HomeMy WebLinkAbout17708-z rows xo. a
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETIIDN OF THE WORK AUTHORIZED)
N° U 17 i U 8 Z Date ~..sa-.~,-~~.~......~..~,?........., 19..x. g
Permission is hereby grgnted to ,
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to 5,~...R,...~?'41...~.~,. ~.sr.':4rQ.~,:!<^.ik~..~ ..~l~O.... ~n•U
ct premises located at ...~.dtr...... 1.+~3r.:?ti?'':~....~~^7?~........~.4-4s.rxJ.!k~~.........
County Tox Map No 1000 Sectio~n~. , Block ...5].,~...... Lot No .
pursuant to application dated 1...7??~^:~~•~- 19 19~.~ and approved by the
Building Inspector
Fee ~s.4.~:..~
.tC~d'I. ~N.a!'4~............
Building Inspector
Rev 6/30/80
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STATE EIIERGY
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D ~ C~.~_-~ ~ I FORM NO 1 1
~ JI TOWN OF SOUTHOLD
1'-' ~ BUILDING DEPARTMENT
BLDG GEPT y TOWN HALL
TOWt~`~',"".~=;TNOL~,.
b °-°^-1 uOUTHOLD, N Y 11971
/ TEL.: 765-1802
Examined 4,-RQa•»~• , 19~~ Received.......... 19
Approve2l~earri~. 3,e , 19~'~ Permit No ~ ~ ~i ° . `-a--~~P ~ ~~-N-~-
'74 S
Disapproved a/c
~GY O-~e .
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .~2~~~ , 19~
INSTRUCTIONS
a. This application must be completely filled m by typewnter or m ink and submitted to the Building Inspector, watt
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 adlommg premises or public stre•
~ or areas, and giving a detatled descnption of layout of property must be drawn on the diagram which is part of this api
cation
c. The work covered by this applicatron may not be commenced before issuance of Building Permtt
d Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant Such perr
shall be kept on the premises avaIlable for inspection throughout the work
e. No building shall be occupied or used in whole or m part for any purpose whatever until a Certificate of Occupan
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY, MADE to the Building Department for the issuance of a Burldmg Permit pursuant to t
Burldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnb.
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authonzed inspectors on premises and in building for necessary ms ections
(Signature of applicant, or name, if a corporation)
. /~Bo G}v~2'cvq~.r.~ . f,~.2~c.~ S'ovY~aP~
(Mailing address of applicant) 97~
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build.
Name of owner of premises ~l~- i4~1~-r-C~~ . - .
U (as on the tax roll or latest deed)
If applicant is a corpo'ra~~tj-i~~o'n-~~`s''i'g~~riiature of duly authorized officer
(Name and
title e of corporate opfficer)
Builder's License No ~~Z~~l ~~,rpp.'
Plumber's License No I ~xy~itil~r"~,~?~,~~ .
Electncian's License No~~Y//II`3~~ ~~~~L'Xnnr?-~~
Other Trade's License No Lct~-~ ~L 41'. ~~~-7~`-r"
1 Location of land on which proposed work will be done
House Number Street Hamlet
County Tax Map No 1000 Section ~ "7~/ Block ~ .~i p . Lot . ~G~. ~
Subdrvrsion (,,:(TUlti1 Filed Map No d ~ Lot ~ .
U (Name)
2 State existing use and occupancy of prem/~ises~and~in~tende~d~/~,u~se,/aJnd occupancy of proposed construction
a Existing use and occupanciy . V G~".%~w~ "A"`Yy~(~~~ / ~.p/~~,.,~.~....
b Intended use and occupancy ...ld'~.'~ ~~~i,~-~/
3 Nature of work (check which applicable) New Building Addition . ~.l~eration . .
Repazr kemoval , . Demolition ~ .
_ (Description)
4. Estunated Cost . ~7~6 ~ Fee
(to be paid on filing this application)
5. If dwelling, number of dwelling units . Number of dwelling units 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. Dunensions of existing structures, if any. Front Rear Depth .
. . .
Height i Number of Stones . .
Dunensions of same structure with alterations or additions• Front Rear . . .
Depth Height Number of Stones . .
8 Dunensions of enure new constructron Front .Rear 6.?. Depth .:~r2...... .
Height ? . .Number of Stones . ~ fem. .
9. Size oflot~Front l~~.. Rear Depth ...Z.~P..
10. Date of Purchase i. Name of Former Owner . .
11. Zone or use district in which premises are situated . . .
12. Does proposed construction violate any zoning law, ordinance or regulation /4-~ 0. .
13. Will lot be regraded !~9. Will excess fill be removed from premises Yes ~ t
14. Name of Owner of premises Address !~b`v od/4w>ov+~ .4tr.. Phone No.. art-S'~!1`rT. S~
Name of Architect Address ~'.°v. SLtocv~ Phone No.. . .
Name of Contractor ..S~a!+1£ ~ ..4a~wir~:. .Address .Phone No.. .
PLOT DIAGRAM
Locate cleazly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions fro
property lines. Give street and block number or descnption according to deed, and show street names and indicate wheth
intenor or comer lot.
SEE` i~LratiJ
STATE OF NEW YORK S S
COUNTY OF ,~'U f't:4 ~K.. ~ .
, ~El2(?~(. being duly sworn, deposes and says that he is the apphca
(Name of mdrndual Signing contract)
above named
He is the ..~`d ~f~02~' ~6 O'~f~~ GEi'~
(Contractor, agent, corporate officer, etc )
of said owner or owners, and is duly authonzed to perform or have performed the said work and to make and file tI
application, that all statements cpntamed in this application are true to the best of }us knowledge and belief, and that t]
work will be performed m the manner set forth in the application filed therewith.
Sworn to before me this
day of ~.rC7~aG.. 19s~'
NotarylP~ tic, v ~U . J U~~ County i1'
NDA J COOPER • • • . • • • `yi- A~
NNo 4822563, Suffolk County~~ (Signature of apphcar
Term Expves December 31,19.=-
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_ ~ ' SURVEY OF
LOT 2
"MAP OF REYDON COURT"
SUfFpLKCtIUiJiYl3EPRRr,^!EPlr2; HE+:(rttcrq•.,~..~ FILED SEPT. !7, 1987 MAP NO 8395
. ~ r..L„
~ - AT BAYVIEW
Sirl~ Fur;rrlV F,,;p211i,E ` ' TOWN OF SOUTHOLD
GRrE r 2-! Z-F~__ . _ SUFFOLK COUNTY N Y.
+'r'`'` ~~Y 1000- 79- 05- 162
RPr'R1~+,'il_
EXPIRES rW'0 YERRS FF 9 D jE QFAi PROti'i SCALE l"= 40'
NOV. 8, 1988
~1357~
~o nNQs
v y c~n~o PLERSE AJ~TE
Requires septic tanlt
N S L*! NO 49668
cover to grade,
9 9 ORS, P C ELEVATIONS ARE REFERENCED
f51 SB~6E1N 0 TO AN ASSUMED DATUM.
P.O 9 ~
MAIN ROAD
SOUTHOLD, N.Y~ Il971
88-612