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Home My WebLink About16638-z lvOR~ NOo 0 TOWN OF SOU'i~IOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, H. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N-°16638 Permission is hereby granted to: ...~.~.....~.~......~......~.: ............... -. ...~.~.v..~._~...~..: ...... u.~..~ ..... . ,o .e~u~ ...... ~.~a~i.~....~...~ .... ~........0~..~..?.: ............... : .......................... ~ .................................................... at premises located at ...~..,~......~ ....... ...~..~:....~. .......... ...~..~~ ................... County Tox Mop No. 1000 Section ...... ~;..~...~.. ...... Block ........ ~.} ........ Lot No ..... ..~:...~..~. ............ pursuant to application dated .... ~O...~...l...~ .............. , 19.~..~..., and approved by the Building Inspector. Fee $. ~..~...~..~./.. :....../ Building In.~ector Rev. 6/30/80 FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved /~.~. [~., 19~.TPermit No ............ Received ........... ,19... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ...8.e.p'~....1. ~ ....... 19.8.7. INSTRUCTIONS a. Ttds application must be cmnpletely 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 l)epartment for the issuance of a Building Permit pnrsuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordin,'mces 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 inspectom on premise~ alld in building for necessary inspections. ·.. Gr~.enpor.t .Deu~./.op~Pnt. ¢~. ............... (Signature of applicant, or name, if a corporation) ...53..Glen..CQVe. Rd,. Gr.eeo¥a.%~,. N...% ..... '~./: (Mailing address of applicant) 11548 State whether applicant is.~owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Nmne of owner of premises ..... Gr ~.e. npor.t..DeyD.].qp~a~t,. (~O.. ........................................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly anthorized officer. Wolowit~ - Partner (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 donm N.Y.S. 25A (North Road) North...........~Side Greenp.o.r.t, Sout..hol. d, New Y. or,k. House Number Street Hamlet County 'Fax Map No. 1000 Section ................. Block 01.00 Lot 025. 000 035.00 ...................................... Subdivision Breakers at Lands End ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended ese and occupancy of proposed construction: a. Existing use and occupancy Farm-Woode.d d nd .R.e..c.r.eatio.n Fac.ili. t,~; (private) b. Inten ed use a occupancy .......... . ...... 3~ Narure of work (check which applicable): New Building ...X..' ..... Addition .. Alteration Repair Removal Demolition ................ ........................... · ............. Other Work ............... (Description) 4. Estilnated Cost .... $5.0.Q ~ OD.0 ........................ Fee,. ...................................... 't ' ling this application ~ o be paid on fi ) 5. If dwelling, number of dwelling units .............. Number of dwelling units on each floor ...... If garage, number of cars ................ ' ......... 6. If business, connnercial or mixed · ' ................................ occupancy, specify nature and extent of each type of use . Pr. ivol:.e..¢¢~ ..... 7. Dimeusions of existing structures if any: Front Rea ................ r .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions'of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... iteight ...................... Number of Stories ...................... -- 8 Dimensions of entire new construction: Front .175 Rear .1.7.5 85 .......................... Depth ............. Height .... 3.Q ......... Number of Stories .... .2 ................................................... 9. Size of lot: FrOnt .R¢.f.e.r...t.q .$~.t.o..P..lo.n' Rear ...................... Depth ................ 10. Date of Purchase ...................... Name of Former Owner .l~r~.c. lqr~ock .A~.q,. ii. i... 11. Zone or use district in which premises are situated... M ......... 12. Does proposed construction violate any zoning law, ordinance or regulation: .. 13. Willlot be regraded Yes · ' ......................... ..................... Wdl excess fill be removed from premises: Yes 14. Name of Owner of premises Oreenport p.e.v.:..C.OAddress Greenvale, .I?: ?..Pi~one No' .~13.4..:~5fi.0.. NmneofArchitect .O.a.r..y..D... Cannella .A.s.s..o.c..Address Huntington N.Y. Phone No. 673-0001 Name of Contractor .......................... Address .... ~ .............. Phone No .............. t5. Is this property located within 300 feet of a tidal wetland? *Yes ..... No ..... · If yes, Soutbold Town Trustees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frown property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ;TATE OF NEW YORK~ :OUNTY OF..5.0. ¢(=Pl {~L. .... S.S ...... ~f.0. c..e..../-g) .~ lc~.~ i ~ ........................ being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. le is the ......................................................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, and is dnly authorized to perform or have performed the said work and to make and file this pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the 'ork will be performed in the ~nanner set forth in the application filed therewith. worn to before me this ...................... day of.. em otary Public, ......... ~ ............ Connty BARBARA DIACHUN _ No, 4635190, ~O ~ ~ y ~ g6 ~ C ~mmiss~on ~xp~r0s Octobor