HomeMy WebLinkAbout19591-Z 1057[ N0. e
TOWN OF SOUTNOLD
BUILDING DEPARTMENT
TOWN HALL ~~G,j._, ~ f~
SOUTHOLD, N. Y. ~
r~~~
10~13~13
lUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N ° 19 5 91 Z Date ..-s.~. ~ ~9..~ o
Permission is hereby pwntad to:
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ror ..C~.......~-~.... ~t-...~.,~...... G? ..............~..4.............................................
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at premises I«ated at .....:.....~R.c!!!i!{!.!~4.~.........
S .w"C a~~ai /Q
....`~......~.~:::~i.....~ ................................1...................................................
County Tax Mop No. 1000 Section ......~~.w~--1..... BI«k .....Q..1........ Lot No.......~..~..........
pursuant to application dotedCR^..:en.l~.....~..~.........., 19..~.~, and approvod by the
Building Inspector.
Fee 5..~....
..:.:.~:Y..1...........
Bui np Inspector
Rev. 6/30/80
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P,OUGH FRAME & .J
PLUMBING
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IidSULATI0P1 PER N. Y.
STATE ENERGY
CODE
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ADDITIONAL COMMENTS:
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' ~ BOAFD OF HEALTH
FORM NO. t ] SETS OF PLdNS .
TOWN OFSOUTHOLD SURVEY
BUILDING DEPARTMENT Ct1ECI: . .
TOWN HALL SEPTIC FORPt . . . .
SOUTHOLD, N.Y. 11971
TEL.: 765-1802 ttoTIFY;
CALL
I' . .
Examined . y? ~p'!'pr+!~, .~.1 191 ~ MAIL T 0
Approved .1 1990. Permit No 9.x.9 ~.Z? . . .
Disapproved a/c -
- Q U IS
...................................~s~"?~.. ~ ~ i
(Building Inspector)
APPLICATION FOR BUILDING PERMIT BLDG. DEPT.
TOWN OF SOl1TMOLD
Date . Pc, . ~ y.........., 19 .90
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.
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of premises ~ a. ~`{!'.K ~ ~ :S .
(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. Q:``'^'.~ .
Plumber's License No. .
Electrician's License No. .
Other Trade's License No. .
1. Location of land on which proposed work will be done. h: ~ i' f' ° `r.°.`:': ~
House Number Street Hamlet
County Tax Map No. 1000 Section Block Lot
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 ~Gr. 4^ ,
3. Nature of work (check which applicable): New Building Addition Alteration .
Repair Removal Demolition ..............Other Work .
(Description)
4. Estimated Cost.... r°..~C Fee......................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units Number of dwelling units on each floor .
_Ifgazage,numberofcars
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 ...............NumberofStories........................................................
Dimenslrnts of~sayne• lnieEwrwT,ith alterations or additions: Front Rear .
Depth . Height Number of Stories .
3 ~O PYFC
8. Dimensions of entire new ~truchon: Front ......?.y f ar De th .Z <.?O .p~•:
P
Height ~ Number of Stories ~ .
9. Size of lot: ron ......,35~............ Rear 7.
~ Depth .
0. Date of Purchase . . • , , . , , • , , , • , , • Name of Former Owner ..R~c K F . F.4-~~'~' S
1 1. Zone or use district in which premises are situated .
12. Does proposed construction violate any zoning law, ordinance or regulation : .
13. Will lot be regraded w.~ c ....Will excess fill be remov d from,gp~g~ise~s: Yes No
14. Name of Owner of premises ..~d k<It2Q ~u t S.! .Address ~ 7 ..S~e~~~s ..~lione ~o...2 g a : SL?~.. .
Name of Architect ...........................Address ...................Phone No............... .
Name of Contractor ..........................Address ...................Phone No............... .
15. Is this property within 300 feet of a tidal wetland? eyes,,,,,,,, No .
*If yes, Southold Town Trustees Permit may be required.
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.
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'New (~A~N
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STATE OF NEW YO I~ S.S
COUNTY O ! 1 ~ ~ _ C-~~„4rC !0 w //A~2(3FS.
• • • • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the.......~:te°?'l~/.L
(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.
Swom to before me this
~ 1;51.... ...day.~of ~~?`^^kx 19 o
d( 'J 5,.~
Notary Public, County
~ 4725089 Suf~t (Signature of applicant)
Term Expires May 31,19
TOWN OF SOUTHOLD , BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying'?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL• (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees _
Esamined , 20 Contact:
Approved , 20 Mail to:_
Disapproved a/c
Phone:
Expiration , 20
Building Inspector
~y _
_s
_j,i.
' 1 ~ < i APPLICATION FOR BUILDING PERMIT
MAV I 0 2005 G.": ' (rot C3acn 1 CwineTaSt;~~
_ -1 Date A oc' \ a9 , 20 OS
' ~ ` r' INSTRUCTIONS ~
T~N~'. '.F S~'~~' ~ r._
~l__.- ~
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
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 a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
p~uperiy have Ueen enacted ir. the interim, the °uilding Inspector may authorize, ir, writing, the extension of the per!ni± fer an
addition six months. Thereafter, a new permit shall be required.
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 Lav: s, 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.
~1~. _ _
(Signature of applicant °
P.o•a3~Isar
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
w
Name of owner of premises CQwncd W ttarbe{
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
Nc7'r PrDOlictibl2
(Name and title of corporate officer)
Builders License No. b lvid'~
Plumbers License No. w hlr
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
o L v~ cK -
House Number Street Hamlet
wn
lotwe ru,~, _
Block OI
County Tax Map No. 1000 Section I1a Filed M K ~yrG Lot,
Subdivision ~ ~rwlpi}na~or+ne~
(Name)
~ ~w~,ne"T'as~=t~~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ~-}ocage, '
b. Intended use and occupancy wt,neey Tns{-irg Room
-to o.yts~dt:
3. Nature of work (check which applicable): New Building Addition X Alteration
Repair X Removal Demolition Other Work(2~r~~-E-~onS -4•o i~ieeioc~
(D\\escription)
4. Estimated Cost,~loAooo.oo Fee ~3$,pD r[1,~p~1~3~igg6)
(To lie paid on filing this application)
5. If dwelling, number of dwelling units Npt-f}pP. Number of dwelling units on each floor N~k- f~Pe,
If garage, number of cars Nc`s} P~t~cnet-e .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 35' Reaz 35' Depth aa'
Height t~ ` Number of Stories t~~
Dimensions of same structure with alterations or additions: Front "1' Rear 35'
Depth yQ' Height t~ ~ Number of Storiess~ne
8. Dimensions of entire new construction: Front Rear Depth
Height Number of Stories
9. Size of lot: Frontg~pc+ox.360` Rear4~aeoX~~' DepthuP(~c`~c.a~0`i`i'
10. Date of Purchase 1q8 S Name of Former Owner i~~b2c'E t: n}enmann
11. Zone or use district in which premises aze situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO~
Mir~:mCt\ O.Y`1~t7vctt'~~(-Qn~/
13. Will lot be re-graded? YES_ NO~_Will excess fill be removed from premises? YES_ NO_~
14. Names of Owner of remises~dwncdw.Fkacbec Address 11SN ltoct~L.ri• ~
P h,cx ~ t vsi Phone .Io. (bB~ 835-8N8`(
Name of Architect `Iou r~ ~F'ycy ~ w Address ~ o~a Phone No C63~ Tat=x303
Name of Contractor N acne a~ oc'~en} ~1.dmeAddress Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO X
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED.
h. Is this property within 300 feet of a tidal wetland? *YES NO_~
* IF YES, D.E.C. PERMITS MAY BE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
~~p SS:
COUNTY OF vc a',~
°l w a r ~ ~ 4 r being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
~eaid 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 aze 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
a-q~-t' day of 20 05
No a Public Signature of Applicant
r ~
i~
,r~°'~7
TOWN OF SOUTHOLD BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying'?
TOWN HALL ~ Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL: (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey
www. northfork.net/Southold/ PERMIT NO. Check
Septic Form _ _ _
N.Y.S.D.E.C.
Trustees
Examined , 20 Contact:
Approved , 20 Mail to:
Disapproved a/c
Phone:
Expiration , 20
Building Inspector
! w _ ~1 U' APPLICATION FOR BUILDING PERMIT
MAV 102(' LJi ~c3ac~aCw~r,emakln5]
Glti ~ ! Date (.gyp e: t ag 20~
--"~t.~.~~'P'~,~ir _J INSTRUCTIONS
_~~_s,_r .
a
This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
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 a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
£ Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interm, the Building inspector may authorize, in writing, the extension of the pernit far an
addition six months. Thereafter, a new permit shall be required.
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 ether applicable Lav: s, 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.
w e~~
(Signature ofapplicant ,
p.o.~is~v
Pc~u ~lti+ck ~ ASa
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
OC~h2~
Name of owner of premises Ec(~.uacd w t~Facbts -
(As on the tax roll or latest deed)
[f applicant is a corporation, signature of duly authorized officer
_ 4~1 ot- f~Pet;cct.bFe
(Name and title of corporate officer)
Builders License No. rTooo.r' d~td
Plumbers License No. -
Electricians License No.
Other Trade's License No.
1. Location of land on which proposed work will be done:
-I15 hMlloc,(c t_ane ~ J`natl~~ck
House Number Street Haml Y1J~2
M
County Tax Map No. ] 000 Section Block O ~ r t O'1 _
Subdivision Filed Ma nogtM"^~-ot
(Name)
Bam aLw',re ma~~rg~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S~-p ('cepe
b. Intended use and occupancy W ihQpy p podJ C{-~Ov~ !'aor~
3. Nature of work (check which applicable): New Building Addition Alteration
Repair X Removal Demolition Other Work
(description)
4. Estimated Cost ~S~OOO.oo Fee X35.00 C~~r4C ~3~1q"l 1
(To be paid on filing thi application)
5. If dwelling, number of dwelling units N ts1- I~ • Number of dwelling units on each floor N Cs~" (a-o o
If garage, number of cars N eY~ (~Q~t'.cab Y'2.
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use.
7. Dimensions of existing structures, if any: Front 'dam` Rear a0` Depth a$ `
Height t6` Number of Stories Ew~2
Dimensions of same structure with alterations or additions: Front Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: Front N Rear Depth
Height Number of Stories
9. Size of lot: Front~pcox.36a' Rear apocox• aa,' Depth QPp~~X• a l~4`-lt
-•T -mot
10. Date of Purchase Name of Former Owner Y~~bec~- En~ehmar~n
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES NO ~
~`c~i~tmal amDUCtbtl~a~Y
13. Will lot he re-graded? YES NO Will excess fill be removed from premises? YES NOS
't IS F~allocl~i-a.
l4. Names of Owner of premises[Lr..,ao~t~~. {{eJh~ Addresslha `kXk, t~g53 Phone No.(~3~8~5'~Y$~/
Name of Architect~l0ucu ~yo~~ Address s ect w ~hol-Phone No~3ha1"a'~l
Name of ContractorNDr~ea~~e~Cn-~ f;M2 Address Phone No.
15 a. Is this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAY BE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NOS
* IF YES, D.E.C. PERMITS MAYBE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
17. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
SS:
COUNTY OF
w a r W ' ~ 0. r ~rs being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
~F•eai~•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 tlvs 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
a~ day of 20 O 5
Notary blic Signature of Applicant
~ r
~~a7
TOWN OF SOUTHOLD ~ BUILDING PERMIT APPLICATION CHECKLIST
BUILDING DEPARTMENT Do you have or need the following, before applying'?
TOWN HALL Board of Health
SOUTHOLD, NY 11971 4 sets of Building Plans
TEL• (631) 765-1802 Planning Board approval
FAX: (631) 765-9502 Survey _
www. northfork.netJSouthold/ PERMIT NO. Check
Septic Form
N.Y.S.D.E.C.
Trustees
Examined_ , 20 Contact:
Approved , 20 Mail to:
Disapproved a/c b 23
~ f
Phone:
Expiration , 20 /
------1
- ~ Building Inspector
i
MNY I ~ Z005 ~ ~{~~PPLICATION FOR BUILDING PERMIT
I c (3nrn 3 CF'~+'wK wine Prod. cK and
Date R~e:1 'a,q , 20.05
INSTRUCTIONS
a. This application MUST be completely filled in by Cypewriter or in ink and submitted to the Building Inspector with 4
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 waterways.
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 a 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 what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing the extension of the pcrrmi fog au
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Petmit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and ether applicable Lav: s, 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. /
(Signature of applicant ,
Ro.t~,
oi< ~Sol4
tro,1}i'wck, Ny \\95a _
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
c7wrYe.r
Name of owner of premises C-C~W(1c'(~ ~.y ~Qt'b~c -
(As on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer
'k-
(Name and title of corporate officer
Builders License No. W ~ ~ '
Plumbers License No. c~lrv~e~.~nl
Electricians License No. r~2ed
Other Trade's License No.
1. Location of land on which proposed work will be done:
House Number Street Hamlet
t~yt~~
County Tax Map No. 1000 Section \ \a Block C~ ~ *W w~M to MYZ 7ib0'~ ,4~1 -
Subdivision Filed Map No.~p°Y`„~t _
(Name) 4~> rys ~ .~su>'i oar:..,,,
3acr 3 CP~~ce Wi~~ Pci,d~ C+;~n"~
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy S-!~ CQA e
b. Intended use and occupancy t'~S{..~~~' e W iheey P (`~dJ c~Dr Q ms
3. Nature of work (check which applicable): New Building Addition Alteration
Repair x__Removal Demolition Other Work
(Daescription)
4. Estimated Cost $1t~p.~p Fee~3s.pp C~.lnr-rKA~3~°hil
(To be paid on filing this application)
5. If dwelling, number of dwelling units4~ \Yt- H-a~o. Number of dwelling units on each floor
(V_p~
~o.
If garage, number of cars P~D~ llCnbl~e_
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 1 Depth 53`
Height ls' Number of Stories O d1e
Dimensions of same structure with alterations or additions: Front tst- Rear
Depth Height Number of Stories
8. Dimensions of entire new construction: FrontiV Rear Depth
Height Number of Stories
9. Size of lot: Front~{Pecthc:~b~' Rear~ooe~x~a~!
Depth pQ~pX_o1t~~-1yt
10. Date of Purchase \R85 Name of Former Owner ~~~oe t~ Eh~enmQhn
11. Zone or use district iu which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation? YES_ NO~
fCl t il\'~ ~ Qrho~tt} t Q rW
13. Will lot he re-graded? YES_ NO~WiII excess fill be removed from premises? YES_ NO
~ t 5 4lallock l.lt.
14. Narues of Corner of premises Edward t~ Hn(i~s Address S \\q hone No.(63
Name of Architect ~lovtia ~tyovrg Address Phone No 63 '-la1'a3~
Name of Contractor 0.1or>e
p~wgStn~ Address Phone No.
15 a. [s this property within 100 feet of a tidal wetland or a freshwater wetland? *YES NO
* IF YES, SOUTHOLD TOWN TRUSTEES & D.E.C. PERMITS MAYBE REQUIRED.
b. Is this property within 300 feet of a tidal wetland? *YES NO~
* IF YES, D.E.C. PERMITS MAYBE REQUIRED.
16. Provide survey, to scale, with accurate foundation plan and distances to property lines.
l7. If elevation at any point on property is at 10 feet or below, must provide topographical data on survey.
STATE OF NEW YORK)
~ SS:
COUNTY OPp„U[ieQlh )
~i r ~ ' ~ 0. ~°S being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)He is the
in,._._,,,,.,._ ~ ncc ~
id• 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 tlils
o~~~" day of ~ ,
L.,..SZ 20 p
No Pu lie Signature of Applicant
Nofxy Y ~
,t.»°i~'san7
_
INSPECTORS
Victor Lessard O~SVFFO(~-C
Principal Building Inspector Q
Curtis Horton Gym SCOTT L. HARRIS, Supervisor
Senior Building Inspector y z Southold Town Hall
Thomas Fisher P.O. Box 1179, 53095 Main Road
Building Inspector ~ • 'F
'y Southold, New York 11971
Building Inspector * ~a Fax (516) 765-1823
Telephone (516) 765-1800
Vincent R. Wieczorek
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
ORDER TO REMEDY VIOLATION
Date: September 27, 1991
TO: Edward W. Harbes
715 Sound Avenue
Mattituck, N.Y. 11952
PLEASE TARE NOTICE there exists a violation of:
Zoning Ordinance - CHAP. 100
Other Applicable Laws, Ordinances or Regulations
at premises hereinafter described in that BUILDING PERMIT #
145162 HAS EXPIRED AND A CERTIFICATE OF OCCUPANCY HAS NOT
BEEN OBTAINED. THE FARM STAND (BUILDING PERMIT #19591-Z IS
BEING USED WITHOUT A CERTIFICATE OF OCCUPANCY.
In violation of ARTICLE XXVIII CHAP. 100-284
YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the
law and remedy the conditions above mentioned IMMEDIATELY
The premises to which this ORDER TO REMEDY VIOLATION refers
are situated at:715 SOUND AVENUE, MATTITUCR, COUNTY OF
SUFFOLK, NEW YORK,
SUFFOLK COUNTY TAX MAP #1000-112-01-7
Failure to remedy the conditions aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both. 1 f /IA ~ ////D ~
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NCENT R. WIECZORER
ORDINANCE INSPECTOR