HomeMy WebLinkAbout33266-Z
FORM NO. 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No: Z-32586 Date: 09/10/07
THIS CERTIFIES that the building NEW DWELLING
Location of Property: 2160 NORTH
(HOUSE NO.)
County Tax Map No. 473889 Section 79
BAYVIEW RD EXT
(STREET)
Block 6
SOUTHOLD
(HAMLET)
Lot 3.8
Subdivision
Filed Map No.
Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated
JULY 23, 2007 pursuant to which
Building Permit No. 33266-Z
dated
JULY 23, 2007
was issued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is issued
is SINGLE FAMILY DWELLING WITH ATTACHED GARAGE AS APPLIED FOR.
The certificate is issued to HOWARD & OLLIE MANN
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL 14-S0-122 08/30/07
ELECTRICAL CERTIFICATE NO. 3040062 07/23/07
PLUMBERS CERTIFICATION DATED 07/24/07 ED NEYLAND
~ize1::!!::--
Rev. 1/81
~
Form No.6
TOWN OF SOUTHOLD
BUILDING DEP ARTMENT
TOWN HALL
765-1802
.
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
/t. Final survey of property with accurate location of all buildings, properiy lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form).
v.J. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 of 1 % lead.
5. Conunercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing bnildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre.existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied; the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00,
Swimming pool $25.00, Accessory burldmg $25.00, Additions to accessory building $25.00, Businesses $50.00.
? (2) Celiificate of Occupancy on Pre.existing Building - $100.00
3. Copy of Certificate of Occupancy. $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Conunercial $15.00
Date.
~2~20()7
/
Old or Pre-existing Building:
tit IV~
(check one)
New Construction:
LocatiOllofProperty: 2/tb~ Ji! !?AYV);:W RnEx r.
House 2 Street
Owner or Owners of Property: ~jT, ,...tJJ~~J/J. /J14/l/J
..5tJl)TIJ~
Hamlet
Suffolk County Tax Map No 1000, Section
'79
Block
C:,
Lot .1_ 8
Subdivision Filed Map. Lot:
Pennit No. / B 1)50!332~(' Date OfPe:"'?/2t.;J2a:l7 Applicant t}JJ/~ M.Iv?t?/l/l
Health Dep!. Approval Underwriters Approval: 1ii'11I3tJ40tJ162 -4ptj/illozid
PImming Board Approval
Request for:
Temporary Certificate
Final Certificate:
/
(check one)
Fee Stlbmitted $.25. f)(J.
~.1?6c?-1
ClY ~3J5fC
O/h~./)n~
Applicant S . gnature
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
It'
."
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
33266 Z
Date JULY
23, 2007
permission is hereby granted to:
HOWARD & OLLIE MANN
2160 BAYVIEW RD EXT
SOUTHOLD,NY 11971
>for :
CONSTRUCT A ONE FAMILY DWELLING AS APPLIED FOR. THIS PERMIT
REPLACES BP 18550.
at premises located at
2160 NORTH BAYVIEW RD EXT
SOUTHOLD,
County Tax Map No. 473889 Section 079
Block 0006
Lot No. 003.008
pursuant to application dated JULY 23, 2007 and approved by the
Building Inspector to expire on JANUARY 23,
z:~.
'"\., '
'\
\
,///
Fee $
1,135.20
~...
/
ORIGINAL
Rev. 5/8/02
l!I.l!I
~ BY THIS CERTIFICATE OF COMPLIANCE THE 71, - ,,- 3,8' ~
I .N!:W YORK BOARD OF FIRE UNDERWRITERS I
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ LANCE LARSEN OLLIE M. MANN ~
~ 2160 N. BAYVIEW RD. EXT. 2160 N. BAYVIEW RD. EXT ~
i SOUTHOLD, NY 11971 SOUTHOLD, NY 11971 i
~ Located at 2160 N. BAYVIEW RD. EXT SOUTHOLD, NY 11971 ~
I Application Number: 3040062 Certificate Number: 3040062 I
I Section: Block: Lot: hBUildingh pe3t3 :21"?> I BDC: nS1.1 f I
@.! Descnbed as a occupancy, w ereln t e premises e ectnca system consisting 0 @.!
i electrical devices and wiring, described below, located in/on the premises at: i
~ Basement, First Floor, Second Floor, whole house, Attached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of July, 2007. ~
~ Name OTY Rate Rating Circuit illll< ~
~ Miscellaneous ~
~ as built 1986 ~
~ Alarm and Emergency Equipment ~
F.!I Transfer Switch 1 0 100a F.!I
~ Appliances and Accessories ~
lID Electric Heater Baseboard 2 0 1.0 KW lID
~ Electric Heater Baseboard 2 0.5 KW ~
~ Exhaust Fan 2 0 F.H.P. ~
~ Pump Motor I 0 3/4 F.H.P. ~
~ Dish Washer I 0 1.2 KW ~
~ Water Heater I 0 4.5 KW ~
~ Electric Heater Unit I 0.5 K W ~
@.! Range I 0 50 Amps F.!I
~ Wiring and Devices ~
~ Outlet 30 0 Fixture ~
~ Fixture 23 0 Incandescent ~
~ Fixture 7 0 Flourescent seal F.!I
~ Outlet 104 0 General Purpose ~
~ Continued on Next Page I of 2 ~
~ ~
I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I
l!I.l!I
I!I~~I!I
I BY THIS CERTIFICATE OF COMPLIANCE THE I
~ .' NEW YORK BOARD OF FIRE UNDERWRITERS ~
~ BUREAU OF ELECTRICITY ~
~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~
~ CERTIFIES THAT ~
~ ~
~ Upon the application of upon premises owned by ~
~ ~
~ LANCE LARSEN OLLIE M. MANN ~
~ 2160 N. BAYVIEW RD. EXT. 2160 N. BAYVIEW RD. EXT. ~
~ SOUTHOLD, NY 11971 SOUTHOLD, NY 11971 ~
I Located at 2160 N. BAYVIEW RD. EXT. SOUTHOLD, NY 11971 I
~ Application Number: 3040062 Certificate Number: 3040062 ~
I Section: Block: Lot: Building Permit: BDC: ns11 I
~ Described as a occupancy. wherein the premises electrical system consisting of ~
~ electrical devices and wiring, described below, located in/on the premises at: ~
~ Basement, First Floor, Second Floor, whole house, Attached Garage, Outside, ~
~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~
~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~
~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~
~ authority having jurisdiction, and found to be in compliance therewith on the 23rd Day of July,2007. I
F.!l Name OTY Rate Rating Circuit ~ F.!l
~ Receptacle 71 0 General Purpose ~
~ Switch 40 0 General Purpose ~
~ Paddle Fan 2 0 ~
~ Receptacle I 0 20a Laundry ~
~ Receptacle 1 0 30a Dryer ~
~ Lighting track 220ft ~
~ Multi Outlet System 120ft ~
~ GFCI Circuit Breaker 6 0 20a GFCI ~
~ Service ~
~ 1 Phase 3 W Service Rating 300 Amperes ~
~ Service Disconnect: 2 150 cb ~
~ An as built inspection, ofthe delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to mJ
~ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. ~
~ ~
I seal ~
~ ~
I 2 of 2 ~
~ ~
; This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. ;
I!I~-I!I
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971.0959
Fax (631) 765.9502
Telephone (631) 765.1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
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CERTIFICATION
Date: 7/.>L 0/'0 'r .
.
Building Permit No. 1-&55(9/3326C:>
Owner: )/tJwtJrdr.~tJ/)//,)1 N/J/Jn
(Please print)
Plumber: ED M-y4. ~dJ h'of E C::::;?-/
(Please print) .
lead.
I certify that the solder used in the water supply system contains less than 2/1 0 of 1%
sr
Sworn to before me this 31
~
daYOf~.__, 20J:f-
-~~
ARLENE CURLEY
lic. #60112J8
Hotal)' Public, State of New ~
Qualified in Suffolk ~un~
My CommIssIon Expires _ _~ [)
Notary Public, .!:l~ County
33J-~ ~ z...
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
] FOUNDATION 1 ST
] FOUNDATION 2ND
] FRAMING I STRAPPING
] FIREPLACE & CHIMNEY
] RRE RESISTANT CONSTRUCTION
[ ] ROUGH PLBG.
[ ] INSULATION
t><l FINAL Ii,'
[ ] FIRE SAFETY INSPECTION
[ ] FIRE RESISTANT PENETRAnON
REMARKS:
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(}L,JbJ1V;,;t~ i)
DATE ?~J--07 INSPECTOR ~~
~
<3 ~~ l,
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
] FOUNDATION 1 ST [ ] ROUGH PLBG.
] FOUNDATION 2ND [ ] INS ION
] FRAMING I STRAPPING [ FINAL
] FIREPLACE & CHIMNEY [] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
REMARKS: hh<5<1f ~~ < (0
ft:Tl/If7.->t':;, c;,p~~ t.&}W~~/r:>,
I
DATE
INSPECTOR
Tf~
765.1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ J FOUNDATION 2ND ~ULATION
[ ] FRAMING
[ ] FINAL
REMARKS: ~ 8.L-
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DATE .3 I 1'0
I NSPECTO
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765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [~OUGH PLBG.
[ J FOUNDATION 2ND [ ] INSULATION
[ L-(FRAMING [ ] FINAL
REMARKS: @ k.uJ ~AAAV~ ~~
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DATE 12-/10/ <;? r
INSPECTOR LJ ~(;)/~
'lELD INSPECTION
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DATE
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'OUNDITION (1st)
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'OUNDATION (2nd)
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:OUGH FRAME &
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PLUMBING
3.
INSULATION PER N. Y.
STATE ENERGY
CODE
tl.
FINAL
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Town Hall, 53095 Main Road
P.O. Box 1179
Southold. New York 11971-0959
/'
Fax (631) 765-9502
Telephone (631) 765-1802
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
July 18th, 2007
Lance Larsen
2160 N. Bayview Road Ex!.
Southo1d, NY 11971
RE: 2160 N. Bayview Rd. (New dwelling)
SCTM # 79 6 3 8
Dear Mr. Larsen,
Please be advised that your Building Permit # 18550 issued September 29th, 1989 has
expired. According to the Code of the Town of Southo1d, a Certificate of Occupancy
must be issued prior to use of the structure.
To renew your Building Permit, please submit a fee of $1135.20; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions, please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
PLEASE NOTE: Road needs to be completed to the requirements ofthe Planning
Board's site plan.
.
FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-180~
Examined D~. .~. .., 19~~
Approved a~. :i!. . ., 19~( Permit NO.~. u:::J
Disapprov~d alc ......... .'t~a;(..iw ~r..~ ~,rr
...~......../5#,47...............D ~
.U.~~~...........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
i....~.. .r.....I.~~r~} CG.3TfXi I:~B-L~~j,f..'I"l:~~.
" . ----'-----"11
I I; !.~
:'1\(\ SEP I 31985 II \ i
IU\11 I L-
t . BLDG. DEPT.
TOWN OF SOUTHOLO
Received. . . . . . . . .. . .19. ..
~
13,~ of ~~
3;ruL - I~
fk~~~
Date~r:-. ):3........, 19f?:F
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
,ts 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
r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
ltion.
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
lall 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
lall 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
uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
egulations, for the construction of buildings, additions or alterations, or Jor removal or demolition, as herein described.
he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
lmit authorized inspectors on premises and in building for necessary...}ns~9ctions. < _. ./,).
. .~.{t::;{:;;;t;12t: ~/t:=;i~:;;;;)' . . .
/ 1!1I~P(u: /!r:. . 1..0. ~ . . .~f!"p!qt;l!. . NY. . F1.7!. .
(Mailing address of applicant)
tate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . . . . . .0. 7u: ':-! .r::-:~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ameofownerofpremises . !-fi{!<.//l;t<. 0. . .r... .9-:-... .9.~qs... .N.l.,.. .0.0 Nt!. ....................
(as on the tax roll or latest deed)
. applicant is a corporation, signature of duly authorized officer.
.......................... ,- .................
(Name and title of corporate officer)
Builder's License No. ...... \? . . . . . . . . . . . . . . . . .
Plumber's License No. ........................
Electrician's License No. ......................
Other Trade's License No. .....................
Location of land on which proposed work will be done. .................................................
;211,0 M"I2711 Rb TV !3/1'/VIGuJ 5o<---n-tt:lu::J
...................... '. ............................................. .......... ..............
House Number Street Hamlet
County Tax Map No. 1000 Section. . .1?1.'1. ~q. . .. . .. Block... Qi?~I? .. . . . . .. Lot.~. 9. .. )!l. P.~.. .. ..
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot. . . . . . . . . . . . . . .
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy . . . . . . . v.~ A ~ ~. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
- I
bIt d d SI"'GU; P;.rVl1\ICY DLVG:'L/...,IN(;,"':, .,'
. n en e use and occupancy ............................................ ... . . . . . . . . . . . . . . . . . . .. . .
I
1.
.
9.
10.
II.
12.
13.
14.
(~ ~~.. v
3. Nature of work (check which applicable): New Building ..... . . . . . Addition... . . . . . .. Alteration .........
Repair ....... 1" I . "",' Removal. . . . . , . . . . . . .. Demolition .............. Other Work, . , . . , . . . . . . , .
,,~\\:l " , (I], (Description)
4. Estimated Cost. .. f?!!?... .c? ~ .C?.. .. . . , . .. . .. ... .. .. . Fee. . .. . .. . . . , . ...... .............. .. , . ,
.... (to be paid on filing this application)
(
5. If dwelling, number of dwelling units. . . ~>;J:9': . . . . .. Number of dwelling units on each floor. . . . . . . . . . . . . . .
If garage, number of cars ..,....q t;-{~ . . . . . . . . . . . , . . . . . . . . . . . . , . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . , . . .
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 D. . ft' t t' F t6L1 f'; R /,/1 J" D th.5"2'/".<c"
. ImenSlons 0 en Ife new cons ruc JOn: ron .. T.. .. . .. .. ... ear en .. .. . '.. .. .... ep .. .. .. 1-. .. . .. .
H . h ;Z0'10" N b fS .
elg t .,'............ urn er 0 tones................................,..........,........,.,
Sizeoflot: Front.. .1.-?.I.'.8'!. ~.,.,...... Rear. ,{'fr...~~.........,... Depth,. 7':.:?,3.".':'t.......,.,.
Date of Purchase ,/!11'!'(..~!..... ~ 1.8.<1: . . . , . . . . Name of Former Owner .r:~~<.. ~{~I;( . . . . . . . . . . . . . , . . .
Zone or use district in which premises are situated. . , . . . , . . . , . . . . . . , , . . . . . . . . . . , . . . , . . . . . . . , . . . . . . . , . .
Does proposed construction violate any zoning law, ordinance or regulation: ... (';9. . . . . . . . . . . . . . . . . . . . , . . :-f-
Will lot be regraded ..........,...,.......,...., Will excess fill be removed from premises: Yes (ffi
N I' 0 I' . 1-1 '1 ~ outa Af, HlA-.JN dd I lfAYVl1!<J Ao/ RC "'" Ph N 7/"'9 ~
ame 0 wner 0 premIses . '. '. . . . . . . , .'. . . . . . . . . A ress 5"U'71o("~4 .NY. /1R:1-/. . . one o. .S., Xl..,...
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 ail set-back dimensions from
property lines. Give street and block number or description according to deed, and show street nanles and indicate whether
interior or corner lot. .
r-
fM<-~t
STATE OF NEW YORK,
COUNTY OF . , . . . . . . . . . . . . . ,. S.S
"............ ,- -........... ......................
being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the, . . . . . , . . . . . . . . . . , . . . . . . , . , . . . . . , . , . , . . . , . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , , . .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have perfonned 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
............ .l~........ .day of.. ,~;..:<Ii"h<...., 19.f.r
Notary Public, ... .)4..&.~.. Y.. Pa...I!K....
NlJYM't IlElDlIl. DE WE
No.4==:t~
r.n. Ex_llircli 30, 1
county. .,0. / /l~ /~
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FORM NO.1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
r' ~ rC!D\IO@ ~
0= ~ ,
SEP I 31985
BLDG. DEPT.
TOWN OF SOUTIiOLD
ExaminedD~..~..., 19~~
Approved a~. ~..., 19~< Permit No. d~.~ ~.~. .
Received. . . .. . . . . . . ,19...
Disapproved a/c. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
,.................................................D cuL
.U.~~~...........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
~
13~ of ~
3~-f~
~~
Date~-r:-. J'?......., 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 inspections. /' ~ /-
..~~~~:~f=:~)....
/ ,!1(,,:~.',!r:.. !..o.~.. .:ft!V!1!c!t;Il.. ..o/Y.. F'l.7!..
(Mailing address of applicant) ?
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
. . . . . . . . . . . . . . . . . . .~. 7'! ':-!.~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Name of owner of premises .HQW Il:P.O. . r. .. .<:1:-. . ., 9L,l.,\1i'....~.,. . .'!:t.0Nt!. . . ... .. .. .... ... ...
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
.......... ............................. .......
(Name and title of corporate officer)
Builder's License No. ...... \:>. . . . . . . . . . . . . . . . . .
Plumber's License No. ........................
Electrician's License No. ......................
Other Trade's License No. .....................
I. Location of land on which proposed work will be done. .............................................
.. ?Ib~....... .f-/.'~/?7!(...R I?... .T!?... .l?1,(Y(~u)............... .-?C;.'-: .-r:1~~.......
House Number Street Hamlet
fJ
County Tax Map No. 1000 Section .. .rn.1. P'Q. . . . . .. Block... qc".C!l? . . . . . . .. Lot.~. 9. . . )P. P.~
of
ap
Wo
Sw
Subdivision. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. .............. Lot.. . . . . . . .
(Name)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: \VOt;
a. Existing use and occupancy .. . . . . . V.~ A Y. .'\. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . .
b. Intended use and occupancy ..... ~!~9.L.S!... ~ ~,,!,:,.l.\- Y. ... .~!-1--.~.... .,. ..':....... ..'
//---
9.
10.
II.
12.
13.
14.
3. Nature of work (check which applicable): New Building . . . .V:: . . . . Addition. . . . . . . . .. Alteration ..........
Repair .. Ciltif e','ca2' Removal. . " . , . . . . .. .. Demolition .............. Other Work. . (D~~~ri~~i~~) . .
. 0 ~ ( Go D
4. Estunated Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 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 .......q ~Eii. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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 . . . . . . . . . . . . . . . . . . . . . . Num ber of Stories . . . . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front ~. 'I. . . . t .'~ . . . .. Rear W:. . ~ .": . . . . . . . Depth .~?:(d::'. . '. . . . .'
H'gh '20' /0" N b fSt'
el t ............... urn er 0 ones. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Size of lot: Front.. .1..fi/..t1.'l.:.......... Rear. .('ir...~+............. Depth .. ~-?,3...'?7:...........
Date of Purchase . .1!1t'!'1(. . ~!. . . . . (1.8.'1: . . . . . . . . Name of Former Owner .('!'!'.. F!<I;( . . . . . . . . . . . . . . . . . .
Zone or use district in which premises are situated. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Does proposed construction violate any zoning law, ordinance or regulation: ... ~9. . . . . . . . . . . . . . . . . . . . . . . >.(
Will lot be regraded ............................ Will excess fill be removed from premises: Yes <E9>
N f 0 f . u i. q. ()/.J,IG /If. AlANA! Add I IfAYvl4<J '"" 1U) dZ Ph N 7/Z- "''I
ameo wnero premises'"!:.................... ress 5DV"""",..,.NY./Ift:1./... one o...~.~ Y.7.......
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 comer lot.
r
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-~
STATE OF NEW YORK,
"'OLJNTY OF . . . . . . . . . . . . . . . .. S.S
(Name of individual signing contract)
.ove named.
.... ......... -............ ........... .....,. ..,.
being duly sworn, deposes and says that he is the applicant
) is the. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Contractor, agent, corporate officer, etc.)
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
jlication; that all statements contained in this application are true to the best of his knowledge and belief; and that the
"k will be performed in the manner set forth in the application filed therewith.
lffi to before me this
......... .f:?....... .dayof.. .~...., 19~
ry Public, .... )4.-&.~. . Y. . Po-;.t! K--~. . .
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ISURVEY OF PROPERTY
I SITUATE: BAYVIE~
TOHN: SOUTHOLD
SUFFOLK COUNTY, NY
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SURVEYED 01-30-2001
SUFFOLK COUNTY TAX #
1000 - 1'1 - 6 - 3,8
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CBRTIFIBD TO:
OUJBMARlBMANN
HOWARDT.MANN
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MONUMENT FOUND
AREA = 63,86'1 S.F. OR 1.4062 ACRES
JOHN C. EHLERS LAND SURVEYOR
GRAPHIC SCALE
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6 EAST MAIN STREET
RIVERHEAD, N.Y. 11901
369 8288 Fax 369 8287
N.Y.S. LtC. NO. 50202
REF.\\Compaqserver\pros\07\07 187.pro
....
roBII NO. .
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. y,
BUILDING PERMIT
<THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
''?> ~''kl,
N~~~ ~/;;:;!:;;;;l;;j;';/:~.I
Permission is hereby gront~:
. /~*..$;...r.z;~............
. ./.....~.... ..' .......r2v.:t.........;(q.(.i!.2.
....r,1:*/.L:i.}1.
to .~~..a.....ChttL........ .... ..~t1....2>~~.....~............
.~/:tI4.........~................................................................................;...........................
':::::::.~=~~<~~~~~~::::
................................................................................................................................................................
County Tox Mop No. 1000 Section ......7f,......... Block .......6.......... Lot No. ..~..,r.........
pursuont to application doted .........!..q/i/f..~....................., 1911!. and opproved by the
Building Inspector.
I'OBM NO. .
TOWN OF SOUTHOLD
BUILDING DEPA.RTMENT
TOWN HA.LL
SOUTHOLD, N. Y.
BUILDING PERMIT
<THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~jr:\~~
N~ I~
z
Date .IP./CZ.........................................., 1$.7...
Permission is hereby gran~, to:
~~t/:.g{t.....~J1........................
/ ~-::..(k(~...~~:?:......................
. ~ ~{g4..:a-t.j!.t.ZI....................
to~~t,f...~"t:/.....2t:.. . ... ..&. .' ...'#../I..~.f(p...:;;;..-:4.......
~~a-....~....~...... .....................~t::...~......~~...
at premises located ot ../l/6...t2..... . ....o&.ut!.:;;f::~~:r.. .......... ......... ....,?tV.l
................................................................................................................................................................
................................................................................................................................................................
County Tax Map No. 1000 Section ...,Q..7.f.......... Block ....ll.".......... Lot No. ..:3~.?.........
pursuant to application dated .....l.e/3XK..;(-;:..........................., 19........, and approved by the
Building Inspector. 10/9/ ? 7
.Hot) --
Fee $..7-.1.....<...........
..d-4[!(J~m.m....m.....
Rev. 6/30/80
I'ORM NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD. N. Y.
BUILDING PERMIT
ITHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~~J-6L"
N~ i~, z
Dote ....a..~~.~.~...'j,....................... 19.:~~:
Permission is hereby granted to:
...Hl!-':';~:"~"~'''Cl:...::m.~...............
..1..~I(,~........ ...... ......~~..~.................
~~....~.:.~.!...!!..l:z.~...............
IO....~.....9w.....~.1~..~.~,....Q.e.....9.f~
~~....................................................................................................................................................
at premises located at ..~I..(Q.9.......&~..~~. ..:1.~...:R~.\).:.~~.......~~:..~~:...!~.~....
................................................................................ ................................................................................
.................................................................................................................................................................
County Tax Mop No. 1000 Section ......9.J.~....... Block .......s;:)..!,Q,...... Lot No. ...:~.!jL......
pursuant to application doted ......4l!h...,b...t~............. 19.'j~. and approved by tne
Building Inspector.
~~3.'i'"
Fee $........................
.~kcL.~Lm..m
Building Inspector
Rev. 6/30/80
Chief Building Inspector
Building Inspectors Office
Town Hall, Southold, N.Y. 11971
1 Bayview Av
Rural Route #2
Southo1d, N.Y. 11971
April 7, 1987
Dear Sir,
Please consider this my request for an extension of
time on Building Permit #14340 for construction of
my private home.
Thank YOU',,/)
~VI)/~
Howard T. Manl{
/J1au-' jZ-~
10( gig 7
~