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HomeMy WebLinkAbout16031 & 16033-Z FORM NO. 9 TOWN OF SOUTHOLD BUILDING DEPARTMENT q J TOWN HALL 61 ! ^a V SOUTHOLD, N. Y. rem BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N2 16031 z Date .......... .., ... ....................... 1AT Permission is hereby granted to:: �. � .� ............................................. ..�4...N:'�.,...1�.4s . ... -%............ .&t....QzrnT to ........ �.... . . ....... .:: ..................................................................................... at premises located at ....t D. .......N :4: X .)1-1. . ........�. ...........................................................................1...................................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section ......0 ... O ...... Lot No. R.. Block .............. ....�!. ........... pursuant to application dated .... ..... ..:.................... 1911., and approved by the Building Inspector. Fee $.� .?............. ............................................................... ... Building Inspector Rev. 6/30/80 3 OUNDATION ( 1st) ` OUNDATION ( 2nd ) z o r0 OU,GH FRAME & - PLUMBING :NSULATI.ON PER -N.. Y. y A STATE ENERGY CODE x FIaAL \J,D.10 . AD.DLTIONA;L COMMENTS x ' V x o - a y .. .. C7 ETJ BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY - . TOWN OF SOUTHOLD CHECK . . . .. , • - BUILDING DEPARTMENT SEPTIC FORM . . . . . . . . . . . . . TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL - - - • - TEL.: 765-1802 - ' • " " ' • • - � MAIL TO Examined . . . . . . . .'�. . . ., 193.7 Approved . .aw-44mk . ^. . . ., 14.1 Permit No. .�. 0 3 t E a WiY3 . V Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . .. . . . . MAY 1 11987 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . .; . . . . . . . . . RLGO C3E; T. s TOWN OF'SOUTHOLD U. � (Building I.nspector) . APPLICATION FOR BUILDING PERMIT Date . .\ . . . . . . .. 19 INSTRUCTIONS a. This application must be completely filled 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. 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 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 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 building for necessary insR5p-tons. \ ' matureAoa�p�plicant or name a cor orati( g p ) (Mailin address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises � - . . JS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises �\.O.V. (as on the tax roll or latest deed) applicant i co�rjpor� ionr�of duly authorized officer. (Name and title of corporate officer) ALL CONTRACTOR' S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. . . . z!. . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . �.9 . . . . . . . . DIV. . . . . ..i'l. . . . . . . . . . • • • • • • • • • • • . . • . . • •�q• • . • • . • . , • . • • • • . . • • . • . • • . • • • • • . • • • • • • • • . • • -House Number Street Hamlet County Tax Map No. 1000 Section . . . . . `�. . . . . . . . . . Block . . . . . . . . \ . . . . . Lot . . . . .� . . . . .. . . . . . . Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed c nstruction: a. Existing use and occupancy . . . .� • • • �t` •G..� ?��. . C!S . . . . . . . . . . . . ... . . . . b. Intended use and occupancy . . . .6_�;;'Lfi. . �J. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . I1 3. . Nature of work (check which applicable): New Building . . . . ... . . . . Addition . . .X" . . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . . . (Description) 4. Estimated Cost . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` tto 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 usl&­. .". . . . . .,.. . . . . . . . . . . . . 7. Dimensions'of existing structures,if any: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . ... . Depth . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions*ofisame,structure with alterations or additions: Front Rear Depth . . :. . .'. .�. .`:`:"y. . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . S. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . Height Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . . . . . . . ... . .. .I" ' Rear: . . . ..;.. . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . .. . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ` 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: - Yes No 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . ... . . . . . Phone No. . . . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . .. . . . . . . . . . . . . . .Phone No. . . . . . . . . . . . . . . . 15. Is this property located within 300 feet of' a .tidal wetland? *Yes . . . . . No . . . . . *If yes, Southold Town Trustees Permit ma be required. PLOj 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. STATE OF NEW YOR (� S.S COU Y OF . C�:c�?- . • • © �` • • � ' •�� . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the . 4��1' <' .\. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . . 11. . . . . . .day of. . . . Notary Public, . . �. . .1� •. . . . CI —. . . . . County HELEN K DE VOE . . . . . Qom? NOTARY PUBLIC,State of New York No.A707875,&j fciik aunty�9 (Signature of applicant) Tarr,Expires�ir:rch 3G,tS FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. &,q BUILD114G PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N 2 1 ,60 3 3 z Date ......... ............... Ign Permission is hereby granted to: .:. I...... ................. ........................................... ....�.. s u A.. m z— .... .... . . ... . .... to Zy-,r�-- .... . ........ ...... Jk.. 9.6-31....q4 _ C I......A .... . ...... ........... ...........at premises located at 4.0 ................................................................................................................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section ..... .... Block ......P.A....... Lot No. .....)-�............ pursuant to application dated ........... - - ..................... 191.j., and approved by the Building Inspector. Fee $ .................. ... ...................... .... . ........ . .............. wilding Inspector Rev. 6/30/80 H W OUNDATION _ ( 1st) - CA OUNDATION ( 2nd ) • i zoo OUGH FRAME & I - PLUMBING INSULATION PER N . Y. STATE ENERGY, i CODE x FINAL • I z ADDITIONAL COMMENTS : x I r o- Qu BOARD OF HEALTH . . . . 3 SETS OF PLANS . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OF SOUTHOLD CHECK A4' 7 BUILDING DEPARTMENT SEPTIC FORM TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 CALL TEL.: 765-1802 ' " " ' " " " " " " " " MAIL TO : Examined . .I 5 . . . ., 19�3� Ug Approved . . ' -. . . . ., 19TT Permit No. Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MAY ! 11987 I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . BLOta. DEP1. ..- . 4 . . . . . . .�i.0�•. . . . . . . . 'OWN OF a (Building Inspector) . APPLICATION FOR BUILDING PERMIT Date R. \ . . . . . . . .. 19 INSTRUCTIONS a. This application must be completely filled 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. 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 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 permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole of 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 building for necessary sections. (Signature of applicant, or ame, if a corporation) (Mailing address of applicant) State whether applicant is—owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,-,.VX. . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . Name of owner of premises \M ui G.-C.`Cl . . . . . � '�`( it�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) �Ifappli.cant i a col o signature of du uthorized officer. (Name and title of corporate officer) ALL CONTRACTOR' S MUST BE SUFFOLV.COUNTY LICENSED Builder's License No. . . . . . . . . . . . . . . . . . Plumber's License No. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . /!�: : . . . .r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • House Number Street Hamlet County Tax~Map No. 1000 Section . . . . . .°\. . . . . . . . . Block . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . ... . . . (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed constr ct' ?' a. Existing use and occupancy . .� ���.� . • •`��'(�l&WN '. . . . . :`i,g�4 ►r. . . . . . . . . . \ b. Intended use and occupancy A 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . .1 . . . . Alteration . . . . . . . . . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . . . . . . . . . . . . (Description) 4. Estimated Cost . .c--)QQQg. . . . . . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 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 . . . . . . . . Deptll, . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . : .�. . . . . ' . . . . . . . . . . . . . Dimensions-of:sarrie structure with alterations or additions: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height A . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . q. . . . . . . $. Dimensions of entire new construction: Front . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth . . .146 . . . . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9: Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . .Rear . . . Depth . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of Former Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . ... . . . . . . . . . . . . . . . . . . . 13. Will lot be regraded . . . . . . . . . . . . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: 14. Name of Owner of premises . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . 15. Is this property located within 300 feet of a tidal wetland? *Yes . . No . . . . . *If yes, Southold Town Trustees Permit may be required. PLOT 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. STATE OF NEW OR S.S COU Y OF . . cam.. �9. . . . . . . . . .�v�1Ca_ • • • ��!• �•e, fj�V� . . . . . . . . being duly sworn, deposes and says that he is•the applicant (Name of individual signing contract) above named. Heis the . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, 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 that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this " . . . . . . . . . . . ././. . . . . . . . . .day of. . . . . .. . . . . . . . .. 19 7 NotaryPublic "". �f. . .�� . . /.l.-. . . . .C�/. . . . . . . . bounty HUN K.OF.VOE NOTARY#'mi tr. L York C k" . . . . . . . . . . , NoA?wa•:"a u,.C�ur�ty (Signature of Terre Expires ibjarch 3i3,19 applicant) � , � I � � I I � . 1 , • \ ,/' Al 01 dL Apr A :.- � O .� ct -�, i .� ' All C jei�j ZAL el 14, IV ex ZVI N e �y IO�afl LA IV S 33696 . 'OF NEW YO • QO G \ 71 vj� -/ All . �-��''��-� r=�. "!- _�.�/fir`:/,�: .� ,y"�•"�,�';�,:;.,�,;G-;.,�,.�;,_... _....f