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HomeMy WebLinkAbout4184-z FORM NO. ~ TOWN OF $OUTHOLD 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) N? ~18~ Z Permission is hereby granted to: Dote .............................. ~.II~;I~,TIL~....~ Q 19....69 .......... I'&si~r.s...~a.~and .................................... to ..... ~,t~,,1,4...lze~...~...~.e~;L~...~,~e~,;L~ .............................................................................. at premises located at ................ ~....~.~9~l'a f,~..J~iJ. .................................................................. .......................... F~.~.e.~...~.~..~..e.~......(q.~;L~.~...~..~.~...~,:.~..,...~....~...e~. ~....#.,z. ...... pursuon~t to application d~ted ............................... ~4t~ ......... ~. ......... , 19~.., and approved by the Building rnspector. Fee $....~.l~.e.~J). ........ FORM NO. 1 Examined "~ f O ...... ......... .......................... , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ,, ,, t. i i Approved ........................................ , I0 ........ Permit No ............................. Application No. Z/f? ~/ Disapproved a/c ........ .................................................. (B~) APPLICATION FOR BUILDING PERMIT Dote ....l'm):l~'~l~Z~...2 ................................ , 19.1[I~. ....... 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 a detailed description of layout of property must be drawn on the diagram which is port 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 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, building code and regulations, (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. Name of owner of premises .......... I~.~J~JlE~; ............................................................................................................... If applier is a corporate, signature of duly authorized officer. (Nome onE'title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ...P~,l~..~'~e, ............... Lot No.: ........................ Street and Number ..... I';I,~I~,~..,Z~t,IM~e..~II~..XgA'~ ................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:", o. Existing use and occupancy ...................................................................................................... ; ....................... . .... b. Intended use and occupancy .............. ~I~I,~II~QO ............................................ ............... :., . 3. Nature of work (check which applicable): New Building .... ~ .......... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... .~.~...0.!..0...0..0..?..0...0. ............................ Fee ...... .~1..~..0..?..0~... ..................... (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 .................... Height Number of Stories Dimensions of same structure with a.lterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ' 8. Dimensions of entire new construction: Front ..... ].~..*..~..". ................... Rear ...."/.~.s...0..". ............. Depth ...3&.*.O? .......... Height .~.~:!.0.". ....... Number of Stories .................. ,~ ........................................... 9. Size of lot: Front 273~0" Rear ...~1~.~.~..(}?......~. ........... Depth ....... 2~0...(3 ............. 10. Date of Purchase ...... ~.~ ......................................... Name of Former Owner ...~,,~.~,,t,.t~t..~l ..................... 11. Zone or use district in which premises are situated .....l~,~ll~/~,.~ltt~.~ ........ 12. Does proposed construction violate any zoning law, ord nonce or regulation? ..1~O ........... 13. Name of Owner of premises ..~.g.....~.~.~.~. .............. Address .~1~.~1~1~..¢1~..~1~ ......... Phone No ..................... Name of Architect ...~..~..~...~.~'..&......~..~...]'..]t~. ..................... Address ...l~...~...~dll~/Dll~...l~ ......... Phone No ..................... Name of Contractor~...*..~..?....~..~..~?...~....Address ..~..~.~.~....~.~.~.....1~. ~ ~..?~hone No.~..~...(~.?..2..~..~.. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate oil 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 e COUNTY OF ................................ ,f '"'~' &~ ~TO~I~ ¢3~-4~ ~T~', being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............. .(~.l).tdl~.~.~.~. .......................................................................... (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 oil statements conta:ined 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. Swam to before me this Notary Public, ..~~ ............... ' ......... ......... County ~/ (Signature of appli~'t')' ...................... I~0tary Public, State of New York Residing in Suffolk Co. Off. No. 52-6439000 Commission Expires March 30~ ~ <~ ~ o 1 A B C D E F G H I ~ I I I I I J K L M N P 1 8 9 I, F'[~OVlD F_. 5~TE- PLANI " ' B' I~l= ~5 CAL -. 'I' ? INDEX OF_ 2 ' DRAWINGS E L EVAT I O N S A.2 FIRST & SECOND FLOOR PLANS A'3 'SCHEDULES THIRD FLOOR &ROOF PLA NS, A.4 3 ~ SC H E D U L ES / INTE RIOR ELEVATIONS STRUCTURAL SECTIONS & FRAMING PLANS WALL S E CTIQNS & DETAILS A-5 A.6 HEATING PLANS M.1 ELECT R ICAL & PLUMBING PLANS M.2 4 GEdF=r~ALNOTES ~. ~U/LT-Up ~OOff ~¢~LL ~E ~ V~A~ BONDED ~ ply ~FlN~ 4. %EALANT TO ~E ~OW O~Q,B, CLEAE %ILIEOM~¢ ~OTI&, T~IOKAL,o~ ~UAL, ~, OS~ ~ALVAN/~D NAIL50~L~ ~OLT5 TO ~ riot DIPPED dALVANIZEp, q, F~A~INQ LOMI~E~ E~POSED TO vIEW ~LL ~ ~ELECTErP COH'GTDUCTIOM G~AP~ FIr~, lO, DEC~KFC~ TO ~ECI~V~ ON~ COAT ~C~{MO ~TAIM, I~, ~OOF TE~ACE ~NALL ~E ~pALO~ ~F ~AT~IAL ~'~B~A-~A~D" AS IZ, N~BTAL FLA5~:~ 70 ~$ ALUMINUI~, ~, C~5ET S~IELYES TO ~E I"~ I~" ?OLE~ TO ~ I" GALVAniZeD PlP~ ~F~kI~E~ ~G ~LANKET /NSULA%/OM TO ~ FULL THIC~ FI~Q~5 WiTH VAPO~ ~7, AWnINg6 W~MPOW5 ~HALL ~B ~'AM~5OM" ALL OTRE~ WiMDOW5 AMD WBATHE~?I?~ ~WANU~D~IKIQ CO~P, 5 6 7 8 9 REVISIONS DATE RICH A R D J CARROLL STRUCTURAL ENGINEER HARVEY FISHER'S ISLAND HOUS NEWYORK T A T A R A N D K E L L Y ARCHITECTS PLANNERS 520 LIGHT STREET BALTIMORE MARYLAND 21202 SHEET TITLE SITE PLAN, DFZAWJ C~Ekl E EAL MOTE5 SCALE V:: A1 DATE PED. 5 Iq-~q