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HomeMy WebLinkAbout18735-Z / (TH)S PERMIT MUST BE KEPT ON THE PREM)SES JNT)L F)3LL COMPLETION OF THE WORK AUTHOR)ZED) / 18735 ,/~/~ ..... Z ~,~ ............. ~.~ ...................... , ~f~ 5/30/80 goard Of Southo]d Town Trustees $OUTHOLD, NEW YORK PEP, HIT NO. 7-7-89-70-13-20.8 DATE: Sept. 2% 1989 ~SSUED TO DR. RICHARD HALL ............................. Pursuanf fo fhe prov[slons of Chapfer 615 of fha Laws of fhe Sfa(.e o~ New Yor~, ~893; end ~epfer 4~ o{ ~e Laws o~ ~he rifled "REGU~T~N~ AND THE PLACIN~ OF OBSTRUCTIONS ~N AND ON TOWN WATERS AND PUBUC ~NDS ~d fha REMOVAL OF SAND, GRAVEL OR OTHER MATERIALS FRO~ LANDS UNDER TOWN WATERS:" ~d b ~ccord~ce wffh fha Resobf[on of The Board adopfed ~f a meefing ~e[d o~ ~pp~. ZS, 1989 [9 ..... a.d in =o.slderaHon of fh~ sum ef$ p~id by of ......................................................... N. Y. and sub]ecl (.o ~'he Terms and Oondfflons [is('ed on ('he reverse side hereof, of Soufho[d Town Trus(.ees au(.horizes and permffs ('he foJbw]n9: Construct single family dwelling with associated sanitary system, 4' x 25' walkway, 4' x 7' stairs for beach ~ccess. Proeprty located on Kimberly Lane, Southold, N.Y. ail in accordance wffh (.he defa~[ed specif~ca6ons as presen(.ed in (.he originaflng app)ica6on. iN WITNESS WHEREOF, The said Board of Trus(.ees here- by causes frs Corpora(.e Sea[ (.o be affixed, and (.hese presen(.s (.o be subscr[bed by a ma]orffy of (.he said Board as of (.his da(.e. FORM NO. TOWN OF SOUTHOLD BUILD1 NG DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 E.,amined · Approved- · ~2~-'~ ......... 19 .~-~. Permit No ........ Disapproved a/c ..................................... BOARD OF HEALTH 3 SETS OF PLANS ..... SURVEY ............ ~.~ .... CHECK ....... SEPTIC FORM ................ NOTIFY CALL ...... ~ ..... ~ ......... MAIL TO: (~ildin=~fspector) APPLICATION FOR BUILDING PERMIT Date . .D.e. qe.~]o.e.r.. 7 ...... 158.9.. INSTRUCTIONS a. Tins application must be completely fiBed 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. Hot plan showing location of lot and of buildings on premmes, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of tins 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 permSt 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 Bui/ding 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 removCb/o~gm~tion, as herein~_.descfibed. The applicant agrees to comply with ail applicable laws, ordinances, bmTdq3ag code,~ot~fn~r/6d~,_and regjai~jzcfig, and to admit authorized inspectors on premises and in building for necessary ~r(spe .,~..~s. ~-*J~ YXL;i!~/~l. bj~g~r~ture or a'nypqicantv~X',fi~a corp'oranon/ ~.©. ~ ¢ 17, Cut*~*~, ~¥ ~ i ~ ....................................... Phone: [$~) 7~4-~8~ ' ' (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............................ .* ..... ?: ....... ............................... · Applicant is ~he a~en~ of ~ne o~me~ . ................ Name of owner of premises . .D.r. ?. ~i. 9~.axd...A.,..~ .a.i.l .................................................. (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...~qt.. y.e.~. $.e2~ec¢~.d. .... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ i~2~ ~ ly ~ ~ ~ Kim er e $¢uthold HouseNumber Street Hamlet County Tax Map No. 1000 Section ...... 7.0 .......... Block .... !3 ........... Lot ...... 2. Q ~.8 ......... ?aradise by ~he Bay 6463 8 Subdivision ...: ................................. Yiled ,Map No ............... Lot ............... (Nmne) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... .V.a. qa..n.t..t.g~.d ................................................... b. Intended use and occupancy Sing!e-famiZy re~id ¢~.c.e Rep~r .............. Removal .............. DemoH~[o~ .............. O~h~r Work EstLm~t~d Cost ..... S:On~O00 ........................ F~e .... ~ ~1 i (to be prod on ~Hng this application) 5. If dwelling, numbe~ of dwelling units ...... ~ .... Number of dwelling units on each floor ...... If garage, number of cars ............... J .... ', 6. If business, commercial or mixed occupancy, specify nature and extant of each type of us~ 7. D~ensions of existing structures, if any: Front ........... A.. Rear .............. Depth Height ............... Number of Sto~es DLmensions of sam~ structure wi~ alterations or additions: Front ................. Rea: Depth ...................... Hei~.t ....................... Number of Stories 8. Dimensions of entire new construction: Front ...8~ ~ Rear q' ~ *' Heigh~ .... 2 6? ........ Number of Sto~es ....... q a 9. S:ze oflo:, zron ...... ,aS.. 5' ''~ ....... Rear ....... ~.~[ . ......... ,perth .. ~.I~.. I0. Date of Purchase ........... ;S.~ .......... Name of Foyer Owne~ .i}?~-¢-.=-rs. ~-~ ~v>~I ~es [ i. Zone or use diet,ct in which premises are situated ...... ~-T~-9 12. Does proposed construction v[ohze any zoning law, ordinance or regulation: . Jqq ............... 13. WE1 lot be regraded .... ~9~ ................... Will excess fill be removed from premises: No ' ~ ~ ~ ~ Fall t4. N~e of Owner of premises S~A%T~. P.~ ~=~[ain R~.~ Sou~hc!~ M~ N~e cf Architect Robert TM ,,n ~. ~ r~,~ ~na,,~ ~o ~ ?~n ..... Name of Contractor . ~.~ .tr~;..~?~P.q'~p~ ...... Address ......... . .... Phon~No 15.Is th~s property locate~ wittlin ~00 feet of a tarot ~e~a2~. ~ ..... *If yes~ $outhold To~m Trustees Locate clearlv, and distinctly ail buildings, whether existing or proposed, atria,' md~cat~' : = ax~" set-back dimensions from property Enos. Give street and block number or description accord~g to deed, and show street names and indicate whe~er Lnterior or corner lot. See attaehments~ STATE OF NEW YORK. COUNTY OF ................ S.S (Name of individual signmg contract) above named. being duly sworn, deposes and says that he is the applicant He is the ....... gg.e.~ ........................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed tko said work and ~o make and file application: that ali statements contained in this application are true to the best of his knowledge and belief; and Ikat tine Work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ....... ...................... "' / o N0..4853108, Sufiaik Cou~t~ =0mm~ss[~n fixtures Febraary t8, !~