HomeMy WebLinkAbout9258-Z FORM NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N.. V.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NO 9258 .......... ' -)
Z Date ..� �...�.�.�.............................. 19.
Permission is hereby granted to:
............ ' ..........................
...............GZC� L�s�i. � .. ?aq• ..........................
.... ? ?®� t . .. '3. ... ........................
to ........5=�'), ...�?.t CW�. ,y.. • •; ..tires;3r.. :u. .. . � �. ...............................
................................................................................................................................................................
at premises located at ......C'��,C:�a.Q��,?�:.�...1�...3�.........................................
................................................................................................................................................................
...... b vi 3;®7�......: ..H5pggI......�®tj '..........................................................................
pursuant to application dated .....MaY...23.y.................................... 19.7..., and approved by the
Building Inspector.
Fee $./.ti�.. .........
Buil ing Inspector
C) 5-P-(-
�e�� a ��m,
FORM NO. Y �� 3 qGI S �Z
TOWN OF SOUTHOLD �
BUILDING DEPARTMENT �V
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
May 2� 77 .r, . 92
Examined ......................................... 19.....:.. Application No. ...............................
Sra23, 77 92584 -
Approved ......................................... 19........ Permit No. ...................: .......
Disapproveda/c ............................................................................................
LICXXXX
.........................................................................................................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT 1\
May 23, 77 o
Date .............................................. .. 19...........
INSTRUCTIONS III
n
a. This. application must be completely filled in by typewriter or, in ink and submitted in triplicate to the Building 4
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 streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application.
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 issue 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 buildings for necgsary inspections.
............................................ ..... ..... ...........................
(Signature of applicant, or name if cor oration
640 Lesl.ies Road' Cutchogue 2 N. Y.
...............................................................:....................................
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
...............Donald..&..Barbara Sch ley. ................................................ `._...........................
Nameof owner of premises ............................................................................................................................... .................
If applicant is a corporate, signature of duly authorized officer.
................. ................... ... .. `\ r1
. .... ... ...... ............
(Name and title of corporate officer)
Sel f
Builder's License No. ....................................................
Plumber's License No. ....................:........................... 7 �7'- 9v S
v'1
Electrician's License No. ............................................ 11
Other Trade's License No. .............................................. Baas FomeS
1. Location of land on whi r os i I done. Map No.: ............5 7. .............. Lot NoCltbi: O e
Streetand Number .............. .........................9........................................................................................................
Municipality
2. State existing use and occupancy of premises and intended use and occupant of proposed construction:
Private bne family dwe�llitg
a. Exisiting.use and occupancy ................. . ; ............ ..............
ame. . pith....a... . .. �... f Xae .... . .d.s ddition8 ..
in
b. Intended use and occupancy ....................................................................re=.Yard......................................
w
v
v
3. Nature ofwork (check which applicable): New Build ` —. Addition ------ Alteration ..................
Repair -----.,' Ron�ovo| ------'^[�nn�Ution--�:'.^.-- Other Work ................................................ '_
�_ (Description)
4. Estimated Cost --.---.---�e��Q*���--'�--.��.-.F�� .���x��x��...r.---_----_—_---_____._____—_
' ^ (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. Dimensions ofexisting structures, if any: Front ............................ Rear —.--'.,—.--.----' Depth .....
Height ........................ Number of Stories --------.----.---------.--_—__--__._______
Dimensions of same structure with alterations or additions: Front ..................................... Rear ............................
Depth ................................ Height --.-------Nunnbar of Stories ................................ �� ^
8. Dimensions of entire new construction: Front.......8.............................. Rea r ... ......................... Depth ........T12----
Haight .................... Number of Stories ------_--'----*-�—�—� --'
----------------—_—_—
---
9. Size of lot: Front .....W----_----------' Rear -- ......................... D pt h .....3.30
_+/...........
lO Date of Purchase —�—.AMPSA;A A97-3-------.None of Former Owner � m � ulav� sen
_'_~-'-'— ....................
v��o
11. Zone or use district in which premises are situated ------.--------------_—.------------
l2� Does construction violate any zoning |ovv ordinance or regulation: --.����----.----------
' JJ
13. Will lot be rngoodad --.AQ................ Will excess fill be removed from premises: ( ) Yes [ -rNo
� �wjd .....................' ..... phone ���
l/L Non�eof Owner ofprenoises -------------- . roma .. ~.-. .......................
Nome of'/\nchitec! .............................................................. Addrms� .................................`Phone Nko. .......................
-
-
Name of,[ontroctor ---------------'---�—' Address .�----'�--_-.�._' Phone No --..----.^.'~
`.
PLOT DIAGRAM `
\
Locate clearly and distinctly all buildings, whether existing or proposed, and-indi Uset-bock dimensions from
property lines. Give street and block number or description according to deed,' and show street ''names and indicate
whether interior orcorner |c*.
1.10
'
� -
� �� ^
�_� - '
������ � ���� ��c» A���
STATE OF NEW YORK, (
� -'s es and says that he is the cam
(Name of individual signing co racf)
above named.
5ne /s the c �:��� ~ __.
r orate officer, etc.)
' , or p�of � or owners, m� is duly � � �v ���� �o said work a� �� make and file'
this opp|icoflon; -thof all statements contained in this application are ono true to the best or his knowledge and oa`/�
thor the work will be performed in the manner set forth in the application filed therewith. '
Sworn
tobm nne+hio
� 7 �T- ~v� �/ V�
..--'cz��.����.. doyof .—......1//��,� ..—............... � l9.���..
Notary Public �� ��� � ..... County -'����:�zx�r���,n�`=...�+�' ............._.
' (Signature mfopp|icont)
/ v
m, E. oxWSON
m �8Y�un
� u New York
� '
wv� o "ox/z� xu�m� Cv���
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
'OWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ....My..2.37................. .. 19...7.7 Application No. ...92>rs...................
Approved ......IIay..23-1. ............. .. 19...Z7. Permit No. .....9.2.584..................
Disapproved a/c .ylk� .
X)O.................... �.. .........................
.................................................................................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 streets or
areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application.
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 issue 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 buildings for necessary inspections.
44,1�% . .. V(S
s �
ignature of applicanme, if orporation)
6 Le 'e Rod Cutcho ue PT. Y.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
................................................................................................................................................................................................
Name of owner of premises ....... 0,U ld..&..Baxb.carid..t5..QhAUe.Y.................................................................................
If applicant is a corporate, signature of duly authorized officer.
........................................................................................
(Name and title of corporate officer)
Builder's License No. .......PAL..
Plumber's License No. .................................................
Electrician's License No. ............................................
Other Trade's License No. ..............................................
•1. Location of land on which proposed work will be done. Map No.: ..A4Y HOITICGA................ Lot No. ........................
Street and Number ..6?kp...Le s1i es...$aqd7.................................................... ...................Cut.Qh,qg?ae.
Municipality
2. State existing use and occupancy of premises and in±ended use and occupancy of proposed construction:
a. Exisiting use and occupancy ................PxLvat.e. bhe...family...du,eI Liu 9...............................................
b. Intended use and occupancy ............ .aMe..V.i.th..addita.m..QX...$..K.12..aC0y.....b�-d ..1xi.............
rear yard
3. Nature of work (check.which applicable): New Building- AQQ7....... Addition .................. Alteration
Repair .................. Removal .................:-_Demolition...........:........... Other Work .................... ............. ...... ..
(Description)
...... ... . .Q QQ
4. Estimated Cost .......................$?�:QO.�Q......:.....:' .Fee � ,. . ..........................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................
Ifgarage, number of cars ................................,...............................................................,.............................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type.of use ............................
7. Dimensions of existing structures, if any: Front ............................ Rear ..............................., Depth .....:..............
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front .................................... Rear ............................
Depth ................................ Height ...........................-Number of Stories ................................
8. Dimensions of entire new construction: Front-....�.............................. Rear -.8....................... Depth .......112.............
Height .................... Number of Stories ......................................................................................................................
9. Size of lot: Front ....135............................................ Rear ...:..1135.............................. Depth .....33Q..:f:/r............
10. Date of Purchase .......................Name of Former Owner ..TA9a:r...Q)_a.U- SPXI....................
11. Zone or use district in which premises are situated ................�.A!t..........................................,,,,,.
12. Does proposed construction violate any zoning law, ordinance or regulation: .......N.Q...............................................
. 13. Will lot be regraded .......UQ................. Will excess fill be removed from premises: ( ) Yes ( A No
14. Name of Owner of premises ................................ ................ Address ............. . ............... Phone,No. ... .............
Name of Architect ................ .......... ............................... Address ..........................:..... Phone No. ...................:..
Name of Contractor ...........................:..::..:.......................,. Address .............::................. Phone No. ......................
- ..: -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.
= .�
�rv-1 r
I r
J
STATE-01F NEW YORK l
COUNTY OF . S.S
................................ . .
being duly"sworn, -deposes and says that he is the applicant
(Name of individual signing co tract)
above named.
jHeis the ................... ...... ::...:..... .....:-.......................................................-......
(C trac r, age , corporate officer, etc.)
of 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
than the work will be performed in the manner set forth in the application- filed therewith.
Sworn to before me this
.........Q............... day of ..........</l ,l ...................... i
NotaryPublic ... �.� �G�1. ... County ............�.4A ........ . . .... ...................
.....
(Signature of applicant)
RY E. DAWSON
NOTARY PUBLIC, State of New York
No. 52-4643721, Suffolk Cou❑Qty
Term Fxnirec mn,,h 4n ia"X)
o��FFo��o
VICTOR LESSARD O Town Hall, 53095 Main Road
PRINCIPAL BUILDING INSPECTOR r P.O. Box 1179
(516)765-1802 n Southold, New York 11971
FAX(516)765-1823jo�
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 27, 1990
Mr. & Mrs. Donald Schilley
640 Leslie Road
Cutchogue, New York 11935,
Re: Building Permit #9258-Z & 9954-Z
Premises: 640 Leslie Road,, Cutchogue, N.Y.
Suffolk Co. Tax Map #1000-97-9-5
Dear Mr. & Mrs. Schilley:
In reference to the conversation that Mrs. Schilley had
with this office on March 22, 1990, the above building permits
have expired and Certificates of Occupancy have not been issued.
No inspections have ever been made.
According to the Code of the Town of Southold, Article
XXVIII', 100-281 and 100-284, a Building Permit is needed for any
construction of accessory structures and it is unlawful to use
said accessory until a Certificate of Occupancy has been issued.
In order to avoid legal action, you must contact the
Building Department and resolve the violation immediately.
Thank you for your cooperation in this matter..
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Vincent R. Wieczorek,
Ordinance Inspector
VRW:gar