-'"-"-"]~) ....... ~ .............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................... ............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. MapNo.: ~;~C ~ 7 ,~ otN ~x'~J Street and Number ..... ~..R,~.;../...,~.~..~,J.....~(~.d,~Z, ....................................... ~ ........ ~....~../ ................................ ~' Mur~ip~]i~ ly, ~0 G u ~ 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 ..........................~'~' "~"~'~'~*/~'r/,~'*')~,.;,~';,:~"~ ....................................................... 3. Nature of work (check which applicable): New Building ......... ./~r:~..... Addition .................. Alteration .................. Repair .................. Rerrtgval .................. Demolitian .................. Other Work (Describe) ........................................ 4. Estimated Cost ................. ~..~ ....................................... Fee ............... /..~. ........... .~.....f~ .................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .............. J ............ Number of dwelling units on ea~h.flogr ............ / .............. 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 ........................... ................................................ '4';~"-:~ ............................ Dimensions of same structure with a.lterations or additions: Front .................................... Rear ........... ,~-. ........... Depth ................................ Height ............ ~..'. ............. Number of Stories ................................. 8. Dimensions of entire new construction: Front ........ :7..:...(~ ................... Rear .......... .~..~.../ ........ Depth ...... '~...c~ ........ ... Height................' ~,f i .... Number of Stories ............... L,~...d..~ .................. 9. Size of lot: Front / ~'' '~ / Rear ........................................... /...,~..,, ............. Depth ............ ~....s..~ ......... 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, ordinanec or regulation;~ ............... ~"O ................................... 13. Name of Owner of ~remises~`~;::~i~z?~Ii?~j~.~I.~.~A~r/~,s~/7c~¢~7*~t~:~?f~I4~ne N Name of Architect ........................ ;~.¢ ............... ¢ .......... Address ........ Ft .................. 9¢ ........... Phone No....,? .............. Name of Contractor ..................... ~.., ........ ' ......... /'~ ........ Address .......... ¢ .................. z..! ........... Phone No....,.~..., ........... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back ,dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ! c c COUJ~TY OF .................... ,~ ....... J' .... .~~,...~.~.;.~..'~..."'~:?" ............................ being duly sworn, deposes and says that he is the applicant (Name of individual signing application) ~ · above named. He is the ~t),.*~Dt,.~,.~ ¢ cY-~-~'~ . ~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 a.nd 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 applic, a,~on filed therewith. Sworn to befor~ me this ~ ?',~ /. ~'¢ /] /~ ,-~ · ............ of ......... . Notary Public~'~.~.... ~ ,....~ .............................. i~;~'~';';~ ;; "~¥ '; [~i;~'~¥i ............................ EDWIN S. ~LARE September 5, 1979 Building Department Town of Southold Main Road Southold, N.Y. 11971 Re: Premises Cutchogue, New York Gentlemen: This office represents Mr. & Mrs. Leonard Modelewski upon the sale of the above premises. Enclosed please find a photocopy of the description of premises. Please send me a duplicate certificate of occupancy for the garage on the premises. Enclosed please find a check valid to the sum of $10 in payment of the fee. Thank you. ESC/lab Encls. r ! I