HomeMy WebLinkAbout12669-Z rosat xo. a
TOWN OF SOUTHOLD ~ d ~
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
No L~,~6~~2 TH~~~~
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N~ 12669 Z Dare ...~7~.f.~.....~..........~~ 19~~
Permission is hereby granted to:.~
.........s~.~I,S... ~~f.
/.7,~r..~
of premises located at .........~1.~...~..1..~,.~........~~-~
t f
...............................................................................................~/...jj..~..7..................................................
County Tox Map No. 1000 Section ...~Q.~....... Block ...1,%~....... Lot No..~~.5
c~
pursuant to application doted 19.0..-x?, and approved by the
Building Inspector.
Fee
Building Inspector
Rev. 6/30/80
FORM N0. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
f~~ TEL.: 765-1802
Examinedy~ .4......., 19Vp.--' ~J,/ ~ Received.. ~/a... , 19~~
ApprovedS,~.l . /t?........, 1911.~Permit No. iR"b .
~a f~~"
Disapproved a/c
'
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date SG~~......., 19 8~
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 azeas, 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. ~
(S n ture of applican r name, if a corporation)
. • 5 8 • W i ntev St, , (3o S'f'o vr,11'1c,55. D ~ !•CZ~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
.......`+.tVLI~ItGLt .............uu...............................................................
Name of owner of premises rfeh.ry ~"uGe' ~
(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. 5 n .
Plumber's License No. ..~~q.5?. r.......... .
Electrician's License No. . 9 ~ 4 E
Other Trade's License No .
1. Location of land on which proposed work will be done. FI,SI-+GV 5, I S ~u Nd• . , . So ut~ o ~ c~ x N :Y•
~45~" , ~nd:.~~,................................................
House Number IStreet Hamlet
County 1'ax Map No. 1600 Section ~.~l.......... Block ..~L Lot .
Subdivision Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises arnd intended use and occupancy of proposed construction:
a. Existing use and occupancy .SjE'!~~G'..rG,Yh!!V„ V¢G4"E;I,ov~, hou5~,,,,,,,,,,,,,,,,,,,,,,,,,,
b. Intended use and occupancy .SLa•tYl2.,,,,,••
3. Nature of work (check which applicable): New Building Addition . Alteration .
Repair ...............Removal Demolition Other Work .
' oo (Description)
4. Estimated Cost . ~ p~.. D O ~ Fee . .
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..Q r!?-........ Number of dwelling units on each floor .
If garage, number of cars .
6. If business, commercial or mixed occupancy, specify not ~re and extent of each ty~e of use f .
7. Dimensions of existing structures, if any: Front { ~1.Q........ Rear ~ t~1........ Depth ...Q ~ .
Height Number of Stories ..'~WO .
Dimensions of same structure with alterations or additions: Front ..1.~ ~ ~
~ y Rear ..9 0
Depth (3.Q Height ..:30....... , , , . , ...Number of Stories .'('.W Q .
t ~
8. Dimensions of entire new construction: Front .....x.~.. , Rear ...7..~.......... Depth ~ .
~ .......Number of Stories ..Q.. e-
Height . ~ » i p......... .
9. Size of lot: Front ,~+~Q Reaz 4 (S {
, De th j.5... .
10. Date of Purchase . ~ V h v.. j 910 8, , , . N me of Former Owner M4 A??'.la~.y .
11. Zone or use district in which premises are situated ra,$j~eh'~',{,q~,- c.=grj LvFiftjYa ~ . . . . . . . . . . . . . .
12. Does proposed construction violate any zoning law, ordinance oi• regulation:.hQ .
.
13. Will lot be regraded Y1 0 Will excess fill be removed from premises: Yes No
14. Name of Owner of premises ~ e)'1rY ~rV44 Address' S!!'~9Y! q s .~~L ...Phone No Z^~?'.7~~..' . .
Name of Architect4~k!~~.~. V~. R.1~h"He1". , , , , , ,Address ~B.Wfnt4°Y. S1:.QQ5{ol~phone Nol.{'7'.4°,t•1.'.F~'.Z4.0.
Name of ContractorZ."~' 3 f?!1f''!!~4"j'!~'! Address ~{S~G+r.S, j3,~~7 NY. Phone No.si(?'7~ts'
PLOT DIAGRAM
Locate cleazly 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. 5 ~ 0. ~'1'}'0.C•h.ed T 1 t'e ~~w I'i
STATE OF NEW YORK,
COUNTY OF S' ~
• • . • • • • being duly sworn, deposes and says that he is the applicant
e of individual ing contract) -
above named. 11
He is the...........~,rChllEG~
(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 y~-
13. .....day f .~f~'!~?7.G'(' 1....., 19
Notary Public ....'~~LQ~~~. -CJ . County $,r(~~jlc C+y. /Y)aS5 ' '
Sanr+ra S. Fitzgerald
NOTAEY PUBLIC
a,.,,~,,, ~,~Bx aa, t1A~ (Signature of applicant)
NEW YORK STATE DEPARTMENT OF ENVIPANI>ENTAL CONSERVATION
Regulatory Affairs Unit
Rldg. 40, SUeiY--Room 219
Stony Erook, liY 11794 `
(516) 751-7900
nn7,.Z0 `~~i, i~.~ .S~,t~ s o4
/ICS V e rK ~ ~IC,W ~J ,^K ~ Ci U I 1
RE: ll
Dear fir. ~ea~
A review has been made of your proposal to:
,,tt ~ ,
L.Un)~'u~ ~ Qv x,17 c:c/~~40.• oni~ eX~£i4ny hem e,.
~J
Location: '~JICCK 1SIcayC? Sc?.~nc~~ ~'sS~ <~,~n/~, Y!S/~~5 1.~/a-~d
S u ..Cho/dam ~~i~~zi~^ ~'~~n~ ~ ~t,~
New York State Department of Environmental Conservation has found the
parcel project to be:
_ Greater than 300' from inventoried tidal wetlands.
Landward of a substantial man-made structure rSC'c ~-~~ll~
greater than 100' in length constructed prior to September 20; 19i~7.
_ Landward of 10' contour elevation above mean sea level on a gradual, nat-
ural elope.
_ Landward of topographical treat of bluff, cliff or dune in excess of 1J
feet in elevation above mean sea level.
Therefore, no permit under Article 25 (Tidal Wetlands of the Environmental
Conservation Law) is required at this time since the current proposal is beyond
State mandated ftitriadiction pursuant to this act. However, any additional work
or modifications to the project may require a permit. It is your responsibility
to notify this office, in writing, if such additional work of modifications are
contemplated.
Very truly yours, _
~
Daniel ~7:arkin
Regional Supervisor of
Regulatory Affairs
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 ~~ii''
Examined 19... Received.. , 194.
Approved 19 Permit No........... .
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date .I,4. SG,(?~'•......., 19 8~
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 azeas, 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 pazt 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. - i~
(S n ture of applican r name, if a corporation)
, 8 , W i nfevr7,'~, , (3o S-f'o w,l)1u55, D~ l,c~
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
G vc,~?ittc~'
Name of owner of premises ~eh,Y~!_~--uGf_,]].1,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
(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. F~,ShGV 5, ~ 5 ~li NG~, , ~ . $o v1-t,o~ a.z , N..y,
. .....~~.st, ~hd:.R~
House NumbzF.,:,,,~ / Street Hamlet
County~T'ax Map No:.1,000 Section v.~ Block Lot..................
Subdivision .
Filed Map No. Lot...............
(Name)
2. State existing use and occupancy of premises arnd intended use and occupancy of proposed construction:
a. Existing use and occupancy .S)f'!~~C-, rG,t»i,4„V¢Gk'~;I;oh, hOU1,e..,,,,,,,,,,,,,,,,,,,,,,,,,,
b. Intended use and occupancy $c~,M2.
3. Nature of work (check which applicable): New Building Addition . Y........ Alteration
Repair ...............Removal Demolition Other Work .
(Description)
~J~ o O
4. Estimated Cost . ~ t7~~- O ~ ~ Fee . .
(to be paid on filing this application)
5. If dwelling, number of dwelling units ..Q ~ Number of dwelling units on each floor .
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of each ty~e of use f .
7. Dimensions of existing structures, if any: Front ~ ~0~ Rear ~a........ Depth ...Q?~......... .
Height ...~QI.........NumberofStories..'f:W~
Of ....................I.............
Dimensions of ~ame structure with alterations or `dditions: Front ..1.~ Rear ..9 4 .
Depth ~ 30 Height ~0...... ~ Number of Stories W R f .
8. Dimensions of entire new construction: Front , Rear Depth ~?.~P......... .
Height . ~.~I........... Number of Stories ..Q ner..... I i .
9. Size of lot: Front ,Z.J~'.G Rear ~ Depth ~.~.5....
10. Date of Purchase . e1 V h v. , 1 q-b 8, . - - . , , , , N me of Former Owner m4 (~?Kla~ ~ .
11. Zone or use district in which premises are situated !'e$~ ~e nf',I,g1,- tyc)rj e.,v My Yq ~ , , , , , , , , , , , , , , , , , , , , , , ,
12. Does proposed construction violate any zoning law, ordinance oi• regulation: .hQ .
13. Will lot be regraded Irl O .............Will excess fill be removed from premises: Yes - • No
14. Name of Owner of premises f"~ eiZt!Y G-V44 *R Address' Su'~91? R ~ .NAG ...Phone No?~iZ'.7.s.4'
Name of Architect./caw?~,~ - V., iZi h#~N ..Address }Fl.Wll'1.}p,Y. ~-$45'~l+Phone NoGI7~.4?r. t'.5.Z4.0.
Name of ContractorZ."~ ~ ~?rl'h!~s'1'I.i~~- , - , - - , -Address ~{yliG.t-,S, NY. Phone No.s((?"7~ts'
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. 52 L ~•i-r0.t~''LQd S 1 'ke P~YI
STATE OF NEW YORK, '
COUNTY OF S.S~,
. . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant
e of individual - ing contract)
above named.
He is the...........~rC.hI~F.L-)
(Contractor, agent, corporate officer, etc.) ,/r,n~:,:.;, ,
of said owner or owners, and is duly authorized to perform or have performed the said work aka t l,~dke~~nd file this
application; that all statements contained in this application are true to the best of his knowl~dgp afld bcue~'~a~ii1 that the
work will be performed in the manner set forth in the application filed therewith. is ~`;-,'~,G~ ~i
g,,
Sworn to before me this ( ~ ~ , I, ,
_ ~ ~ r, ;
~..t-,(......day f / 19.".~
~ ~ II
Notary Public,'-~,ulil~~lL.~' `.`.~%~/Il!'Q~~.. County Sv~~D~~c ~t~~. mtlS<. ~ ~ ,
~
NOTFPY PUALIC .
M„ ...,..„e nm.~,~n,. tIP~A (Signature of applicant)
~a~n~s Volney Fighter
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Memorandum from .
BUILDING INSPECTORS OFFICE
TOWN OF SOU7'HOLD
TOWN HALL, SOUTHOLD, N. Y. 11971
765-1802
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