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Home My WebLink About18950-Z IOEM N0. 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) a 18950 ~//r,3 0 N _ Z Date .....rr 19.9.... ~~-~iD Permission is hereby granted to: I u~~L v1 D . .l.G{?~..... ~ ~ x g ...................i.............................................................~... at premises located at .....~lZ..~~......,~~...~L~ .....................................................~~4~*~..~..%~...../.................................................................... . County Tax Map No. 1000 Section ~..~/....../7~... Block Lot No.......... pursuant to application dated ....~`,I.(o..,1..2~..Q 19........, and approved by the Building Inspector. ~ ad Fee S..c?~.m~... i~ ing nspector Rev. 6/30/80 _ ,I ~ ~ ~ ~ ~\J~/~L 4 B0.\FD OF HEALTH ' 3 SETS OF PL.\NS ~Yy~ Eii FORtnN0.1 SURVEY J1........ ~ ~ 6~ j, TOWN OF SOUTHOLD CHECK ~.~{,dA , . lU{lU, L~~ BUILDING DEPARTMENT SEPTIC FORPI . ' 9LOr, DEP7. TOWN HALL TOWN OF SO°JTHTLt7, w $OUTHOLD. N.Y. 11971 NOTIFY ; - TEL.:7G5~1802 CALL G7 ttAIL T0: G~a Examined 19qq`/.. F' pp /EeQ.... . Approved 19/~ .Permit No...~~~J~.~ ,!14. . Disapprovedalc ~f ...:~vtE"~ Bui mg In ector) APPLICA710N FOR 6UILDING PERPrliT Date 15... 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 sho~vin~ 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. i 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 Pezmit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and. other applicable Laws, Ordinances or Rc;ulations, Cor the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to cnmply-yyit~t all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. i 2~. ' ~ (Signature of"applicant, or name, if a corporatwn) LY.D.~,;9r'.9.e...~P (Mailing address of applicant) State whether applicant isOWner, lessee, agent, azchitect, engineer, general contractor, electrician, plumber or builder. ~.i.^!.~.~12 Name of owner of premises .:?^.~-t:~tss,-r...? . (as on the tax roll or latest deed) IC applicant is a corpoFaxipar, signa'EUre of duly authorized officer. (Name and title of corporate oftcer) Builder's License No . . Plumber's Liecnse No . . Electrician's License No . . Oilier Trade's License No . . 1. Location of Ian) on which proposed work will be done; (louse Number Street Hamlet County Tax Atap No. 1000 S¢ction ...C3 7°..4.u.:....: Block , gr.`~.4P.......... Lot . O.<<t6.4 , . Subdivision Fiicd ivtap No. Lot . ~(Namej State cxistin^ use and occupancy of premises and intended use and occupancy oC propose) construction: ~ - o a. Existinguscand occupancy b. Intended use and occupancy ...:a•a v.I, ....:~S.h. s. cK 3. Nature of work (check which applicable): New building • . Additicn yr craft n . Repair Removal Demolition ..............Swi:1l~i~pb~a . Tennis Cour[ Accessory Building..........Fence .......Other lJork............ 4. Estimated Cost ....d~.cN... r Fee - . (to be paid on ding this application) 5. IC dwelling, nutnbcr o(d~vclling units Number of dwelling units on each door • IC garage. number of cars 6. iC business, commercial ar mixed occupancy, specify nature and extent oC each type of use . 7. Dimensions of existing structures, iC any: Front . . . Rear Depth . . Hci_ltt Number of Stories . Dimensions of same structure with alterations or additions: Front Rear . . Depth Ficigh[ Number o(Storics . 8. Dimensions of entire new constntction: Front ~ Rear p......... Depth ~ , Height ro........... Number of Stories .......u w: s . 9. Size of lot: Front ..!Q•^.+ ~ Rear . ~~.~7 Depth J.1P.u ;/1', • _ . • , 10. Date of Purchase ,r.~;~z~~~'~,,,,,,••,,.•.•.,,,,NamcofFormerOwnerA.lY~~l.2..5~x~t+.~~........... l 1. Zone or use district in which premises are situated . . Does proposed construction violate any zoning law, ordinance or regulation: ...H/o • . . 13. Hill lot be regraded .:f.a , , , . , , , Will excess fill be removed from premises: Yes X.. No . . 14. Name of Owner of premises .~/f{: , ,/~n Uf.^.°.. Address . GYo..Gr~.K} e .2n • .Phone No. ~1,u~. 31.,,,"L1.. , Name of Architect .Address ...................Phone No................ . Name of Contractor Sc~ ...........:........Address ...................Phone No..... . 15.Is this property located within 100 feet of a-tidal wetland? =YES.._.NO.:S.. *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 comer lot. A1~ AS NOTED DATE: g° e.e,r .s a FEE: NOTIFY ILD G OEPA NT AT 765-T802 9 AM Tp 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH -FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION ~ ENERGY CODES. NOT RESPONSIg~E FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEN YORK, S.S COUNTY OF . • • • • • • • • • • • • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant -,..(Name oC individual signing contract) above named. He is tltc Q::^:. r! _ (Contractor, agent, corporate officer, etc.) ~ ~ • • ~ • • • oC 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 applica[ion arc true to the best of his knowledge and belief; and that the work will be pcrfomtcd in the manner set forth in the application filed therewith. Swom to bciorc me this .......day oof/..../~,~ p:~. fw........ , 19 ~P. Notary Public, 4."s`.~•;!..Gl•, ../S./, Qo K.~"~, f . County NOt11RY?U&IC,Sdt°NNemYalt Si^nature of a Terni~fxprat~/ucd30,18._71 PPlicant) Fu~MER.LY _L~h~' .MAP 0}= PR~PFC~.TY : r~ a _ ~{V~ ~ ~ l.c~V ~~=L„? Gam ..~~UT'NC)~~C~ j - 1.r ; -TrJ~r~N GF':~JZ'HC~LD}f`_Y, - I u. ~pn, = G~) Ii ' t;%~ ~9I kPPRDV D N rED . ~ - i q ATE:.-.~_ 1-.4.r0"w^( FR.. 7 i ~ u~'a_U_'~V ' 4 NDT " }loins I = ~ C__` iuNt~ M i=NT 76 2 ~ILADMG EPARM, MENTtAT =n a _ _ ~O ~j_~.f:~ri;\j rf~~~ ~~L WINO ~MS~c'. ;t~NS1 FOR ~}iE r`' i3NDATIUfd - 71N0>~EQUI~D L7 0 (I~ OR POURED C CRETE a . 7 ~ {/S ,~Z ROUGH _ PRA 1 G & F~.UMB~G _ n . ~~C~~~PANCY OR =~S~LATIDN ~ .lCl...~ .J, 4. PiNAL - CO RUCTION ~,rJ.~ 0950~~W. S ( Q? BE COMPLETE , MUST o !~i i (L ALL CONSTRU R C•O. C;~~.N~~ ~~~r~T ,~WT CERT~FICA~ ESTATE CONSTRE OF MEET _ N 8 ' B~?ERGY ~ CODES. NOT PONSIBLE '1=pR \ DESIGN OR CONSTRUCTION ERRORS T . ' /i ~ GUADr;~ii!;t,G ~ THE (.<~~Js~RH_~.AD ~~iNG5,_E~~N~ ado uo~~~ ~ ~r~c ~~~t~.SlQ~t=.CHtCC1G0'I'tTLF iNSUi<A~;CE CO. 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