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Home My WebLink About18276-z 1 Y gosae< 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~ ~ $ ~ 1 ~7 Z Date 19.b..(l. Permission is hereby granted to: ......~.....~.t....... to .....~5?~.~.......c~".,P.rK:........ fly....... G U ~ of premises located at ..sr~..~t.U.~......~./!~`~,X(~L..... . ft;:rhsL,,,,,,,,1;~Gk~ 1 County Tax Map No. 1000 Section Block .......~'...~.....~v.pp Lot No......~.y.......... pursuant to application doted 19..P..~, and approved by the Building Inspector. Fee $.,o~.,S:...../ Bu ding Inspector Rev. 6/30/80 BOARD OF HEALTH 3 SETS OF PLANS FORM NO.1 SURVEY v TOWN OFSOUTHOLD CHECK BUILDING DEPARTMENT SEPTIC FORM TOWN HALL • SOUTHOLD, N.Y. 11971 NOTIFY 7~G~_ ~ 771 • TEL.:765-1802 CALL / / Examincd.•~.~nM..{....,19Qgr MAI T0: Approved ~Lj~. 19~ J. Permit No. L~ Disapproved a/c/ ~ C~ ~~1 .~c~..~. . ~ " ~ (Building Inspector) ~ PT BLDG. DE APPLICATION FOR BUILDING PERMIT 70WNOFSOUTNDLD Date . ~y~~ 15 s~ INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sell 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 Lasvs, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Tlie 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 ins ectioc (Signature of applicant,~ame, if anon).. . 0?6o S ~~Po~r/.~A~~. ~~~~y.~~u~ ~uy~l9,~ ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~WJI/~~ Name of owner of premises ~!!le,r~M..... (as nn the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ....owiv.ER . (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Other Trade's License No . . 1. Location of land on which proposed work will be done. ~6 US. ~pti~ / .4~?~ House Number Street. / Hamlet County Tax Map No. 1000 StlChOn ....1..~ BI'ock ...CT Lot Subdivision Filed Map No. Lo[............... (Name) State existing use and occupancy of premises and intended use and occupahcy of proposed construction: g p y . •s,:lr,~e~ . FA!~li•L, ..a ~ Ecc,-aiG-- a. Exispn use and occu anc ~ W b. Intended use and occupancy ..:'r!p~ll~. • • • • • • • • • • • • • . i 3. Nature of work (check which ('applicable) New Buildin Repair ~ • • • . • • , S ' ' ' ' ' • • • • • Addition Alteration . • • • • • Re Imoval , . Demolition • • . • • Other 1Vork ~f~~~'.~ . II (Description) 4. Estimated Cost ~ Fee . 5. If dwelling number of dwells (to be paid on filing this ~plication) ~g units , , , , , , , , , , Number of dwelling units on each floor . . If garage, number of cars ~ . . . . . ' ' ' ' 6. Tf business, commercial or mixed occupancy, specify nature and extent of each type of use , , . 7. Dimensions of existing stru NU;res, if any: Front . . . . . . .Rear • • • ~ • • • ° Depth . Height mberofStorics... imens~ons of same structure 'with alterations or additions: Front Rear , Dc th.....'. j P TIeight . Number of Stories . ' 8• Ditensions of entire nett' construction: Front Rear . .Depth Heiht ,NuhnberofStories. 9. Size oflo~~t..........!............ Rear ..:.............Depth....................... 10. Date of Purchase , , ,ii , , , , , ....Name of Former Owner 1 1. Zone o'r'use district in which prremises are situated , . , , , , , , ~ ~ • ~ ~ ~ ~ ~ • ~ • ~ ~ ~ ~ • ~ ' ' ' ' ' ' ' ' ' ' ' ' ...~.j 12. Does proposed construr, tori vi¢late any zoning law, ordinance or regulation: lei . . 13. Will lot be regraded ,Address . ...Phone No. 14. Name of Owner of premises . Name of Architect . , , . ' ' • Will excess fill be removed from premises: Yes No .................Address . .Phone No............... . Name of Contractor . ~ . ,Address . . ,Phone No. . 15.Is this ro ert located with in 300 feet of a tidal wetland? *YLrS....NO. * If es So thold Tow Y , n Trustees Permit may be required. i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ali set-back dimensions from property lines. Give street and blocl[ number or description according to deed, and show street names and indicate whether interior or corner lot. ~I III I I - I I I STATE OF NEW YORE, I COUNTY OF ~'S ~ ICI being duly sworn, deposes and says that he is the applicant (Acme of individual signiltg contract) above named. I Hcisthe II .I. I (Contractor, agent, corporate officer, etc.) • ~ ~ • • • • ~ • • ' of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manncr''sct fortis in the application fjled therewith. Sworn to before me this ' ~ Notary Public, IL U .County ~~y~-~ Notary Public, Stato of New York (Signature of applicant) No. 4822683, Suffolk County ~/(j Term Expires December 31, 791_ I Lot /B LnE, /7 . N. 35°52r27~rE i i2./O~ EVtL6}I - L•tt.~ Lot /5 AREA= 40, 060 S. F. H U O ~ . ~ - ~A F' ~itY.~p°~ ~ '6 'l w O ~ ~ ~ 4r e71m O ~~~~~a20wdl ~U~gOcL~ ~0'. Yw'~'h~ ~Z BOO ZCSWI~° a ,ri mggFWOg p~~w~a~ ~ ~guizgo~cggw~~~jTpp h QZ O ~t'-p ri ~~~yrL O c9 a 'a a- g~ d o O m r •mN~ao~a.~a®a ~ \~LL°~GOO~?m~y~OW Q ,~iJO 1P O LL. N ~ ~ Q tr- ~ V Q t` ~ p LL Z r O ' 3 2.5 ~ EL=3/f fr.O_ ti 32.5 as.o' x _ _ ' 0 i EL •lO.S V (~D 1 //O , FIN. FL R.=34.5 /STORY FRAME v 5 ~ ~ ~I~}G' ~ ~ 6AR. ~ NOOSE Y?ei r +~s' x z/.s' +s. r' J x iro' ----------r---- - EL+.}'A a ?EL.}r.r 32. YO' Y0.7 w ~ 1 ~ 5 ~ ~ I I o PROP. I r (y El.•t9.t ~ a ~/S r/ Iri ri ~ ~ ~ 1.. Lp ~ -i ~ \ PROP. I ' ~ ~ /cPJ I ' I ro /35.50' lo' 26.20 e t;/~ S39%_4~/~ a. LAND o L ANE C , _ ' ~ - SIIRYEY FOF S!!PFOLY, CO!INTY DFAARTMEIdT pf HF,A.LTH SElNICES MOHRING EPTERPRISES, INC. LOT 15, ~~HIG~ILAND ESTATES" ' POR APPROVA! OF C01~15iRUCTIpN Ot+,!Y AT CUTCHOliUE TOk/N pF SOUTHOLD p.~ry H5 REF. PtU' SUFFOLK COUNTY, NElY YORK ' RUN*V TNORIfi EO ALTERATION OR AOOITION rD nns GUARANTEED AP}RO'VED SURVEY Bi A YIOIr TION oP 3ECilON 7209 OF THE NEW YORK STATE rnuCAT10N lAW F. H. R COPIES OP TNIS }URVEY NOT bEAPwG THE LANG H.U.D. SVR VE YOIIS INNS 1 SFAI OR EMBOSS EO SEAL SMALL ' •i NOT bE CONlIOEPE6 TO bE A VALIO TRUE COrv MGW RANTEES INLI CA TfD NEREON }MALL RUN ONLY 10 HEALTH DEPARTMENT-DATA FOt? APPROVAL TO CONSTRUCT THE PERSON YDR \'NON THE SURVEY IS PREPARED ANO OI NIS bf.NAI P Tn TNP Tm r rwn•w