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HomeMy WebLinkAbout1000-121.-4-12~OUND A Id..' LEE LAUR£L TO~//V OIr $OUTAtOL ~ /V. ~( su/~d,'v/Je4 HENRY lil. RAYNOR. ,Tr.. Chairman FREDERICK E. GORDON ~fAMES WALL BENNETT ORLOWSKI. Jr. GEORGE RITCHIE LATHAIVL ,lt. SLaY Southold, N.Y. 11971 July 11, 1980 TELEPHONE 765-1938 Ms. Abigail Wickham, Attorney Main Road Mattituck, New York 11952 Dear Ms. Wickham: The following action was taken by the Southold Town Planning Board at a regular meeting held June 30, 1980. RESOLVED to approve the lot line change on map amended June 20, 1980 of the minor subdivision of John W. Lee located at Laurel and authorize the chairman to sign the map. I enclose one copy of the map. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary HENRY E. RAYNOR, Jr., Chairman FREDERICK E. GORDON JAMES WALL BENNETT ORLOWSKI. Jr. GEORGE KITCHIE LATHAM, Jr. S Southold, N.Y. 11971 August 7, 1980 TELEPHONE ~65- 1938 Mr. Charles Grigonis, Chairman Zoning Board of Appeals Town Hall Southold, New York 11971 Dear Mr. Grigonis: The following action was taken by the Southold Town Planning Board at a regular meeting held June 30, 1980. Advice was given to Abigail Wickham, attorney for the applicant, that this~was the procedure to follow in this matter. RESOLVED to approve the lot line change on map amended June 20, 1980 of the minor subdivision of John W. Lee located at Laurel and authorize the chairman to sign the map. I have enclosed a copy of the map for your information. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOU~qOLD TOWN PLANNING BOARD Enclosure By Muriel Tolman, Secretary W{~LIAM WICKHAM ERIC J, BRESSLER ABIGAIL a. WICKHAM WICKHAM, WICKhAM & BRESSLER, MATTITUCK ~-ONG ISLAND June 23, 1980 Planning Board Town of Southold Main Road Southold, New York 11971 Gentlemen: Pursuant to your letter dated June 17, 1980, I enclose~ amended subdivision maps. Please return one map in the enclosed self-addresse~ stamped envelope after the Chairman has signed it. Thank you very much for your help in this matter. Very t~uly yours, Abigail A. Wickham AAW:mld encl. HENRY E. RAYNOR, Jr..Cbairman FREDERICK E. GORDON JAMES WALL BENNETT ORLOWSKI, Jr, GEORGE RITCHIE LATHAM, Jr. Southold, N.Y. 11971 D June 17, 1980 TELEPHONE 765- 1938 Abigail Wickham, Attorney Main Road Mattituck, New York 11952 Dear Ms. Wickham: The Planning Board sees no objection to the proposed amendment as outlined in your letter of June 6, 1980 regarding the change in lot line for the minor subdivision of Adeline Lee. Please submit map showing same for stamp of approval. Yours truly, HENRY E. RAYNOR, JR., CHAIRMAN SOUTHOLD TOWN PLANNING BOARD By Muriel Tolman, Secretary WICKHAM, WICKHAM & BRESSLER, MAIN ROAD, P.O. BOX I424 MATTITUCK LONG ISLAND NEW YORK II952 516-298-83~3 June 6, 1980 Planning Board Town of Southold Town Clerk's Office Main Road Southold, New York 11971 Re: Adeline Lee - Minor Subdivision Laurel Way Laurel, New York Gentlemen: Mrs. Lee would like to amend the Minor Subdivision by pivoting the boundary line between Lots 2 and 3 as shown on the attached survey, 12 feet to the east. The reasons for this change are as follows: 1. The encroachment of the driveway servicing Lot 2 would be eliminated. Although the cesspool for Lot 2 is shown to be some distance westerly from the boundary line, it is, in fact, located on or within a foot or two of the existing boundary line. Changing the boundary line will bring the cesspool well within the bounds of Lot 2. I would appreciate it if you would forward to me a letter con- senting to the amendment. I will be glad to furnish a new map con- taining all of your descriptive matter. Thank you very much for your consideration. Very truly yours, Abigail A. Wickham AAW:mld June 24, 1969 Air. John W. Lee 251-22 Hillside Avenue Bellroee, 0ueens, New York Dear The Planning Board has aplproved the lay out of your lots on N/S Laurel Lake, Matt~tuck, N.Y. as per your appl~cation dated May 14, 1969 and map dated May 13, 1969. The private road leading to this property will have to be hnproved by curt/rig back some of the overhanging l~mbs and brush, filling in holes and leveling the road to a minhaum width of 15 feet or as much more as the Board of Appeals may require to grant approval of access as required by Section 280 A of the To~n Law. Snoloeed please find the necessary application forms to apply for #approval of access" as required by Section 280 A of the To~n Law. There ia a fee of ~20. due to the Planning Board and a fee to the Board of Appeals with the access appl~cation. Please forward another print of your map so the Planning Board can endorse it for your records. Yours truly, John ~ickham, Chairman Southold Town Planning Board APPLICATION FOR APPROVAL OF PLAT To the Planning Board of the Town of Southold: The undersigned applicant hereby applies for (tentative) (final) approval of a subdivision plat in accordance with Article 16 of the To~vn Law and the Rules and Regulations of tbe Southold Town Planning Board, and represents and states as follows: 1. The applicant is the owner of record of the land under application. (lf the applicant is not the owner of record of the land under application, the applicant shall state his interest in said land under application.) 2. The name of the subdivision is to be ....... .~'..~..,%,..O. ..................................... 3. The entire land under application is described in Schedule "A" hereto annexed. (Copy of deed suggested.) 4. Tbe land is held by the applicant under deeds recorded in Suffolk County Clerk's office as follows: Liber .... 6...~Q:'....~..3. ........ Page ..... 1~../..7. ........... On . .~..~. ?.'..2:....~. ,..I. 7..~. ?.; Liber ........................ Page ....................... On ....................... ; Liber ........................ Page ....................... On ....................... ; Liber ........................ Page ....................... On ....................... ; Liher ........................ Page ....................... On ....................... ; as devised under the Last Will and Testament of ....................................... or as distributee ....................................................................... 5. The area of the land is ..... ~ ............ acres. 6. All taxes ~vhich are liens on the land at the date hereof have been paid except . ..A40 ....... 7. The land is encumbered by ....... ./~...0. ................................................. mortgage (s) as follows: (a) Mortgage recorded in Liber .............. Page ................ in original amount of $ ................ unpaid amount $ .................. held by ......................... ........................... address ..................................................... (b) Mortgage recorded in Liber .............. Page ................ in original amount of ................ unpaid amount $ .................. held by ......................... ........................... address ..................................................... 706~'~"67'15]M T]]~, TIlLE GUAR~ Policy No. ~--5~9~ SCHEDULE A The premises in which the insured has the esf6te or interest covered by this policy ALL t,~at lot or parcel of land, with the builder theresa erected, situate i~ Laurel, T~m of Southold, Huffolk County and State of New YorK, bounded and described aa follower BKGII~'~fQ at a point formed by tho lnterfection of the o~Atherly line of a pri~ate roadway kAown as Laurel Way and the easterly line of lands of Barbara Jazon~ekI ruflning TH~CE alor~ the aoutherl~ line of said private roadu~y the followinS four courses and distances to land now or Formerly of ~larenee N. Schinpf; 1. North 88 degrees ~8 uflnutes ~0 ascends hat 100 feetJ 2. South 7~ de,reef mloutea t.' sout~59_ degree. ~ Ltaute, ~ .stand, Bast seconds Bast ~0 feet, and feet.~ South ~degrees ~ minutes 30 seconds ht ~0 feetj ~ along lands now or formerly of Schimpf the followins two courses afld distances: 1. South ~ desrees 17 minutef 10 feconds West 228 feet, more or 2- South ~ degree8 17 minutes. 10 oeeo~-~f Weft 170 feet, ~ore or leaf, to Laurel Lake; ~e~CE northwesterly by a~d alor~ the shore of Laurel Lake to lands now or formerly of Barbara S8~ombek; TH~HC~ by and along said lands of Jazombek the following ~hree courses and distances: ~. 1.. North 2~.degreef ~12 minutes ~0 ae~ondf ~ 1~ feet, more or ~ Afar, r.O a st&ks, 2. North 1~ de,reef 1~ minutes 20 seconds Bast ~6.~ feet to a fte~e; 3- North 15 degrees ~6 8~nutef ~0 seconds ~est 2A~.~2 feet to the ~ leant or place of ~X~. ~ TOGETHER with an easement and right of wa~ over the private r~ad bounding 8aid property c~ the north 25 feet in width as the same win~s and turns 8~_uthea~terly &md northeasterly through the land of Conkling to the land _ · or other o~ners, and thence northerly over the extensions thereof, 20 g~ feet in width to the public ~l~eay km~en aa Sound Avenue. (c) Mortgage recorded in Liber .............. Page ................ in original amount of $ .............. unpaid amount $ .................. held by ......................... ........................... address ..................................................... 8. There are no other encumbrances or liens against the land except .... ~...0..~..e2 ............. 9. The land lies in the follo~ving zoning use districts ........................................ 10. No part of the land lies under water whether tide water, stream, pond ~vater or otherwise, ex- cept ......... .~'...0. ..................................................................... 11. The applicant shall at his expense install all required public improvements. 12. The land ~ (does not) lie in a Water District or Water Supply District. Name of Dis- trict, if within a District, is .............................................................. 13. Water mains will be laid by ............................................................. and (a) (no) charge will be made for installing said mains. 14. Electric lines and standards will be installed by ....... ~....~'...~...~..~T.. ..................... ..................................... and (a) (no) charge will be made for installing said lines. 15. Gas mains will be installed by ........ ~ ?. .............................................. and (a) (no) charge will be made for installing said mains. 16. If streets shown on the plat are claimed by the applicant to be existing public streets in the Suffolk County Highway system, annex Schedule "B" hereto, to show same. 17. If streets shown on the plat are clalmed by the applicant to be existing public streets in the Town of Southold Highway system, annex Schedule "C" hereto to show same. 18. There are no existing buildings or structures on the land which are not located and shown on the plat. 19. Where the plat shows proposed streets which are extensions of streets on adjoining sub- division xnaps heretofore filed, there are no reserve strips at the end of the streets on said existing maps at their conjunctions with the proposed streets. 20. In the course of these proceedings, the applicant ~vilI offer proof of title as required by Sec. 335 of the Real Property Law. 21. Submit a copy of proposed deed for lots showing all restrictions, covenants, etc. Annex Schedule "D". 22. The applicant estimates that the cost of grading and required public improvements will be $..~.....'~... as itemized in Schedule "E" hereto annexed and requests that the maturity of the Performance Bond be fixed at.. ~ .... years. The Performance Bond will be written by a licensed surety company unless otherwise shown on Schedule "F". (Name of Applicant) By ...................... k an~ ~' ~ ............. (Sign~ature · .. (Address) ~C~ ~o3e ~, h/. STATE OF NEW YORK, COUNTY OF ....(¢...¢'.c.-?:.,f.) ................ , ss: On the...{..~. ......... day of .... .~. ~.Y ................ 19..~..~., before me personally came .... . ."~....0...~...~....~...:....~.. 77.¢ ............ to me known to be the individual described in and who executed the foregoing instrument, and acknowledged that .... .t-J.q'.... executed the same. Notary Public " ~'; ' v',~... STATE OF NEW YORK, COUNTY OF ................................ ss: On the .................. day ............ of .............. , 19 ....... before me personally came .............................................. to me known, who being by me duly sworn did de- pose and say that resides at No. ................................................ that .......................... is the .......... the corporation described in and which executed the foregoing instrument;that .............. knows the seal of said corporation; that the seal affixed by order of the board of directors of said corporation. and that .............. signed .............. name thereto by like order. Notary Public Jolm #. Lee 251-22 ll:Llls~de Avenue Bellzose, Queens, Bev York 1Lnce wzLt~g you ~e, way, ye hi~ z~n~ly ze~Lved g~u ~e noz~z~y nd m~r~y o~ of ~e ~e. we ere now ~n · better lx~it~on to coueider your &pp~J~atJ~m to ~v~ ~uz lot ~ o~. ut~l such t~ t~ ~ ac~ee z~d nd ~ lute z~t- of~ ~ ~ilt. Should you wt~h ~o pursue thJ~s matter, the Planning Board Met ~aAn bi ~t c~n~ent ~o wh~ ~ a~tted prev~el~, ~ted ~e~ 4, 1~7. by ~to · hould you have any further Changes in mind please b~4ng & map ~ho~.j them ~hen you come ~o the meeting. ~-Bo~rd of Apponls John w~c~hmu, Chairman Iouthold bn Planning Board June 4, 1968 M~. John w. Lee 251-22 Hillside Avenue Bellrose, Queen~ New York Dear Sir~ Since your visit to the Planning Board about the division of your lot on the north side of Laurel Lake, Laurel, Ne~ York, we have received a map from the New York State Department of Transportation showing the Long ~sland Expressway coming through your area. We are returning the check which you sent for three building permits aa we have to revise plans for access to this entire area in order to accomodate this new road. we will contact you on this matter as soon as we have further information on the State Plans. Yours truly, John Wickham, Chairman Southold Town Planning Board POP,~ ~0. g TOWN OF SOUI'HOLD BUll, DING DEPARTMENT TOWN CLERK'S OFFICE SOUI'HOLD, N. Y. NOTICE OF DISAPPROVAL File No .................................................................. Date ................................ ~.::!:~.u.~: F ~......~ ....... 19....(;? PLEASE TAKE NOTICE that your applicationSdated ........................ :.~..c...~ ........ <.~.... 19.~.~... for permit to construct ....................................... ze[~-~c premises located at ..:...I..~y.., ..k.~.:... ~..o...~.q.. Map xx ......... ~lock xx .... Lot Xx is -r~m, rm~,, ......... (,h~etxj~,w_.i,~t~,,~cu?~,_~ disapproved on the followinF grounds ............... ':..~,:.*.~.~...~.~:..*.k.:. ~, : , :. ,~ ~x FO~M NO. ! '['OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , 19 ........ Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT \ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 issuence 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 progress of 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. ............... .................................................... (Sign~lture of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................................................................................................................................. Name of owner of premises .~.....O. ~ .4d.. ..~'..: ~..~..~ .............................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number ...... J~.J~..I/...~..E..L......1~'....~...~. ................................... Z~....~...'~...~...~..~'....~...c...~. ...................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~ ..~ C .,~ N~.. / ~ ~ ~ b. Intended use and occupancy J ..~....~..~.../i .~.~.. .~....o...~'..~ .................... 3. Nature of work (check which u~plicaNe): New Building .... ~ .......... Aoumon .......... Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ...~.....~....O....o....~.. ................................... Fee ..........~/...J.R ....................................................... (to be paid on filing this application) 5. I[ dwelling, number of dwelling units ....... ~.'..z~...~.~. ........... 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 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 ........ ~.,~ .......... Depth Height ..... ~.~. .........Number of Stories ......... ~ 9, Size of lot: Front ..... ~..~..~ ............. Rear ........ .~.~. ................... Depth ....... ~.~ 10. Date of Purchase ........ .~.~.~.,..~.~.....(..~-~Z .............. Nome 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. Name of Owner of premises .~/V~..~:.~.~z.~.....Address Name of Architect .f..~.g.m...ff..9..~.~.~..[J~.~. ......... Address ~.t...~.~.~L.f.~...~c;~_YJ.~ Phone Name of Contractor ..... .~.~X~.~....~.:...fi.~.~ ........... Address ~.~.lm.A.~.fl~f.~.~l~...,~,Phone No.~.!'_Z.R,~YC . 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 STATE OF NEW YORK, ,: ,, ~ c c ~' COUNTY OF ......... ~. ~..~.. ~ .~...,,).... ,( a.o. '"ID/, ~) ~-]-,... I~. ~.' be na duly sworn, deooses and says that he is the apa[ic,za (Name of individual~jgning application above named. He'~s the ..... 0~.~...~...Z..~-.....:' ~ ' (Contractor, agent, corporate officer, of said owner or owners, and is duly authorized to perform or have performed the said work and b: make ,mzl this applicatioJ~; that all statements contained i~ this application ore true to the best of his kn'.,w!edge c~n(] b,,liaf that the work will be performed in the manr~r set forth in the application filed therewith. Sworn to before me this .........'~..~....~ ......... daYlj, ~ ~, ~J[.A~ZT1 ~of ......... .0.. ~.....k,. .................. , ] 9....~. ~) --' ..~. _... ,:...~...:...~,~. ~? ...... . ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , 19 ........ Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote ~....~..~.~'.~...~.....~....~. ........ .~.~:~ ., 19.......~.... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 progress of 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 o 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, ora nances buffd~ng code, housing code, and regulations. ............ ..................................................... (~i~nature of applicant, or name, if a corporation) 7. 1- (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... .................................................... Name of owner of premises ...... ..O~...?...~..../~..........W..:...~.~. ........................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number ~ ..~.. ~/1' ~/,~ ..1~.~ ~ ~ ~:~ ~' ~/' j '/' U ~. t~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ............ I ....... ..~.../~...~..I]..L....~.......~/..~..~. ~f..¢~ ................................. 3. Noture of work (check which applicable): New BuiJding .,...V.. ........... Adaffion ........... A~teration Repair ................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ~' /,Z0Oo Fee ..... .~..../...0. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ..O.....4(...L'E.~ ....... Number of dwelling units on each floor ,.O~r.~-.~ ..... If garage, number of cars O,vLr 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 .................................... Rear ......................... Depth ...~'..~ ........ 8. Dimensions of entire new construction: Front "/' ~ Height ...... .~...q ........ Number of Stories 9. Size of lot: Front .......... ~.../..o..¢).... Rear .... ~. ~.~ Depth ..... ~...-.Z....~.X~- 10. Dote of Purchase 1/'O V '~. /~ kl,~m~ of Former Owner ,~/v ~Z:~/.,~' ~vZ~: 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? 13, Name of Owner of premises .,~..o.!~..A,(.....?(~,..,~:~i~ ........ Address ..Z..E../..'...z.~.-./.tJ.i.~.~,~./.~.~:....~..~Ph(~n~e~No. Name of Architect ~ ~ /~ 0 ,~,x/ ~-tt/~ Acdress .~ ~: .>.C.~. ~. ~ ..~..~ .~..,fl.'.~.~ Phone Name of Contractor ._.~'...o/'/~,/ ~ ~ ~. ~ Address ~.Ir.V,,~, .l:t.i..L:..~z..)..L./t.~...4..v~- Phone No. F~.L..~..q.~.~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~ting or proposed, and indicate oil set-back dimensions fiorn property lines. Give street and block number or description according to deed. and show street names and iodicote whether interior or corner lot. SmAm OF NEW S COUNTY OF ...... ..~.~ ~.~..T..! ....... ~ ..................................... being duly sworn, deposes ond (N~me of individual si~ning ~pplicq~iom obove n~med, He is the ......... ~...~..~.~..~.~..~~ (Controctor, ogent, corporci~ of s~id owner or owners, ~nd is duly ~uthorized to Derfor,m or h~ve performed the s~id work this applico~ion; that all statements cont~iqed in this ~pp~icat~on ~re true to the best of that the work will be performed in the manner set forth m the application filed therewith. Sworn to before me this ........ E.] .......... of ......................... , FORM NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , ]9 ........ Approved ........................................ , ]9 ........ Permit No ............................. Disppproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..~..~..C..~....~.....,1~.....~...~.. ........ ~.....~. .......... , 19...~ .~.... INSTRUCTIONS o. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving o detailed description of layout of property must be drown 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 o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until o 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 ali applicable laws, ordinances, building code, housing code, and regulations. ............ ..................................................... (S'~ature of applicant or name, if o corporation) Z,¢'l ~ z ¥4..../.f. ...... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... ............................................................................................................................... Name of owner of premises ............ ...O~.....O....H..../~.........l~/.......~...~....~.. ............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number .......... ~..~..~..~.~...~. ......... ..~'...~..~'.. ................................... /~....~...7.....T...i...~.....~...c.,/~. ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... ..V'...~....~....~.~ ...... .C....~..../~....~. ................................................................................ b. Intended use and occupancy .......... ! ......... ~...4~.¢~..~..~..~.. ....... ~..?..?..~..~.. ................................................................ 3. Nature of work (check which applicable): New Building ........ }~ .......Ade.rion ........... Alterction Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost ....~...~..O..~.~ ....................................... Fee ............... /~..../.?. (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 ........................ -9. cV...-~. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use _~'....0. 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 ....... .~._..O, ...................... Rear .....~.,.O. .................. Depth ....~.,¢~ Height ...~.?.. .......... Number of Stories ......... 9. Size of lot: Front ........... .l...0....O. ........ Rear ...........~.~. .................Depth ..... .~..?..~ 10. Dote of Purchase .......... ../~....°...~.....z...~....../..~.J'.Z ............. Nome of Former Owner ...... ~..4~....~....~..~./~.~'.~..-~.~.~..~.,'~.fi 11. Zone or use district in which premises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation? 13. Name of Owner of premises ....O~..~.l~hZ.....~.'..fi~,~ ........ Address .2..~'./.;..z..~,..~.~..~i~,~.~'.R~....~..~..~.. ~ ~ ~ Phone No ................ Name of Architect ..C..~.~ .~.......((.?J..¢.rX.Y...~..~..~ ........... Address ~'.~.~,..*r.~,~./].h/.~...~.'L~fl.;~YPhon~e~ Name of Contractor ......~..?.../'/...~.-.....~.......,~,.~-c. .............. Address~..~./..-..z.~.../~.'~./~.Z.,~..~....~.K~'... 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 tot. STATE OF NEW Y,~I~.~:, ~- c c COU T F ~ vc'~r ~,~ f .... ..................... ~.~.~ ................... .~..~ ............................ bmng duly' sworn, deposes and say_, thc~ '.~: is apph~:~ (Name of individual signing application) above named. He is the ......................................................... ~...~.!.~...O..~..M (Contractor, aaent,~ co~pore~e oJ~icer[ e~,',~ of said owner or owners, and is duly authorized to perform or have performed the said work an<l ie m::J~zc ~:rd [~ _ this appJicatio~; t~qflf all stotemen?s containea in this ap~Jicotion are true to ~he best of ,~ ,~n~vle,.g~ and !;~(~{:: that the work will be performed in the manner set 'forth inThe application filed therewith. Sworn to before me this ....... ......... of ..... Notary Public, .~~.~..~ ......... C~ ~t~'''''~':'' {''' ' ."~J;~'~ '~[~,'~'~'",~ ~:~f~ ~ FOILM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................................ , 19 ........ Approved ........................................ , 19 ........ Permit No ............................. Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ..... ~....~.....C?...~.~.../~..,~...~..%..,.. ,~,.. ,~.. ........... 19.~.7. .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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. ( 'gtre of applicant, or name, if a corporation) ........ .............. (Address of a~ppl~icant) .~ ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........ .................................................................................................. Name of owner of premises ...... .~.~....O....L4...~.. ....... ....~...:......~.....~.~.....~.. ................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No.: ........................ Street and Number ...... ~.~./~.L/...~...~....~ ...... ..~..?...~. ........................ .../~.....~...~..~'..C..'~'....~..~....~. ........................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use and occupancy ......... ..V~....~....~....~...n~....'C... ...... ..~....~...4,~....0. ........................................................................... b. Intended use and occupancy .......... ./......~....~.....~.../....q..~......l..'[...°..?...~..~. .................................................................... 3. Nature of work (check which applicable): New Building ......V:¢~..i ....... Ada.don ...... Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) 4. Estimated Cost _..~.....~. ............................................... 0hQ ~-ee- ..~./.?,.~;~.: (to be paid on filing this application) 5. [f dwelling, number of dwelling units ...... ~....~..~ .......... Number of dwelling units on each float If garage, number of cars ........ O.....~....~. 6. If business, commercial or mixed occupancy, specify nature and extent of each type o~ use ..M._O.~ 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 .....~...0. ................ Depth Height ....~....0.. ........ Number of Stories 9. Size of lot: Front ........ .c1.~'7. ............. Rear .........-,q....~.~ .................. Depth -.,~2~..<?..(~ ............ 10. Date of Purchase ..... .~'..D. ...... .Z-. ....... t...../..1.~..;I ............ 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, Name of Owner of premises ..~.0..~...~Z....~.',..~.~.~i...Address ..'~-.....~..,(..':,~..lm/...~/?.J.~..~.).!.~r:.~ ~Phone Name of Architect .~.....*.0...~.~,~'~/..¢)..~ .................. Address '~D..J.,.~...(/.~,.~..~6,.Jf,{f.~'!..%. 'Phone Name of Contractor ...'~...~...H...,'~....~kC....~..~.~ ...... Address .~....~..~..-..%...,~...~J.!....~,).Mx..4..:. Phone PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and iadicale all set-back dimensions property lines. Give street and block number or descriation according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW,,YOR~ COUNTY OF ...I~.~,..t~.....~.:.~...? ........ ~ S S ..................... ~.~...~.~...~:....~.~..C ............................. being du y sworn, det~oses and s~ys thet h (Name of individual signing above named. He is the ............. ~.~.(..~..q.~.~ (Contractor, agent, corporate officer, etc , of said owner or owners, and is duly authorized to per,~orm or hove performed the s,~id v, ork this application; that oil s~ratements cor;tc~ined h~ this application ore true to the bec cf h~s kr~-w[ed0e that the work will be performed in the manner set forth in the applic~tio~q filed therewith. Sworn to before me this ..... ~.~ ............ day of ...~.~.~ ............................. , 19..(?, ~ ~ ~k Notary Public, ,.....~~~.~ ..... ~,our~l'. '[Lr~'qnc.~ ,,-, ~f