HomeMy WebLinkAbout15044-z I~OIR~ NO, ~
TOW'H OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERJ~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No. 15044 Z
Permission is hereby granted to:
,o
ot premises Iocoted ot .......... (~.. ..... t ....... ~; ......
County Tax Map No, 1000 Section ........ L../.../. ......... Block ........ ./.,/. .......... Lot No ..... ,./~.. ...............
pursuant to application doted .... ..~..~..~.....~.. ................... , 19.~...~., and approved by
the
Building Inspector.
Building Inspector
Rev. 6/30/80
VICTOR LESSARD
EXECUTIVE ADMINISTRATOR
(516) 765-1802
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 2, 1988
James R. Lechmanski
14 Central Ave.
Garden City. Park, N.Y. 11040
Dear Mr. Lechmanski:
I am writing to you regarding B.P. #15044Z
issued June 28, 1986.
If work has not been started within one year
the permit is void. Since you have not begun any
work under this permit and the year was up on June
28, ]987 the permit is now void.
VGL:hdv
urs trl~l~L~y,:',/ .~
Victor G. Lessard
Executive Admin.
FIELD I~SFEC~~ON
FOUNDATION
(1st)
FOUNDATION
(2nd)
ROUGH FRAME &
?LUMBING
INSULATION ?ER N~
STATE ENERGY
CODE
COd ~E~S
FINAL
ADDITIONAL COMMENTS:
'FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined..~gd~L-4 ~., ,~ ..... 19 ~.~.
Approved . . .~...,3.~....~..~. ,., 19 ~.~. Permit No. ! .~?}..q.~..~..
Disapproved a/c .....................................
(Building Inspector)
APPL.CAT~Orq FOR EJJ!LD]NG PERMIT
Received ' ,19
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.
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 building for necessa~inspection~) ~. ~
_ . . .~...,T,x.,.,.,.,.,.,~ .q.~. ~,~-x r'y~.. ~'..,'.,~.. .....
,~. . ~ z) ~- ,_ \ ~(Signature of applicant, or name, if a corporation)
_.,............,.,
(Mailing address of applicanf)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.... .O...V~..617.-V: ............................................. , ....................................
Name of owner of premises .\1..~..h?~..x.--x .~...~,..L .~..¢-.k .~'h..~.~...~..~.~. ....................................
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(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. .......
...................... ..... ....... e.,/.. ................................
House Number Street Hamlet
County Tax Map No. 1000 Section ........ /.I.I ........ Block ....... I't ......... Lot. ~.:....~. ....
SubdivisionL~.-.~...F.~..~ ........... Filed Map No. ?.0.~. ......... Lot ..k].~...~. ........
(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 .... O^ff_ ~t'v4 1-~
Locate clearly and distinctly all buildings, whether existing or proposed, and. in
property lines. Give street and block number or description according to deed, and sho,
interior or corner lot.
3. Nature of work (check which applicable): New Building .: .... Addition ..... Alteration . .i.. .
Repair .............. Removal .............. Demolition ........... !... Other Work
, (Description)
4, Estimated Cost .............................. Fee ..........i ............................
' (to be paid on filing this application)
5. If dwelling, number of dwelling units ...... [ ........ Number of dwelling uniis on each floor ................
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 ....... i ....... Depth ...............
Height Number of Stories
Dimensions of same structure with alterations or additions: Front ............ : ..... Rear ..................
Depth ...................... .Height ......... ,; ........... Number ott'~Stories ......................
--~8, Dimensions of entire new construction: Front .... ./2.~.': .O ...... Rear .... (a.~..°. ...... Depth ...~ .6.'.O. .......
Height l~. . .'... Number of Stories . . .I ~ .
10. Date of Purchase .O.e.T.,..0.~.~. [ .cl.~.l ............... Name of Former Owner ~.l?n[.~.t9 ..~: .nTvYMt. ...........
I I. Zone or use district iu which premises are situated.. S.o 9.~. o [ d.. iH, Ut.. i..' . .
12. Does proposed construction violate any zoning law, ordinance or regulation: .... ~p ..........................
13. Will lot be regraded ........ ~/.0. ................. WilI excess fill be l:emo~te~ from.ureinlses: .- Yes No
Name of Architect ........................... Address ............... I ....Phone No ............ . ....
Name of Contractor .......................... Address ............... ,;.... Phone No ............. '
PLOT DIAGRAM
ticate all set-back dimensions from
? street names and indicate whether
STATE OF NEW YORK,/ q ~
COUntY OF ................. ~'~ ~ ~
................................................. being duly sworn, dep6ses and says that he is the applicant
(Name of individual signing contract)
abuve named.
He is the ............................................................. , ...... .....' ..................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the ~aid work and to make and file this
application; that all statements contained in this application are true to the best of hi! 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
~ ,,-.2'~ (Signature of applicant)
'i
. . ¥~ J'Jl~s I~/~Si~leE will C,o~F~r,,rl t~ I~ ~I/~N'cJ~tR(ts RODER(CK VAN TUYL. P.C.
oF TIq~ S,,F~:oit{ Co~t,ii'~, b~F, o-F' I-t~.n L%," ~. '~'~.--
GREENPORT NEW YORK
SUFFOLK CO. HEALTH DEPT. APPROVAL
h S. NO,
STATEMENT Of INTENT
THE WATER SUPPLY AND SEWAGE DISPOSAL
SYSTEMS For THIS RESIDENCE WILL
CONFORM tO thE STANDARDS OF THE
SUFFOLK CO DEPT. Of HEALTh SERVICES.
(si
SUFFOLK COUNTY DEPT. Of HEALTH
SERVICES -- FOR APPROVAL OF
CONSTRUCTION ONLY~.! [r~
APPROVED ~ /~ ~ ~
SUFFOLK CO. TAX MAP DESIGNATION:
DIST. SECT BLOCK PCL
OWNERS ADDRESS:
14- .5: ~, /?/~' .' ~"i ~':
DEED: L. ~'O'7L P....~ :.
TEST HOLE [ STAMP
I
SEAL
SOLDER 'USED IN WATER
suPPLY SYSTEM cANNOT
,: c.~,~UPANCY.OR
2/10' of 1% LEAD.
EXCEED ,,
}:;: .,,U,$E~ IS UNLAWFUL'
WITHOUT' CERTIFICATE
/',OF'OCCUPANCY : .
PLUMBER CERT~CA
ON LEAD CONTENT BE_F~RE
CERTIFICATE OF OCCUPANCY
~, ' , , ~OTIFY ,BUILDING DEPARTMBNT AT
?*;5.1802 9 ,AM TO 4 PM' FOR THE
, ~,~lplng I~ll ~ 2 ROUGh FRAMING b PL
_ 3 ~Nsu~no~ ,
~" '' " ' BE COMPETE FOR C.O.
, ALL CONBTRUC~ON SH~ M~ '
THE ~EQUIREMENTS OF
d /
.)
Phone 477-0400 ~, Main Road ;,"
GREENPORT' N'¥1'11944 ' t''i
T
Pfione 477,0400 ~ Mai,l
GRFENPORI~ N.Y. t 1944