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HomeMy WebLinkAbout20898-z FORM NO. D 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) WM 208982 Date 19. y Permission is hereby granted to: -,61mN. C.: IiuA............ 1 G...H.. .7. /?q ~~uLTY IC 9 ..L& (.111......... to i~1rS T./e l 7 ......~'`~......Twirl...... tsk ,171.1 ZQ .......T . G~~T `r at premises located at ,.!~,f~.l.E!~ - • r........ County Tax Map No. 1000 Section Block Z...... Lot No....... f ..1°....... pursuant to application dated and approved by the Building Inspector. Fee 5..1~©.s.... Joe Bui ding Inspector Rev. 6/30/80 tE' ~ %i::S: EC_: m II ~ ~ y N OUTIDATION (1st) c OUNDATION (2nd) C" r • I o ;OUCH FRAME & I C .PLUMBING I A m :11SULATION PER N. Y. Q STATE ENERGY CODE n FINAL • I o ADDITIONAL COMMENTS: m a \ a \ • H O H of H _ Y a 1 CI CID `c \ z 4 O O f O W\, O O 'c O f ~ f \ O 1~ y o On, 5° N o -3 O IA 14. pR`~ ASK -c W v ~ ~c x o m. `ol LM1 u CEP Z3 g4'r SF x L \ K::~ of 3 "Z- . b41 Cl ^10 Y. M1' s 6A by g off' l w X~l N w~'• 765 / `?O a ,N!n' a/ ? N W O ~y- E ~6 LA 6 N6 DN p p Dv 1 .(\6 S~Si Qa ~ G ~P~ N?G ' 7)di770,J 71) tar P E efteo log SURVEY FOR JULV 21 /982 /9 JOHN C. D/LLER NO V. /0, 82 NOV /O, /980 OCT. 2/, /980 AT LAUREL DATE OCT 6, 1980 TOWN OF 5OU7-HOLD SCALE = 50' SUFFOLK COUNTY, NEW YORK NO. 80-484 _ R UNAU THOR 12EO ALTERATION OR AD OITION TO THIS SURVEY 3 A VIOLATION OF SECTION 7219 OF TIE NEW YORK STATE EDUCATION LAW *COPIES OF THIS SURVEY NOT BEARWO TML LANp SURVEYOR'S INKED SEAL OR EMBOSSED 3EAL SMALL .1Q Of NBW 00 NOT RF rnm%IDFRF0 TO RF A VAL 10 TRITE EDPT 00 S~P------\ 1n BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 (1 TEL.: 765-1802 tt07 IFY; `:xamined 11 , , 19 .9. - MAIL TO . lpproved (G(J/! 197: Permit No. )isapproved a/c AUG ( T 1992 ~ (Building 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 Is o j 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ition: 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 all 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 all 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 iilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or :gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ie applicant agrees to comply with all applicable laws, ordinances, building code sing c e, and regulations, and to mit authorized inspectors on premises and in building for necessary inspections ............v!~1~ . - (Signature o'.applicant, or name, if a corporation) . (Mailing address of pplicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Ea/ . . . . . . . . . yG . ime of owner of premises !/,~`4t~/ ? ~c?~ (as on the tax roll or latest deed) 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 . Location of land on which proposed work will be done . ................~c~,.,«: V?............... ~r . . House Number Street Haml.et . . . . County Tax Map No. 1000 Section 1.~ Block .....2 Lot.... 1.16 Subdivision /LJG^!0l~.~ oz FfEZE> ~tND`~~~.. Filed Map No. IS~J... Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......S `~Gct~jArtj it ~G?[ZGI b. Intended use and occupancy ......5,.!tl, 3. Nature of work (check which applicable): New Building Addition Alteration Repair Removal Demolition Other Work F (Description) . . . . . . . . . . . . . 4 o~ a Fee....................... . Estimated Cost (to be paid on filing this application) 5. If dwelling, number of dwelling units / Number of dwStling units on each floor Ulf If garage, number of cars ( (1 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .../,e* . 7. Dimensions of existing structures, if any: Front ...3.G ~ Rear ..3A Depth Height Number of Stories .....Y . Dimensions of same structure with alterations or additions: Front Rear . . . Depth 1..7 Height .-1................ Number of Stories 7 . 8. Dimensions of entire new construction: Front ..../P Rear (0........ Depth ..,Z.7. , Height 2 Number of Stories .......7- ;l . 9. Size of lot: Front 9v Y Rear j'A Depth ...Z`7J.1............ 10. Date of Purchase Name of Former Owner ~1rf?~3 4 r:. ,/t/~P r~? F I l. Zone or use district in whi h remises are situated 'e--: Y(? . 12. Does proposed construction violate any zoning law, ordinance or regulation: ....AIr? . 13. Will lot be regraded ....!V`~ Will excess fill be remove from premises: Yes CN 14. Name of Owner of premises Address ..2 ..~f°d•~ f • • . Phone No (6:~1 ?C Name of Architect Address Phone No.............. . Name of Contractor Address Phone No.............. . 15. Is this property within 300 feet of a tidal wetland? *yes........ o......... *If yes, Southold Town Trustees Permit may be required. f, Lvwwr#D iv tQl~ Svc: PLOT DIAGRAM , r3? a r^/~ S •i r r i3Fyoa 3 Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe interior or comer lot. STATE OF NEW YORK, S.S COUNTY OF • • • • • G . ' • . • , • being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) ibove named. is is the .........IYY~ d ~~4~. U oa.an/rrL v` ~Ju,~bx-:~i!..!?L (Contractor, agent, corporate officer, etc.) )f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this Pplication; that all statements contained in this application are true to the best of his knowledge and belief; and that the vork will be performed in therriann~r set forth in the application filed therewith. ;wom to before me this day ot. Us.. 19 Q2 ,y SApk 1~ 4otary Public, County C ...........:............pp..... ROBERTLSCOTT,JR. / (Signature ofa licant: NOTARY PUBII Sfats of NY." No. 4725089, S lk T"renesMar81_ rc A 'EXIST ~ io_o„ $XIS'~ 1 O' S- _ AP RD ED AS NOT D a /"cell l ?s s' q~&p27 DATE: YB.P.k > d-~~,~ ~~g N If1, d FEE: L' _ NOTIFY BUILDING DE DE RT ENi AT ux ~ ? rc 765-1802 9 AM TO 4 PM FOR THE Q -~G --~-r FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED ~1 9 m 5 i1iI2 FOR POURED CONCRETE 1,1i ~l~e N~ OD 2. ROUGH - FRAMING d+ PLUMBING i( - -y'- 1 0 3. INSULATION O 4. FINAL - CONSTRUCTION MUST , N 1 NI - io°'F BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET po ~I xl~ FFAtA%- THE REQUIREMENTS OF THE N.Y. V IN ~TH'SHAC"T ~a~ x STATE CONSTRUCTION S ENERGY -J 111 ~h~ c L O 5 ~T N cmk M (J cl AtI--I'KIM~yJAll3, PRFSH CODES. NOT RESPONSIBLE FOR „1 Ll I 2 C1~UC' ~.DRIG>7M DESIGN OR CONSTRUCTION ERRORS C RILIN Gt3 k Fl.OpRS AIR Q I zg~B N ' OCCUPANCY OR USE IS UNLAWFUL WITHOUT CERTIFICATE w COM?ACT~-=D TILL OF OCCUPANCY ~DAOSToliaa rri ~ x I S~1 ti ~ ~ to ~1L 15 ~ I v i r,i c, Roonti ' ' ~ UNDERWRITERS CERRRCATE I - REQUIRED I 1 / Soil KRIpG. Arycvm T7 F 'T 0 5! p^ -yII _ if) 4L(.°rpo5'''S 1`AXEb W/C~TJAv11' ~YJILED'j'' x1'Z !-IDft- A17OVF J1, _ EO WN D I OQ FLAlm_ ~cot.lT~ cQR PLAt~ r-IplsT ~Lq F2/ PLAN A - - _ 2" toRrp~,E I 3 iie' - I~' oc. ` MATCHIN.G 5, rtLT IAll»!~s - 4' I/6..15~LT +.lo IG"oc. cDY 12. 4 - 3 2"r 12"%FD \ 24" VE. NT 6-D .S OFF'I'/ ~ W~GEL7AR 2 2R IGoG- 1- -e I~oa 2 ~I ~TCL#ING ~-FGI F/~1 2.l.I~oC t: qur OVEQL}ANU I''14 LAV. P. 19, i 41 I w-c. ~ ~8 T~XT.I- l I - F-LAsH- I Ids "L DX --T f~"~XT 2't 8" GEl7AR USE META- II Mwcr. F`iEVELED SILL _ 7 AT ALL 7-il JO(MTs t..- ` my T ll '.I'L41L ~I-19 -{CJ-II~NO~ 2. LK Co" y \sA' j=>=~T 2.4-IG'bc 3/~'cDx I'~G"V-Jc~~~z IM-34 PVc (MICRO y bFL Q+4 ~-19 u CHAMMleL. -PRAII.l 12-2t4 cc 4' Rl~ -pRA1NAGe CHANNBI_ zrzx~ Cd.1G. d o: o o~j1~S f 1A2cDx 8 Co NG. J5Loc. I s -._L-~./y C.o. ~OiOR ~DFiAlbk ?_2~d'a,n A"couc.}FLnt,S-horde ~ l_______ SILL SEgLEGZ 4x GRAM vAaniad, o-IG:'oc 4z-~9 {Z,~9 MEDAL SHIELD PL_ lthl FoF2 o pa,6TBO FILL SCALE: APPROVED BY: DRAWN BY 8"muc. F~~cok ~f AUG 171992 DATE: REVIBED I~ - BLGG tlEF'T. ' Ti1WN OF uC3U5HOLD COWTRACTapi.7O'Y"tF'(ALL IIIME.WSICMS{ C2A401110145 AT St-rip- '~~~TI ~.~,/`~1-A,n a aY rlYNxeoaN no. fooon CL~MfI11nY • , - ORAWIND NIIMBPR l~ ~~z I _ - l r i j, I ! I _ I I - I I i ilH 7M Ift II I' ~'F ill liil II I,I; ' it ~giYTh i Igllii litii I - I It NOP,{Tk-i _~I~~VAT~ON SouTH L-v=- \/AT o N ~x4s-jt Ito ! ~ -I i4 III I II ~I~~~ i~ I I I i r I I it I I - ' I I ! I it i _ - I I I I I 'IIII I A - ,,IIII II _ ,,ill - r ~ I I I I r_ I _ i III, - it R-,AN FO F:?, - p SGLE 4APPROVED BT: GRAWN BY _ LL DATE: REVIEEG IA D%T(ON - 1 A )F~ n` Y. GRAWINGN MBER 'SNY. PRIM. ON No.'000N.."INT.' -