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Home My WebLink About8577-z fORM NO, ~i TOWN OF SOUTHOLD BUILDIN~ DEPARTMENT 'TOWN CLERK'S OFFICE SOUTHOLD, H~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8577 Z Permission is hereby granted to: R:t.c.h~.r~...l~.e~ .................................................... ........... ~u~ene~..l~oa4. ............ ~hoguz ......... at premises lacated at .....L.~.~....1 ........ ~..~..],.q.l~.e.g..k...~..T..q~..e.~.~.~..~.. .................................................. ...................................................... E.ug, enG..2oad ......... .¢utc~~ ................................................ pursuant to application dated .......................... [~,y .......l~. .......... , 19.....~..~ and approved by the Building Inspector. ✓�= �� / /-1 L l-T 1:211 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. Examined ..... . ...�(...... .. 19f7� Application No. .�. ...?..�...... �l Approved ........................... ........ .. 192 Permit No. ......... Disapproveda/c ....:............ ...................................................................... ........................... .......:..................................... .................. ...... . ............. .. .EBuildin...Irispect..r..................... ......... APPLICATION FOR BUILDING PERMIT ��//JJ S Date ...... 0.....(..l&I................. .. 191K... INSTRUCTIONS Cill rq 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. F.ee.according to schedule. . r 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 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 ti 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 I> shall have been granted by the Building Inspector. V 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. .c..:.2 ..... ...................... (Signature of applicant, or name, if a corporation) 3 x. ....l. V/.......NA.ErM.Ch<� .......ff..y............. (Address of applicant) f 9SG State whether applicant is owner, lessee, agent, architect, engineer, general' contractor, electrician, plumber or builder. ................. .W .:.............. ........................ ................................................. Name of owner of premises .................'........�....`.. .�.................. ...................... ......... If applicant is a corporate, signature of duly authorized officer. .............. .... ... ............ ........ 1✓�rr -1-s - � (Name and title of corporate officer) Builder's License No. ........ `:......................................... . \ Plumber's License No. ....................:........................... Electrician's License No. ............................................ OtherTrade's License No. .............................:................ 1. Location of land on which proposed,fwork will be done. Map No.: ........................................ Lot No. .......�............... Street and', Number ...-t�:i M;dnicip'ality" 2. State existing use and occupancy of prem' a and i t ded use and occupancy of proposed construction: a. Exisiting use and occupancy ....... ............................. .......... ..................... . ... ......... " b. Intended use and occupancy .......................................... ... .. t .........................,.................................. ~_ _."= \_ 3. Nature of work (check which opp|ico6|o): New Building. — ---'— Addition .................. Alteration ---...—' Repair .................. Removal ------ Demo|ihor.....................Other Work (Desc..'^.~ ) � �� 4. Estimated. _---'_---_--_--_._----.�em '.f--.--_-----.------__-----_---.----- ' (to be paid on filing this application) 5. If dwelling, nun`be, of dwelling units —.—.�?................Number of dwelling units on each floor ....................... ' If garage, niumbarofcars ------.—_-----.-------_----_--'--__---__-_---------- .. If business, connnnorcio| 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 Stores —_—.—.-----.------_--_-_----_---__--_----__ Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height --.-------NumberofS|ohes ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ------_—.---.----'----------.-------_----- 9. Size of lot: Front ........................................................ Reor -------------- Depth ----------' lO. Date of Purchase ........................................................Name of Former Owner ........................................................ ll. Zone or use district in which premises are situated ------------.--.------------------- 12. Does construction vkdoteany zoning |ovv ordinance or regulation: ---.--------.------- �� 13. Will lot be regvodad —. No Will fill be removed f p/mnnoes: ( ) �~eo (^~ No � ��/u�� .� l4. Mornauf�O�narnfpnannisos —.^:!�y��`�.�-�~�—l��. Address .1�k��l'�'�'�=`��.. Phone ��m �=2E-5.W/' Nonnaof Architect .............................................................. Address ................................ Phone Nc^ ...................... Name of Contractor ............................................................ Address ................................ 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 norney and indicate whether interior orcorner lot. _ x ALL - ` - STATE OF i'"E,,�� 33 COUNTY OF ��,�.- ' .................. R"zVa..----,...—...--.being du|y sworn, deposes and says that he is the opp(icon, of individual signing contract) obnvo.nbn`ad. / . Heis,, —.---.'.—. .................................................................................. (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 +h i�' application; that || statements �� ed in this application one true to the best of his knowledge and belief; and +ho,-the work will be performed in the n�d�ne' sot forth in the application therewith. t�era� �. 3worh�o6mforo me this ' *.' Noto�yPub|ic, .—.-� '—' -------- -----'----' (Signature of applicant) HELEM � O'80Em Notary Public in the State of New Yo& mn.5o'8l7778O Residing/n Suffolk County Commiusivn Expires Mamh3Q. 20K P°lG u ROA N.. 032, 3 E E'V G S 160.14 EUC7 1031IC o 032N w Iw N.75 O49143NE; 75o32p3NE 1 N N.'S 33.8 N. 5219 1 � I . s� ON nl N s�Ptl` N ls� took I � J3 1 Q � • w A N N o ZT. S 6 C \ Rl 'V3 Lot 9 sq. w�rr o Area 4007 - 1 42 o 3 0 o o 0 e i ` • ill we i$�0s$2 �� ' • , ` �Sa-/f S•75036 23 oce II Inspect Vs r r tbia and �t°� Open SP tO ba sat s IS dep rati0a ba e �� C0mm0nS ✓l ° heat �d r be I �� the e Q w � 0 _..... Genew NOTE SerVicesa� ueerib s m =MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY ON NOV 30, I973 AS FILE NO. 6048. I'HE LOCATION OF WELLS AND CESSPOOLS SHOWN FIEP.EIN ARE FROM FIELD OBSERVATIONS AHDIOR FROM DATA OBTAINED FROM OTHERS REVISIONS YOUNG & YOUNG SEPT.23,I975 400 OSTRANDER AVENUE, RIVER HEAD, NEW YORK R} MAR. I6,I976 ALDEN W. YOUNG , HOWARD W. YOUNG APR. 7,1976 PROFESSIONAL ENGINEER AND LAND SURVEYOR APR.291 I976 LAND SURVEYOR, N.Y.S. LIC. NO, 12845 N.Y.S. LIC. NO.45893 SURVEY FOR: UNAUTHORIZED ALTERATION OR ADDITION TOTHIS IS A VIOLAON 7209 FRTHE NEW YORK STATE SECTION 1 °�� `ti' RICHARD REEVE -f '��pji LAW. If -^li�LOT I LITTLE NECK PROPERTI��.+/ •* "T COPIES OF THIS SURVEY MAP NOT BEARING ) THE LAND SURVEYORS INKED SEAL OR 111 `' '��'-��'• " EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. AT GUARA ,� D T ��';:;;. � •`,,� Fi1-� EAST CUTCHOGUE GUARANTEES INDICATED HEREON SHALL RUN 'O ''-' �^_._+��:✓`=' .��•>� ONLY TO THE PERSON FOR WHOM THE TOWN OF 9C �^`Yv�'••r SURVEY IS PREPARED,AND ON HIS BEHALF SOUTHOLD F� .'�, y?��✓ +,µ, TO THE TITLE COMPANY,GOVERNMENTAL AGENCY AND LENDING INSTITUTION LISTED - BY HEREON,AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y. LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL SCALE: I11 501 DATE: S EPT. 11, 1975 I '622 INSTITUTIONS OR SUBSECUENT OWNERS, Examined ............... Approved ......................................... FOIR~ NO, ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. ~rmit Na~ ~..Y...ZZ~ ............ APPLICATION FOR BUILDING PERMIT Oo,e ..... /.0...~ ........................ ~..7~. .... INSTRUCTIONS a. This application must be completely filled in by typewriter ac 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 or 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 far any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment 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, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ............ ........................................ (Signature of applicant, or name, if a corporation) ..... ~.~..L ff g l .......... Ma z..'r.~.z.u, cs.~..~..~.:~ ............ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 2~_ ............... .c~.v~.~ ......................... rp..~ ~ r~ ~ .................................................................................................................................. 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 Trade's License No ............................................... Location of land on which proposed :rk will be done Map No ' Lot No I Municipality State existing use and occupancy of pregaises and intended use and occupancy of proposed construction: r o. E×,s~t~ng use and occupancy ....... ..~...~.~ ............................. ,.,.....~ ...................... b. Intended use and occupancy ............. ...~.~"~,.,.~,t,~.~4~....../,~-,,,t~,~k-~. ............. i':..' .............. .:::ii!;' 3. Nature of work (check which applicable): New Building.. ................. Addition ..... ............. Alteration ................ Repair .................. Removal .................Demolition .................... Other Work .,,~ .~.~,.~.}.~)./1/....~).~..~/~,,,~...(~.~... · ,.~__ 0.4~ (Description) 4, Estimated Cost ............................................................ Fee ,..l.,:~..,~ .................................................................. (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 ................................ 8. Dirnensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ....................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction;.r_violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regraded .........~/~ ........... Will excess fill be removed from premises: ( ) Yes (~ No 14. i'~ame of Owner of premises .]~.l.~>.~..~,,....~l~.~.~.~..,.. Address'lZI6ZZt.~C,~ ....... Phon~ No. Z,YS..z.~.'~,~.~ Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. SI-ATE OF NEW YJDRI~, COUNTY OF ..... ~ ~..~. ~/.J~ ...... .................... ~.~.~...~,....~ ........................... being duly sworn, deposes and says that he is the appiicom (Name of individual signing contracf) ~bove n~med. ................................ ......................................................................... (Contractor, agent, corporate officer, etc.) of so~d owner or owners, and is duly authorized to perform or hove 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 tha~ the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this .......... .......... -- ............. ......... .................... ...... , .............................. ,r, E~ ~ (S'gnat re o appl cant) H[IFN [ 0 ~RI ' ,N0tn~¥ Ps~blic in tl~0 State 0f Ne~ York No, b°-8~77780 e,~¢~,,~ ..... ; :,:,