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Home My WebLink About22108-Z FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN MALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL p, COMPLETION OF THE WORK AUTHORIZED) I 9V Date ~J GIB c?_.....4R 19.1. N° 22108 Z Permission Is hereby granted to: b..........Va..NNA to ..C.f17r.ST5 r...../ ........-f7 S7G. Lam.......%: !!.:C:.... !@....... A p..~.~ fPg= ....~9 t~ 7 ......cos. at premises located at....... . T.............................................. ..............Q....1~.... (..~1:.'y..r.......................................... County Tax Map No. 1000 Section Block ........1 Lot No.-6-1 . pursuant to application dated /..!1..ff.....9 19.x?.. and approved by the Building Inspector. Fee $ Building Inspect Rev. 6/30/80 1E' J i c..:_J:i I~J..: ~I :;~Cti•IENT~ Q OUNDATION (1st) OUNDATION (2nd) o OUCH FRAME & .PLUMBING H.~ n INSULATION PER N. Y. STATE ENERGY CODE 1, m H FI:IAL ADDITIONAL COMMENTS: x jp as• ~r yin ,G-c~t2-moo (S m x ~ b k , H O m -e H 1c)OU --?o -~.5 TOWN OF SOUTHOLD PROPERTY RECORD CARD OWNER STREET L - VILLAGE DIST. SUB. _ LOT 1 z 5o - ILL-nno U, Yt e Nrt c ou o d 5 o Id VI I la s ACR. R M RKS l03 7~ 9 # 0801-11/12fQml_l c~(~ e /ll E(' ~i o ova TYPE OF BLD. 9 ll~~l 98 -PPcProp +-o burt 1-1110-t q4 -pECOr)~c Profer+ies PROP. CLASS -11'Z10 . Qrn Me LAND IMP. TOTAL DATE 1 l b Z Gz _ o e v goo 1,17-S 2- 0 10 3 - a zo Z - - - Exp~RES OFF c{,1, ssa+' - o~ NP. t N C+ R is 5 FINAL Con~R Ar ESSNEn7~ FRONTAGE ON WATER TILLABLE /3 G500-/ FRONTAGE ON ROAD WOODLAND DEPTH MEADOWLAND . So BULKHEAD HOUSE/LOT TOTAL 9405 o II 5 25 1941 1a lS gib 1" F 3 gT x 3S - zg Foundation Bath Dinette B dg. yp 20 71 - ~~a 5 UZ Extension Basement 5 ae Floors Kit. Extension ' Ext. Walls Interior Finish L. R. Extension Fire Place 4-~ Heat D.R. Patio lu Woodstove BR. Porch Dormer Fin. B. Deck Attic Breezeway Rooms 1st Floor ` Driveway Rooms 2nd Floor Garage r, s D.B. v as• r rii Pool BOARD OF HEALTH FORM NO.1 3 SETS OF PLANS TOWN OF SOUTHOLD SURVEY BUILDING DEPARTMENT CHECK _ , , _ . . MAY 1 9 M TOWN HALL SEPTIC FORM SOUTHOLD, N.Y. 11971 DEPT. TEL.: 765-1802 t:DT IT-_-4~ TOWN F OLD CALL' . UC.J.-l. . . Examined . 19.... TO: Approved ......6..w 119. Permit No. /10'1~/ Disapproved a/c uilding Inspector) APPLI ION FOR BUILDING PERMIT _ Date .(P. 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 5r 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 Qrdinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance- or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicaf agrees to comply with all applicable laws, ordinances, building code, housing code, and ulations, and to admit authorized inspectors on premises and in building for necessary ' ections. 4L . - (Signature of applican, or nameff if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...0 Name of owner of premises /Ywi? ...4..... . (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 . 1. Location of land on which proposed work will be done . . o7S~........P./...( wC~ ........................b!~JvTio/..................... House Number X' Street Hamlet County Tax Map No. 1000 Section 6v........ Block d~....... I Lot fir....... . Subdivision Filed Map No. Lot (Name) 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 D.. Uc~tiGE4G/~ pF /`uS f~ S OFc +vc~~ac~ /2. 3. Nature of work (check which applicable): New Building Addition t _ n Repair Removal Demolition Other Work E / i ~L ~G oo (Wgcription) 4. Estimat ost . Fee (to be paid on filinM, 1}s'apglication) S. If dwelling, number of dwelling units Number of dwelling units on each floor :=a 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 ofStories Dimensions of same structure with alterations or additions: Front Rear Depth Height . Numpr f tones . 8. Dimensions of entire ew construction: Front Rear Depth . 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 : ............................(00 13. Will lot be regraded Will excess fill be removed from premises: Yes 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 within 300 feet of a tidal wetland? *Yes........ No......... *If yes, Southold Town Trustees Permit may be required. 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. P 0 D AS NOTED DATE: RR 11 ~-1~4- FEE: ev NOTIFY BUILDING DBy sagli~z EP ENT AT 765-1802 9 AM 10 4 FOR THE FOLLOWING INSPECTIONS: t. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH • FRAMING tai PLUMBING 3. INSULATION 4 FrNA:L _ CONSTP. ICTION MUST BE COMPLETE FOR (-_O, ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE MY, STATE CONSTRUCTION & ENERGY CODES, NOT RESPONSIBLE FOR DES!GN OR CONSTRUCTION ERRORS STATE O EW O JJ~~ S.S COUNT O U./~.~. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. ,.~He is the (Fjvu . . KV (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 ...........1R day ........,19 Notary Public . Db County ROBERT 1. SCOTT, JR. • • • • • • • • • • - State 111& 4725089. Suffolk Co (Signature of applicant) Term Expires May 31. /Z tzO # G.ii~vA - ~C N/0 SSE~Z 4NN a6' s f~~ s ~3/zap. N ANN 77 ~aa h C% c F. / 5y . ' o ? m q { ' 6/dy. cove%Pe ~ ~ J N. S. 87.52'35. W. F E`,4•' 272.85' / Z ' O Oop s` = r3 '?SOO'W~ ~~~1] t r • O xt w r x F l - JASNI1Nt CERTIFIED T01 DONNA L YBURT THE LONG ISLAND SAVINGS BANK FSB SUPERIOR ABSTRACT CORPORATION TRW-S-543938-12 AREA 27,459 sq•ft , SURVEY OF LOT 12 "MAP OF SOUMOLD VILLAS" j Prepared in accordance wilh the minimum FXMJUNE25,1992 MAP/NO.9237 standards for Nlle surveys as established A T SOUTHOLD i by the Luse by. and approved and adopted TOWN OF SOUTHOLD for such use by The New York State Land SUFFOLK COUNTY, N. Y. Title Association. The water supply and sewage disposal 1000 -70-01-6.5 f systems for this residence will conform. to the standards of The Suffolk County Scale 40 I Deparlmeat of Health Services March 11, 1992 JULY 15, 1992 (foundation) The locations of wa#s'and cesspools shown hereon are from flold \ observations and or from data obtained ,from olhers. Oct. 23,1992 (final) t . ~~~f of NE* SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES `4 S ~"~rt 9 FOR APPROVAL OF CONSTRUCTION ONLY r"? p o 92 SO 49 ^ <P 9~'rc`' N.Y.S. L/C. NO. 49"18 DATE "S. REF. NO. 0 1 EC R ORS, A , ,II I tJ e• BQD APPROVED j revise tax number 12108192 SO N. Y. 11971 q7 - 112- I