Loading...
HomeMy WebLinkAbout14786-z FORM NO. $ 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) NO 14 / 06 Z Date ..... ��..�................., 19..0.. ... ............... Permission is hereby granted to: -w{.../.......................... . '......�, .. ' -� ......a-..... .0.:�,, ,. ................................ ................................................................................................................. ................... .............................. at premises located at a .9S ......rd..Q-tnn.�dG...�............i..7.1. rAe'4Mf�4�................... ................................................................................ ................................................................................ ................................................................................................................................................................ County Tax Map No. 1000 Section ......� Block .......�......... Lot No. ...... ..(............ pursuant to application dated .....`AKN .K.....1.te...................... 19.3.0., and approved by the Building Inspector. YYY Fee $. fJ....'............ Building Inspector Rev. 6/30/80 rAR1 i„zi +.t.;.rya a i ;t,, •oft.kk`-+% FORM NO. 1 " �'?ok to TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 10SOUTHOLD, N.Y. 11971 TEL.: 765.1802 LD Examined .l S flv!!�. . a ., 19 �?° Received . . . . . . . . . . . . 1 9 . . . Approved a. . ., 19�b. Permit No. .j Y. CIO S60� Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 1k CX (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .,!•L'. . . . . ., 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, build' g code, housing e, and regulations, and to admit authorized inspectors on premises and in building for necessary inspe 'o s. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . \ ( 'gn ture of a plicant, or name, a or . . . . . . . . (mailing•add ress•of•app i icant5 . . . . . . . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 1�111_I� _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . . � �� (as on the tax roll or latest deed) If applican 's a corporation, si atu of duly authorized officer. '11h I . . . . . .4. . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No . .F��c� I. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . ou N l'. . . VZ 5. . . . . . . . . . . . . . . . . . . . . . . ....�k1�1 '( `. . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . ... . . . . . . . Block . . . .ci�. . . . . . . . . . Lot . I I . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed 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 . . . . . . . . . . . . . . �. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . '. . . . . . . . Alteration . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . Other Workx55 .4 G A4 (Description) 4. Estimated Cost . . . `U . . . .0. . . . . . . . . . . . . . . . . . . . . . . . . Fee ' S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) S. If dwelling,number of dwelling units . . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .�ClH?P�.! C✓.�I� 7. Dimensions of existing structures, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . '. . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of,Stories . . . . . . . . . . . . . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number ofStories . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . '. . . . . . . . . . . . . I . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . ' 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . '. . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes �Io 14. Name of Owner of premises .... . .`... -P ��!'�$(ddress�. !S��!?�.a ^<E 41Y. phone Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . ''. . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . '. . . . Phone No. . . . . . . . . . . . . . . . 15. Is this property located within 1.00 feet of a tidal wetland? * Yes . . . . . No . . . . . * If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and,indicate all set-back-dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. AppnOVED AS NOTED B.Py - 1'rIFY kslI,ILDING DEPARTMENT AT 4 A TO 4 PM FOR THE FOK. .Quvfk, INSPECTIONS: 1 1r1 If VDd+-rIUh1 '4'K1+1O REQUIRED 1=CsR PL) IlLU C . NCIik tE s ?�OIJ�3N PRAYd1ING & PLUMBING 3. INSULA'Orl tt. F t k%(l 'COHSTRUCT1ON MUST ESC (-'Ow�i°R_FTE FOR C-11 ALL r;.'ON4 IALICTION SHALL MEET THE InECI.UiP MENTS OF THE N.Y STATE CCINSTRUUCTION & ENERGY STATE OF NEW YORK, CODES. NOT RESPONSIBLE FOR COUNTY OF ES G�i2 a � rn, deposes CONSTRUCTION ERRORS,. • . • . • • • • � °. . . . . . . , being duly swoep . . w� nd I uses and says that he is the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 of 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 . . . . . . . . . l. . . . . .day of. . .� . . . . . . . ., l9a, No�ta,pry. Public, . . . . . . . . . A ��C . . . . . . . . . County KJ� . . . . . . . . . . . . . . . . . . . . . . . . . . Z �g (Signatu of applicant) Term Explra DeaMnber 91,1 / I ° S.19-03'00"E, BERGEN DATE AVENUE . Z m 1479 a0' S.18°17'50"E. ' 50.00' oN ° �� '�� W O ° `�—�� 0 WOOD FENCE 3 0p m 5.18°55'40"E 49 994' s9 s ' Z now or formerly Joseph A. Wanat (5) °°o FENCE Do LI 0 0 o-- 0- o o- y� o O r Zm I 9.20025'00"Ew ��Oh6 392.02' S 19°27'50"E. 64302' S 20043'00"E LO O 33'50W 250. WOOD FENCE m 819.7 - S29-03'30"EIEAW.+• --*'—�--.—. O oO' O i„ 429.45' CHIND - O' as SHED I POOL LOADING METAL SHED GRASS RAMP �� �'• O CO SOC OC m '... °o O m m METAL DARN O N GRAS, e1 L .Nz lyf WOOD FENCE �' SOXCTRIC SU C5 m 0 LIL z O a s \ 9 2� Q WOOD NCE T x � 695.00' rW N.19°26'50"W 271.26' N 18°32'20"W' 324.06' � Ap `o L N.24°OS 00"W 228.10' N.19°16'00"W 0 896.07' - N.19°30'10"W 83381' / C ° i DOW or formerly John 81 Rose Koroleski CD SURVEY FOR ROBERT ENTENMANN AT MATTITUCK TOWN OF SOUTHOLD SUFFOLK COUNTY , NEW YORK SE OF NEK.r NOTES rOiLpnO W. fO`OT>` I. • = MONUMENT 2. SUFFOLK CO TAX MAP �F DIST 1000 SECT 120 BL 02 LOT 03.1 '�'iV1ON eN•M e A WMAllgl q 3 TOTAL AREA = 38 8721 ACRES e4 ft wNw+es eey • WE/AM INe�uw. • == mu,ler,r NJI ley ewN• �4x ° 4589$ ee me OL1 aMW eeLP N W N A�etl1 MO cor,r 'PFD 4NN SME'rt'+�' ' !I II•IMIO wwam WALL q e leew•..oD aY xis•x'�'.0 ro>� �((/�,•�. ,1 u C91YNfF.00'Y�PApIPAI Aoe4T aw nnw MMUDDH Mum NeeeK 40 APR 4, 1966 �a•e M ee ve•e1e eq YOUNG 8 Y0 ALDEN W. YOUNG,NNS PE 8L.S LIC.N0. 12645 n"�"n °•°Y''qe O� Saloum SCALE I"= 100' 40005TRAIN AVE., IVERHEAD,N.Y. NO BG-126 HOWARD W.YOUNG, N.Y S L S LIC,NO.45895 «.0