Loading...
HomeMy WebLinkAbout17944-z f'08~M N0. f 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) Na 017944 Z Dore .Q.l,.~....°.~d 19.8..1. Permission is hereby granted to . ~9 ....r.~. 1 .:y :!.l.q.~.:.. . ct premises located at ...T.~.!r~.:U:`~.......~.o..-:':::..V~?~......... .g~:f?:!`:4a- . Caunty Tax Map No 1000 Section Q.~.~Pn Block ......~'1.~........ Lot No . pursuant to application dated ......~C?:-t~S.K/.~:Qt 19~~.., and approved by the Building Inspector. Fee Building Inspector Rev 6/30/80 BOARD OF HEALTH 3 SETS OF PL.1N5 FORM NO. 1 SURVEY j . TOWN OFSOUTHOLD CHECK V BUILDING DEPARTMENT SEPTIC FORM • TOWN HALL SOUTHOLD, N Y 11071 NOT ~ Y Q TEL.. 765 1802 CALL • ..7~~~- ~ 1•''~~.... . MAIL T Examtncd . ~Q•4ti-i~..~ . , 199. t~,~ ~ (i? - ~ t5 ~ ~M Approved ~y . . d-d 19~. Petmtt No 79 ~ ~ ' I ' i Disapproved a/c ~ 2 Q } L~ op... TOWN of SOU"rn~tow .....U ~:Gi' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date /%~G~.. 15 .Fi' INSTRUCTIONS a. Tltis appltcatton must be completely filled in by typewriter or to tnk and submttted to the Butldtng Inspector, with sets of plans, accurate plot plan to scale. Fee accordtng to scheduie. b. Plot plan showing location of lot and of bwldtngs on premtses, reIahonshtp to adloming premtses or public stree~ or areas, and giving a detailed descrtptton of layout of property must be drawn on the diagram which is pan of this app] cation. ' c. The work covered by this application may not be commenced before tssuance of Buildtng Permit d. Upon approval of this apphcauon, the Building Inspector evill issued a Butldtng Petmtt to the applicant. Such perm shall be kept on the premtses available for inspection throughout the work e. No building shall be occupied or used to whole or to part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Butldtng Department for the tssuance of a Butldtng Permit putsuant to th Buildtng Zdne Ordinance of the Town of Southold, Suffolk County, New York, and other appItcable Laws, Ordinances o Re,ulations, for the construchan of buildings, adddtons or alteraUOns, or for removal or demolition, as herein descnbe~_ The applicant agrees to comply with all apphcalile laws. ordinances, building code, houstn, code, and regulations, and t, admit authorized inspector an premtses and in building for necessary tnspeNcitons , ~j /~(Stgnature _applicant, or name, sf a corporation) • (M'ailing address of appltcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder . 4~ w1~.~~ ~G~~:... Name of owner of premtses ' ~ • • • • • • • • . (asts>5 the tax roll or latest deed) t. •5~u RrK~ir r,n ~t If appltcant is a corporation, signature of dul}I a4R1~t'bti~C~ oTlice (Name and title of corporate officer) Builder's License No . Plumber's Ltcense No . . Electrician's Ltcense No. . Other Trade's Ltcense No .~0.~?~~. rvwK •FC~ .0,300 ff 1. Location of land on which proposed work will be done. ..tn'.~ ~ t iV . • •l~~?~d ~C C. ~i . House Number Street Hamlet County Tax htap Na 1000 Seaton • • . • • • • • • • • • Blvek CS , , , • • , , , , Lot . C . Subdivision ~2,C,c~IV~ CUe,{~v V . Filed Rlap No 7) .5~........ Loth (Name) State e~tstmg use and occupancy of premtses and intended use a~ndQoccupancy of proposed co s[ructton: a. Existing use and occupancy ..~°N~• • • • • •,•!"t"°• • • y b. Intended use and occupancy • • •N• • • • • • • • • 7 ~ ,LL,.t. 3. Nature of work (check w filch applicable). New [3uilding Adddwn AlteraLon . Regmr . Removal Demaluion Other 1Vork . Ff!t!C e , (Descnpuon) 4. Estimated Cost ~t 3? ° . Fee .a ~ . . ([o be paid an 61mg this apphcatwn) S. If dwethn„ number of dwelling units Number oC dwtaling units on each floor . If aara,e, number of cars . 6. If business, commercial or mired occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any Fron[ . Rcar Depth , . Hec_ftt . Number of Stones . Dimensto~ts of same structure with alterations or additions Front Rear . Depth IIcig}tt Number of Stones . Dimensions of entire new construction. Front Rear Depth , , . Hcig}tt .........:.....Number of Stories , , . 9, Stze of lot: Front Rear Depth 10. Date of Purchase ...Name of Former Owner 11. Zone or use district to ~vhtclt premises are situated . . . L2. Does proposed construction violate any zonm~ law, ordinance or regulation . . l3. 1Vil1 Iot be re;raded , 1Vt11 excess fill be remgv d fro remises: Ycs 1` 14. Name of Owner of premises ~22~i~ ~ Address . Q o}< z r ~ , C;.Te ~a ~e'~1 one No..73Y ~Z Name of Archrtcct . /9 ........Address ~ ..Phone No............. . Name of Contractor ..........................Address ...................Phone No............. . IS.Is this property located with in 300 feet of a tidal wetland? *YES....NO.... *If yes, Southold Town Trustees Permit may be required, PLOT DIAGRAM Locate clearly and distinctly all buddmgs, whether existing or proposed, and,mdtcate all set-back dunensions fro, property fines. Give street and block number or descnptton according to deed, and show street names and indicate whetht intenor or corner IoY. C V APPROYED AS NO~T~E.D~,~~ ~ OATS: B.P. M NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR TWE FOLLOWING INSPECTIONS 1 FOUNDATION TWO REQUIRED OCCUPANCY OR FOR POURED CONCRETE USE IS UNUIWEUL 2 ROUGW -FRAMING & PLUMBING 3 INSULATION W{TNOUT CERTIuf tCATE 4 FINAL - CONSTRUCTION MUST 0~ OCCUPANCY 8E COMNLETE FOR C O ALL CONSTRUCTION SHALL MEET THE REQUTAEMENTS OF TWE N Y, STATE CONSTRUCTION & ENERGY CODES NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEN YORE, COUNTY OF . ~54~ ,rg-/..--E:~ , , S S • ,C~•fL~ u,~( • • • Y~"• Nf~S • • • . • being duly sworn, deposes and says that he is the apphcai `~Namc of individual si~nmg contract) above named p Iic is the ..C?W.tiE ti (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authonzcd to perform or have performed the said work and to make and file th application; that all statements contained m this application are true to the best of ins knowledge and belief, and that tt work wdl be performed m the manner set forth in the apphcauon filed thcrctwth. Sworn to before me tats \otary Pub`lu, . C, , County h ~//J . rI~~ '1'uN."~~~,,~. , . ~ ~ l . ~~Ti.~t1WC~. LINDA J. COOPER (Signature of applican Notary Pu61ic, Stete of New York No 4822563, Suffolk Coun~ty(~l Tarm Expues December 37, 7~.LV ~pand h accordares wVM lM rnhimwn eskndrardsL.u L.~a~~p~ppn wd oA sd AREA=40,5933gfY. ra ~ uu by Tr,. Nsw °York Stal:°Lad TNN Aswdol/ort. Z. ~ s~~ ~ ~2 ~gl zm ~c,~' ~ 4P~ ~ 0 v ~ $ Z ~P~~ m 0 ~ af}~ .lf7C Q'L F_7 \ Q/7' S 1 ~ 1 t~ ~ Y \ Y.C' 1 \ r Y 8 t e' AE~S OF W eL1K. 7 O D \ ~ ~ \ D\ ~ \ J 1 g ~a\ ~ ~ SET o ~ STX ,~,aa• ~r pQ~i O~ 3 ~ /,i~ S $ v+?' OQtP'SN f z ~r , CERTIFIED TOE 5"~ Fi~ST AMERICAN t/TLEWSURANCE COMPANY of NEW YORK , SURVEY OF TITLE NO. 605560!2 ~ SOUTHOLD SAVNJGS BANK \ / O ~ ^ GREGG MATTHEW KoNARSKr L 1 SUBDIVISION MAP OF PECONIC BAY COVE F'KED MARCH 4, 1999 fkE ND. 7159 A T PECONIC TOWN OF SOUTHOLD SUFFOLK COU?NTY, N. Y. 1000 - B6 - 04 - 1.4 Sc © ' v~ 05`~,~ ``F E`.t p O N.Y.S. LIC. NO. 49668 r SU V ORS, P.C. N (5 - •4 ~pt~b . Y. «s 88 - 424