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Home My WebLink About21818-Z FORM NO.9 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. j i BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL, COMPLETION OF THE WORK AUTHORIZED) Date ~I....... 19. No 21818 Z / / Permission Is hereby granteXt:. .w, .......o...... ..s ATT.I e....... ...,.114vook....... t........ Sr :;z . - !1..L.r f? .........70....... < r........... ............d' V ..........x9.5 . s s . at premises located at ~ 00 County Tax Map No. 000 Section 1541 Block ®A~ .....p.. Lot No....... pursuant to applic on dated 19..../...., and approved by the Building Inspect l , 61 "do Fee$.....~ moo. 0160 /Iding . B nspector Rev. 6/30/80 1E1 I::SPE~T=U7 DATn OtVMGNTS 1. f m~ n T FOUNDATION (1st) H FOUNDATION (2nd) 0, 2nd) my 2. zll o~ ROUGH FRAME & O PLUMBING 3. J x m INSULATION PER N. Y. m H STATE ENERGY CODE Gt/ a m H FINAL o n x ADDITIONAL COMMENTS: IX H x . H H O . l*1 a ' r - H C. m -o H BOARD OF HEALTH FORM NO.1 3 SETS OF ,PLAN5 ` TOWN OFSOUTHOLD SURVEY ~t 1~1-M 2 2 BUILDING DEPARTMENT CHECK . • `l TOWN HALL SEPTIC FORM . . . . SOUTHOLD, N.Y. 11971 TEL.: 765-1802 t:OTIFY:Q10MA0 SclI~11411?z q CALL 9 . Examined 19 7,.5 MA I L TO- (,1 QU C) 'L / 7 Approved J~ 2- 19l~ Permit No. [riu2k~IVY I!Syd: Disapproved. a/c (B ' ding Inspector) APPLICATION FOR BUILDING PERMIT Date 19 INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 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 stieets 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 Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The 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 ectio s. (Signature of applicant, or name, if a corporation) 77S f,4~2F1~ /Yy /141 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. 0Lv/!F/2- uSEhi 2 2~rs'- Name of owner of premises s -c- /Lcc_i/ _ Z ~ S~' . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (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. , . l / llf7 ~;/o /L70.,? vrz House Number Street Hamlet County Tax Map No. 1000 Section I. Block U?1'.......:... Lot Subdivision Filed Map No. Lot............... (Name) 2: State existing use and occupancy of premises and intended use and occupancy of proposed construction: 'd-"Ic k7 a. Existing use and occupancy ...R / / O . b. Intended use and occupancy , 3. Nature of work (check which applicable): New Building Addition . . . Alteration . Repair Removal , " Demolition Other Work . 4. Estimated Cost • /.0 00 (Description) Fee S. If dwelling, number of dwelling units (to be paid on filing this application) If garage, number of cars , Number of dwelling units on each floor 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use . 7. Dimensions of existing structures, if any: Front ...4 ,2 . Height Rear ...31 Depth ..Y.4.'Y.:....... Number of Stories , . , , , , • , ~ Dimensions of same structure with alterations or additions: Front Rear Depth i Height . Number of Stories . 8. Dimensions of entire new construction: Front ..../.6 , • • . • Rear . Height Number of Stories Depth . !D..: G. 9. Size of lot: Front " " . . . . . . . . . • • • Depth 10. Date of Purchase Rear Name of Former . . ""'•••••••••••••••'••••••...NameOwner 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: . • • . 13. Will lot be regraded ...,!1!0• • O Will excess fill be removed from premises: Yes o 14. Name of Owner of premises Address Phone No.w~ Q~ .7/• Name of Architect o w / 2 " " " ' Address ..........:........Phone No y7)- J9,20 Name of Contractor ...G w!?F • • • Address 15. Is this property within 300 feet of a tidal wetland? * " " " ' Phone. Yes........ No.- A *If yes, Southold Town Trustees Permit may. be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK S.S COUNTY OF., -L being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the (Contractor, agent, corporate officer, etc.) 3f 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 .vork will be performed in the manner set forth in the application filed therewith. Swom to before me this ~ G/...day of. rl 19 < .3' Votary Public, HELENE D. HORNE . \ Y~ J Notary Public, State of New York No. 4951364(Signature of applicant) • Qualified in Suffolk County , Commission Egires May 22, 19 Q! 76S l9U BUILDING DEPT. INSPECTION FOUNDATION 1ST ( ) ROUGH PLBG. ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: DATE INSPECTO W EST pNA~IA AV FNUF c J~ R3. RV yG100:Qp 1 ~ ~/fig HOh~ ~b ~y • c \3g' 30 " ~ b •FYFr Bg3F i rt~4r ( ~ J S~Pa4. O / ~ CE 0~ ^4p S~p~J d FI ,4 / ,`rte ro~eh ~Oj7 Yh~V4r.Y . ~I.p n0 t ] /40 u d~ 4d a 41b ~ V Are O a 28 • r , o` a r FAO 66T ''tit . ~ N° 0 , .7 r ,70 ~"',IC g 30 w ?Z QJ n0 ,,0 3 t g c°,Ir -0060.0t) Al ar N ',SO M)h F- Ork or i (11151 Q O~ SURVEY FOR ROSEMARY J. BYRNES NOTE' I. ¦A MONUMENT AT MATTITUCK DATE MAY 15, 1954 2.SUFFOLK COUNTY TAX MAP DISTSMSECT LOLK 02TOWN OF SOUTHOID SCALE+ IN •10' SUFFOLK COUNTY, NEW YORK NO. 54-459 *UNAUTHORIZED ALF"AnoN OR ADDITION TO THIS GUARANTEED TO- SURVEY IS A VIOLATION OF SECTION TIDE OF THE NEW TORN Sure IDUCAnDNLAW ROSEMARY NRRES'ETr M COMES OF THIS SURVEY NOT REARING THE LAND CHICAGO T[Fi1 sp;~Ncx~ PANT SURVEYOR'S INKED SEAL ON EMROSS[D SEAL ]HALL FIRST N TK)1(W,lb SAVII{~i 'r Not eF CONSIDERED TO RE A VALID TRUE COPY fI MOUASANTEFS IMOICAffD HEREON SHALT. MIM ONLY TO ,C. ,ry rF•~.. V TM( PERSON fno 01 0 THE IUNYfI 19 PREPARED. M TG JT AND ON NI! A[NALF TO INK TALE COMPANT'GOV[NM Yt..•ri ~~7 MENTAL AOENCYAMD LENDING' INSTITUTION LISI[0 HIRED H, AN0 TO THE ASSm REES OF INS LfeOING lw;ir:,'.I• INSTITUTION. OUASAN T(f! 1A[ MOI IRANSIENASLE I° ADDITIONAL IMSIITV (IONS ON lURIEOUENT OWNER! ha, A(91 M DISTANCES SHOWN HEREON loom PN OPERIV TINES TO VX. TINa Sreuc TURFS ARV FOR A Slec.l. IVSPO][ AND ARE NOI TO Sf USED TO FSTASLISM U PROPERTY LINES ONFOR THE ERECTION Of IEMC(] 400 OSTRANOER IVERHEAD, NEW AYORKUE YOUNG a YOUNG R ALDEN W. YOUNG,PROFESSIONAL ENGINEER AND LAND SURVEYOR NYS.LICENSE NO 12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y& LICENSE NO.45095 DRA•R ro A SONS IHI UNDERWRITERS CERTIFICATE REQUIRED APPROVED AS NOTED I DATE-2rt01 BY.-It ~r Jam` 5is~ NOTIFY BUILDING DEPARTMENT AT 785-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: f ^ prt„~ h ~A T` k n~ 1. FOUNDATION - TWO REQUIRED E ;y G J~ d 16w yS gF F OR POURED CONCRETE 2. ROUGH • FRAMING & PLUMBING 3. INSULATION 4 fiM1iAL _ C.R"i=TRl1%TI(?NtUL:ST BE COMPLETE FOR C.O. ,Ll CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. %TE CONSTRUCTION & ENERGY NOT RESPONSIBLE FOR C 1 a. P i' rU 1' .<......<d. S ~ S O CONSTRUCTION ERRORS TAI f ~oo fl ,h6 P,_y o _ 11 S e~ SNEFi goof VA a. i i. i j SkY ~ /ICS :d St t_LAl-t- 77 °(-(.JAILr gbw CoA u.l ,pow SK W ~ X~ ~OIST~ 0 n 70P a s O ~ ~ X' ISTin 6 STK~cT~2E ~ a / Rook 6 i ~ N w0'1T2?'1 I f s a jprSTf i MPit 00 ~ i , ~ ~ ~ QOw w~nbaw ~ r ~ i