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Home My WebLink About24064-z PORK NO. 8 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° 24064 Z Date ............ rll. `........... l l... Permission is hereby gra to: /%�/fll . . . ... . .. . .. ......... .. v� ..... �1z!.. .... . ..r.................. L. ....Ln /C/ 1............... ^ t0 ..... ............. ....,.r ?'1.. .... 1 ^. .................. .. .................................................................................... ................................................................................................................................................................ ............................................................................... ...........i................... at premises located at..C�7l.Q .7...�f�...wk.'(q?. t` ..� ... ...... ... .......................... County Tax Map No. 1000 Section ...../tr.�../...... Block ........ .....l!.��. Lot No. .../7..1........ pursuant to application dated .......... Y................. and approved by the Building Inspector. Fee $l.. t��.7�....... Build..'^ t.. ....................... Rev. 6/30/80 FII:LII Ilgil'IiG I'loll It I;I•Illl'I' IlA'I'l•: I�•r I'0111111A'1'I UII 1111111:11 111tnIIR I'L111 III I Pit Illli IlLA'1'1I111 1'IUt 11. Y , y BTATR IUMIt11Y 1:11111! I IIAI. Alto t'1'I UHAI. C011HI;11'111 x 1 a An 1 ^ 1�1 F1 _ O U- f" v � I'I BOARD OF HEALTH . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . 9 1997 TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . APR BUILDING DEPARTMENT` `}` ,CHECK . . . . . . _ . _ . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . SOUTHOLD, N.Y. 11,971 TEL.: 765-1802 t.oFIFY ; 3�.6s�QJ• • CALL . . Examined,. 19/.� MAIL TO : AppYbv$d . . � ., ;1 '• • Permit,Nof..: :..:s . . . . . . . . . . .. Disapprdved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . .. .. . . . . . . . . . (Building . .;, ; ,`'nri . ,. :•, P LICATION FOR BUILDING PERMIT „ y �CDatef. . .. . . . . ! . . . . . . ., 19 9� INSTRUCTIONS a. This application mast 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'Uie 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 law's, ordinances; building code, housing code, and regulations, and to admit authorized inspectors on premises and-,in building for necessary inspect'1�o - (Signature of applicant, or name, if a corporation) X36, �AIAI, ?W CY, ; . . (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general contractor, electrician, plumber or builder. � 06PA" Or rRusrmf . . . . . .< liec/ ��T�T . . . . . . . . . . . Name of owner of premises . . . . . . . . . . . . . . . . . .Cru.T,CFFOi�UE , ,Qdiei4($�/TE ��1 , , ?,U/f (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Lo' of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . . . . . Block . . . . . .a2. . . . . . . . . . Lot . . . .17t I '. . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . :. . . . . . . . . (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: CA(vRaw a. Existing use and ocbupancy . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . I . . . . . . . . . . . . I . . . . . . . b. Intended use and occupancy . . . . . . . . . . . . . . . .�'!9f'i�F . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . 3. Nature of work ( PP g . . . . . . . . . . Addition . . . . . . . . . .check which applicable):: New Building V .� . � . . . . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . Demolition . • , , ; , , ,,, , , , , , Other Work . . . . . . . . . . . . . . . DDD : 4. Estimated Cost . . . . . . . . (Description) . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, num frits . . . . NA . . . . Number of dwelling units on each floor yt/A , , , , , , , , If ga$a�;e,a u,m.bi r;of cars g ,. g per of dwelling u . . . . ./Vii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I ess, commercial or occupancy, specify nature and extent of•each type ofaase . . • . Alm, , , , , 7. Dimensions of existing structures; if any: Front . . . .�i�Q, f,'7: . . Rear #O . . . . Depth . . .93• . i . . . Height � . R. . . . . . Number of Stories . . . . . .ONF . :w/,�4/44. .IXWOR`/fW. ,,7'. . . . . . . . . . . . . . . . . Depth . . . . egg h alterations or additions: Front , . . .s el7k4 , , , , , , Rear . . . . . .S�!! , , • , Height . . . . . . �t'�f?+gr Number of Stories . . . . . . ,t'�F', Dimensions of same structure with 8. Dimensions e erasion ht of��re new construction:mFront . . . 7 t �. . . . . ; Rear . . . .�Y /O•u. . . . Depth . . . . . . . . . . . . . . . her of Stories . . . . ... . .M490F71/7`. . a/Y4r1 . . . . . . . . . . . . . . . 9. Size of lot: Front /,SO /c Cr• . , , , , , Rear . . . .430pj , , , , , , , Depth 0, :�'i Pile 10. Date of Purchase t%vw �j{l/g, bi ,C,Ksppv P ' ' ' ' ' • Name of Former Owner . . . . . .� , 11. Zone or use district in which pre , , , 'ises are situated . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . 13. Will lot be regraded .NVQ, . , . . Will excess fill be remgved from premises: Yes `14i Name of Owner-df p'remisesOWre !./9ph5Wn. 0-AtAddress .f,A?X. 1?6, rf , , , Phone No.7% P® . . . Address . . e4(rLl f r: . Phone e of Name o Contractor S. . . . . . . I . . . . . . . . . . . . . . . Address . . . • . . . . . . . . : . . . . . . Phone 15, lIs this Architect �tj:V�' 0 feet of a tidal wetland? *Yes " " " " " " property within 30 . . . . . . . No, . y 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. lzr'c �ee& pu �s � eCe-fez` ;TATE OF NEW YORK, - S.SI ' :OUNTY OF . . . .. . . . . . :. • • • • . . , . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bove named. ye led. is the . . . . . . . . . . .f�CE!Wil� , (y ract Pr P ty C Y�. .led.; aF' !!'t/SIt2C� . . . . . . . . . . . . . . . . . . . . . or, agent, corporate officer, etc.) f said owner or owners, and is duly aa'tliorized to perform or have perfo''rrn'' tlne 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 that the ork will be performed in the manner set forth in the application filed therewith. worn to before me this . . . . . . .� w . . . . . .day of. 19 e.77 otary Public,'✓. - / •, , , / \ ray No.49513 fNe ,. . . HELENE0.H Notary Public,State of Newyork {34 (Signature of applicant) Qualified in Sutfollc Couniy � 7 Commission Expires nMoy 22,19 - - F-A16'rINQ HANvI'µ Fr RAMI-, REMpVG p1Af21N4 1 CON S'rK1.iCjfipN , G41'r LA"pS?C e l p Pc OF 27$ GGJ� JoiyrB To $IT rLU6N aIJ NEW �Q9F pl'cGK . y 23, EzaaF oN �B" 19.YW r� f 1 IrcY�F RACZSKS c4T POR. I't" : 1' v^ PITC . P�avlvS FLN,iH LEpt6ierb eoTM SIVEs HA19TINc / N�`'ECO . olyi HANG E N 3 I Ha NpP-,e.I I_ .----- - i f r— pLAa-H o•/ER IJEW/dL P RcwF 11 GONhIEGTION WAT'ECtTQHT ' I <3UILT- UP FLUSN WCOP STTUIGTURE HEADER ENTIFZE LENrryTH. _—ETiI' i FINIbHES-- — MC✓H WIIJpoW IWG N44 DbL. H JHq WWi, NFILL F�L4✓18 W6 PoW Mo.IF_7 To NEW OLUJLT-LIP {.leap, Naw LoGa,Tlo).J �' HP�AP6PI` OVER NEW PcWFL �—T WALLWp SILK I I'�T4 AJt CtI �E--- — ----- - — — HId1W- DLK. FdUNVATI Ota L� DUI�Q--;' h I i WALL Ca. 24" vERY. PRcdiPB':.', �� GahIPPRG�FINq -- — GUT FKI'.,TIN61 MA-.:PNRY' Tl �ou�IDATON WILL. N I AWIPCONEW AWGaH AMTS PIWIt-H �a. " TNK . IZIGiV INSuj. 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