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HomeMy WebLinkAbout23707-Z FORK NO. t TOWN OF SOUTHOLD " BUILDING DEPARTMENT / TOWN HALL / SOUTHOLD, N. Y. i BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL-E_ULL COMPLETION OF THE WORK AUTHORIZED) N° 23707 Z Date ............... ... ...-k......................... 19..1... Permission is hereby granted to:. �..1....3...... ?`:....J ?a... ..... ................ .. . �`1 �►1.... r�-�°.............. .........-oa f...., . . ........ to ..... ....zp..... . ...........✓......... .!:`:.. ...... .. .... ............../.�M;......... .......... ............... ....... .................................................................... at premises I ated at .. . .J•%./... a.1..... ! ( 1 .. .. . f.::. .................................... . . ..... .... ..... .............................................. ...........I ,l7/ art'fel.. .............................................................. . ............................................:................................................................................................................... Block ... � ��'. County Tax Mop No. 1000 Section .....CC................ ............ Lot No. ... .. ........ pursuant to application dated ..........sw ........ .......... 191,fdO, and approved by the Building Inspector. , Fee $. ..............., ..... vo ' / Oj 1 uil ng Inspector `n D� 1` Rev. 6/30/80 ' IIOARH OF HEALTH . . . . . . . . . . . . . . . FORM NO, 1 3 SETS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTIIOI.D SIIRVKY . . . . . . . . . . . . . . . . . . . . . . . . SEP 1 0 996 BILI LI)I NG DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . 1 TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . BLDG.DEFT SOUTHOLD, N.Y. 1 191 1 TQtnf °03F '1.EL: 765-- IH02 NOTIFY: CALL I?xarrnirrc(1.... 1. ..P-(-9 ..........., 191.1 MA 11. TO: . I�✓ �7cs©V e��Y". . . . Apps oved..... ....., 19�S? Perroi L No. ..........C�.. .. ..... .. . .. ... . . Disaplrr(med a/(: ....................... ........ . .. .... . ........ ......... .. .. . . .. .. .. . . . ........... ......................................... ii / . ..: .... (Ikni (:for) APPLICATION FOR IIIIILDING PERMIT !! Dare. . ..�io . . . . . . . 1970.C/� INSTRUCTIONS a. Ibis applicaticnn niiist Ire cayrlelely filled in try typewriter or in ink noxi ;;iilitnitted to lire Ikiilding Indictor wills 7 ,els of plains, accurate plot: plan to scale. Fee according to schedule. h. L'lot plan showing location of Lot aril of IxrildingH on pranises, relationship to adjoining premises or iublic sheets or areas, and hiving a detailed descripticnn of laycxrt of properly 1111st lie draxrrn on the diagram which is p><ar1 of !,is application. c. 'lire cacnrk Covered by this apPl icat icnn airy nxrL lie ccrule.nCed Before isscranx.e of lkni lding Perini t. d. Upon approval of this application, the Iluilding Inspector a.ill issue a Ikiilding Pennit to The applicant, Such penuit shall be Ieepl: (nn the preinises available for inspection throrl;hOUC the walk. e. No building shall be occupied or used in whole or in hart for any purpose iAnatever until a Certificate of tk.culuxxy shall. have been granted by time Ikri(ding Inspector. APPLICNI'ION 1S IA3RGIlY MAHE to (lie lkrilding Departnx-nL for the issuanCe of a Ikiilding Pennit pursuant to the Ikiilding Zone Ordinance of tile 'awrr of ScnaLhold, Sciffollc t:()curly, New Yorl(, and other applicable Laws, Ordinances or Regulal iOun, for time colBLr%K--Lion of buildings, axidilicnns or alterations, or for raluval or derail ition, as herein &scrilx_al. 'line applicant agrees to cuiWly with all nplil icable laws, ordinances, bui-lding code, hotwinig code, aril regulations, and to aicinit authorized inspectors cni prrruises :urk ion Inrilding for rx�ces ary inspecti(xn:c. (Signature of -pplicant, or narire, if a corporation) . G� t .................. r� (Mai Iing axklress of applicant) State whether applicairnt is owner, lessee, agent, architect, engirieer, gc:nneral contractor, electrician, pluilber Or Inrilder. onwp-e✓ . ...... . ...... . .. ... . .... .. .. ........... ...... ... .... ......... . ....... Nar,Kt of cx.nrcr of premises .......................... .... ..... .. ......... ......... .................. .. . ........ GS on Llre lax 1011 or latest ilec�cl) if aiplicant: is a Corporation, signature of duly auUroriv.ed officer. ..................................... . .....:...... .. (Nark? aril Cille of corporate officer) S� �n Ikri lder:r License iJo. ................. ........ 1'luilbers License No. ........ Electricians 1,icense No. .. Se.l. fK .. ....... .... 011ier Trade's License No. .................... I. L'al:ionr of ]MA On which prx)po;ed work will be dorKz................... .... ......... .... ........... . ..... .... ..... ................. r: `' ?... . . ........_. .... ......... .. .....0..t�h�S House Unlier Street ... .......... . a7 IknileC COUnCy Tax Kip No. 10(X0 Section .....Oa lilcxAS Lc>t .k Subdivision ..................................... . Fi led v5p No. ..... .......... LOC (Nate) 2. Stine existing use aixl cx_culknxy of preniseS and inferxII use Mid! moulraucy of proposed Const ruc.Lion: it. Exist=ing use and occrq><arx.:y ....f-' -0 _ ,. ........ ........ .................... . . 1........ ......... ........ h. intelided use and (x,.cupancy ..... CG L l� 5. . .._. ".U...... vJ' -• ... .... ..... ............ . .. ......... 1 . . .. .. . .. . . tv . . . . . . .. . . 'A I I e I it I i(it I . . . . . . . . . . . I(J.11yorvil I .. .... .. .. . .. 1�13`01 i t jot' .. . . .. . .. .. . 01 her IX)t h . .. . .. .. . . . . . .. . . ... . . . . . . . . . ... . . (I)elwr i pt ioil) 11 F's[ imm ed 0)sl fee .. . . . .. . . . .. .. ... . . . . ... . . i (to Iles paid o4l I i I illp, [hitt app) ical i(x1) 1 iol", INIII)er- of AA0 I ing olli I n fkllixet of (hx-!l I ii,113 ooi I f, on (!,,(:It floor ... . . .. .. . . . . . . . gill age, Imilliller of: cm to . .. . . . . . . . . . . . . . . . . . . . .. . .. . . . ... . . . . 6, If: lxmilwns, c(swilvic-i'll or mixed occuliNlocy, nlwcify salute litill extent. of: each I.YIX! of use.... ... . . . . . .. . . . .. . . . Dilwilnillos of exhsl iol" 61 IlwArlyes, i r Illy: VI o%It . . . . i(em- 12 ,1 . . . . .. .. . f,&llJx!r of X!I Is i(H I.,; of: sivite slortm,tilre Willi ;II(eralJorm or uldiVioos. Float. . . . .. . . . . . I(e,I I. . . . . . . . . . 1k'plll . . . . .. . . ... .... . .. .. IWI)II . . . .... . . . . . . . . .. . . . 14116er of: S(olies .. . . . . . ... .. .. . Dillvilsiom., oI7 col i I(! I w%J roI I-,I I A w I i of I: 171()411 .. .. .. . . . . . l(cm. . . . . . . . . . .. . .. . lkdl)ll .. . . . . .. .... .. .. .. . .. . . . . 14111wr of Slot ietj . .. . . . . . . . . .. . . . . .. . . !;i vp of lot : FI oIII . .. .. .. . . . . . . . . 111!111 IN!pt 11 10. 1411 of, INIff-Imse . . . . .. . . . . .. .. . . . . . . . MKIN! of Follwl OL-mel. . . . . . . . . . . . .. . ... . . . . ... ... . ... .. . . . . I I. /.( ow! or It..;e district ill %Alicli pycillise's are sitlml,ed 12. 1 x x2s toy olioned coost I tm:t i(m] Viol file ally voil fill,, I;R4, otdilvilwe or lelpilat ioll: . . . . .. ..... .... ..... .... 1 ). Will ]of be lef"TmIed .. ..11q0. .. . ... .. . . . Will excess: fill 1w lellimc-A froill pleillisen: YFS Mwlw�-; of: Ouniet of premilw.) 71.. S�e-e,I-e— a, . .. . . . .... .. .. . ...... At U I I(!!;to .13').F 5-.p f!p� )P.. .. .. .. . I 1)oF V! I k)Y7 3Y74�� Mviv of Alchitecl .. ... .... . . .. . . . . . .. . . . . . . .. . . . . . . . . N k I I ess .. . . .. . . . . . . . . . . . . . . . . ...... . . Illone NO. thmix! of Cool lacloor. . . . . .. .. . . . . . .. . . . ... . ...... . . . .... Ai h I I ess . . . . . .. . . .. . .. .. . ..... . . . . . . . ..11 toy je flo. . . . . . . . .. Is Olis I)IX)IX!Tly Within NX) feet of: a tillal A Y I U; All, yliS, IXXTIIXXI) -IXXM I1,Iq .1. ITOT DIAGRAM Imale clearly IM (liflt:itx,-1 ly all Imlilditil".." %Alellwr (!xiSI:itIJ,1 or prolxmed, nowl imlicrite ill] ser-back (Ijilvosiolls l'—' wol—ly Hoes. Give sl reel (110 Ili(X--I( IN 111yer or (lescl i pt lot) nccotd i ill' to (ked, 111VI Miow sl reel Tustien itwl i FwI i(:,I(e 1.Ax!IIw!r iwei jot ()I- (-olryer Jo( S ee. go Al ED AS NOTED DATA 44�B.P.# OCCUPANCY OR FEE: BY- NOTIFY BUILDING OEPAR ENT AT. USE IS UNLAWFUL 765-1802 9 AM TO 4 PIVI FOR THE FOLLOWING INSPECTIONS: WITHOUT CERTIFICATE I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE OF OCCUPANCY 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4- FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS !;1AIE (xl* 1814 Y( (I A 1111 'y (X V7 . . .. . . . . . . . . . . . . . . . . . . . . Awillp duly nvx)l 11, delyones ;Iiwl wlyy; fitm. lie is Ow .1111?1 i(.;Illl (Row of ilmlividt a sig-101110, cool Incl-:� (1, , s I I I ti,I to gout . . . . . . . . . . .06V . . . .. . . . . . . . . . .. .. . .. . . . . . . . .. . . . ..... . . . .. . . . . .. . . . .. . .. . (Cool 1'10 toy col Itot'll e officer, (pt c.) of of IxJIX!Is, llotl is (filly ""Illof iZ(41 10 IX!l 101111 (11 IVIVf! IK!I I0IIIX!lI IIIQ J;.Ij(I Wolk 1110 to litl1w .11WI I ill! 111h; ;tlplll i(-,It ion; Im( 111 --,(Ill(11vot'll (7ool a ilwd in (11 i s ;111111 i(:;It it'll Ill Q 1.111(! (0 1 Ile IH.!I;l of 11 i 9 1AIKA41(ldile 11101 1 It(' '.A)I k Wi I I IK! Ilet-1 ollilt-(1 in IIx! liviowl lwl lot 111 ill III(! ;IppI icill,jot) I i led I Iwo ewi 01 !")Io lo Im!I( I. I - 116"; . . . . . . . . I;ly . . .. . .. . . . . . .. 19—T . ..... . . . ... . . . . . . . . . . .. . ... r .... CLAIRE L GLEW (Siglml toy e I Appl i(.,Illl Notary Public.State of Now York 4879505 QualifiedNoin Suffolk County Commission Expires December 8, THE TANDY FARM 15405 MAIN ROAD MATTITUCK, NEW YORK 11952 TELEPHONE (516) 298-5485 FACSIMILE (516) 298-5485 Ti an avid Steele l� nr Sz,� vo ■ �i � ZiO c� '� \ ♦`\ Ste` r ''- -Vw' ' Q_ SO T 9' 2�0 '' VV 50, e 00 \ a1 Fes• �\ k 01 I 4, � � 4 f Q. c� I HEREBY CERTIFY THAT THIS PLAT WAS MADE BY US FROM ACTUAL SURVEYS COMPLETED APRIL /8,1995 AND THA T ALL CONCRETE MONUMENTS SHOWN THUS: M L O� HERON ACTUALLY EXIST AND THEIR POSITIONS ARE CORRECTLY SHOWN AND ALL DMENSIONAL AND GEODETIC 4c DETAILS ARE CORRECT. A TUf SURVEYOR SURVEY FOR TIMOTHY T: STEED & JEA NNE E. S TEEL E A T OREGON �- TO WN OF SOU THOLD SUFFOLKS�� �D • N. Y. 1000 - 83 - 02 — 103 .Scale: 1" = 100' o 30 too Aw 300 GvDO AS--� StP�'IY3wQ� Dec. 12, 1995 ) V q a w W. ZZ XW rfoundotianl b �Q � f 12' nQs-ti, MCE COMPANY RH 9.5 AVo �BlULL / (l7 j MEr E SCHO+ ®WASV Tf ANY AL TERATION OR ADDIrAW TO TMS ANVEY 1$A VMA TM TI'S DE .X C. NO. 496/8 of grow rw9 0�- ThE nf'w Yr srx rE EtiiJICA MA TTI J '� � h�'R�' AS PER SEGT/AN 7209-3L�lOf{�/ . ALTH6�E� 'tighl� PECONI .C, ON ARE vALD FAR 7MS AfA1� Aho Y sA+O A41P OR CAF'�S 6EAl� TrE M�M�S+�V�l)JL G� 1'lA�i' (516) 765 P. O. BOX AAarrVMUY TO COWL W7W SAM LAW TW •At t cl • TRAVELER STREETr eE v eY A/vY AmuALL AE 'Y LATS AUL SOUTHOCD, N.Y. 11971 To�1�Avr sv =m U*