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Home My WebLink About8931-zTOWN OF SGUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 8931 Z Date ........................................................ , Permission is hereby granted to: .... ~.r...r:..!L.*..~..~ ........ at premises located at ................................................................. ~)* ....................................................... pursuant to application dated ~C ff Z0 19~~ and approved by the Building Inspector. Fee ~......5....~...~ Building Inspector Approved ~ c:~2~ 1 .~...~..... Permit No. ~-~,./.: "' .. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or~ in .ink and submitted in triplicate to the Building Inspector, with 3 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 o~ areas, and giving a detailed description of layout ofproperty must be drawn 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 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 Southeld, 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, and to admit authorized inspectors on premises and in buildings for necessary in~,,)oections. .................................... ........ 'gpp' , ,' ac potation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor~ electrician, plumber or builder. ............. ......................................................................................................................................... Name of owner of prem ses ...~,;.r'-~J:-J..~...~..l~.......~..~...~.~..,~.?r_~.J~(.~.. ................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Zrade's License No ............................................... /~C~C~ t~/. r~' zz~ 1. Location of land on which proposed work w,~ill be done.t'-Y~ [fi J ,o ~,~,Ma~p~N°': ...... ./.....~. .~.....sd....I...k~. ..... LotNo .................... ~ Street and Number ....... ~..~..!..~.....k.~..~...'~z.......i....J:..~,.~..~ .......................................................... Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exislting use and occupancy ......~..(,~..C.~,.~.:......~..~.~ ...................................................................... b, Intended use and occupancy . (~.I..V,...~..T..~. ........ ..~. ~?,.,',c~J ...... · .~...I..~,..~....J~...~..~. ................ Nature of work (check which applicable): New Building,. ................ Addition .................. Alteration . Repair .................. Removal .................. Demolition .................... Other Work ................................................... 4. Estimated Cost ............................................................. ; ........ ~; ............................ (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 alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Rear ....... ~.~. ............. Depth ....~.~ ............. 8. Dimensions of entire new construction: Front ........... .~.~,~ .............. / / Height ...f~"-~ ...... Number of Stories ........ .~ ......................................................................................................... 9. Size of lot: Front ........... ~%...:~::~h...~ Rear ............................... ~ ..... De~t~ ............ ~'"T'"'~ ...... 10, Date of Purchase .................. ~.~......Z..~ .............. Name?~, ~ ~ ~Z~~°f Farmer Owner .~, ,.~c,~.~.~.~.k~....~~ 11, Zone or use district in which premises are situated ~....1~..~.O~--~ .................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............. ~.~ ................................. ~3. W~ll lot be regraded . ~.,~ ....... Will excess fill be removed frgD pzemi~s~ ~) Yes ~No 1~. Nome oS Owner o{ pre~ise~ Lx{~.~.t.~.m....~a...~ ........ Address ....--m~.5~.~.. Phon~ No. a..~7..t.m...u. Nome of Architect ~:,.GJC~...L;.U~.~.m ............... Address .d~,..e~¢~.~. Phone No. Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate property lines. Give street end block number or description according to deed, whether interior or corner Iol. ' STATE OF NEW YORK,, -- lSS COUNTY JDF,/-L /. A"'~'~"J~']"lf~ ......... f -~ , ~ '~ ~'~,¢ ..k~..~ ........ ..~...,~,.,.~. ~ be ng duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. hie is the /~J ~ .......... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hove performed the said work and to make and file this application; that oil 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 ,o b~ore me this"~' '~-'~ ~...~ ~'"~'q (~ ............. ~~~~~. ........................NotaryPublic,.~;~.;l ..... ............... .~.'.~.. ~ ................................. ...... C ......... 0,0 2.7 5.0 12.0 TEST HOLE TOP SOIL SAND ~ LARGE STONES COULS NOT DIG ANY SEEPER THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM DATA O~TAINED FSOM OTHERS. THE WATERSUPpEy AND SEWAGE D1SPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT OFHEALTH SUFFOLK COUNTY DEPARTMENT OF HEALTH6Ei~VIC%; ' - FOR APPROVAL OF CONSTRUCTION ONLY DATE~iiS REF. NO. (¢ ~ ~ ! ~ APPROVED_ ~ MILL N62oOO'OO"FZ 150.0~ ~°" L~4/VE now or formerly John 8 Julia Sepe?.oski (vacant) ~ $o ~io 'oo"~ ~4rea= 5.2cTI ,4cre$ IN62o4~ UNAUTHORIZED ALTERATION OR ADOITION TO THIS S~RVEY ~S A VIOLATION OF SECTION 7~09 OF THE NEW YO~K STATE EDUCATION LAW COPI£~ OF THiS SURV£Y MAP NOT BEARING THE LAND SURVEYOR'S INKED SEA~ OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO 8E A VALID TRUE COPY (vacant] now or formerly F. ~ Over(on Eetafe NOTE: Il: MONUMENT REVISIONS ELEVATIONS. SHOWN THUS: ~4-.5 ARE REFERENCED TO AN ASSUMED DATUM. NEAREST PUBLIC WATER = 2 MILES_~ WATER SUPPLY = PRIVATE WELL YOUNG & YOUNG 400 OSTRANDER, AVENUE, RIVERHEAD, NEW YORK A!~.DEN W. YOUNG HOWARD W. YOUNG SURVEY FOR: RICHARD BERENT LOT 3 OF MINOR SUBDIVISION-"SOUNDVlEW MEADOWS" AT PECON[C TOWN OF SOUTHOLD SUFFOLK CO., N.Y. GUARANTEED TO: CHICAGO TITLE INSURANCE CO. SCALE: j ,~: 80~ DATE: NO. AUG. 25, 1976 76-685 G~AGE t ELEVA-FtOkI_~ f Y LI¥iN~ ~O01A 4~ ~o Ill Ill Ag Jd .~