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Home My WebLink About10089-Z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 10089 Z Date 19 7 Permission is hereby granted to: ......o..✓. .:.a.��J�1/�f...�:v'G h.�................. .. ...�-�. . .........�l fir' to ........)� .. r'.l. ! .ra.... 1� .��c�`............................................................................... atpremises located at ............................................................................................................................ ................................................................................ ................................................................................ ................................................................................................................................................................. pursuant to application dated ........ 19-/7'2, and approved by the Building Inspector. 3/ Fee $..7,;;; ......... .. .. . .. . ............. ... . .. .. . ...... . ..... ilding Inspector l 0 o�- , LA-1 L-r-. FORM NO. Y TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .. . .�....:...., 19 Application No. .VO ........... Approvedr . ..... ......... 19�C1... Permit No.,A 7 .... Disapproveda/c ..................................................... . ................................... ......................... .... .(Buildi g" Inspector). APPLICATION FOR BUILDING PERMIT Date .........:..��:"�.f.................. 19.��.. . 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 Rlans, accurate plot plan to scale. Fee according to schedule. 'b:--,Plot plan showing location of lat-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 aoplication,'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 &ggaj inspections. HOMES (Signature of applicant, or name a cor oration) �••S ......?/i ... .........: 6 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,.....� :!�............ ................................................................................................................................................ nn Name of owner of premises .s�9�� ..11otf��CO"�tl ......................................................................................................... If applica t is a corpora , s nature of duly authorized officer. � .. .. .. .�.. ...... .. . .... .. .......... (Name and title of core ate officer) Builder's License No. .................................................... Plumber's License No. .......... 1 ............................. Electrician's License No. 1.5 ................ OtherTrade's License No. .............................................. 1. Location of land on which proposed work will be done. Mop No.: ......�.45�..... ................ Lot No. ...../................ L �� 7 s i �rG Street and Number ... /�� `7'. .........�...... .....f��............1. ..........-............................................ Municipality 2. State existing use and occupancy of premises and in-ended use and occupancy of proposed construction:, a. Exisiting use and occupancy .........../l./Q�.1/ ...... h./ / ✓ ..:................................................................ b. Intended use and occupancy ...(f-. '�sit�llr ��....(..'' ✓2i�... / / ................................................ ` . ' 3. Nature of work �hock'wh�h applicable): New Building-'-«��- ----. Addition .................. Alteration .................. . ' ' Repair _.----' Ran�ovo| --_--- Den�o|iUon—..—^--- Other Work ----------------. '— ' � (Description) -�� ^� ^�z�� ^�'� ' a"- zi Estimated Cost ----^�A�.mn��.��.--_------'�ee ..^e.x��--_-----_---.-_-------____________ (to be paid on filing this application)' 5. If dwelling, number of dwelling units .....!Pdle..........Number ufdwelling units on each fldor;.-,-------.. If garage, nu ^~ n�bermfcoro ---�r��.��_—..---'------------.�.---------_'~r--_�—'�_--.----' 6. If business, commercial or mixed occupancy, specify nature and extent of each type ofuse ............................ 7. Dimensions ufexisting structures, if any: Front ............................ Rear ................................ Depth ..... Height ................_--' Number of Stores --.--.--_------__---_.-'-----_--'---___-__--__— Dinnonsionoofsome structure with alterations oradditions; Front .................................... Rear ............................ Depth ................................ Hekz�� --------.—'Number of Stories ---_--_--_--' - / ^y~ �ao �-��+ ` O. Dimensions of entire new construction: Front --��..��—',-_----' r -��.--------- Depth .��.�'�'��-- Height .................... Number of Stories ......4?��......................................---------._.. ' 9. Size of lot: Front --- .»��.»°--.------ �aor — .«��.�----.- �eot6�� '"^�.. y ' lC Dote of Purchase .............. ...� 7&............................Nona of Former Owner ........................................................ �~�� 11. Zone district i which premises .---------- 12: _ Does proposed constructionviolate any zoningordinance or regulation: ----' ..................................... |3. '_ ' .'be regraded --- be removed from premises: ( ) Yes (K) No 14. . `ame' dDwne�ofprenn�as ' . .N�C —_- Addrass j61� A Phone.No. Name of Architect ---------------------' Address .................. . Phone No ...................... Nonno of Contractor 3�� -----' � �res � �� +��., Phone .. ..8 PLOT DIAGRAM ota 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 nornas and indicate whether.interior or corner lot. STATE F NEW Y.P�l - ` v ' - / ' ( — . �--..baing du|vs�orn, ond soysthothe ist�a o�o|icon/ (Noma of individual oiQnjA�J controcf) _ above named. C-1pW/-,P All J2___ He is the —.�:��f��.��v . . . ------.----.... .. . . . .. ------.-- . . . . . ----_..--_----~—.----- ��ontroctor agent corporate offcer etc ) of said owner or owners, and is duly., -to parfo or have performed the said work and to make and file this application; that all stotan`anfscn' tzined in-this app lication, dre true to, rha'best of his knowledge and belief; and thar the work i|| � performed i thee t forth i +h application filed therewith. Swornto before mrn/s ......... _-, of Noto ]P ��.--_.---�-^-...^.,..^.-- ~.—x:.�''�..�--' ^ (Signature of opp|ic t) in the.state o tyCwoums"~_-, ` APB 9 M. 12 -000 o .. Nbu510 Ig0•I 04 tJ64 fL-33O • z n � I - 4- Fl=3p OT 192. N O - p 048 4� 8 5.64 Jot SURVEY FOR GREENBRIAR HOMES, INC. SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES LOT 9 GREENBRIAR ACRES " DATE DEC. 6, 1978 AT MATTITUCK FOR APPROVAL OF CONSTRUCTION ONLY `' TOWN OF SOUTHOLD SCALE-- I"=40' SUFFOLK COUNTY, NEW YORK NO. 78-830 HS REF' NO.' DATE *UNAUTHORIZED ALTERATION OR ADDITION TO THIS - SURVEY IS A VIOLATION OF SECTION 7209 OF THE S�A� OF NFL } NEW YORK STATE EDUCATION LAW *COPIES OF THIS SURVEY NOT BEARING THE LAND APPROVED SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL y�P �'0 7 NOT BE CONSIDERED TO BE A VALI D TRUE COPY q �� (� XGUARANTEES INDICATED HEREON SHALL RUN ONLY TO '13 2 HEALTH DEPARTMENT-DATA F PROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED - YcO R AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- �il�" �E NEAREST WATER NIAIN4 ML± *SOURCE OF WATER: PRIVATE ZPUBLIC_ MENTAL AGENCY AND LENDING INSTITUTION LISTED *SUFF CO. TAX MAP DIST loot SECTION 106 BLOCK 3 LOT A-11L HEREON,AND TO THE ASSIGNEES OF THE LENDING *THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT N OTHER THAN THOSE SHOWN HEREON. OWNERS !�C O• 45g93 if THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RESIDENCE *DISTANCES SHOWN HEREON FROM PROPERTY-LINES WILL CONFORM T THE ST ARDS THE SUF LK COUNTY�EPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC E� 1 p UgV�y OF HEALTH SERV CES• 4!1 PURPOSE AND ARE NOT TO BE USED TO ESTABLISH APPLIC TI O„�' /J PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRE �SZ �� '• �� '� ��°'° 4WOSTRANDER AVENUE TEL. YOUNG & •YOUNG RIVERHEAD, NEW YORK NOTE:■ = MONUMENT ALDEN W.YOUNG,PROFESSIONAL ENGINEER SUBDIVI SION MAP FILED IN THE OFFICE OF THE CLERK OF AND LAND SURVEYOR N.Y_S.LICENSE N0.12845 SUFFOLK COUNTY ON OCT. 7, 1977 AS FILE NO..6609 - 4 HOWARD,W.YOUNG, LAND SURVEYOR *THE LOCATION OF WEL L(W),SEPTIC TANK(ST)B CESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893 ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS NOTED 'Ell App[IOVED A DATE- FEE- C,Y, ptjR :SENT AT ROT[FY pJILI)ING D"!P)A 765 2 'f 0 V"ll"I ldppa FOR IZEQUIR- - 6 /0 -0 ED lNcgp!-:'--jjoHs: -cTi.I'T I Fn&VD4 L"*1 70 p ;s OF ANY KIND 103 CON'APLETED I,40T p.ESP't, .-�E FOP, DE SIGN UCTI'(�N E'D"IZOP-S C-q co'�ASTR RUCTION MUST MEET 5, ALL CON�A REQUiRENAVITS OF N.Y. STATE CODE jOVJU ROUSING CODE & ZONING IF- _ _____4 _ __ _____�_ _ .......... ... 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