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Home My WebLink About22145-z;O~M NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N-° 22145 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted, to? ...... ~.~~..,,~.~.~ ......................... ........ .~.¢....o..........~..~.~.~.~....~,~, ...... ~..z~.~.~. .......... ~,~.: ...... ~.~.. ....... ~ ........ ~..o...~.~..., ..................................................................................... Counly Tax Map No. 1000 Section ..........~.,..~.. ..... Block ......... ~ ............. LotNo ..... .?..~,,_~,.. .......... pursuant to application dated ............. U~..~ ......... .~. ............ 19....~....~....., and approved bythe Building Inspector. F~*,.~.~.,,~ .... Rev, 6/30/80 ol~O : 3. Nature of work (check which applicable): New Building .. 7'..'~:~ :}:\ ~,~.~i~i~'i:dn . ......... Alt~a~o~t .~}. ;,~. Repair .............. Removal .............. Demolition .............. Other Wo~, 4. Estimated Cost .~. ~.5~..O, 0o ,/ (Description) ............ · ............ Fee . ~ ,35~, o.o ............... , .... (to be paid on filing t!li:~.~,~,~ .~.F~ti'On) 5. If dwelling, number of dwelling units ............... Number of dwelhng umts on each, floo~,~,-~.~,:,~:,r:,. · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify n. ature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front .... ~ .......... ". Rear .............. Depth ............... Height Number of Stories Dimensions of same stmcfure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Storie~ ...................... 8. Dimensions of entire new construction: Fron~ ............... Rear ............... Depth ............... Height Number of Stories 9. Size of lot: Front ................ ' . Rear .......... ....~ ........ Depth ...................... 10. Date of Purchase ................. ~ ' .... ~ ....... Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................. 13. Will lot be regraded .... Will excess fill be removed from premises 14. Name of Owner of premises .................... Address ................. .. Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ............... 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, 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. STATEOFNEW¥ORK,,~ ? ,, ~ ?. ee COUNTY OFx ............... ~ ......... ~ -~. ~. · · .~.°4 ....................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. I~ is the , .'..O..cq. ~.¢..C~. ............................................................................. (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 ........ .ff.. ........ day of. ,Ch Notary Public, State of New York NO. 4951364 Qualified in Commi3$~on Expir. e$ May E×ami~ed ... Apprdved ..... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 "19'~ '7 X' ., 19~.., .'Permit No,~g./.~....~Z~ BOARD OF HEALTH ......... ~ SETS OF PLANS . ~,'GURVEY ........ Disapt roved a/c ............... i ......'/fl ............ //. (Building Inspector) / A~/I~4CATION FOR BUILDING PERMIT i'; eT I P"/ ~ .a.~g. - ~o. t/.o. CALL .......... MAIL TO: 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 o~ areas, and giving a detmled descriphon of layout of property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this apl; lication may not be commenced before issuance of Building Permit. d. Upon approval of this applic~ tlon, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises availabl for inspection throughout the work. e. No building shall be occupie,[ or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Buildi] tg Inspector· APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Toy 'n of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction ot~ 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 prem] ~es and in building for necessary il~spections. _ ...................... -" (Signature of applicant,(f/~name, if a corporation) · 8.?.o../~ ~.~....~..rf.o~,...~...%..~...,..~,~, (Mailing address of applicant) State whether applicant is owner, ;ssee, agent, architect, engineer, general contractor, e!ectrician, plumber or builder. .6rd~r~4~. : Name of owner o f premises ...~/.[~le'e'~....~?.o~-O....oq~... ~J.v~.., ~ q~. ............................ (as on the tax roll or lates[Ideed~l~P~0~[D ~8 ~0T[~ If applicant is a corporation, signature of duly authorized officer. '. DAI'E; ~ B,R # ~O[.[.,OWING INSPECTIONS: Electrician's License No.. Other Trade's License No. Builder's License No ........ i ................. Plumber's License No ..... i ................. t, I:¢)UNOATION . TWO REQUIRED FOR POURED Cc)HCRETE ~. FINAL CCi ~:'~?~/CT~O~ ~O~ ~E COMPLETe! ~:0~ C.O ALL CO~t*cr,o~ $~ ~ 1. Location of land on which propo~sed work will be done ........ $?A'I~ ¢131~:~'~O~ · .F.?.~. ' .g.~,:/,'.~.. 3..~.~ ~.,~,, ...~ ......... : ....... :. House Number [ Street Hamlet County Tax Map No. 1000 SectiOn ..... ~.~. .......... Block .... ~ Lot... ~.~. Subdivision ................ (DCa~) ................ Filed Map No ............... Lot ............... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy..~. '.l')'~ (~L....~, ~....'~..t.b/..~l { 1'.~.~ .................................... b. Intended us~ and occupancy ................................................................. / , SURLY FOR MAR 30,1993 MAR. 8~[993 VINCENT ERATO ~ DAWN WOY F~S. SEPT 14,1992 MAY 18,199~ AT MATTITUCK OATE= A~. 17,1992 ~N OF SOUTHOLD SCALE: I" ~ 40' SUFFOLK COUNTY, NEW YORK ~0. 92-0303 NOT eE CONSIDERED TO ~ A VALle TRUE COPY CHICAGO TITLE INSURANCE COM PA NY H~AL~ DEPARTMENT-DATA FOR APPRO~L TO C~sTRUcT T~ ~R~ FOR WHOM THE ~U~EY tS P~EPARE~ ,.~,o.. ~,.,,.,.....o,..,,u.,~.~o..,,.,,......, .o,..,......~.,, ....o....,..,,~ ~' ~ W YORK ~1/ MONUMENT FOUND - ALDEN W.Y~NG) PROFESSIONAL ENGINE ER ~/ I"O,LAND SURVEYOR N.Y.S UCENSE NO.I ~ ~ HOW~RO W.~OUNa, ~ANO SURVi~OR ~c~w~(w),~Pt~cr~sisr)~ciss~o~lcPls~s~lsl~ ~ ~J N.~5. LI¢~NSE N0.4589~