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Home My WebLink About13880-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) N° 13880 Z Date ....fir.pre./..�.........�p................ Permission is hereby granted to: �...(....61?:4 .... .....3 tm ./.l. .... ...4e..0...�,1&?f AI....%5/;(LM&7................ to .... ..... Aiz../.oN.... �...k .V4M4QA(.e ........................................................................... ...,.............................. � c�... .. .7.`.................. at premises located of .El l.... IQ�d/cv /.. .4i.... J�^.....1....:"_..... .................... .....................I............................ ..... ........................ ............................ iso?t z...�7/Zrc!r� :�.... ? ........4. `J.............�e. County Tax Map No. 1000 SectionQ.10....... Block . .a.,........: Lot No. .0..5.0........ pursuant to application dated .....:,40W.(r.......1 .............. 19jF and approved by the Building Inspector. Fee $.1.5g Y ...... . . ..... .... . ...................... ........................... Building Inspector Rev. 6/30/80 14, "ro fly --Nt- Lor 7- P41)/Y lve:5, rife Aol-Ep c- CL)",</- G FORM NO. 1 TOWN OF SOUTHOLD APR 1 81985 BUILDING DEPARTMENT p , TOWN HALL BLDG. DEPT, FOUTHOLD, N.Y. 11971 TOWN OF SOUTHOC AA ( TEL.: 765-1802 xaminedA�1.4?, 19d !ii Received . pproved//4G. . .19., 19e5?�-Permit No.� a .d'v �c�Yvil Disapproved a/c . . . . . . . . . . . . . . . . .2. . . . . . . . . . . . . . . . . — _ (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 r 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 hall 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 hall 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 uilding 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 necessary i echo . . . . . . . . . . . . . . . . . . . . . . (Sigena�applicant, or name, if a corporation) (Mailing address of applicant) 1 tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C—/ame of owner of premises . . .C .�N� . . . . . . . /Q . .�. .W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . 2 Plumber's License No. . . �^.n! . . . . . . . . . . . . . . . �! Electrician's License No. �l. . 1 . . . . . . . . . . . . . . Other Trade's License No. �!� �� . . . . . . . . . . . . . . . Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ZIA y. . . . . . . . . . . . . . . . . House Number /,317e7- fei - Street Hamlet County Tax Map No. 1000 Section g . -3— .50. . . Block Lot . . . . . . . . . . . . . . . . . . . `Subdivision .CZRNPn!/l°?T. . 171?>viN� . . . A L. . . . . . Filed Map No. . .349. . . . . . . . Lot . . ./NU . . . . . . . (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . . . 3 X 25r b. Intended use and occupancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cci �Unv3J �` �� 3. Nature of work (check which applicable): New Building . . . . ... . . . . Addition . .Y. . . . . . . Alteration . . . . . . . . . . Repair ;: . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (d .(Jv� . . . . . . . . . . . . . . . . (Description) . . 4. Estimated Cost . . . . . . . .�Q1 . . . . . . . . . . . . . . . . . . . . . . . . . . ° (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . Number of dwelling units on each floor . . . . . . . . . . . . . . . . Ifgarage, number of cars , , , , , , , , , , , , , , , , , , , , , , 6. If business, commercial or mixed occupancy, specifyytP and extent of each ty�e of use . . . . . . . . . . . y. . . . . . . . 7. Dimensions of existing structures, k • g ,res, if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . Depth . � . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . $� . . . . . . �.� . . . . . . . . . Dimensions of saMe structure with alterations or additions: Front . . . . . . . . . . . . . . . . Rear . . . . . . , , . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . i . . . Height . . . . . . . . . . . . . . . . . . . . . . Numb? of Stories . . . . . . �. . . . . , . . . . . . . 8. Dimensiops,of entire new construction: Front . . .. . . . . . . . Rear . . . . . . . . . Dep . . . . . . . . Height L . . . . . . . . . N ber of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . / . . . . . . . . . . . 9. Size of lot: Front . . . . .�O . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . .� /tJ. . . . . . . . . . . . . 10. Date of Purchase . . .S .78 ich p. . . . . . . . . . . . . . . . . . . . N e of Former Owner . . /!�!�??Fl . . . ..•, . . . . . . . . . . . . . . 11. Zone Does proposed r use di coca i u thin violate are situated . . . . es(drvy '. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mate any zoning law, ordinance or regulation: . . . . .NV . 13. Will lot be regraded . . .xcs! Will excess fill be removed from premises: Yes No 14. Name of Owner of prerRises !f!!a�EJ . ^' ,,+ �, , Address .7.?! . .P'4w�. .ST. . . , Phone No. �f 77'!.S. . . Name of Architect . / —f'� ' Zo*M, Address . . . . Phone No. . . . . -dyo . . . . . % . . . . . . . . 4lliil Rd �yPr v97-oYoo . . �T/ . . . . . . . . . . . . . . . Address ??i,aAva ✓ S'i6„T Phone No. S!79-is-68- . Name of Contractor . . . . i PLOT DIAGRAM Locate clearly and distinctly1 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. wtir sTREcT / SJRuc• 31�100� r,Q C��ntLyr+n'" hn 110 � '] �A�Ali STATE OF NE S.S COU Y OF , ( a .. . . signing v • • • ' • • ' ' ' • • being duly sworn, deposes and says that he is the applicant me of individual contract) above named. Heis the .'. . . . . . . . . . . . . . . . . . . . . . . . . . `-??i . . . . . . . . . . . . . . . . . ... . . . . . . . . . ... . . . . . . . . . . . . . . . . . . (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 . . . . . . . . . . . . . . 1 '. . . .d . . . . . . '.. . . . . . 19� . Notary Public, . . . . . . . . . . County <va.u46716U6 -S. MOUSE H _ .of Now York ( . . . . . . . . . . . . . . . . .',',,A,,PUBLICC, Slel hark Courtly oYLVIR „„, p pea6 901 19 (Signature of applicant) e eq AP d� AS 'N'OTQO �/ �@,l j'I'� JL'J'1 ViFUL DATE:c{ P. '# 15370 'G i ' � � SOLDER USED IN WATER FEES=BY : _ i � TE SUPPLY SYSTEM CANNOT NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE �� o �Y � � EXCEED 2/10 of 1% LEAD. FOLLOWING INSPECTIONS: db 1 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING PLUb2BER CERTIFICATION 8. INSULATION ON LEAD CONTENT BEFORE 4. BE FINA - CTE FOR MUST I BE C^MPI_ETE FOR C. O. f �r tubing is used CERTL%'ICATE OF OCCUPANCY ALL CONSTRUCTION SHALL MEET i If Copp' THE REO'IIREMENTS OF THE N Y. for water distributing STATE CONSTRUCTION & ENERGY shall be CODES. NOT RESPONSIBLE FOR system; ':,IngO': CO.°1STRUCTION ----- -- -' - k f r,,, e. - _ of types K or L only 6e 7 no..ii G 7 in - _ u �P '9 IE`a.L Zr�x fcr.c MEW _ . �. ) llJj tq _ �� G•PET SKY UCH'I I I , L 2 % L_ r,�v 19' • NCS_ . aPENiniG 1Z o---SPAN Ex ,3n�r� l tx 2EU lzno'� I feed Lrn� SEWu - 11 A -r.,, A .. HALL_ (!k �, CL :o �o .0AIL A. I rtR Ccoe AL-1 fJ:H�i�f cP p n�'A I_ k I ..wns ,♦♦d"''RY' - o' r �=r 5s SE[-r ��ry C F _dlEe—_, d�4 � , :71 �F'PU MS W;70 fLPT CEI LI nI tr FP1 rl l L.,s R nr i — ----�= �Jr 'BED Rar.o-f ti b ` 9 ' I�' v� Ts toK Coivpc c SAiloe� Ca�c7�o�I zz>< z � 8�0 ��i\ a' q.� �-.. . /t �C�c,rl4:0 3e47 o txfSTlu 38'n'- a . __-. 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