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Home My WebLink About8533-Z (2) FORM NO. I / 3�3/77 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .......... .... ........... .. ., 19.2.k Application No. di- .............. Approved_ ....................E�......? ., 19.A 'Permit No.(�F.. f...�:........... — Disapproveda/c ............................................................................................ �c ................................................................. ................... ................. .. V Building Inspector) APPLICATION FOR BUILDING PERMIT Date .... . f:.e.�,. ......1................. ., ..... 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. I 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, housin code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary infections. ' (Signature of applicant, or n e, if a corps anon) A ..... .4........ (Address of appl' an State whether applicant is owner, lessee,,agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................................��...!.. ...,.r.U....0... ......................................... ...................................................... Name of owner of premises ...... � .Y: ?.�: ... : . .... ..... ! `;.v C.... .`� 1.e..�.......................: If Opp is nt is corporate, ig ture of duly authorized officer. (Name and title corporate officer F Builder's License No. .................................................... Plumber's License No. .......i......................................... Electrician's License No. .....l.l ��.:4�. ::. .�.�.�.. OtherTrade's License No. .............................................. c 1. Location of land on which proposed work will be done Map`No .. .......... .. `. Lot�No. ...... ............. Street and Number .....1�-.... ... 1......... ..... � `C�:r. ...rJ ..............................� �:.�.:�.�? .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................... ........................................................................... b. Intended use and occupancy ..... . G'" ... .:...................................................................... r 3. Nature of work (check which applicable): New Building. .................. Addition .................. Aiterdtian ...............,.. Repair .................. Removal .................. Demolition.........:.......... Other Work ................................................ .... _ c/tp (Description) ......$.2.5,4. Estimated Cost 09.0 QQ.a.. ...............................Fee � . .................................. ..........:.............................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......ORf................Number of dwelling units on each floor ............................ Ifgarage, number of cars ........one.............................................................................................................................. 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories ................................ 8.1 Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..� ................ ............................................................................................. 9. Size of lot: Front ............c �`�. -� Rear .......:�............................... Depth ...VA.0.................. 10. Date of Purchase ............!.974...................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................res I dent i a .. ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..............N.o.e................................... 13. Will lot be regraded .....Y.P.S................. Will excess fill be removed from premises: ( ) Yes (X ) No 14. Name of Owner of premises .......Lau rle...Propert i es.._, Address ...Ma.st.'.0............... Phone No. 281.-5454 .. Name of Architect .............................................................. Address ................................ .Phone No. ...................... Noriie of Contractor .....Frank...Bq.rn Address ;aQ.Vtb.Q..Ld............ Phone No. ..7.65-3.4.4.6. 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. r d STATE OF NEW YORIsz.e_ ZPD COUNi Y OF .SI B."..(...'..... .... ...........:.......:..OF .._ ... . .:�........ :,�................. ..........being duly sworn, deposes and says that he is the applicant (Name of individual signing contract') above named. Heis the ........................... - .............................................................................................................................. ontractor, 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 than the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 3 .... of .................. 197.G... Notary Pub. �.. .... ..... County ,r't^`�i .. .... . ................ ....4` rr....... (Signature of applicant) e statCROe ofu �Io1?,80-th � es MaC 3�,� f7 y Conussion 'r' - i, + s $ Y T .#•..' 1 T41 ?AT s.f., rneriy - , .d for erties , Inc. i Pow a -'4"'h �; ',t�"°°•�• 7L� F.�'Y, v'x�f_4 tc i s i v� prop LaurC0,504 Robe tw . 0 11 w no or r re Prapieties, ° --= • / . 5 ,S•3 r ✓Q r I X. t f N �l3 Ol-E p 50 E• Z �, r 'N.7 o 7 . sr ores =1,445 . �/.4.7 Q CP 450-00 'i e `�� •�`.1. 1' r•'-i t ' 7 f e� r t •l ll1 u,. .. _ - .' '-,- .. � i`• . „- � - 40 ' •• �� c/z a.a • $ 70�/3 50. 17 _ our1e 'grope - - 7 �erty Robert Cosnlo WEuS qN0 CE PO I v° C° ;;now or for AND SEW, V. DATA OBTA►NEp FRO EREONARE F 'TAN wAGE.DrS M,O rH6RS, .ROM FIELD /C� 7X� ; ; R�DER RpA D �S OF THE uSAL $YSTEAtS'F ; C [ !1' /�fin' QO�/V �+mod.r FFOLr( co THIS YRpE qRr$RESIpENCE. `_�+. O /V/'`Rr1 I, l L 'P. ,' ,3:r,. - rn,E„rr WILL O p ,� °FHEa�rH V.Y CTR�ET 'L ,r J -TEL NTY DEPARTM '�. . �• �� e• �O Nr'OF HEALTH'SERVICES VAj RFVrsrpNs OF CONSTRUCTINO -I- . ONLY - iit, ^ems HS John r�erly t for acon or J now < . . 0.1001 i O C former►t1es, Inc. �.0 3 Acres or proper 5 , now _l.00rjet Are o ' I Alt. pert Goso�o. Jocon t AGE t E .. R N . � � 55 N �lv o 20 THE LOCATION OF WELLS AND CESSPOOLS SHOWN HEREON ARE FROM FIELD OBSERVATIONS AND/OR FROM 04TA OBTAINED FROM OTHERS. THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS.OF THE-SUFFOLK COUNNTf DEPARTMENT.OFHEALTH SERVICESGi�.L;. _C. )>�4 AFFI-iCANT —,r/1 _ _ l i'DRESs i/ ' Lit o>.�t� �1.. � _ - -'%_- `+ —S�J TEST HOLE' 0.0 l-`— -- SOIL 0.8 LOAM SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES 4 SAND 8 SRAVFL FOR APPROVAL OF CONSTRUCTION ONLY WATeR DATES 7 HS REF. NO. APPROVED' • 00 C-) d 240•1a y mac+ o former opert'es ' In or ��e �a� 0 now 1,o� n t ' Go501 ,v o c o Robert , vocor, ertjes , Inc ROAD Prop R wER I.o�rje IN a50 : R POW COS OR NA formerly R rPEET or 5 now KING. - NOTE { V--.MCINUMEW , WATER SERI//CE-pR/VATE waus NEAREST WATER MAIN =3 M/LCS + REVISIONS YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHE � oR ALDEN W. YOUNG Ow Y PROFESSIONAL ENGINEER AND LAND SURVEYOR, N.Y.S. LIC. NO, 12645 5 `u SURVEY FOR:UNAU z ,7 THIS SORI2E0 ALTERATION OR ADDITION TO LAURIE PROPERTIES THIS SURVEY IS A 41OLATION OF SECTION p :a.�_�_,•a.-�•.- O ,7209 OF. THE NEW YORK STATE EDUCATION LAW. � ,oF�s f L•e• t COPIES OF THIS SURVEY MAP NOT BEARING 8�pvry1 EIjr,i THE LAND SURVEYOR'S INKED SEAL OR `�•�� EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. AT GUARANTEED TO: OR/ENT GUARANTEES INDICATED HEREON S4ALL RUN ONLY TO THE PERSON FCR WHOM THE TOWN OF SOUTHOLD _ SURVEY IS"PREPARED,AND ON HIS BEHALF TO THE TITLE COMPAN•,GOVERNMENTAL AGENCY AND LENDING !NSTTUT:ON .LISTED BY HEREON,AND TO THE ASSIGNEES OF THE SUFFOLK CO., N.Y. LENDING INSTITUTION. GUARANTEES ARE �;. 40T TRANSGE.RABLE TO ADDITIONAL - SCALE: �� DATE: /� N NSTITL'TIONS OQ S:1REFpUENT CWNEH% -50 Qr/7. 1, 1976 6 -'/A7 A. DEPARTMENT OF HEALTH SERVICES : • . . MARCH S, 1979• DAVID HARRIS. M D., M.P.H. - COMMISSIONER Laurie Properties G c/o Frank Born RD1 Box 551 v _• Riverhead New York 11901 RE: 6 SO 69 w/side Orchard St. , 240'. n/o' Kiang Street, Orient'' Dear Sirs: A recent check of our files indicates that this office has never issued. a final approval for the above referenced job. Please, be advised- that it is illegal to occupy the building until the fol— lowing paperwork is submitted to this office and/or the following inspec- tion(s) are completed: Well Drillers Certificate Water Analysis : Cesspool Certification Final Surveys : Other • 17 S u d hav any questions, leas feel o contact this office. ho 1 you a q e please free t Very truly yours, n Cc: Town Building Department COUNT C.tNTKR •• • RIVIC01"K O,NKW VORK 11901 • ��1.1' 7:7•UOA COUNTY OF SUt=t-ULM DEPARTMENT OF HEALTH SERVICES DAVID HARRIS. M.D., M.P.H. March 5,.,1979 CO.M,MISSIONER • ru Laurie Properties ' RD ' .1 , Box 551 Riverhead, New York 11901 0 RE: 6 SO 67 w/s Orchard .St. , 590feet n%o Kirig Street Orient Dear sirs: A recent check of our files indicates that this office has. never issued .a final approval for the above referenced job. Please be advised that it is illegal to occupy the building until the fol- lowing paperwork is submitted to this office and/or the following inspec- tion(s) are completed: Well Drillers Certificate 12SJ'Water Analysis " Cesspool Certification Final Surveys 2�0ther We must. do an inspection of the final grade over 'your system. Rlease call us to do an inspection. Should you have an questions, lease feel free td contact this office. Y .� 4 � P . Very truly yours, Ca . a cc-: Town Building Department COUNTY CCNTKM • PIVIKAHCAO,NRW VONH 11901 • , (/141 7E7d700