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Home My WebLink About20172-z · OB~ NO. ~ TOWN O~ SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT ~'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 20172 Z Permission is hereby granted to: ............ to ........ ~...:.~. ............. ~ ..............~ ,, ,,..,,, ,~.,ed .,..~..~......~J~.....~., ............ ~~ ........................... County Tax Map No. 1000 Section .... ..(~..~....~.. ...... Block ....... .~....~.... .... Lot No. -~" ~ pursuant to application dated ....~..~.'~..~.~%~........~:.....~......, 19...?J.., and approved by the Building Inspector. Fee $..~-..~...:...~ Building Inspector Rev. 6/30/80 ~'OW~t'6F'SOUT~Om FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTIt ......... 3 SETS OF PLANS .......... 'SURVEY ................... CllECK .................... SEPTIC FORH .............. Appro. x,j -, .v~..~,I~,A,/O..~..,~.~, 19 .~./. Permit No..~ .O..J.7..&..~ Disapproveda/c ........................ ..... .,,.,.../ / APPLICATION FOR BUILDING PERMIT Date " ........ ........... , 19.. INSTRUCTIONS a. Th/s application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets 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 Dr areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- zation. c. The work covered by this application may not be c~mmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit ,hall 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 ,hall 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 3uild'ing Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or legulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. E-he applicant agrees to comply with all applicable laws, ordinances, building codex hqusing code~and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. [J / ~ ) ~/ ................. F-re.. ............. - ' (Signa, ture~of a~plicant, or name, i ation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ~../4..~'..e.-~.. ........................................................ . ........................ Name ofownerofpremises ~.~../~. ~ ~..~..J-~.~.~.l-~t-~ (as on the t~ roll or latest d~0~f[~ AS [f applicant is a corporation, signature of duly authorized officer. OA~E ~J_~ 8.~ ~ ..~ ............................................. NOT~FY 8[IILD~NG O[[I&~TMEN7 AT (Name and title of corporate officer) 765-1802 9 AM TO z] p;,~ FOF~ 7HE Builder's License No.. ~.~. t ............. FOLID~%'ING FO~ POURED CONC~EZTE Plumber s License No ......................... 2. ROUGH . FRAMING & P!_UMB~NG 3. INSU~T~ON Electrician's License No ....................... 4. FINAL CONSTRUCTK)N MUST 8E COMPLETE FOR Other Trade's License No ...................... ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, Location of land on which proposed work will be done..' ....... ~T~T~ .C~STRU~O~ & ENERGY ~, ~ CODES. NOT RESPONSIBLE FOR .... : ............ ~ ~~~CTiON ERRORS tlouse Number Street Hamlet Cou,,~y ,~ ~p ,o. ]00o s~io~ ....... ~7 ........ moc~ ....... ~ ......... rot...?~/ ............ Subdivis on .... ~/~. .................. Filed Map No ............... Lot / (Name) }. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............ ~ ................... '. ' ~ . · · · . ....:2 i [ ..... b. Intended use and occupancy ....... ~ ......................... ~ .... , , ~..... 3. Nature of work (check which applicable): New Building ........ Addition Alteration Repair .............. Removdl .............. Demolition' '.... ' .... '6t'h'e~ Work ;~'~=~.~i~,' i ' ' 4, Estimated Cost ~, ,/,~,, ~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor .... · If garage, number of cars ..... I ............ 6 If business commercial or mixed occupancy specify nature and extent · ' . , of each type of use 7 Dimensions of exisiing structures if any: Front ............. ........ · Rear . Depth Height Numger of Stories ..... ' ....... ~' ' ' ' ........... : .............. Dim ensi;~i ............ ' ....................................................... of same structure withialterations or additions: Front ................. Rear .................. Depth .... ............. i :i tr; '; ~) ................... Number of Stories ...................... 8, Dimensions fent~re new construc n ........ · ....... Rear ............... Depth ............... Height ............... Numbei of Stories ....... 9. Sizeoflot: Front ............. ~ ......... ' Rear ........ ' .......... Depth .. ..................... 10. 2;Oo r5;%;; .......... i... . rmer. Owne,.. ........... . ................. 11. ict in which't;r;miies a'r~'sit~l~;(i .. Na 12. Does proposed construction violate~ any zoning, law ,-~.~[-' .... '__' ' ' ';: ...... ;74 ........................ 13. Will lot beregraded ... ,~. i .......... · ...~ ............... · .............. 14. Name of c~ ....... r .... .' ' ' ~'a' '~b-/'~:~ )~_;~LL% ...... wni excess/nn,~.e re, eye, ill ~ortl premises: Yes No Name of Architect ~ .......... /. · ............ ~ .............. Address ................... Phone No ................ Name of Contractor ........... ~ .............. Address ................... Phone . 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No .... t~.... · If yes, Southo2d To*m Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, an& indicate all set-back dimensions from property lines. Give street and block nut tber or description according to deed, and show street names and indicate whether interior or dorner lot. ,: ,i \ ;TATE OF NEw,tYORI~,/) . ~ ,, ,, ~ 'curry OF. [ · :' '. ~ '~' · :" ").. · · ! ............... being duly sworn, deposes and says that he is the applicant (Name of ,nd~wdual s~gmng cpntract) bore named. 'e is the .... ~r-4 ( ontractor agent corporate officer ftc ) ......................... C said owner or owners, and is duly au :l~orized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application ire true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth Jn the application filed therewith· .vorn to before me this ............ ....... day of... ' .9'/ , 1~0,411§1~t114 ~ ^., ' ............ · .... II'mllfl~l I~ Surfeit ~,,nllr c?,...W (Signet#re o £ applicant) ~om, mit~lon F..xpIr~ May ~ I~ 0 Z: 0 0 0 o e PLATT NI OIF H. M. DEMAREST SONS S. 53° §3' I0" E., 323.93' LOT I AREA ': 5.110 ?,CRES CERTIFIED .TO: TICOR TITLE GUARANTEE S'OUTHOLD SAVINGS BANK YAN H. REIGER FRANCOISE A. REIGER Prepared in accordance with the minimum 5~ondards for title surveys as established by the g I.A.L S. and approved and adopted for such use by The New York State Land Title Association. LIC. NO. 49618 '0 ENGINEERS , P. C. .ECOm'C'--SUR VE~'ORS (5,e) 765 - 5o~o P.O. ~0~ 909 MAIN ROAD $OUTHOLD, N.Y. ii971 SURVEY OF LOT I SUBDIVISION MAP OF SETTLERS AT OYSTERPONDS leILED MAY 4, 1984 FILE NO. 7729'. AT ORIENT TOWN OF SOUTHOLD SUFFOLK ,COUNTY, N.Y 1000 - 27 - 02 - 2. SCALE I" MAR. 14 , 1986 ee -leo