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Home My WebLink About24169-Z rose` xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. r f BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) t% N 24169 Z Date .....,:.' .. ..... ................. .. 19f..� Permission is hereby grant to: ......... .. ...... . . .., :... . . ,...�� ..... to ... . .... ...... ....... :. ....... .. .... . . '.:c.. ............... .. .. ................ . ........ ...... . .... ... - .. . ...................... .. ' ....... ... . . .... . . .. ............... '.......... ..... ........................................................... , t* atpremises located at.... ........ ............................ .......................................... County Tax Map No. 10190d Section ....... f..... Block ... �......... Lot No. .2 ............ pursuant to applicatio dated ........... ........................... 19f(7, and approved by the Building Inspector. Fee .... ...... .. r. ... ...... .. .. ... .. .. ......:.............. Building Inspect i Rev. 6/30/80 T6S- 802 BUILDING DEPT. INSPECTION [ j FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ J 1 ULATION [ ] FRAMING [ FINAL�Ct,,,9,�11�) [ J FIREPLACE & CHIMNEY REMARKS• DATE (117,01f INSPECTOR`2L& _`" snbu:nns Jo scrn!n»•,u,IeucM:rpp.01 IOU nl: . ....�..,�.L•'i;fti ,1's1q L'-;PuQI s2zur-::.i9 Ow 31 Pug"00184 p8:sll uolln,ltrn Lu p;;ai I;uawwenr,8'.tugdutz.)ap;j Z ''o',n cj Pil9q q4 uo pUv7wjet3ja A Aenuts p "1o4µ�W&W 04101 imc Pip 44 papopq seem.r..103 Cl t Xdw ono p11K a cq n ►'�Plsuoo sqlwon gays I pnwquw JO I°Ps PWMino pun(,V-4 eQ i"+u dsun Awuns 141 Io soplc J "+"qt 4%MON sill Io u UO11j+$ Yom' W WI1sWM s sl Bruns sq W 1, .AD }. ("1 ITT rzzr- 14 .� ..a j �'�• • ,'• , it �2 i ty� • � t. I/�T '� � l r1-lu ,,.� -- ----------------- s ax v �o � y .—� �--.-- ----- - -----tet---tt---- --f-- - _ tt -- - - 11:1.11 I lliil'1;1:l i till 111:1'1111 I Irk I V l Ulll)I 111'1I ATI 1111 I� �J 1 I U1►Illrn'I'lUll�^�_( llil))^^ r ' � 1 1 �Ilrllll rlunrlr+�;♦; � v\ ri.ura�ii,1 rres -- ...,w_w_-,.,_n_ _nn___nrn_w •d_,--,n•wwr .-.-nnn w_r,w,n.,r-.w.�.•r.�rr..a,r..----r-----------------------r-nww !7111.n I l Irrl 11•.11 11 !:'I n 1'11. r.Irlrlt 4L 11 (� I' I IIn1. ................-- -_........,------ -- ---------------- ------------------------------------- ...nl'1-I'' I urinl. cc,rlt11�1r 1 lI , r r/ i .. HOARD OF HEAi,rn . . . . . . . . . . . . . . . FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . l TOWN OF SOUTUOLD SURVEY ... . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN iIALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 -"� TEL: 765-1002 NOTIFY 4h." 'y1y� -�r 1�v� r. CALL Examined. ... .., 19. - MAIi. TO: .�GY.'�Ll�t(�.:�.�!>�r•� Approvt'c .... 19 1� Permit Nj�6 ; +; . :. Px:. !0............. Di, a/c ............................ ... 7:KC��.J .��.�.�... ........................................ .. 4-p.l lu 51'rt� -Owl Building Inspector) AP i .CATION FOR BUILDING PERMIT Da t e. .1✓l �I...�. , I O� INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink aryl submitted to the ikuildirng Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to sclnehnle. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public akreets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c. 7be work covered by this application r•vly not be- commenced before issuance of Building Permit. d. Upon approval of this application, the Building, Inspector will issue a Building Permit to the applicant. Such permit slnall be kept on the premises available for inspection thuxugImt title 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 iluilding Inspector. r APPLICATION 1S 11EFs-M ENE to tlne i>wuildinng 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 descrilx>d. The applicant agrees to cominly with all. applicable laws, ordinances, building code, housing code, aril regulations, aril to admit authorized inspectors on premises aryl in building for necessary inspections. .......l;.;t1� Ll..r. y-,-.._._........ (Signature of applicant, or name,�- a corporation) (bailing address of applicant State wix�ther applicant is owner, lessee, agent, nrchitect, erngineer, general cotntrnetor, electrician, plumber or builder-. \ I�`-L1 �� - •�=�►�r�i�i.P, _�r'+� Luc.�7-fDe Name of owner of premises .... !(�!� ..1.. ... ..... . l9 ...:l:.. b.A�Y�. $�'E" Q!-E S-NOTE D.... (as our the tax roll or latest dml) 13.P If applicant is a corporation, signatrme of thuly autlxurizAed officer. i .: .__�BYW — �a`J�. ... .. ..... CSG rf'3 -1X fitlil..l�ar� II[ ��.?....-•---........ .,_. JEi5 1802 a �1M TO ron1IE (Kim mxl title of corporate o�f icer) ["OH-OWING iNSPECTIO : OCCUPANCY OR 'I. F011;�D ATIC)NI .. Tl�1lf,)13f:c�l.11ia�:i� f°'m t'ouiim OUNt.,IIE TE Builders License No. ......................... USE IS UNLAWFUL p.. HOUGH . FRAMING Y CERTIFICATE :nl�:ul.nlltai�; Plumbers License No. .......................VITHOU Electricians License No. ....................... OFOCCUPANCY BF (10ft af'G...1-7-F FOR G.0- "A' � Other Trade's License No. .................... 4t'' ,'3E dJN!!s?4 1N n I. Irocation of lard on which proposed work will be done........................... •i ',.' : ' . �3li� l'1Ill.. �.1"1lI:' t;;'�' NOT - R r r 4tbir'4�I a�S91� `.l)41dCxI:I1:l ►frZ13r)i,s .... • m .- •...... . . .. ........ ..... Iuuse Nuber � Street A4j � lianlet • �E-� Ccxmty Tax Map No. 1000 Section ....... Block ......... Lot ...I.0........ . Sulxlivisio. ...................................... Filed Map No. ............... int ............... (mime) 2. State existing use and occupancy of premises and inte"decl use and occupancy of proposed construction: a. Existing use aril occruporncy .....:4 ..`��i.��1ti"�:1•t-:n�.... ................................... b. Intended use and occupancy ..... � �C� 1C1 �Ca.1.............. 9t � i. ,aE....---. .aett,rr�igs1=4 3. Milme of cork (check vAdd► alrlilicuble): N�-► Iklildirr!. .......... hklition .. Alteration .L 14tlkr i r ..___.-..... Mmiuval ............. Dawl i L ion .......... 6tiler-wrk .. yam- (Description) TDC;\Ct 4. [sLinr,ted Cost �:::. :h:�:''... fee .... 7 .................................... (to be lurid on filing this application) • 5- If (Liellinil. rxmber of dwelling units , Umber of (k4el l ing unf tl s cxr each fltx)r ............. Ifgarage, insiber of cars ............. ....................... 6. If (xrsiness, cam ercial or mixed ocenpancy, specify nature erre) extent: of each type of use................ - ]. Dimensions of existing structures, if any: Front... ...... Rear .. ..... Depth ...�Q......... height ... .................... Muber of Stories ...... . - Dimensions of sane stnrctture with alCera cxrs or ackIitions: Front [tear Depth ....t.Q........... lleiglrt ..... ........... Ninlrer of Stories .............. tries ............... 11. Diuensions Qf entire new consL'nxlAon: From ................ [tear ............... Depth .............. Ilei&[: ......................... Naber of Stories .... ... .... 9. Sire of lot: Frnnl .............. Rear .................... plh ..........,.{. .... M. Male of Hrrchase �.�,1��......._ Marc- of Kornner l6nrer l:�7 i �t:? L 1��,.):.(,.t�J -:J 'hC1- 11. Imre or use district in vAdcir prenises are situated .J:C..1l.`::�1��S I� C�-! Ib `'.,.1/................................. 12. es propxr rsed ccstmetion violate anux y ring law, ordin toce or regulation: .. 13. Will lot be regraded ............•...... Will excess fill bereetoved frau premises: YES ND 14. Nares of Owner of prenisea l �41!�.1. 1 0.t. klre Iris�J:.�Q �C? lNrorre No.-7 7' :r,.�.G' �. Mare of Ardritect ...... ............... -SC�un ............ hklresa ............................... .. Pirorre No. Nate of CAwitractor � ........................ hklress r-Y _._.................Iixme Nu. 15. Is this property within 300 feet of a tidal. wetland? * YGS .......... M) ..�..... *IC YES, SOUIIKID 7U,R1 JIMI M-S 1ti1iMl'1'MAY 1113 Itige putt:[). PIAT DIAGRAM I.cx:ate clearly and distinctly all IrcrildiiM,,s, whetlier existing or prolxwsed, nix] Irmlicate all set-back dimensions frau property lines. Give street and block nnber or description according to deed, and show street rurres and indicate %Aretlier interior or corner.lot. UX V k-J) tilME.. M- M:M Y(H(K, ` , J��b� ..... �s (xAlN1rY�IA� `�'� � -�.. �. ..............Ixlinil duly raven o, rk!lxi:xt:: aixl rays: that he in the appl ie•aul N-1111! of individual signing ming contract. alxrve nimix-ti, lk in Lhe .....l .� .....� ........................................... ((:cxtl:ractor, agent:, rorlxwa(e•officer, efc.) of said macer or tmw.rs, nix in dully rart.horized to lx--rfonn or have p-rfornied lite said work and to nuke and file this appl ical:ion; LhaL fill statements contained in Ibis appl icall nr are t.rr,e to llle bent of his kixrealedge and ilel ief; a,x1 that- the work will be performed In hre urrnner set forth in the application filed l.berewith. :waonr Lo before �lIne this ......I.. z►:. lay o .. 19.r Notary Hybl iL'.. �..... .. r M L d tibAt ... ... IhA�1y (Sii,cr.-aure of Applicant) BAR V 44 ��a t,� •\ ,.. �,� s G f tit �,: `�a <'(. �� ,ti �> � t F `� �• X. vf;IN N 4�(! 29 / 6 ,' b � - _ °�`� 's'� �� _ � � r -�- .___. _ _ a �4' �`�� `#�� ► , , ��. « �'� a �� : ,�.�. � � v r t' �: ,f,. .. �- 'J v� i; �� r -- �. ,. ._ y��.' ' _ y^ �r ,�� S��h'l� ��-� 1� V� • '.rte, �,. "�' kw IIt lil�11 ,. 'me �.�:rti, , `j °�,� ,gip