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Home My WebLink About13359-z "am NO. a TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1 M 13359 Z Date . 1 �............. 19i Permission is hereby granted to: ....Y:.....� ................... a. �....... ..........:... -... �. ..... . .. .... .... ...�, ..J.3...7 ............. at premises located at .s .... ........... ............:.h ?? ! ...:` `#. ...... ... ....................: ................................................................................ ................................................................................ ..................................................................++............................................................................................... County Tax Map No. 1000 Section ..../..w�.�i�...... Block .......a.......... Lot No. ...a ............... pursuant to application dated �''O .... 1.�.5............ 141., and approved by the Building, Inspector. \ Fee 5...�:14&P... !! .............. Buil ing Inspector Rev. 6/30/80 FIELD INSPECTION DATE COMMENTS H FOUNDATION ( 1st) a FOUNDATION ( 2nd ) — M 2 . 14 o ROUGH FRAME & -O PLUMBING - to H 3 . r� INSULATION PER N . Y . y STATE ENERGY C40DE t� 4 . H FINAL o ADDITIONAL COMMENTS : G[u >a ro H O Cf v � r � H x •d 1 � 0 ro H -a TEL. 765.1802 FUN(CpG TOWN OF SOUTHOLD 'f OFFICE OF BUILDING INSPECTOR 11.0. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 This is to advise you that the job under building permit no . 13359Z issued to Raymond Pynn on 8/16/8.4for New Dwelling is completed and a final inspection list; ( ) has not�been done . An Underwriters Certificate is needed fn order to complete this file , it is necessary that a Certificate of Occupancy be issued . Please fill out the enclosed form , return same to the above office with a check for $25.00paynble, to the Town of Southold . Please indicate to Whom the Certificate of Occupancy is to be mailed , and arrnnge with this office for an inspection date . Occupancy or use is unlawful without a Certificate of Occupancy . Plense help un to clear tip this mntter so that legal action does not hnve to be taken . ; 'thank you for your prompt attention . Very truly your.B , ' ..t Cid- ttio MA--GL Victor Lessard lixecutive Administrator VL : gar Alsoineeded: Foundation 1 & 2 , Incl . Rough Frame & plumbing, and insulation inspec— tions. . zlk� A., I a�a — FORM 336 - S/a y TOWN OF SOU 1 OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765.1802 Examined��tLo�1. 19d . l�P . ., �( .: 7 R@ceived . . , , , , , 19 . . . Approved 19$. 7. Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . . . . . . . . . . . . . . . . . .. 19 . . . INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted 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 appli- cation. 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 issued 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 construction of buildings, additions or alterations, or for removal or demolition, as herein described. I The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulati ns, and to admit authorized inspectors on premises and in building for necessary inspections------- (Signa t;r-e nspections(Signature o applicant, or name, if a coon) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Mailing address of applicant) State whether applicant its owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. G/.4 4/ / . . . . . . . . . . . . . . . . . . . . . . . . .C... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . ��'`??� `�D. . .'.' ' ��'J . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as n the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . .. 1. Location of land on which proposed work will be done. . . . . . . . . . House Number Str et Hamlet County Tax Map No. 1000 Section . . . . . A�35. . . . . . . . Block . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of pre is and intte�nded use and occupancy of proposed construction: a. Existing use and occupancy . . . . .v7esi k;�!I.'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy LUeI L /W.G' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E : 3. Nature of work (check wl,ich applicable): New Building . . �!. . . . . . Addition . . . . . . . . . . Alteration . . . . . p a . . Repair ; : 1 Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . (Descriptior, 4. Estimated Cost J. . . . . . . . . . . , Fee . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this ap lic1ation) g, dwelling units . . . . . ��✓. , . . . . . Number of dwelling units on each floor . . . �e? . . . . . 5. If dwelling, number of 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 . :, . Dimensions of same sight tructure. Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . Depth Height . . . . . . . . . . . . . . . . . . . . . . Number f Stpries . . . . . . . . . . �. . 8. Dimensions of entire new',construction: Front . . . .to/ Rear . ,.umber , , , , . Depth . . . . . mber . . . .ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . .� Rear � . . . . . Depth . /.�r 10. Date of Purchase . . . . . .j. . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . Y g g /V4. . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate an zoning law, ordinance or regulation: . . . 13. Will lot be regraded L�. .' n . . . . . . . . Will e�tcess f 1 b ret. v frot�},premises: Yes 14. Name of Owner of s/7i9j�HGLVl� /U!t/Addres7""' ti i. .. ... one Nor7!a:. . . -S/O. Name of Architect . . . . .ii. . . . . . . . . . . . . . . . . . . . . . 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 fi property lines, Give street and;block number or description according to deed, and show street names and indicate whet interior or corner lot. fy , F � f II STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . . . . . . : . . . (Name. . individual. . . .. . . . . . . ' ' . ' ' ' • • • • • being duly sworn, deposes and says that he is the applic signing contract) above named. lie is the . . . . . . . . . . . . . . . . . (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 t application; that all statements;contained in this application are true to the best of his knowledge and belief;and that work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ! , ?. . . . . . .day of. . . . . . . . . .. 19 � Notary Public, . . . . . . .hl. �i , ,lJ`�. . . County --- HELEN K.DE VOE l�yyy ./° ° ° . . . . . . . e - NOTARY 708878, State of New York Q�BgYYatYDY'^L' ®�appllt�a TermExpire 8,Suffolk Countyy� — Term Expires March 30, 19-4�IS 7r � , ! SUFFOLK CO. HEALTH DEPT. APPROVAL H. S. NO. II -------- STATEMENT OF INTENT `AT THE WATER SUPPLY AND SEWAGE DISPOSAL jo SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUFFOLK CO. HEA CES. (s)— AM - -vgaffim'effi� lvrffl�- APPLICANT 0 E 32 n SUFFOLK COUNTY DEPT. OF HEALTH SERVICES - FOR APPROVAL OF r 'A rJ CONSTRUCTION ONLY ;5 1 DATE: FEB 06 W4 H. S. REF. NO.. 14 Lee) i"t APPROVED. 7 'A SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL. OWNERS ADDRESS: 7 12 In wP. DEED: L.55? TEST HOLE STAMP 72o;OF ni, -STATE To P,lH 71 L A, suzy., RRN' SEAL tl IR615fk ICK VAN TUYL, `� LICENSED LAND SURVEYORS GREENPORT NEW YORK TELEDYNE MST N32477