HomeMy WebLinkAbout26388-zFORM NO. 3
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)
PERMIT NO. 26388 Z Date MARCH 13~ 2000
Permission is hereby granted to:
PATRICK LONIESKI
315 GREEN WAY
CUTCHOGUE~NY 11935
for :
CONSTRUCTION OF A NEW SINGLE FAMILY DWELLING WITH ATTACHED TWO CAR
GARAGE~ FRONT STOOP & REAR DECK AS APPLIED FOR.
at premises located at 315 GREEN WAY
County Tax Map No. 473889 Section 109
pursuant to application dated FEBRUARY
Building Inspector.
CUTCHOGUE
Block 0005 Lot No. 014.023
23, 2000 and approved by the
Fee $ 759.80
Authori~ S lgnatfre
Rev. 2/19/98
ORIGINAL
STATE OF NEW YORK )
)
COUNTY OF SUFFOLK )
SS.:
, being duly sworn, deposes and says:
That deponent is over the age of 18 years, and resides at
That on the a-~ day of .¢~-/~,~/k.-7
/
,1999, deponent, being the
architectJengineer, licensed by the State of New York, hereby states that s/he
accepts full responsibility for the accompanying plans compliance with the New
York State Fire Prevention and Building Code (9 NYCRR).
Sworn to before me this
C~-~ day of
19-99.-,~ 00 O
Notary Public ~j~
LAURA HOGAN
NOTARY PUBLIC, State of New York
No, 500961t
Qualified m Suffolk Coun~ ~ ~
cc: applicant
FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION ( IST)
FOUNDATION (2ND)
ADDITIONAL CO!~NTS:
TONN OF SO1JTItOLD
BUILDING DEPARTHENT
TO~I ItALL
$OUTHOLD, N.Y, 11971
TEL: 765- 1802
Disapproved a/c ..................................
(Building In~i/e~tor) (/
SEPTIC FORtt ...................
NOTIFY:
CALL '. ........
HAIL TO: ....................
APPLICATION FOR BUIlDInG PERHIT
INSTRUCTIONS
a. 'Ibis application ~st be c~apletely filled in by t~e~riCer or in ink and anl~irted to the Building Inspector w
3 sets of plans, accurate plot pIan [o ~cale. Fee ~ording to schedule.
b. Plot plan sho~ng location of lot and of buildings (aa premises, relationship ro adjoining prem/ses or public
streets or area~, and giving a detailed de~criptiee of layou~ of property m~r. be dr~x~ on the dingran ~/aich is pa~t of
this applicatico.
c. 'lhe ~ork covered by this application my not he em~enced before issuance of Building Pemit.
d. Upon approval of this application, the Buildinglnspector ~ill issue a Bu/lding Pemit to the applicant. Such
pemit shall be kept on the preaisee a~ailable for inspectioe throughout ~he ~ork.
e. NO building shall be occupied or used in ~/~ole or in part for any purpo~ ~harever ~mcil a Certificate of
Occupancy shall have been granted by the Building Inspector.
APPLICATICa'I IS I~llEBY [[a2[E to the Building Deparr~nt for ~ ism of a ~ildi~ Pe~t ~t to t~
~ildi~ ~ Ordim of ~ T~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~r a~li~le ~s, ~imes or
~lati~, for ~ mt~ti~ of ~ildi~ ~iri~ or alteraci~ or for ~al or ~litim, ~ ~in
~ri~. ~ applier ~s to ~ly ~ ~1 a~li~le l~s, o~,.~i~i~, ~i~ c~, ~
~ili~ ~m~f
State wt~ett~er applicant is owner, l~esaee, agent, architect, engineer,' general cootrantor, electrician, plumber or build{
............................ .........................................................................
·
lq,~ae of owner of premises ........... ~.; ........................................................... ' ....
If arq)Ii siguature of duly anChorised officer.
........ ............................
(Nam amd title of corporate officer)
Builders License No ..........................
Plumbers License Ro ..........................
Other Trade's License No .....................
I. l~catice of laml ce ~/fich propoand ~ork w/II be do~ ..............
ttomse h~ber Street
ocunt~J Tax Map blO. 'OQO Se~tlon ..1...~.. ........ .Block ...0.~.~. ......... LOt .l..~..~.~..~.. .....
2. Stare existing nse and occelmocy of pre~i~es ~d inteeded u~. ~ed occ~an~ of proposed coa~tmction:
a' Existing use and occulmac-7 ~ i--~.~f-- ..~- ~.. ' ........
b. lnterfled use and occupancy ......... . -.
P~ture of ~ork (check ~id~ ap~ licable):
~ir . ~,~1 ~litt~ Otl~r
Est i~mt~ ~st , f~ ................
(to ~ ~id ~ fili~ this a~li~ti~)
If ~11~, ~r of ~lla~]~m~ .......... l~r of ~lltng ~tts ~ ea~ ~r ................
If ~r~e~ ~r of ~rs ..... ~...~
If ~i~8s, ~mial or ~ ~, ~i~ ~ure ~ ~ten~ o~ eada ~ o~ ~ .....
I~i~t ........................ [. ~r of 8~rles ..............
~pth ..........
.......... .................... ~r of Stories ...............
......... ~ar ......... ~p~ .............
t~i~t ......... [ ~r of 8tortes
2. s ~ ~tt~ icl te ~ ~1~ 1~, o~i~e ~ ~la~i~: ..................
.
· .. .....~ .......
PLOT BIAU~
{
~a~e clearly ~ dtsCi~ly ~ I ~ildl~, ~r ~isci~ or ~, ~ i~i~ce all ~-~ di~nsi~s
~r interior or ~r lot.
.........
~ o[ i~ivial si~iug cmtract) ,
(~trsctor, ~nt, cp~rate ogficer, etc.)
No. 01B06020932
Qua,fled In Suffolk CouP-.
Term Expires March ~, 20
0
R= 946.6~'
LOT
........
,, ~ SURVEY OF
LOT 2~
"FA~WA Y FARMS
Well
,¢¢.~..s 15d4'
L= 172.65'
GREEN
well
A T CUTCHOGUE
TOWN OF SOUTHOLD
SUFFOLK COUNTY,
1000- 109- 05- 14.23
Scale: 1" = 40'
NOV. 6, 1996
well
The Iocetions of wells ond cesspools
shown hereon ore .from field observations
ond or from doto obteieed from others.
CER ~ rcr~D 0~/08197
TO'
CRAZY CHINAMAN CORP.
COMMONWEAL TH LAND TITLE
~VS'URANCE COMPANY
TH~ BANK OF NEW YORK
ANY AL ]'ERA TION OR ~)DITION TO TI~ $t. IRVEY IS A VIOLA TF.~
OF ~EPTTON '1~09 OF THE NEtF YORK STATE EDUCATION LA ~IONS
k~R_~O~ ~F. vAt. e FOR T~S ~ ~ co~$ r~q~:OF ~ ~v~,
:$AI~ MAI~> OR COPIE$~F. AR THE ~ BF--AL OF THE -~.IR OR
AOOII~I_LY TO CO~PL. Y mTH ~I-A~.. ~ TER~
OR- qR.5