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Home My WebLink About9104-z rOIU~ NO, 1 TOWN OF SOUTHOLD BUILDING DIrpARTMEhlT TOWN CLERK'S OFFICE SOUTHOLD, H. Y. Examined March 22 19.~.~, Approved Mar 22 19.~..?.... Permit No. 91~0br Z ..... Disapproved o/c ............................................................................................ .................................................... i"i ......... .......... ........................... .... APPLICATION FOR BUILDING PEP. MIT Dote March 22 ,,-, ~77 (,~ INSTRUCTIONS o. This application must be completely filled in by typewriter o~ in ink and subm tted in triplicate to the Building Inspector, with 3 sete of plans,' accurate plot p an to ~ale. Fee according to schedule. b. Plot plan showing~ Iocafion of lot and of buildings aa premises, relationship to adjo n ng prem sas or pub c streets o areas, and giving o detqlled d~scrlptm? of layout ofpr0perty must'be drawn on the diagram which is part of t'his application. c. The work co~er~d bY this application may not: be commenced before issuance of Building Permit. d. Upon approval of this opplicoHon, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the Premises'ovqilabJe f(~ inspedti0n th~'oughout 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 Buil~Jin~ Inspecto~,. APPLICATION IS HEREBY MADE to the Bqilding Department for the issuance of a Building Perm t pursuant to the Building Zone Ordinanc~e of the Town of ~outhbld,' Suffolk County, New York, and other app cable Laws, Ord nonces or Regulations, for the constr~jctl0n ~)~ ~uildings, o~;l~itio, ns or alterations, or for removal or darnel t on, as herein described kg The applicant agrees to c(~mply with all applicabl/e laws, ordinances, building code, housing code, and regulations, and to/,~ admit authorized inspectorrs on prem!ses and . ,> in buildings for gecessary inspections. ...... :.L....: Cutcb. ogue (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner - builder Name of owner of premises Joseph d: Judith Arvn Llzewskl If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. Plumber's License No ...... .o.~fi.e...z: ............................... Electrician's License No .... ..~..~...~..b..e...]:.,].~ ....................... Other Trade's License No ............................................... ,,w~/?. (~ Fleetwood Cov~ . 8~9 1. Location of land on which proposed work will be done. ~ap r~o.: ........................................ mar No ......................... Street and Number ....... ~/.~......~.~.W.9..o..~....~.{..o..~...d. ......... ~..t.t.t..g..~.z..o.g.¥!.e. ............................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: vacant land a. Exisiting use and occupancy .................................................................................. b. intended use and occupancy ......... D~...~.iJ.y..~.lZ.~% ......................................................................... FORi~I 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? 910~ Z Permission is hereby granted to: · ;~c~se~h...L i.~'~ s k.~. - · ~ · · ~,~-i. f. e ......................... ................ .c..~.t...~.~..o.~?.. .......................................... ro ..~.~,~ ~L ..~...~¢,...f:~ilT....d~:.e.1],±¥~ .................. :/. ............................................................... at premises located at .L.~.t...~...C...9.....F.i~.~,.t...~.QO~...C.o.v~ ............................................................ ............................................... ~.~.o.~.£~o&..R. o~ .............. .¢~l;e~o~.~e ............................................ pursuant to application dated .................... .~.,[~It.....2~ ............... , 19..~.~7.., and approved by the Building Inspector. Fee $..~...QO .......... Building Inspector 3. Nature of work (check which applicable): New Buildm~g', ................. Addition .................. Alteration ................ Repair .................. Removal .................. , Derdolitjdr,,.,.;..~.',...4:;... Other Work ................................................... (Description) 2)+~ 000 + 4. Estimated Cost ........ --:. ' . ..'.Tee ..... .~;3~.~,..(~) ....................................................................... ., .J,';" ' :':' (to be paid on filing this application) 5. If dwelling, number of dwelling units ........... .O.~..~ ........... Number of dwelling units on each floor .......................... :. If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, specify ndture 6~d-extent' of each-type of use ...... ' ............... : ..... 7. Dimensions of existing structures, if any: Front .............. .,..,....,........ Rear, · .......... .......................... Depth'. ...,,:-¢,';:..q:~,,,'-;: Height ........................ Number of Stories .................. [[ .......... [ ....... [ ............... ,., ....... ,. ......... ~'"'.'.'"'.'j'", ........ ,'"'", ........... Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .,..;~%~.~.,(~..[:,....:.'...,-- R'e~' ..'...~..~2.~. .............. Depth ...... .~D. ............. Height .................... Number of Stories ....... .o..~..e. ........ -:-.-.-:.. ......... ,'".',",' ..................................................................... 9. Size of lot': Front .... .1...05 ............................ ........ i.....i..' ~,~a,-']'_.9.%~:L.... ...................... Depth ..223.,3../...29.1,,.9 10. Dote of Purchase .............................................. Name of Former Owner ........................................................ I 1. Zone or use district in which premises ore situated ~ A .£~:i$.t... 12. Does proposed construction violate any zoning aw, ora nonce or regulation: ........... ~O ........................................ 13. Will lot be regraded ...~..e..~ ................. Will exc~ss,,,fill be remove~d~f?q,m~premise~: (i-~,~s,,~, 1 4. Narae of Owner of premises ~., ~,1,¢,.~.~]~:~ .~ ~ ......... Address ....,¢.l~Q~g. ft ...... PJ~oae No. ; ............... Name of Architect ...................................... ~. ...... Add~'ess.,~...~..,,...~,,..,..,,.-,.,.'.-' ~ ,Phone No, '' hone No ....................... Nome of Contractor owYte~ ' Ad~ress .' ..............: ............. '., ~ ~' '¢ ........ PLOT D~AGR'A~ ' ,,,: Tr,! "~ n,, ,. Locate clear y and d stlnctly all buildings, whetner extstmg o¢ propos,~d, ~od i~d, tCe~te 9,[l §etq.,l~ack property lines. Give street and block number or description according'to'deed;' and show stre'ef'nomes '~na iriaicote whether interior or corner Iol. See Filed an :, ~,~-i~., ,,, ~,,,, ' CTATE OF NEW YOR[<, ~ COUNTY OF .....S.A~:.~:.o..:],.~ ........... f S.S ............ . ..... ............................. ¢i.,....~.~.~.~r¢&~, ......................................... being du y sworn, '~]¢¢6~e~'an8 s'ay~?F~at he ik the app icanl (Name of individual signing contract) ............... '.',~ above named. He is the ....................................... .0.)~?.'.~.-..b...~..~e.:.r....2;.::.~.:u~....~::...~;:!r~`:"".>~..~.~.?~.~.~:.~.~.~.v..~.~.`L;.~.`.~":..~ ......................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed:~R~q~d(~J~ ~)B~k '~nd'rf6 'mdke and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set'forth in the~applicotion filed therewith'." Sworn to before me this [ / /) " 22da' of biarch , 9 ~.7. ~ /] /~ Notary/1 · Public~ . .............................. ~ /~'~ ~'.~.' Count,/ .......... ~ ................. ~gn~i~: ....................... : ..................................... New York State Department of Environmental Conservation 50 wolf Road, Albany, New York 12201 Commissioner James L. ~iggane March 15, 1974 Joseph J. Lizewski Depot Lane Cutchogue, NY 11935 RE: Petition No. 15275-0059 Petition for Moratorium Permit Dear Mr. Lizewski: Your petition has been forwarded to this office by the Local Tidal Wetlands Permit Administrator who has made a review and site inspection. As a result we have determined that construction of a single family dwellimg, located in the Town of Southold, Suffolk County, New York will have no adverse affect on adjacent tidal wetlands. Therefore, pursuant to Section 25-0202 of the Environmental Conservation Law and the Commissioners Directive dated November 12, 1973, you are hereby notified that no permit will be necessary. Very truly yours, Central Tidal. Wetlands Permit Administrator LMC:SJZ/scs cc: D. Larkin T ,I :1" DATE: E~ INSPECTIONS: OR COI~STRUCTIO~I ERRORS ALL' CONSTRUCTION MUST .M~b-[ REQUIR~J*,'U~NTS OF N,Y ~ATE CODE I