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Home My WebLink About13854-z FOBM NO. ~ TOWN O~ $OUT~OLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, hl. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No 13854 Z Permission is hereby granted t~: ~.:-.......::.::..I ....... ~.~;~.:.; ..... ~ .................... I.A.!.::..~...~ ....... .~..~. ......... ~ ................. ,o ....~ ....... .~.....~...~~ ...... ~..)...~ ...... ',;m,,e, ' l,~ ~ Co,,n~ Tox M,.p No l ooo Sexton .O, ~ ~ B =k 0 ~ ,..,,,,,. ~a~..an, ~o a~I,~at,o~ da~e~ ....~...~ ...................... . l~. and o~ro~O by Building In*pector. Fee $.ZL/. ................. Building Inspector Rev. 4/30/80 FIELD INS?ECTION IDATE COMMENTS FOUNDATION {1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY ODE FINAL ADDITIONAL COMMENTS: L.o! 12 L Lo! 15 40,7'00 /4 h~3, LT'r H SERVtC[S SURVEY FOR LOT A/O. /.~, "P~'~"T/ '~ 8/G//T " AT ON/~WT 'l~glN OF $OUrHOLL) SUFFOLk( COUNTY, NEW YORK ' FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL,: 765-1802 .... Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Received ........... ,19... 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 hi buildfl~g for necessary ~ectioffs~ t, ....--~- %..~-. ~,,..~. ,~'x~..4. ~.?.~.,?:x,_(:~.~')' ............... (Signature bx~ppl~ant, or name, if a corporat, ion) (Mailing address of apl~cant) / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .(~),.~3-,~., ................................................ .. ........... ;i Name of owner of premises .......... ct ......-.. 2. / .... : ............................................. [ (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 ....................... 1. Location of land on which proposed work ,~f,~ll be don . · .~..~..~ - ..... ...... ........... House Nun bet Hamlet County Tax M4m No. 1,000~Section . ~. [.~ ............. Block .O.~ ..... } ........ Lot..Ii ................ Subdivision ..~..J~..~ t~r..~.'~ ..-'.~?~.~fl.4_ ...FiledMapNo.~.."~.~. ........ Lot.il ............ · ..... 2. State.e isting.se and occ pancyof rem/; sandi 2 useand occupancy ofproposed construction: a. Ex~sbng use and occupancy ...~! .(&.O.....q~' ........................................................ b. Intendeduseandoccupancy ...~..~.g.~....~9~.Q.~..................... ..... ...... ........ ............ 3. Nature of work (check which hpplicable): New Building .......... Addition .......... Alteration .......... Repair .............. Removal .............. Demolition .............. Other Work ............... Cos?. ~.~. 0:t47&'~ (Description) 4. Estimated ... t .......................... Fee ...................................... i ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units .... ~ ........... Number of dwelling units on each floor ................ If garage, number of cars ... ~ ~ .................................................................. 6. If business, commercial or mi~ed occupancy, specff, y~natureandextentofeachtypeofuse ...~. ................. 7. Dimensions of existing structures, if any: Front..~.¥.\.er44¢~ ...... Rear .............. Depth ............... Height ............... Nqmber of Stories ........................................................ ~ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth .................. ~... Height ...................... Number of Stories ...................... --- 8. Dimensions of entire new con!truction: Front ............... Rear ............... Depth ............... Height ,Ndmber of Stories .......... ~; ........ , 12. p p ,[ion '2 y zoning law, ordinance or regulation: ~('~)..' ................ .~ ......... · ' 13. Will lot be regraded ¼~-& ai, ..... , ~ .. . ....... . .. Will excess fill be rem~zedd~,ve rom premises'. ~es~ ocs ' N Name of Contractor .~..~ ' i ' . Address ~ ~ . Phone No Locate clearly and distinctly all property lines. Give street and bloc interior or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensions from number or descriptioAa according to deed, and show street names and indicate whether STATE OF NEW YORK, ' COUNTY OF .~..O.~.~.~.L.~ ...... [ S.S ......... . .-~..~.~/~ ./r~.. fi~..D.~.~../f..~..~. ................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dOly authorized to perform or have performed the said work and to make and file this application; that all statements conltained 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 ............. ,...day f .... ./ff.~.~./..&~.. ........ 19~? MARY: VALERIE .:..~,,~;..w,~/~,~... ~ ..... }lot.r~ Public,faO. 416101aState of aUw ¥orl/ ~' ............... i~ig~;~;e';; app iCant)---I''-' Qllalified in Suffolk County~v~ MyCommission Expires Mar. 30, Lof 12 .~ Lot /3 ¢ ~ Areo= 40,700 s.~ ~ Lof /4 SU~Y FOR GEOPGE NEWMAN' 8 IPVING NEWMAN SUFFOL~ COL NTY DE~ A.,Fh,~ ,1 OF LOT NO. I~, "PE~Y AT ORIENT DATE: MARCH 15, HE~L~ OEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ~ ~R~ FOR WHOM THE SU~EY IS PREPARED NOTE, I ' RIVER~AD~ NEW ~RK ALDE~ W, YOUNG~ PROFESSIONAL ENGINEER ~I~ItlON MAP FI~E~ IN ~ ~ OF ~ ~ OF AND ~ND SURVEYOR N.Y.S, UCENSE NO. 12845 SUffOLK COUN~ ON dAN~ 86, 19?~ AS ~1~ NO ~9. Lot Lof 13 Areo= 40,700 s.f. 'EXCAVATION It SI)ECTIOH 'RF UiBB) SUFFOLK COUNTY DEPARTIViENT OF HEALTH SERVICES FOR APPROVAl OF CO~!STR!.ICTF~i~! Single Family HEAL~ DEPARTMENT-DATA F~ APPRO~ TO C~STRUCT ~F co. Y~ MAP ~ OTH~ THAN THOSE ~OWH NO;rE: OF THE SUFFOLK COUNTY OEPANTMENT SUBDIVISION MAP FILED IN THE OFFTGE OF THE CLERK OF SUFFOLK GOUNTY ON dAN. ~, /9)'$ ~$ FII.~ NO. $B$9. Lof 14 SURVEY' FOR GEORGE NEWMAN LOT NO. I.~, /'PETTY AT ORIENT TOWN OF SOUTHOLD I/?VING NEWMAN EIGHT" #Uf4a, UTHOR1ZEO ALTERATION OR AOOITION TO 1141S SURVEY~ ~ A VI~ATION ~ IECTION 7209 ~ THE NCOPIEi ~ ~lS S~VE~NOT ~AR~6 THE LAND ~T BE:CONSIDEREO TO~ A VALIO TRUE COPY NGU~R~NTEES IN01~TED ~EREON ~L RUN ~LY ~ ANO ~ :HIS; BE~LF ~ T~[ TIYLE C~Y, GOV~N- H~E~i ANb TO.~E ASSIGNEES OF THE LENOI~ TO ~I~AL IHST~TI~S OR SUeSEGUENT OWN~NS ~ MOiSTANCE~ S~N HEREON FROM P~ERTY UNES YOUNG YOUNG ALDEN W. YOUNG, PROFESSIONAL ENGINEER AND ~ND SURVEYOR N.Y.S. UCENSE NO. 12845 HOWARD W. YOUNG~ LAND SURVEYOR N.Y.S LICENSE N0.45895 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK ' Phone 477-0400 ~o~.2y Main Road GREENPORT, N.Y. 11944 cz~f Main Road !