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Home My WebLink About21985-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL N~ 21985 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) at premises located at ..................... ./'.~....~...~.,......L~...~...,....~ ........ i..~///~.<.~ ................................. , --~Jo~ ~,~..,..,,,.././..?..~,z. ........................... ~,' 'T~'I~' ~'~.''' 'i ~''' '~;,'~' 'n' '.','.'.'.'.~'.'.'.'.'.'.'.'.'.'.'' ~;~ 'k' ~ ...... LotNo ..... .?...~... ................ pursuant to application dated ............. .<.~./..~..~........~....~.... .......... 1 9..././...., Building Inspector. F , ~'g~ ~-~ ee ~ ......................... and approved by the ng p Rev. 6/30/80 Title No. TS-34893 Policy No. 514S10157 SCHEDULE A All that certain plot, piece or parcel of land with the buildings and improvements thereon erected, situate, lying and being at Bayview, near Southold, in the Town of Southold, County of Suffolk and State of New York, ~nore particularly bounded and described as follows: BEGINNING at the comer formed by the intersection of the Easterly side of Midland Parkway with the Northerly side of Main Bayview Road; RUNNING THENCE from said point of beginning along the Easterly side of Midland Parkway North 24 degrees 46 minutes 40 seconds East 318.63 feet to the Southerly side of Lot No. 1 as shown on "Map of Seawood Acres, Section 1", filed No. 2575; RUNNING THENCE along the Southerly side of said Lot No. 1 South 67 degrees 46 minutes 00 seconds East 137.0 feet to other land now or formerly of Adolph R. Trapp; RUNNING THENCE along said land South 25 degrees 38 minutes 10 seconds West 324.74 feet to the Northerly side of Main Bayview Road; RUNNING THENCE along the Northerly side of Main Bayview Road, North 65 degrees 13 minutes 20 seconds West 132.0 feet to the comer aforesaid at the point or place of BEGINNING. TOGETHER with the right to the use of a fifty foot fight of way in common with others, extending southerly from the Southerly line of Main Bayview Road (adjacent to land now or formerly of Mahlon Dickerson) a distance of approximately 2044 feet to ordinary high water mark' of Peconic Bay. 0 !1 BLDG. DEP~, i. ,~.~TOwN OF SOUTHOi-J~) 0 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ....... '.'~/~. ]. ..... ,197~. Approved ...... 3/~,2]. .... 19 .~.~. Permit No ~/~.2~'~' Disapproved a/c ..................................... . (B~ylnsp6ctor) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF PLANS SURVEY ................... CIIECK .................... SEPTIC FORM .............. CALL .. . ... MAIL TO: Date.../~tfr~l......Z .~/., 19 ~.~. INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance o.f the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constmcfion of 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.og, de~and..regulations, and to admi,t authorized inspectors on premises and in building for n~i .e.;i. /~/~Z::>~. ............. --- ~ ~2~/:ppl~cant., or name, if a corporation) ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, epgineer, general contractor, electrician, plumber or builder. ........ :(. .......................................................... ....... Name of owner o~f premises .~../].~./?..~.. ,/t.. ~7~,~.4~...~../~ ..~.~../d/t/~9 ............ 9 .AT~.:. ~.87..~. ~../~..~.. '.~... ' (as on.the tax roll or latest I~Ed) _~5';, r-,q9 Sy:~,ffL~,/z~ 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 ..... 4/t. .............. Other Trade's License No .... ./'//~f .............. NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULAT)ON 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CO~STRUCTION ERRORS 1. Location of land on which proposed work will be done .................................................. ~;u:; ~}~, .......... /' ...... ~ 'Z' ~;r~;~ .............. ~~ .... h~le~ ......... ) L~ ........... County Tax Map No. 1000 Section .~..~ .... Block .~ ......... Lot..~~ ..... Subdivision ...... __ ,.,~/~'a~;) ................ 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..~. C.~..~ .~/~(~ .................................. "~ ,,~ Intended use and occupancy ~(~.~ .~¢~.. ~.~(~.. ~. f.~*~ ................... 3. Nature of work (check which appl!cable): New Building .......... Addition ...... .~ation .......... Repair .............. Remov~l .............. Demolition .............. O~er Wor~e~.c~.~ ,.~s'~//~2~.~',~/ ~. ~ff.~. ~. ~ ~/ (Description) 4. Estimated Cost .................................... Fee ............. ' ......... (to be paid on filing this application) 5. If~dwelling, number of dwelhng units ........... Number of dwelling units on each floor ................ . If garage, number of cars .... ~/./~. ................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .. ,?~/~.. ............. 7. Dimensions of existing structures, !f any: Front ............... Rear ............... Depth... ............ Height ....... .. ~.... Number of Stories ........................ Dimansio~ c~ s~jnffi)tm, ctur,, with alterations or additions Front ................. Rear .......... pi .............. ~ ....... ~ r~elgn~ ...................... Number of Stones ...................... 8. Dimenskoa~o.[ e~nt~J~l.new construction: Front ............... Rear ............... Depth ............... Height .JJ~fi.~ ,~ JlJ.. Number of Stories ............... 9. Size of lot: Front ............. i ......... Rear .......... Depth . . .- 11. Zone olO~JlJ~l~vhich prem!ses are situate~t...~.-~ .H.~. ............................................. 12. Does proposed construction violatq any zoning law, ordinance or regulation: .. A/~ ........................... 13. Will lot be regraded ..... /~.0 .... I ................. Will excess fill be removed from premises: /U//~ Yes Name of Architect ...... ~Y-/~., · .i ............... Address ................... Phone No ................ Name of Contractor ...... ,,u/~..1 ............... Address ................... Phone No ................ Is this property within 300 feet of a tidal wetland? *Yes ........ No.. ~ .... 15. elf 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 nu tuber or description according to deed, and show street names and indicate whether interior or corner lot. ISZ. 0 STATE OF NEW YD~ county OF... .... S.S ..... '..~. ~.~//.~. ~ · · ~../. O,~..,~). ................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. (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 ail statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the~er se~t forth in the application filed tgerewith. Sworn to before me this //~/// ! r e~~l~-~'~'~l~'" of applicant)