The URL can be used to link to this page

Home My WebLink About18247-z Poaa>< 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 G g ~ ~ ( Z Date ...14./Z.~ 19~. Permission is hereby granted o: s ......%~~=~.~n.~,.... ~r9....8...... Q~~...d.--~, ro.../.G,Q .........C:.~...L~ p of premises located at .......~~D.J.r..~.......41.f ....G..4-•:'.....~/-.~::G....~ y ~y~~~........................................................................ County Tax Map No. 1000 Section/..... ~.7......... Block .........~2.'1.......... Lot No.......... pursuant to application dated .....(!~/~r./ 19..~~and approved by the Building Inspector. 0 0 Fee $.d?5,l Buildin for Rev. 6/30/80 Lof No. /38 a~ ~ - _ n ~ ~ ~ ~ ; ' ` 1~ _ ~3 Mon. " - . - _ v . stake Map ~ ~ I h ~ I ~ ~ ~ fi ~r..,,~ f I ~ % ~ lr`cYx""fa a ~v ~ ~"0'~ , k h~ 4 ~ 5~ v ~ ' ) ' 4'/ S~~ a!'y/~., ~ ti i _ ~ ~ mil' ~ ~ ~ ~ ~ ~ . ~ , a ~ ~ . r - - e~;~ ~ t - _ - ` W ~ ~y~ ~ V 1 ~ moo. A 0 .3t~Re Got /?o: /4•/ 6~ Lot Na ~ / Mon. ' ~ - / ~ _ . ~p _ ~ - M.9P o~ L ors /39, /4~0, /4/ „ GARD/NERs BAY ESTATES SECT/ON TWO - EAST M,9Rion; N Y. Sca/e 40'_- / _ G"uaranfecd 1o Tit/eGuaronree ' Trusf Corn~ony assurveycdFe6.,2~ /9~'2: ~ . rE: MoP o f Section Tito is~/ed i.~ , " ~fo/k CounyC/c~,~.iof~ccinFi/cNo.,Z7S •~/~'~'nsed Sarvey%,, . Gr~en/no~T, N. _Y. T:-»,t `g ~ 7 ~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [/~}'~INAL POp L REMARKS: ~Fi~' C,~ ®L , DATE INSPECTOR B0.1RD OF HEALTH FORMN0.1 3 SETS OF PLANS . SURVEY . ,tl; , TOWN OF SOUTHOLD CFIECK i~ , ~ BUILDING DEPARTMENT SEPTIC Foari TOWN HALL ~ ~ ~ " " " " • SOUTHOLD, N.Y. 11~J71 NOTIFY G TEL,: 7G5~1B02 CALL .7~°?~. ; ~~l ~ , Examined ~ ~ 19 rtA I L TO : ~ . ~ - Approved ....1~~?~ 19(S~, Permit No..~O Disapproved a/c uildi nspector) APPLICATION FOR BUILDING PERMiT Date 15... INSTRUCTIONS a, This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;:.ts 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- ~ation. 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 Buildin; Inspector. APPLICATION IS HEREBY MADE to the Building Department, for t:fte issuance of a Building Permit pursuant to the 3uilding 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. Tire 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 in do s. _ K . u~d~ . (Signature of applicant, or name, if a corporatton) lf// (~ailJin ddress of appIicant)V State wheth applicant is owner, Jesse agent, architect, engineer, general contractor, electrician, plumber or builder. L„' .p.................................... \'ame owner of premises ~'t92~r2//z(.~ (as on the tax roll or laces[ deed) [f applicant ia~r~~n„sip ~ r~~~ly authorized officer. ~1'I clfErcer) ~ ~e • ~~µa , , , : tMMEDtATE~.Y' Buitdcr~'s L~ice~t[~'1~"'f'i"~J'` I' ' ~ ENGI.OSE po0i.'ro CODeI tr?Jk ~tt'±CC t ~;.j a . t fIFON~,~ Plumlicr's c~ sH11~IO~,1eti~1,~"~AC~~ ,,~~yy ~J / 7~~1/ ~11~1t4h3.Pr ~ ~vttAA~,'!?' ~ c~ai1'•rt133..~........... C~-~J L L. ..G ~(/--~~~`/oyd' rtrr'~:1~,'sit Electrician's License No.. . . . . T3t4At+ y1C?t1"?'ay? ~ ~;",i 1 .~1".t ,:gin, Other Trade's Lit:~s~c ~ ,tt„~: . Y31h14 .S 6~.~'w .ha i4~')41f~^. ~ Location pAf I#h1~1 o'~w it~+~i~sht+ii` 1~ b+a ~ (/VIA,/~~( tJ yy ?g g ~~t-f;~f i{{~Q.' Sid ~v.rk will be done. d° L~, 4lts' IlppjY• ~ House NtfCt~1§~'3'.4('s Z'' StrccL....... Hamlet County Tax A1ap No. 1000 $eC[IOn , Block , , , . , , , , Lot , Subdivision Filed Atap No. . ..1Na~nej Lot............... State existing use and occupancy of premises and i ended use and oc upancy of proposed construction: a. Existing use and occupancy , . ' b. Intended use and occupancy 1 i 3. Nature of work (check which applicable): New Uuilding ' Repair Removal Addition .Vtcration " " • • • • • • • • Du;rit lition Oth 15'ork . • 4. EstimatcdCost.....~C.p„~~..,,,,,,,,..•.•.•. (D:scription . Fee . (to be paid on filing this application) 5. If du•ellin~ number of dwclli oara_e number of cars Ong units umber of dwelling units on each floor , , , If ~ c 6. If busyness. commercial or mixed occu anc • • • • ~ • • ' • " " " " " " • • • • • • ~ • ~ • • ~ • P Y, specify nature and extent of caclt type of use . 7. Dimensions of existing structures, if any: Front , Hciaht . N'umbcr of Stories , ' • . • . • Rear Depth . Dimensions of samestructure~withaltcrations Depth . or additions: Front Rear • . • . • . IIcir-ftt , . Number of Stories . ' Dimensions of entire new con;truction: Front , ~ ~ ~ ~ • ~ ~ ~ • ' • • • . • • • • • • • • • • • Hcigltt Number of Stories • • Rear Depth • • • • . 9. Size of lot: Front 10. Date oP Purchase . Rear Depth . ""••••••....NamcotFormcrOwner 1 1. Zone or use district in which lrcmises arc situated , , , • ' ' • ' ' ' ' ' ' ' • 1~. Does proposed construction vy!olate any zoning law, ordinance or regulation: • 13. ~Villlotberegraded • ~ • • • • • • • • • • 1Vi11 excess fill be removed from premises: yes • N~ 14. Name of Owner of premises . ~ , , , , ' ' Name of Architect , ~ • • " " • • Address ...................Phone No... Name of Contractor • ......Address ...................Phony, No.. . IS.Is this property loclated within •'•Address.. .PhoneNo.. *If yes, Southold Tool,n Trustees Permit may bee requiredetland? *YES.. •.t70....• PLOT DIAGRAM Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bloc} number or descriptio accordin^ to decd interior or corner lot. o ,and show street names and indicate whether ;g ~4' - ~-y ~ ~ ~ .GZ A _ ~~ypry~,h." ~ ~ t ~ N ~,+.t s ~yq' ~ ate: ~~~~~uRr,1„~,„~? i I n N E, D • ~ I 788.1tp$ $ AIN 10 4 IMM1 ~s30:3 ~tT.It30~? FOLLOWING NVSI?L~~TIpN$; ~ 1. FOUNDA ~ N~INRLD ~S2[Tia"'1HSS5;I t4C1 sl~l FOR POUREp f:ON T,1 TE O F \ El4' YO R SS 2. ROUQFI - FRAMMIQ' i p~~~e ~U\TY OF 8. INSULATION 4. FINAL - CONSTRUC?ION MUST (Name of individual signing contract) ~ ~ ~ ~ • • • ' ' ' being duly swa~L~~~~~"§ NSTRUCTIpN 1CetOhe is the applicant rove named. THE REQUIREMENTS OF ~ MEET is the . , ~ STATE COMSTRUCTION 8 E N.Y. .....................J~.... CDDES. NOR ~'IYERGY ' L1~S~•;~ RESPON8181t`~F IrOR (Contractor, agent, corporate officer; ctc.~b~ CbN$'FRUC~ION ER~fpgg " " " said owner or owncrs~ and is duly ~uthorizcd to perform or have performed the said work and to make and file this ~lication: that all statements containj:d in this application arc true to the best oChis knotvledgc and belief; and that the rk wdl be periormed in the manner sqt forth in the application filed thcretvith. om to before me this I OS .~da/y o f/.~ L.',, 19~F , ar; Public, ...~'r:`s'S!./J•...ftlR}L~Q'~:-........ Cou , my ~ NOTARY PUBs Mor~E VOE • . • i . HELEN K. to of New~tY~or~k Na.47P67878,Sgh3019_.7L I 1 (Si-natureoC applicant) , ~I ~