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Home My WebLink About18237-z soaai xo. s 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) N ~ ~ 8 ~ ~ j Z Date .....~i.~?~ 19.1. Permission is hereby gro ed to: to /aoo at premises located at _ .~..~~!4iu:5.................. County Tox Map No. 1000 Section Block .....~.........,.~cc~;Lot No......G~..~.~........... pursuant to application doted 19.U../..., and approved by the Building Inspector. ~ Fee i~Y~ r ..Or.~........... I tar Rev. 6/30/80 BOARD OF HEALTH 3 SETS OF PLANS FORM NO. 1 SURVEY . TOWN OF SOUTHOLD CHECK • - . BUILDING DEPARTMENT SEPTIC PORN TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 TEL.: 765-1802 CALL c, MAIL T0: Examined . ~ 19~/. f Approved ~J/.~ 19~. Permit No. V.2. 3 7 pp~u"~""°~~C"-a ~l_` Disapproved a/c ~ w1V ~ ":7 f9Bg 1 ~~111~ l,~ i "'rl (B ing Inspector) ~ `~°`5`'""° ~a~~ APPLICATION FOR BUILDING PERPAIT Date ~ S......., 19 ~ e~ 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 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 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 code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. CV K".e.-P.° ~~n.e°r£'.-..Jt. 57.c~k'61. . (Signature ~pplicant, or nam~if a corporation) Pct .~Q~.~~s.. xS~ l~. NY..~.,~:~ I (Mailing address of applicant) State whether applicant is owner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. I r- . R-- Name of owner of remises .hit C~-. ~„€;-r-I-•1•<; y- I AP YED AS NOTED p .B.P.B...~~ (as on the tax roll or late'~t't2 ~ If applicant is a corporation, signature of duly authorized officer. FEE: BY: NOTIFY UI GEPA ENT AT 786-1502 9 AM 'lay 4 PM FOR THE FOLIAWINGINSPECTIONS: (Name and title of corporate officer) i. FOUWQATION - TWO REQUIRED ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED FORPC~UREDCONCRETE Builder's License No. 5~i 2. ROUGH =FRAMING $ PLUMBING 3. INSULATION Plumber's License No . 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. Electrician's License No . ALL CONSTRUCTION SHALL MEET Other Trade's License No. THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION NERGY CODES~~.,,~NOT RESPONSIB FOR 1. Location of land on which proposed work will be done. ~~•I ~1L°J' CONSTRUCTION ERRORS• • o ~ House Number Street Hamlet County Tax Map No. 1000 Section d......... Block Lot . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: + a. Existing use and occupancy ~ .~:•2 . K~~ x : 4 rv•t e,'C~,r." ..p~• r~ C•ri; , , . • . • .....l...('.. . b. Intended use and occupancy ~.I.ra.~.~_. i.•:.~. Y~.~....r..~.~•n ~.•1`~-f'. ;F•~?, Q,e,~,g•e,lirgn~r, 5~,~~:h•-i@a~Ic~, ( which applicable): New Building , . ~ Altera •o , . 3. ' Repair of work check Removal . Demolition Addition : Other Work .~c'. m ~,,Q_..J.. , (Descripttion), 4. Estimated Cost ,-r..~. 0 Fee , ....(to be ~ 4, Q , , ` paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling un~ts 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, if any: Front ...............Rear Depth , . Height ...............Number of Stories i . De ~ sions'of same structure with Heerht ons or additions. Front Number o, • • • ' Rear . p g Stories.., E ~ 4^,r•~? t%r,~, akt8#()nfi . Dimenstons of entire new construction: Front Rear , . , y7,j, Degt)h,{gt~~i3=CE..t: ~lr, . . Height ...............Number of Stories , ~~,1,, ra+:>~.f t4tsr . $r. rp}~?^}.. . , CtF 1# 9. Size of lot: Front Rear ::Name of Former Owner: ~ ~,1?tht ~p..f ~.xr=.. ; • • • 10. Date of Purchase ~ , - + z ~ • •`x` t ~r t ? 11. Zone or use district in which premises are situated ys.- ~ • ;q• fi; ; , ; , ,`t, C 4; , • , • s , • , 12. Does proposed construction violate any zoning law, ordinance or regulation: . a . y . .57...::'i' . 13. Will lot be regraded : ...Will e~cess fill bye remdyid~fi' r~7$'inis s,:7 P~c~,,,:~~,No 14. Name of Owner of premises .........~.-~:r?:r.e,+C`.,.. Address . g.~'' cc.,.. ?.r T~l~ h u' ~3, St ,Q • Name of Architect ...Address ¢ t #t t No..~u_>n.,,t:~~t;,L7 . . .cu c, r. ~•e~,c~. 5tCln.S.Address~ ~.~5...3 ~ ~Q( s~~~'~r,.,~~. Name ofContractor~e ~ - oB~.,~o,T~~~r~q~,~„ 15. Is this property located~ithin 3081 feet of a tidal wetland? ~e: sIESCS;t,d ~~o,~~.Q ~4i Lt3i3 ti;E' *If yes, Southold Town Trustees Permit ma be regqw~ired. ;~kslt-X Btlk9-L7i49~ tt~v'y'B~-`'~~ ~F1 PLOXI' DIAGKAM ? BA• n__ Locate clearly and distinctly all buildings, whether existing or proposed, and~tld~cate'all"'lS'a~~iie ins ons from property lines. Give street and block number or description according to deed, and shoal str t e whether interior or corner lot. 131-~,,c~ fiw , ,S h 1 ' i I~~ I~ i - ~ I ! I I - I ~'h ti `~h r°~ rJgr~_ °,~,Y~ ~ ~D,$T GL GAP ~EG{;, R~• 'ins-ra((a`rio.-, o~•o.~~re~c*.w•r~~ -rwo L,~r,~,-~~ ~,~1,~-~. ,vr.~~:. 6 f v v r ~ oT' Y, , cJ h ~ I qc k, v , r„71 , c, r, c~ o i ~ a~e,~<, a h ~ rcq r- , ro Y 1 m4Tti~ a , ~r ~ ~ ~ r~ ~-eer.-r o~ f , vex ~ao-Y k , h eedAr ~ o V Jr?r" e r a , n ~ ~ , S q z~ In -r" S T• Y'P~r o o Iu 5 ~ rc~ .~-T STATE"OF NEW YOIILKK, SJ J J COliNTY OF . bein dul sworn de o •••••••••••••••••••••••••••g••~•••••••j•••••• g y p sesandsaysthatheistheapplicant (Name of individual si nin contract I above named. He is the I........................ (Contractor, agent, corporate officer, etc.)', , t? of said owner or owners, and is duly authorized to perform or have performed the skid work and to make and file this application; that all statements contained in this application are,true to the best of hid knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn.to before methi~s / ~ ..............f,~.Y~0.~.dajyof...:?:..........,19~ III Notary Public . County I , LINDA J. COOPER pv{w~,/ ' Notary Public, State of NewYor i (Si nature of a licant) No. 4822663, Suffolk County i Tartu Exgirea Decernber 37, 18__ i I ~