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Home My WebLink About25882-z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Hall Southold, N.Y. f� BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UN L FULL COMPLETION OF THE WORK AUTHORIZED) PERMIT NO. 25882 Z Date JULY 20 1999 Permission is hereby granted to: ROBERT S KOEBELE 1525 GULL POND LANE GREENPORT NY 11944 , for : CONSTRUCTION OF A SECOND STORY ADDITIO & ALTERATIONS FOR AN EXISTING SINGLE FAMILY DWELLING AS PLIED FOR. at premises located at 152 GULL POND LA GREENPORT County Tax Map No. 473889 Se ion 035 Block 0004 Lot No. 012 pursuant to application da ed JUNE 1 1999 and approved by the Building Inspector. Fee $ 317 . 00 yo�d Authorized Signature ORIGINAL Rev. 2/19/98 PECTION REPORT DAS_> � ------ea=_-.COHMNTS - - � -_a=_==n_asaaa_-_ NDATION �> IST) X "• ('}J N NDATION (2ND) X � L� ------------------------------ `1 X _ JI - �i u IGH FRAME S u PLUMBING 11 - � N SULATION PER N. Y. X yV STATE ENERGY u CODE X H p Ill T X y . u I u FINAL N G' Z5- ADDITIONAL COlMNTS: - 1 BOARD OF HEALTH ' FORM NO. 1 3 SETS OF PLANS . . ... . . . . . . . . .. TOWN OFISOUTHOLD SURVEY .. .. . . . . . . . BUILDING DEPARTMENT CHECK .... . .. . . . . . . . ..... . . TOWN 54..'...._. TEL: 7 HALL SEPTIC FORM . . . . . . . . . .. .. . . . . . . F.iDG. pFPT. SOUTHOLD; N.Y. 11971 _7n�°�*' S:S '� -T1,71D 65-1802 NOTIF! CALL//�nf�(( // �� 9Y !•�S /�� Examined........ ......... 19.... MAIL TO: . . . . . . . . . . . . . . .. . . . . Approved.....I.-P een...... 19.9". Permit No. .. 5A2 Disapproved a/c .................................. .................................. ?ft Building;Inspector) ON FOR BUILDING PERMIT J n Date. . . . . .. .9. . . INSTRUCTIONS a. Ibis application must be completely,filled in by typewriter or in ink and submitted to the Building Inspector- 3 nspector3 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 not be drawn on the diagram which is part of this application. c. 'Hie work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue 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. AMACAT= IS IJMW MNL+ to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the lbwn of Southold, Suffolk County, New York, and other applicable Laws, Ordinances*or Regulations, for the construction of buildings, additions or alterations, or for renwal or demolition, as herein described. The applicant s to with all linable laws, ordinances, building code, bousing code, and regulations, and to admit authorized tors on ses and in ilding for necessary inspections. apP ✓>E� Y inspectors prem (Signature of applicant, or name, if a corporation) AW ................. ....... .. (Mailing address of applicant) State A*the appliis owner, lessee, agents,, aarrchitect, engineer, general contractor, electrician, plumber or build Name of owner of premises .4:.1. :•:.••...�........................................................ (as on the tax roll or latest deed) i If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate offiezxer) Builders License No. ... .!.....��..... Plumbers License No. .. �• .• l ... Electricians License No. ..................... Other Trade's License No. .................... C) ...�Y .� ..� l. tion of land on ca�nJ�p/roposed work will be done..... f u ..........•.. .......1..� .. .. ...... ..... ........ .................................... Clou. . Ise Nmbe Street Hamlet County Tax Map 1 Section ... 3. ....... Block .....(.......... Lot ..11J....... subdivision . J..... .. Filed Map No. .. s�! ... Lot �� (Name).. ......... ....... . y in ended use and Vganstruction: 2. State esisting use and occupancy of premises and !/ toa3s98 :3l,#3U'�°fElN1C73l a. FSdst' use and (no.{`a��A.* •••••••••••.• b. 7nteoded use and occupancy ..................I rlbolbut3 ttl3>t 71 ". .................... ................ Repair ......... Removal. .... ..... Demolition ............ Other Work ..Gly( ............. y� � (Descripytion) . O � ............:Estimated Cost .....�l..��.. fee .... i�..:�..cJl i (to be paid on filing this application) if dwelling, amber of dwelling ugIts .... ..... Number of dwelling units on each floor .J:x"V.10....... Ifgarage, number of cars ...................................... If business, commercial or mixed occupancy, specify nature and extent of each type of use...................... Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Height ......................... Number of Stories ...................... Dimensions of same structure withlalterations or additions: Front ............... Rear ............... Depth Wight .................... Number of Stories .......,........ , Dimensions of entire new eonstrucoon: Front ................ Rear ............... Depth .............. Height ......................... [umber of Stories ..................... Size of lot., Front ............. ,...... Rear .................... Depth .................... Date of Purchase ................!,.... Nam of Former Owner. ....................................... Zone or use district in which premises are situated ....... , /. ............................................... Does proposed construction violate any zoning law, ordinance or regulation: ................ Will lot be regraded Will ss fill be removed f�o�� 7 YES �\ Names of Owner of premise /.� ... AddresafZe-C ... i °:.......... Rmonle�NNaa� Nae of Architect ,//�'� r� ... Address .............................. Phone No. ............... Name of Contractor/ J� yYRddress��ld�,.{G�rQ�1Z .....Phone No Is this property within 300 feet of a, tidal wetland? * YES .......... NO .......... *IF YES, SOUrim =a TvwlI gS PUMT MAY BE REQUIM. PLOT DIAGRAM Locate clearly and distinctly all ,buildings, whether existing or proposed, and indicate all set-back dimensions am property lines. Give street and buock n umber or description according to deed, and show street names and indicate ether interior or corner lot. hm of low YObZiC, SS uN Sura j k l/.'4!:m'.' z`" i^' ...............being duly sworn, deposes and says that be is the applicant 'am of in0 '*dividual signing contract) ove named, is the ......... ............................................................. (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'plication; that all statements contained in this application are true to the best of his knowledge and belief; and at the work will be performed in the manner set forth in the application filed therewith. orn to before me this 51- Qq .A....�........ ay of .... U Yl a ...19...t.d.. Notary Public �.��"£:..Y.:.:..i.�:`:.:�- (Signature of Applicant) LYNDA M.BORN NOTARYPUBLIC8tateolN�lbl►1bi1 No.O18b6020M Qualified in 8uflolk Term Expires Marsh 116 IIO