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Home My WebLink About22131-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN SOUTHOLD, N.Y. N_o BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 22~.3~. Z Permission is hereby granted to', .../z~...,..~.~.~ ................................ ~.. ...................... .~.....~;'.-y..,~.~....~.~.~ ................. ......... ~.~7..~..~ ./..~..~..~...Y....~ .......... to ...~.~ ~..~.......~.....~ ~.~......~.~......~.~.~.~.,~ ...................... ....... ~.~ ....... ~ ....... ~.~., ............................................................................................ at premises located at ....... ,,~..,.,.~...~.. ........ ¢ ................................................. ~.~. ¢-~ ~./.,~., .......... , .................................. Building Inspector. Fee*..,.~. ........... Rev, 6/30/80 and approved by the APproved..:./.~../.~. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ..................................... fiLDG , '[. · TOWN Ol: ~',, ",: 0 ....... .~ INSTRUCTIONS BOARD OF HEALTH ......... -"~3 SETS OF PLANS .......... ~'~SURVEY SEPTIC FORH .............. HAIL TO: a. Tl~is 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 appll- ~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 cmnply with ali applicable laws, ordinances, building code, hofising code, and regulations, and t~o admit authorized inspectors on premises and in building for necessaryfi~ spections. -- (Signature of applicant, or vame~ if a corporation) ~&P ~/.:.i.~,h .k...~:'0~.~'~. ~. ttx ~..~... '~ (Mailing address of applicant) State whether applicant is~, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~0t~.l~ ~ ~. ~. cji. ~..~..~[ [ Iq ~O ............... 'PR~D ~"~"" .......... (as on the tax roll or latest def~)~'~: If applicant is a corporation, signature of duly authorized officer. ~ FEE: ~ ........ PULLUWING INSPECTIONS: ~. FOUNDATION ~O REQUIRED Builder's License No .......................... FOR POURED CONCRETE 2. ROUGH . FRAMING ~ PLUMBING Plumber's License No ......................... 3. INSULATION Electrician's License No. 4. FI~AL ~O,~TdUCTION ~UST ...................... CE COMPLETE FOR C,O.- ALL CONSTRUCTION SHALL M~ET Other Trade's License No ...................... THE REQUIREMENTS OF THE N.Y. l. Loc~tion o~]and on which proposed work will be done .... ~.. ~.. ~,~'~t ~ESPO~LE..~. Street Hamlet cou~ ~ ~ ~o. ,o0o s~,~o~/o~...~ ...... ~...4 ............. ~o,... ~ ........... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . .~..PO...~.. .......................................................... b. Intended use and occupancy .................................. ; c..': ..... ;.... ........... property lines. Give street and blockinumber or interior or corner lot. 3. Nature of work (check which ~pplicable~. New Buildin ....... ,. J. ~ .......... ,'xumnon .......... Alteration .......... Repair .............. xt Removal ...... Demolition ......... Other Work .-~.ffOC~ ..... Co'~ r~O~.t~.st~,~ i .... (Description ) 4. Estimated . i ~.~ ..~ · --, .......................... Fee .: ......................... i (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ If garage number0f cars 6. If business, commercial or mixed occupancy, specify r~ature, end.extent of each type of use ..................... 7 ..... i if · D~mensmns o! emstmg structu es, any: Front ............. ' Rear .............. Depth ............... Height Number of Stories Dimensions of same strucfure with alterations or additions: Front ................. Rear ..... ' ............. Depth ........... i Height Number of Stories 8. Dimensions of entire new consiruction: Front ............... Rear ............... Depth ............... Her, hr ............... Number~of S~[ories., ............................. .: Sizeoflot Front i - · · ~>2o~ '"' L.' .' ............. 2'" 10. DateofPurchase ' · ~aE~..~[,~_. ,~ p:~n ................. .......... , ................... ainu m runner t-,Whet ...,.,; ................. ,,;.~.~.. 1 1. Zone or use district in which premises are situated ~ 12. · . I . ' .................................... ' ........... Does proposed construction vmlate any zoning law ordinance or regulation ~ .... 13. Will lot be regraded ./~J21. .... ~ ................... Will excess fill.be removed from premises: Yes -! 14. Name of Owner of premises ~4\~w,,~ .~ L[ ~.~ 0 ..... Address CloD. ~(t~qh ¢., ....... Phone No.~J'.Si':~.~.% ..... Name of Architect ......... ! .................. Address ................... Phone No ................ Name of Contractor ,. "' Address ............................................. Phone No ................ I5. Is this property within 1300 feet of a tidal wetland? *Yes ........ ~ .... · If yes, Southold iTown Trustees Permit may be required. '''' PLOT DIAGRAM Locate clearly and distinctly alI buildings, whether existing or proposed, and, indicate all set-back dimensions from} description according to deed, and show street names and indicate whether, STATE OF NEW ~1~;~. .. .xJ. .... I ' COUN?Y OF...,:..cji. ~70.~.~...... .................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named.. g~He is the ~ (Contractor , agent , corporate officer , etc. ) of said owner or owners, and is dulj authorized to perform or have performed the said work and to make and file this application; that all statements contalned in this application are true to the best of his knowledge and belief; and that the work will be performed in the manneriset forth in the application filed therewith. Sworn to before me this//~ i ' ................. /~.~<...aayt~../e ..... ~ .......... 19 .'g.'['- Notary Public, . .,~ .~.~.. County OEItT I NOTARY PUBi'I~"',~eT~"~N.Y. (Signature of applicant) No. 4725089, $,uff01k lerm Exoim M~ 31, 19 ..4W- SURVEY FOR WILLIAM VILLANO & EILEEN VlLLANO SUFFOLK COUNt' DEPARTA~ O~ HEALTH SERVICES LOT NO.Z"GREENBRIAR ACRES" SEPT. 17~ 1987 AT MATTITUCK DATE: dUNE ~5, 1987 FOR APPROVAL OF CONSTRUCTION ONLY TOV/N O~ SOUTHOLD SCALE. J"--40' SUFFOLK COUNTY~ NEW YORK NO. 67-690 3ATE HS REF. NO. L I~l~] 400 OSTRANOER AVENUE ~L YOUNG ~ YOUNG .,VER~AO..~w YO.K SURVEY WImmlAM VlmmANO & EImEEN VILL. ANO SUFFOLK COONTY DEPARTMENT OF HF~kLTH SERVICES LOT NO. 2"GREENBRIAR ACRES" SEPT. 17, 1987 AT MATTITUCK. DATE: JUNE ~$, 1987 FOR APPROVAL OF~ CONSTRUCTION ONLY ~ TOWN OF SOUTHOLD SCALE: I"= 40' ~ sUFFOL~ COUNTY, NEW YORK NO. 87-690 N ,~,4AUTHOR1ZED ALTERATION ON ADDLTION TO THIS ) SUR~VEY I~ A VIOCATION OF SECTION 7209 OF THE ~'~ APPROVED , HEW,YORK STATE EDUCATION LAW ; ; HGUANANTEES INDICATED HEREON ~ALL RUN ~LY 10 HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE P~R~H FOR WHOM THE SURVEY IS PREPARED ' . AND (~q HiS BEH&LF'TO' THE TITLE COMPANY GOYFJ~N- YOUNG 8 YOUNG ~c. , , 400 OSTRANDER AVENUE -I .,VE..eAO..EW rOR. NOTE: I~,MONUMENT A =STAKE A~D'EN W YOUNG, PROFESSIONAL ENGINEER SUBDIVISION M~P FILED IN THE: OF THE CLERK OF AND'LAND SURVEYORN.Y.S. UCENSENO, I28~45 SUFFOLK COUNTY ON 0CT. 7~1977 AS FILE NO. 6609. - HOWARD W. YOUNG,~ ~ANd SURVEYOR #THE LOCATION OF W~., L(W),~PTIC TA#NISTi& CESSeOOL$(CP)~goF/N H~NEON N,Y.S, LICENSE N0.45893 :. BRANDIS & SONS INC. 1046