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Home My WebLink About16468-zTOWN OP $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 16~;o8 Z Permission is hereby granted to: I .~ /'It ~ ~ . ....~...?.~..~....~.... ................................................. ..... ........ ....... at promises located at .~. <~..~.~...~....~........~.~...~..*. ........ ...0....~ .................................. County Tax Map No. 1000 Section ..... ..~..J...~.. ......... Block ...... ..~....J~q ....... Lot No ......................... pursuant to application dated ...'~..~..~......L..~........,c-~ 19..~....'~., and approved by the Building inspector. Fee $....~....~....:..~ .~,,4~C~ C~g4'~'~ ........................................... Building Inspector Rev. 6/30/80 .... TOWN OF ,SOUTHOLD 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL.: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK gEPT%C FORM ............. NOTIFY CALL ................ MAlL TO: Examined ~. ~v~ .~, 19 .~.]. Approved~..~'~4,.~,~., 19~.?. Permit No/..~.~. ~ .~..~. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................. , 1 ... 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 ~b,een 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. The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. f~Signature of applicant, or name, if a corporation) · (Mailing address of applicant) State whether applicant is_owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........... O ~.~,..e?f.~. ............. :: .'. '.7.~ ............................................... Name of owner of premises . .~.(~.b~ .~.'.JT..: ~..,..~....~...~. ~:'.Z:-.~.~.7.(~..~.~. ,.. !5'.~77 ~ ~ ......... (as on the tax roll or latdst deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of co, orate officer) · ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED 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 .................................................. ~.~..s~...-7.. .../~7../?/.z¢. ~.z).. ................. ~7£/.~/~.. ~ .......... ~.. House Number Street . Hamlet County Tax Map No. 1000 Section ....... .~../...~.. Block .... .~...Qe. ......... Lot...> S~u/b/ddi~is~mn.../..~...b~...~...O. .....&....~..0.~..~. il ..... Fiied Map No. 'Lot ............... (Name) 2. State existing use and.occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....... ............................. - ......................... : · ~ ..... b. Intended use and occupancy . . ..... ........ .. .......~ ................. 3. Nature of work (check which applicable): New Building ..... ' ..... Aa, ~on ....... _... A,l~t~htion .......... Repair .............. Rempval .............. DemohUon .., Work! ............... (Descr/~)~tion) 4. Estimated Cost .. ....... ~ ............ Fee - . .... ~ . ...... ~to~ prod on filing thi~ application) ~if dwelling, number o f dwelling: units ............... Number of dwelling units on each floor ................ If garage, number of cars .... . ................................................................... business, commercial or mixed occupancy, specify nature and extent of each type o~ use .; ..... . .............. 7. Dimensions of existing structures, if any: Front ............ ~... Rear ........ ';. .... Depth ............... Number of Stories Height ............... . ............................... D~ens]ons'of s~e structure with alterations or additions: Front ................. Rear .................. Depth HeiSt Number of Stories ' '-~ Dimensions of entire new const:ruction: Front .......... . ..... Rear ............... Depth ....... Height ............... Number of Stories ......................................................... 9. Size of lot: Front .......... ~ ......~....~.. ~r ...................... Depth ..................... ~/Zone or use district in which p~emises are situated .............................................. V...~ ~. Does proposed construction violate any zoning law, ordinance or regulation: ........................... "~ 13. Will lot be regraded ..... ~.. .............. ~ ...... Will excess fill be removed from premises: ~s 14. Nme of Owner of premises ~O~..~..fi~¢~ Address ~.~. ~.~ .... Phone No..~.. ~.~ Nme of Architect ......... . .................. Address ................... Phone No ................. Nmne of Contractor ........ ~ .................. Address .... : .............. Phone No ................ ~5. Is th~s property located~wSth~n 300 feet of a tSdai wetland7 *Yes. .... No ..... *If yes, 8outhold Tom Tr~stees ParmSt maybe required. PLOT DIAG~M Locate cle~ly ~d distinctly ~1 build~gs, whether existing or proposed, and. indicate ~1 set-back d~ehsions from number or desc~ption accordin~ to deed, ~d show street nines and indicate whether property lines. Give street and block interior or corner lot. q. 9 STATE OF NEW YORK, S.S '~ COUNTY OF ................. r~ ............... . .................................... i being (Name of individual signing contract) I above named, i 3. INSULAT{O~ I duly sworn eposes and says that he is the applicant' He 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 this application; that all statements contained in this application are true to the best 6f his knowledge and belief; and that the, work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ........ :. · ./..~. ...... day of .... ~ ...... . .... 19 Nota,'jPublic, ..' ..... '. ?...~_~... ~.~.~ .~..d~. County /~ ~'_N~Y PUBLIC, State of New Yedc . NQ._4707878, Suffolk County,~v~. ~a'm z-xp~res I~rch 30 1~_ MAP OF HiLL LOT 2 $/,f N 78°34'40'' E. CR EST PLOT 2 N/O/F MAY WATSON R,O W S PLOT 3 78° 34'40"W N/O/F MAIN ROAD P.O. MAIN ROAD SOUTHOLD~ N.Y. 11971 .lC. N0.49668 PLOt NUMBERS REFER TO "MINOR FOR HOWARD L YOUNG ESTATES LOT I PLOT AREA = I. GEORGE L YOUNG SUBDIVISION" MADE SECTION NO. 1 FILE NO. 7218 PARK AREA 302 26' 61 ACRES 327 04' MAIN ROAD ( Ny, S,Rte, 25) CERTIFIED TO - FIRST AMERICAN TITLE INSURANCE CO OF NEWYORK REM ABSTRACT CORP. ROBERT A. KEHL SHELLEY G. KEHL TITLE NO. 585 S 0151 SURVEY OF PROPERTY AT ORIENT TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y. lO00 018 06 P/O 24 SCALE I" 30' AUG, ~1, 1987 Prepared in accordance with the minimum standards for title aurvey~ as edablished by the LI.A. LS. and approved and adopted for such use by The New York State Land Tille Association, 87 - 669 (I)