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HomeMy WebLinkAbout7842-z FOEM NO. ~ TOWN 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) N? 7842 Z Permission is hereby granted to: ~w!z~..Eor~..~'.e~.ce...C.a...&/C...~s.....~io~ ............ .~.~i-~ok. ........................................ ~o .~.r.~..e..~..~.~.¢....~. ~.~.~....~.r..q~.~....a....s..~..e...~..~...f..e.~.~..~.~.~.~....-...~9..~4.~..~...~.~.e..k.~..~ .. at- premises located at ..~t..~- ............ Q,~,~t~e~..~l~lJ~h~ .............................................................. ........................... : ........................... 3?..o......~.e..e..~..~.o..~.¢ ......... .~,.~ ~.%,~.t..~ .e..x......~.....~.: .................. pursuant to application dated .......................~.~.;~], .... ~ ........... , 19..~.~..., and approved by the Building, Inspector. Fee $...~.~..?...(~... .......... ...... · /~-Q~i'~-~.-i:~spect~or.!. ~ ..................... FORM NO. i � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... V .. ............ 19.Zf Application No. ................ ............... Approved .................�....................1 19 Permit No. ........ Disapproved a/c ..... ..... ....... .. ............ ........................ (Building Inspector) APPLICATION FOR BUILDING PERMIT c Date ............7.'. .` ...................... 192`��..� 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 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 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. R 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. (Signature of applicant, or name, if a corporation) .... ..,... 4. .Y..� ..-. .....::............... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................................�- .. ............. ............... .................................................................................................................................. Nameof owner of premises ................... '...... .... ..... t � . ......................................................................: 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. ............................................ OtherTrade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No. ..................... Streetand Number ....... :......... ................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................Q� �' .... ..... ` :!``�`. .......... .. .... ...:............................................... b. Intended use and occupancy ................................................................ ..... ............`.......:..... .............................. 3. Nature of work (check which applicable): New Building ----_—. �^dddk�n —.----.. Alteration -----. . , ' Repair .................. Ronnovo| .................. Demolition—.----.- Other Work --.. --''— \uescnpr��/ ��~�°�~ - � 4. Estimated Coot ................�—v���-_------'----.�ea -----.- ....... ' (to be paid on filing this application)' 5. If dwelling, number of dwelling units ---------..Numbe, of dwelling units on each floor ............................ Ifgarage, number nfcars ...........................................:................................................................................................... ' 6. If business, commercial or nnbxmd occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, ifony: Front -----------' Rear ................................. Depth ----.�-- Haight ........................ Number of Stories '�,,_--.—_--'----_—.--_--.----_----...---______ Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height —_--------Munber'ofStories ................................ . 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth --------. Height .................... Number of Stories .------..'...''.'.'--------.--------'------------ g� ^��r2 ~ ----------- ---. ---...�.-- Depth ^� .—.---. xn' ` of lot: Front � � '-l0.�'Dote-of'Purchase �—�----------------'Noma of Former Owner ........................................................ , lZone oruoo district in which premises are s —..--_---__--_--.----------------.`—^. 12� Does proposed construction violate any zoning law, ordinance or regulation: .............................................. .'......... ' 11 WiU'lot:be�regraded! --- Will excess Q| be removed f ( ) Yes. No ' 14` Name ofOwner-of premises ..�-.� ... . Address -- - ' APhone No, No / e.bf Architect .............................................................. Address .................................. Phone No ............... ....... �� Non�e�of Contractor ............................................................ Address .................................. Phone No` -------- ' PLOT DIAGRAM ' ' Locate clearlyU buildings, existing ' ' n` owhether exis i�q and indicate i| oot��oc� dimension's from property lines. Give street and block number or description - ption according to deed' and show street names and indicate lot.whether interior o��nrner �� ' ' ' � . ----' . ` ' ' - - ' _ � _° ~~ /t�`/ � - - STATE OF SS COUNTY, _ �.—.—.�bojho duly.sworri, and says that he is the opp\iconi (Nam `y/ xm/,muu/ x/y/m/u c,xu'ucv above'nonied. ' � Haio the ���� - / --~`-,=..="=.=.°"., ...—..—..--~.—.^-.^...~.~^.--,,^.....,.,..~........—.—.-----....-`�� ( ��� of smd and is dulyrhznn' or have .n�ake, and fi|b ' this app|icot and i _ ~ ' belief,: e-f��,.o_n�� �ho� tho �orkwU be' "performed i' the ^ ~ ~ ~~` fo�� i^ th� ~,r|icotkzn fi|od tho'~ aworn no before me this , ........................ of s ' � Notary ____.___.�. '/(Sibriatura of applicant) ` � '1muLounw �/ pUuu�� Ba� "; ww° ,",� �u"`^'��zzoz� ' SuS�/k c""�, '^^ — Nap� m` |o........ _ Commission-Expires . . r~ '40 low. E N U S 11' ►oo, 1AV EMAN 1 .51',40 E 0 FR E N 1,1 o •. 52` ro n -� p \ \ W Q1 1_ Slor. _ �• W - fir' 0• S ? NautG 1 i Z A.I• i • i4a'k roA yf 1J' It 111 r . yeti V 1 IIit l H .o o Fn qi _ I 2 � . , 0fi\& I1, ;: FAII 1 1\ �ll 1 `1 i— H C3 It FAR > 1 ` a uo cc © k m 01\ O� o - ,� ,d 4-I T, cisN cb W 1 b a\ •"-�35-00 G y 10 NO 0 3a L► a = MONUMENT S 70 S41E01WSION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTYON' LOt caT JUNE 24,1929 AS MAP NO.577. t • r THE LOCATION OF SIELKS AND CESSPOOLS ShO1VN 1;E-E7NI Es:'_FF'O_•=r`M-0 Cn`37R'7ATIONS ANDIOR Fi'Oi. DA 'A Oi3 .rliNED 1 10:r OTHERS. REVISIONS YOUNG & YOUNG DEC.3I,1973 400 OSTRANDER AVENUE, RIVERHEAD, NEW YO'RK ALDEN W.YOUNG HOWARD W.YOUNG PROFESSIONAL ENGINEER AND LAND SURVEYOR LAND SURVEYOR. N.Y.S. LIC. NO, 12845 N.Y.S. LIC. NO.45893 SURVEY FOR: UNAUTHORIZED ALTERATION OR ADDITION TO THIS.SURVEY 15 A VIOLATION OF SECTION C.H A R L E S M E L O T- 7209 OF THE NEW YORK STATE EDUCATION LAW LOT 12 " GARDEN HEIGHTS " COPIES OF THIS SURVEY MAP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. - - •AT Gq GUAR NT ET' n ? MATTITUCK SOUT OL .SAVI ;s' C GUARANTEES INDICATED HEREON SHALL RUN SECU ITY ITL GUAR NTY CO. ONLY TO THE PERSON FOR WHOM THE'' TOWN OF SOUTHO LD SURVEY IS PREPARED,AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERNMENTALAGENCY AND LENDING INSTITUTIO ` A HEREON,AND TO THE ASSIGNEESNOFITHEO SUFFOLK CO., N.Y. 6Y � Q 9^ LENDING INSTITUTION. GUARANTEES ARE - NOT TRANSFERABLE TO ADDITIONAL SCALE: 11 DATE: SUR INSTITUTIONS OR SUBSEQUENT OWNERS. I = 30 NOV. 8,1973 7 .....- .•. r.ce a �a enr,nn. ..