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Home My WebLink About21355-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CI"HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~N'? ~13~ Z Permission is hereby granted to~ A _ , ..~~...~...~......~. ....... ................ ~,,,,~ ......... t,L ........................ ,,,~~,~',,~.~=~, ~.~,~,,,~,,,~,, , at premises located at ....~.~.~.....~.~~.....I.....~ ........ .~.~.~/... .............. ............. ="i"ii'iiiii"::::iii ......... i'"'iiiiii ........... County Tax/ Mop No. 1000 Sectio.g..~....~..~..0.. ........ Block .....~.~"~.. ........ Lot No .......~..~ ......... to application dated ...~.......,~....o.. .................. , 19.~..~,,, and approved by the pursuant Building Inspector. Fee $ ....................... Rev. 6/30/80 B~)ARD OF FORMNO. 1 .,1 SETS OF TOWN OF SOUTHOLD SURVEY - BUILDING DEPARTMENT Cllr_Cl~ TOWN HALL SOUTHOLD, N.Y. 11971 . , ', TEL.: 765-1~02 Approved ~ ...... 19~ ~, Permit NoZD/a.~...-~.. · ' 'i~.~la,,vh..~' (BuildingS'Inspector) APPLICATION FOR BUILDING' PERMIT Date ................... 19... 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 sti'eets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- dation. 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 comply with all applicable laws, ordinances, building code, housing c~ode, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r necessary'y.,,te-,cti°ns/""~ ~/Signature of ap~e~'nt, or name if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N neofownerofpremises /t50,O ¢. A (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 L cense No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ............................. i ............. · ....... ·..4.z....i....... - .' · ... House Number Street Hamlet Comity Tax Map No. 1000 Section ....~.~. ........... Block .... I~..~. .......... Lot/~.~..~.. Subdivision . · .................. '. Filed Map No ............... Lot ............... (Name) 2: State existing use and occupancy,,°f premises and intended use and occupancy of proposed ~onstruction: a. Existing u~e and occupancy1.~¢, .'r (0.~..~e~' ' ' b. Intended use and occupancy .......................... ~ .......... ' t,, ~,~~',~ ,~ ',a .................... · 3.Nature of work (check which &pPlicable): New Building . ~ ........ Addition .......... Alteration .... ;~.~2.. , Repair ..... ......... Removal .............. Demolition ..... : .......... Other Work..~..~.~.(~,.. 4. Estimated Cost .... t; ................... Fee .~:. ~ ........................... 5 If dw'~lling numbev of dwellin~ units Number (to be paid on filing this application) ' ' ' ................ of dwelling units on each floor ' If garage number of cars .................. 6. If business, co~nmercial or m~x~d occupancy, specify nature and extent of,each type of use 7 Dimensions of existing structures if any: Front ................. ~" ' DePth ............ ~. Rear Height Nu~er ................ of Stories ' .............. lmenmons of same structure With alterations or additions: Front ................. Rear .................. p~h ~.',. ...... . De . ~ ....... HeiSt ...' .... ;., Number of Stories .............. ~ ........ 8. Dimensions of entire new construction: Front .............. : Rear ............... Depth ............... Height i ~p~be f St ties 9 Siz of lot: Fro'bt ~. 2.'. R '~&~' ....... ' ............ ~' ¢ ...... ] ...... . e ..... i ..... ..... ear .... Depth . .~.: ...... 10 D fPu cha '~ .................. . ate o r se ..... ' ............ N f F ...... ...... ' .... ameo omerOwner ........................ I 1. Zone or use district in which pr~mises are situated ........... ' .... ~ · . 12 Does proposed co structionvi ~atea yzoninglaw ordi a~c ...... ~ ........... '13' n o n , n e or regulation: ............ . Will lot be regraded ........ '. ~ ........ Will fill be d fr .............. 14 N~e of Ow ofp ' i . · ........... excess remove om premises: Yes No · ncr rem scs ., ~ ................. Address ..; ...... .......... Phone No ....... Nme of A chitect ......... r ......... ~ ................. Address ................... Phone No ............ Nme of Contractor ......... ~ ................. Address ............ ; ...... Phone No ............ ' .... 15.' I~ this property within B00 feet of a tidal wetland? *Yes ........ No.~ ..... ~If yes, Southold ~own Trustees Permit may be required. PLOT DIAG~ Locate clearly md distinotly ~1~ build~gs, whether existing or proposed, md, indicate fil set-back d~ensions from property Hnes. Give street ~.d block ~umber or description accord~g [o deed, a~ show street nines and indicate whether ~tedor or corner lot. ......... ~ '" , . ', ~ 1. F()UNDTzT~G~', ~iMC, (*EQ[J~RED FOt.~ PO~ ~RF:D CONCi,~ETE ; PLLIM ALL CONSFFtUC'ft(')a~ %.~ IViEEl' , STATE OF NEW YORK, ' - - cou v ..... s. s (Name of individual signin contract) being duly sworn, deposes ~d says that he is the applicant ~bove named. te is the ,' ~m~'. (Contractor agent corporate officer etc ) ............... ,f said owner or ownem, md is duly [uthofized to perfom or have perfo~ed the said work and to m~e and file this pplication; that all statements contained k t~is'application are true to the best of his knowledge and b~lie[ and that the zork wgl be perfomed in the m~ner set forth in the application filed therewith. worn to before me this ~ . -~ , /~ / .* .~ ' ..... , ............ . . v N~Ry PU~LIC,~ d N:Y. '~' '~ ...... ~/:~ ~ t... ~ ....... ' ' . i . . ~ · ' SUR VE Y OF LOT 22 SUBDIVISION OF CEDARFIELDS FILED JUNE 27, 1990 FILE NO. 8966 AT GREENPORT TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 40 - 05 P/001 Scale I" = 30' July 11, 1990 Sept. 28, 1990(found. loc.) March 1, 1991(final) ~,~ June 12, 1991(revise) DRIVE t~ S. REI~ NO. 90 - SO - 95 AREA = 20, O07sq. ft. CERTIFIED TO, FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK TITLE NO. 605 - S - 8818 HARTFORD FUNDING Ltd JASON C. LEONARD LAURA A. LEONARD 0 ~o~ (J~ E~UFFI~R F GR~ENPORT NIOIF~ ......... SUR VE Y OF LOT 22 SUBDIVISION OF CEDARFIELDS FILED JUNE 27, 1990 FILE NO. 8966 A T GREENPOR T TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 40 - 05 - P/001 Scale 1" = 30' July 11, 1990 Sept. 28, 19~O(found. loc.) March I, 1991(final) June 12, 1991(revise) ~ S. REI~ NO. 90 - SO - ~5 AREA = 20, O07sq. ft. CERTIFIED TO ~ HARTFORD FUNDING Ltd. JASON C. LEONARD LAURA A. LEONARD 5C,~.NlC' ~o* ~ GRf~ENPORT NIOIF~ ......... ~ SURVEY OF LOT 22 SUBDIVISION OF CEDARFIELDS FILED JUNE 27, 1990 FILE NO. 8966 A T GREENPOR T TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. 1000 - 40 - 05 -P/O 01 Scale 1" = 80' July 11, 1990 Sept. 28, 1990(found. loc.) March 1, 1991(final) June 12, 1991(revise) ,, FIELOS t~ =40.00' L = H. S. REF. NO. 90 - SO -95 AREA = 20, O07sq. ft. CERTIFIED TO: FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK TITLE NO. 605 - S - 8818 HARTFORD FUNDING Ltd. JASON C. LEONARD LAURA A. LEONARD LOT ~ LOT ~) GREENDORT NIOIF F~ [2~f~ I~ I NJY. S Y.$. LIC. NO. 49618 Prepared in accordance with the minimum atandarda for title surve]fa as eatabliahsd P.O. by the LI.A.L.S. a~d ~proved and adopted for such u~e ~ The New York State Land P~~ Title A esociatlon. SOUTHOL~ N~ 11971