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Home My WebLink About19759-z ~BM NO. ~ TOWN OF 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) N-~ 1 9759 Z Permission is hereby granted to: ~ ....~.~.~:...~.~... .................................................... ~.~.L_,..~..:.~. ....... .u...~..~ ......... ....................................... f~:~[;~--y.]~]-.~;.~]~?...~-....~/..~-]....-~-.-..~--( ..... "~ .......... 11~i~ ........ ~"~ ............................................................................................ Co,,~ Tox *ao, No. ,000 S,ctio. ..... ~..~.~ ...... mo~k .... ..~..~. ........ Lot No....~..I .............. pursuant to application dated ...... ~.......~.. ...................... , 19..~.~.., and approved by the Building Inspector. Rev. 6/30/80 0N LOT i/~ S~Y HOUSe & CERTIFIED TO: FIRST AMERICAN TITLE INSURANCE: CO. OFNEW YORN TITLE,, NO. 121 $ 8541 LONG ISLAND MORTGAGE CORP. MICHAEL FINGERLE CHERIE A. BERGMANN NO. D~OF N/O/F uAN' $URVEY OF LOT 40 "MAP OF EASTERN SHORES u FILED APR. 27; 1964 FILE NO. 4021 'AT GREENPORT TOWN OF SOUTHOLD SUFFOLK COUNTY , N.Y. lo00 ' 033 05 - OI SCALE I":SO' MAY 8 , 1987 AUG. 2, 1989 Au<. ~/, /~8~) ~.¢. FEB. 9, 1990 (FINAL,) 49668 Prepored in occordor~ce with tJ~e minln~um $,"andords For title surveys os e~t2bJL]:o,j h)' the LLA. LS. and approved and cd .,', for such use by The New York St~r~ I~c~ ,~ Title Associaffon. 87 - 352 3. Nature of work (check which applicable): New Building .......... Addition .......... Alleration ... Repair .............. Removal .............. Demolition .............. ~...x~...~..-'~i..~... 4. Estimated Cost ...... ..~v,~../. ~ ~,,O.~ .,7-~ (Description) // .......................... Fee ...................................... (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 ........ · .......... 6. If business, commercial or mixed occupancy, specify nature ahd extent of each e of use ............ typ ......... 7. Dimensions of existing structures, if any: Front ............... Rear ............. Depth ..... Height ............... Number of Stories .. . . ............................. ' Dimensions of same structure with alterations or additions: Front Depth ........... · ................ Rear ............. · · ......... Height ..... ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear Height ............... Number of Stories ............... ' .............. Depth ............... 9. Size of lot: Front /..Tz~.. Rear ./. ~-7 10. Date of Purchase .................... Depth . .../...%<2. .................... ' ......... Name of Former Owner ............................. 11. Zone or use district in which premises are situated .................................................... 12. D°es pr°p°sed c°nstruct on violate any zoning law, ordinance or regulation: 13. Will lot be resraded ................................ N ............................. Will excess fill be removed from premises: Yes No 14. amc of Owner of premises . .,a/~./..~..~.~.z.. ~..,4].~/.t~-dress ~.c. c,~,~/ Phone No Name of Architect ...~.. ,, ................... Address Phone No Name o.f Contractor /.~. ['~0./71~ ~~~.A~,~ ')go'j~fe''~'"i'd~'~ ' ~'/_';--'"i.'t~'' .......... ; ./, uuress ~. ........ ,4-5T.fi .,.,.,.,~2 ~:?JPhone No z ,~ ~, ¢ /./. ~.7. · 15. Is th~s property within 300 feet of a tidal wetland* *Yes. .~ ............ · If yes, Southold Town Trustees Permit may be'requirerS'' ~ ....... ... 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 number or descriptio~i according to deed, and show street names and indicate whether interior or comer lot. . FEE: NOTIFY BU~i:.DING DEPARTMENT AT 76,5-1802 9 AM TO 4, PM FOR THE FOLLOWING iNSPECTIONS, I. FOUNDATION P.NO REQUIRED 2. ROUGH - FRAMING & PLUMBING 3. IN'SULATION 4, FINAL CONSTRUCTION MUST · T BE COMPLE E FOR ALI. CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY ]TATE OF NEW YORK, S.S CODES· NOT RESPONSIBLE FOR i?.U..NT..Y..(~.~~a.c~i , DESIGN OR CONSTRUCTION ERRORS .......... being duly sworn, deposes and says that he is the applicant bore named, [e is the ................. (Contractor, agent, corporate officer, crc,) f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ~plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. ~vom to before me this ........... · 4 .......... dav Of .~t~.~ ~taryPublic, ..fi~'~r. 7/- /t./~,_ .............. \ ...... ~oun[y / / ,: HOTARY PUBLIC, ~e el ~ Term ~p r~ March SO 1~ - · ~ . ,, ', .',,~".: ;~, l/[JJl ..... J~'21 ~:~'~'~'I B TOWN OF SOUTHOLD . : UILDING DEPARTMENT Nil 21991; , ItJtlL,.~ ..............I ; :~,'~ SOUTHOLD NY 11971 ~ ~.~,',' ?, .... TEL' 765 1802 Approve .... ,3 , 19~l ~e~it No ~ ~ ~ ~'~,~ .... . ............. (Building Inspector) APPLICATION FOR BUILDING PERMIT CALL ................... HAIL TO: Date ................... 19... INSTRUCTIONS a. This application must be compleiely ill/ed in by typewriter orin 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 loi and of buildings on premises, relationship to adjoining premises or public streets )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- :ation. c. The work covered by this apphcaBon may not be commenced before issuance of Building Permit. d. Upon approval of this applicatioq, 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 ot~ used in whole or in part for any purpose whatever until a Certificate of Occupancy ;hall have been granted y the Building II, spec,or. APPLICATION IS HEREBY MADE!to the Building Department for the issuance of a Building Permit pursuant to the 3uilding Zone Ordinance of the Town ~f Sou,hold, Suffolk County, New York, and other applicable Laws, Ordinances or [egulatinns, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ?he applicant agrees to comply with all' applicable laws, ordinances, building code, housing code, and regulations, and to tdmit anthorized inspectors on premises !nd in building for necessa~ ~.~.d.,,...____ (Signature of applicant, or name, if a corporation) ; ~ (Mailing address~of applicant) / grate whether applicant is owner, leSse~, ggent, architect, engineer, genera ac lectrician, plumber or builder. qameofownerofpremises /')-~ .[i~,/~ ~4~Z- ~ ~r~"A_/~-~ APPROVED AS NOTED f apphcant is a corporation, signature ofiduly authorized officer. " f:EE:¢;~, ~ BY' ~~.. i .' NOTIFY BUILDING D~PARTMENT ~,~;' (Name and title of corporate 6fficer) Builder's License No .... ~ .~r~..q, Plumber's License No .......... Electrician's License No ........ Other Trade's License No ..... Location of land on which proposed, ........... ..... .... ! Street House Number County Tax Map No. 1000 Section .i .... Subdivision ................ .~.t~ ............ uork will be done ................ 765-1802 9 AM 30 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TVVO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR · ' ' DESIGN'OR CONSTRrJCTIrON ERRORS (~ _~-- Hamlet .... Block .............. Lot .... Filed Map No ............... Lot ............... (Nam~e) State existing use and occupancy of p~emises and intended'use and occupancy of proposed construction: a. Exist~ng' ' Use and occunancv . r..~..'~...~-... . .~.~/~... ~ ~*~/~,/ · , V ....... ...... . .......... '