HomeMy WebLinkAbout17937-z rows xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MU5T BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~ 0 017 9 3 7 Z Date .........~.c~.~c.~.... 19.~.~
Permission ~s hereby granted Yo•
to
ct premises located at .1..7`:~.~.....L.t~..f,:t~.~G.~~.2~~.. . St.-~......~.7.,~.Cr'.~....
County Tax Map No 1000 Section ! a~/n~.A Block ....0..~~..~9. Lot No 7:.J.
pursuant to application doted 41~,C.!!1.. ~ 7 19 6 ~ and approved by the
6wldmg Inspector.
Fee S.~s..l~
r ,
Building Inspector
Rev 6/30/80
',p n ! .L.i ~ p Sp ~
y yy~
tl M1M1 ~ Y+i ~J
y J ~ yl~~r.° ~ ~ E
!
! ~
yt77 ~ ~
c l~ ~P ~ 14 r ,r ~ F .J x t
N 1 ~ ~;t ~ ~
{ ~ ~ i '~J. 417 1
~ 1i ~ ~ U
i,~~ ~t 1 d ~
~ Zr i• .Y
1~ ~ ~ V ~ V~ ~ ~ ~ j ~
1 ~ ~
R ~
~ ty ~ r , f 1 I
1c ~ i~F.Y ~ r~ ~I ~ t i
'}an. ~ o~.urr tt
LI. ~ l.~ ~C tL~ _ o V O
D ^ ~
R ~ ~ T t~
~ a
~ a G
~ ~ ~ ~
hh
s„~ - ~ ~
~ ~ m
N t
~ i 4y F _ ~y
~ - ~ z ;a ~ ~ ~,`1
~ ~ y ~ ~ ~ .
c. ~ '
~ ~ ~ ~
r ~ j w ~ h
i ~ ~ ~ ~ ~ l ~ ~ ~i ~ ~
~ b r n P ~
y r w
+~R:e t Y
t
Y h r. t ti
q ~ Q
~ 1 A /a ~ ti
h ~ ~ ~ 1~ Il rum
~ Yi"~ it „1 ~ ~ M1f ~'1Y ~ T"~ ~ t Y
`t ~ a y r ~ . ,
! r r+ ~ 17
K ~ t_
k ~ a ~ ~ V \ /~li ,
l ~1 4_
H hb ~ x ! .x '
;iio`n N ~ p
T
n~`c ~ <r~
, ~ p '
r~
1 tAi h. i0 ~ i~C~1.~f'X~~A ct ,
y C
~ i tD,~~, NS1n~~pr~
r V Y ~ ~
~ t S~i 1 ' 6~ ~ O
D 6 d'~,5t~
r ~ f
rS-.tY L L
v f to F4 hte G+ND ~~rYdtrw?~~~ ~ ~
S' Qt r{ v ~-J 1~ an P d c,ar~va ~ Y9'l~~1
f.. •
rZ z ` rt ~ L ,'Zf n
'y $ t~3" # 1'~
~ t'd 5 L~ i y
TF Z k.~11 S ~I, Y'(j ~R~d
itl 1t i ki 7 a ii L a b ~ i l i~
BOARD OF HEALTH
3 SETS OF PL.1NS
FORM N0.1 SURVEY
TOWN OFSOUTHOLO CHECK ...:~.1:I.9
BUILDING DEPARTMENT SEPTIC FORAf
' TOWN HALL
&OUTHOLD,NY.11971 NOTIFY
TEL.: 765-1802 CALL
nn qq MAIL T0: IpO.'~0-~Sf
Examined ..~lr.4CX1..o~1R.., 19~.L P-i-e-n-ru~.
.lpprovcd ..~U~1-Cxil..a0.., 19 ~9. Permit No.1 79,~~ ,Z1•., R~'ii.~ ~r
DisaPProveda/c .
(Bui ing Inspector)
APPLICATION FOR BUILDING PERMIT
Date ~ .r 15~
INSTRUCTIONS
a. Taus application must be completely filled in by typewriter or in ink and submitted to the Budding Inspector, with
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 stye.
or areas, and givurg a detazled description of layout of property must be drawn on the diagram which is part of ttus app
cation.
c. The work covered by ttus application may not be commenced before issuance of Budding Permit.
d. Upon approval of this application, the Bwlding Inspector will issued a Buddmg Permit to the applicant. Such peril
shall be kept on the premrses available for inspection throughout the work.
e. No building shall be occupied or used rn whole or rn part for any purpose whatever until a Certificate of Occupam
shall have been granted by the Buddmg Inspector.
APPLICATION IS HEREBY MADE to the Buddmg Department for the issuance of a Budding Permit pursuant to ti
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances •
4te;ulatrons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe
The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and
admit authorized inspectors on premises and in building for necessary insp ion . s
L
(Si attire t' apphcant, or name, rf a corporation)
.,JOB +"~~~x..~S r ..~'C1~Ir_!G.
• (Mailing addres f applicant) ~
f
Stale whether applrcant rs owner lessee, agent, arJch`rt`ec~t, ern-gr-n-e-erg-a-neral contractor, electrrcran, plumber or builde
Name of owner of premrses ~ .~I~'JC~, fS....~~,~},,(~•~E,l T.
(as on the tax roll or latest deed)
If apphcant is a corporation, signature of duly authorized officer
(Name and title o~corporate officer)
r F J/[~n
Builder's License No. S . .,17.. l . • .
Plumbei s License No . .
Electrician's License No . .
Other Trade's License No . r ~sd
1. Location of land on which ~rro~osed work will be done. j'• ~ ~n ~ L~~'
r A. 5 . . . . . . • . . • •
Y y! llal 1,~ ' .~r`. ~.'l~~ F.C. .
iii4~.. 4 SAC.. r /
.
House Number ° a y ,,p,t ~4. -Street Hamlet
a >„i • s c ~g'
County Tax hiap No I0$b ~cctron • • • • • • . • Block -3...... Lot ...y.7......... .
Subdre~rsion Filed i\tap No. Lot .
(Name)
State e~rstmg use and occupancy of premises and mtend~ d use and ofc~pancy of proposed cons ruction:
a. Existing use and occupancy ....~'T~ . ..Q"• .
r . ,vt;,tc.~,rtc. V
b. Intended use and occupancy
3. Nature of work (check tivhtch apphcabte). New Building Addthon .Uteran
Repair Removal Demohuon Other 1Vork ''fie '
(Dcscnpuon~
4. Esttmaud Cost....,...~Y iY..~~ Fee....................................
(to 6c paid on filing this apphcatton)
5. If dwclhn„ number of dwelling units Number of dwclhng units on each floor .
If gara^_e, number of cars .
6. If business. cornmerctal or mt~ed occupancy, specify nature and extent of each type of use . .
7. Dimensions of existing structures, tf any. Front Rear Depth .
Hetgltt Number of Stones , .
Dtmenswns of same structure with alterations or additions. Front Rear ,
Depth Ilctght . Nuntbcr of Stones
Dimensions of entire new construction. Front Rear Depth .
Height ..............Number of Stones .
9. Size of lot. Front ~ Rear ~...C~ Depth ~.c."1c;..... ,
10. Date of Purchase .
....................NameofFormer Owner
11. Zone or use district to which prcmtses are situated .
12 Does proposed construction violate any zoning law, ordinance or regufatton• .
13. Wdt Iot be re;raded r1~!.:' lVtll excess fill be removed from premises. Yes
14. Name of Owner of prcmtses Nrl~.~ ~,T~~'$fess ..~:Cr <.l;
/1~rn...... Phone No
Name of Archrlec[ Address , Phone No......... ,
Name of Contractor y~/?l. ~Cf'.? ~ r'l~~a.`!C~Address,~J.vt,{'~X 5:.~...... Phone No .`~.Tv'~~.
IS.Is this property located within 300 feet~of a tidal wetland? *YES.. NO.
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAhI
Locate clearly and distinctly all buildings, whether extstrng or proposed, and indicate all set-back dur.enstors fro
property hnes Give street and block number of descnptton according to deed, and show street names and md:cate wheth
tntenor or comer lot.
~ ~__a-._.__._. - - - I C.-h ~ f3 Imo'
Z ~el
ct J/ d j~'(~ l L
D
'~i/ s-
~ ~ r ~ ~ ~
3 6i
60/
APPROVED AS NOTED
DATE; 3__ ~ 4__ B,P. # 1~~
NOTIFY
BUU_DtryG DEPARTMENT AT
765•}802 9 AM TO 4 PM FOR FHE
FOLLOWING= INSPECTIONS
STATL OF XL-R' YORf:, S S f FOUNDATION - TWO REQUtREO
COUNTY OF FOR POURED CONCRETE
. 2. ROUGH - FRA
be$ie~gliy~byr~, crd~~'c$~aR~IR11Cat he is the apphca
(Name of mdrvtdual signing contract) 4 FINAL - CONSTRUCTtON MUST
about named 8E COMPLETE FOR C.O,
ALL CONSTRUCTtON SHALL MEET
Ie is the . THE- .REC3FJiREfiAE T '
(Contractor, agent, c8dr1d6ttrwQ(,j~~~~ ~F T`HE ~N.Y ~ ~ ~ " ~ ~ ~ ~ ~ ~ "
N ~ [NER Y
~f said owner or owners, and is duly authorized to perform or ~rfc~F€i~dREER01dSy$1!,$.k ap~to make and file tt
Pphcahon, that al! statements contained m this appIlcauon arc TrT lYt~t~ 6iIlY&oTRUL'Xt[pW~R#~pgd belief, and that t,
work wdl be perfomtcd m the manner set forth m the application filed therewith
>tvorn to before me tfus
f .7 . day of `7~'1`lc`n.c~_......... ]9~
•otary' Public, t~~~t-/... ~ County ~ 1
HELEH IC DE VOE
HOTARYPUBLIC,StateoiNewYark (Signature of apphcar
Tertt~Expair~
tech
30,16u8-/-~