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Home My WebLink About8534-zTOWN OF SOUTHOLD 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) No. 8534 Z Permission is hereby granted to: .Cas.ole...,,...I,m,~le...R~opaz~*l. es ................ .... C~/.O..J~orz~./~ea/.t~..~t:v. erhe~cL) ............ ....1..~D~.... J4~n~a~lc..B~.....lda ~t/~ ................ ~o ...,l~v~ 1 d...ne.v...one../'a~Ll~..d.~e.l:]-lng. .................................................................................. at premises located at LO.t,..Z....m/zlOZ'...s~tb..~....~..~a~o~,~..,~..~U3~:t~..P3~c~ ...................... .............................................. D~ch~r~l...~r.e~t ........... ~rte~t ...................................................... pursuant to application dated ........................... &~l~.;~.....~.~. ...... , 19..~(~.., and approved by the Building Inspector. Fee $..~2.*~ .......... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved q ~ '9 19.2.... Permit No. ^pplicotion ............... Disapproved a/c ~.~..~~..../~._ (Building Insp~ector) ( 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 m areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. T.he work covered by this application may not be commenced before issuance o~ 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 Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the cdnstruction 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, end to admit authorized inspectors on premises and in buildings for necessary inspections. / i ,'/ tY /, ~ u, nt, or name, ill~cl~rporation) .... t4.~8,, hloz~tmt~,..li.i.gb~¥.t../tla,~.i~:,...N~w...Y.o~.~.. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .......... .I;{~R~;...~.~.~:kJ.{ll..-.~ll.~tt..j.~...~l~.~;.j.e~. ............................................................... If applicant is a corporate, signature of duly authorized officer. ............................................................. R..~..e..~.... ............... (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No .... .~...~....~.....~.'- Electrician's License No. Other Zrade's License No ............................................... '~'~''~'C'''~'~~- ,~,,m__.,~ ;.~.~ 1. Location of land on which proposed work will be done. Mop No,: -Lot No ...... .~. ................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy ...........,......~,~. ......~... ...................................... i ............................... Intended use and occupancy ....... Zi~ ..................... -/ .................................................................... 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work .................................................... (Description) 4. Estimated Cost ...... .$..~,~.,..0..O.O..~.g..0. .............................. Fee -~7"'¥~---"~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ,.9,p.,e_ ................... Number of dwelling units on each floor ..... , ...................... If garage, number of cars ..........o...n..e. ............................................................................................................................. 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 ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ...[.(~.J..,.~..~...f.~ ................................. Rear ....[,~..0.,..~...~ ......................... Depth ,..~.,~.0.....f...~. ............... 10. Date of Purchase ....... .I.,C)..~..~. ....................................... Name of Former Owner ........................................ ................ 1 1. Zone or use district in which premises are situated ................~.s.J.clf~.~;.j.~.J ........................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .......... .N..o. .......................................... 13. Will lot be regraded .....Y.9..~ ................. Will excess fill be removed from premises: ( ) Yes (X) No 14. Name of Owner of premises ....... .L..~...u..r,..j..e....~.r'...o.p..?..l?.~...i..e..§.... Address ...~.~.,.~.~.J.g ............... Phone No. ?,..8..]..-...5..4-...5.,4.... Name of Architect .............................................................. Address ................................ Phone No ....... ................ Name of Contractor ..... .F..~..n.,k.....B..°..c.n. ............................... Address ....~..o..?.~..h.,o..!.,d. .......... Phone No. E.0...5. Z..3..~.,,4.,0.... PLOT DIAGRAM Locate clearly end distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from prop¢:rty lines. Give street and bloc/< number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW~YOR, K,- ~ I ~ ~ ..................,.,~.,.~ of indi'~;~;I ;i~;~.~c~ntracf)u,.,..~ ~ ........ ' duly sworn, deposes and says that he is the appliconl n~med. He is the ........................................................................................................................................... (~ontractor, agent, cbrporate 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 fo~h in the application filed therewith. Sworn to beJore me this ..... ..... .................... , Q No,a ................ ~o. 5~ ~- ~- ~ ry ~ml~s~on ~lres Mar. 30, or · pr~,'" nov~ ,o . l.our~.e~ L C,~50~ voCOj' , ~ let~ THE[ ~-OCAT[ON OF y/ELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATtOI~S AND/OR FROM DATA OBTAINED FROM OTHERS THE WATER SUPPLY AND SEWAGE. DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL ~FOR[~'T~ T~E ~;T~N~)ARDS OF~.T~HE SU~O~K CdONTY DEPART~NT ~NEA~TH / SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES. FOP- APPROVAL OF CONSTRUCTION ONLY -. NO._ /: or former ly · REVISIONS HO F£ : · -' MON~ENT UNAUTHORIZED ALTERATION OR ADDITION ?O THIS SUf~V£Y I$ A ViOLATiON OF SECTION 7205 OF THE NEW YORK STATE EDUCATION LAW YOUNG & YOUI 400 OSTEANDER AVENUE, RIVE ALDEN W. YOUNG SURVEY FOR: LAURIE PROPERTIES YOUNG q t . t