Loading...
HomeMy WebLinkAbout23309-z s FORM NO.3 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) Date W G ..�. /. 19. Nf 23309 Z Permission Is hereby granted to: ..... .j.......................................... ............. y'� �-� ..... ..... -� '....... ... to .... e .....4........l.'......,/, . . .. �..: * -�,-..��4, .. ..... ............... .. '.........G�.....,/�.. . ..... ............ . �r.....�� �az....,� ....... ... .. .;,� �.- ..... ........................ ...................................................................................... ........................................................................... / .. J �/�,t=�- at premises located at................. / ... ....... ��r-�� ..... ��� ....yG............................. ......................... � ...................................... . ............ County Tax Map No. 1000 Section ..........7..�.l.... Block.............. ......... Lot No. .. f..................... pursuant to application dated ......................`�i �� �.cr�-K,.f�3, 191. ........ and approved by the Building Inspector. Fee$...� . .......... .. ......... .................... ..... ............... ...f...ram... Building Inspector Rev. 6/30/80 BOARO of tiEALTIi FORM NO. 1 o ] SETS OF, PLANS . MAR 13 0`' ' ' � ' � TOWN OF SOUTHOLD SURVEY . . . . . _ . . . . . . . . . . . . . 19''0 k -- BUILDING DEPARTMENT CIIECK _ • TOWN HALL SEPTIC r• ORrI _ _ . , , , E IG. "EP SOUTHOLD, N.Y. 11971 , OC AJTIOFSOt;' TEL 765 2 1.,DT I Fy 19 Examined . .GZ•L��LG�� � - . CALL . 5i� _2 99—�566 0 :it . ! HAIL TO Approved No . . . . . . . . . . . . . . . . . . . � •, 9P./. Permit � �09. Disapproved.a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . . 4 <7_0 (Building Inspector) P ICATION FOR BUILDING PERMIT-. - -. .'`. .... . ', .. , . .... .... Date . . 9 L'1•. 199 . . . . . . . . . . . . . .. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 r sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing l9cation 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 sliall be kept on the premises available for inspection throughout the work. : e. No building hall he'occupied of used in whale or'in part for'any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS fIEREBY 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 of 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 inspecti� s. -- . . . . . . . . . . . . . . . . . . ( `gnature app icant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer; general contractor, electrician, plumber or builder. .. . . . . . . . . . . .. . . . . . . . . . . . . . .Qt41Nlip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises . . SUE. -K .*•A'?MR-P. . . .VIAN.Aq 9;R . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorised officer. (Naj 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. . . .. . . . , ' ►d.5. ' Sou#-30 01 y t G. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . [louse Number Street M�4�'r�Tu;Ct. . . . . ... . . . . . . . . . . . . . Ilamiet County Tax Map No. 1000 Section . . . : . . Pcli . . . , . . Block .Q� . . . . . . . . . Lot . . . . . ���. . . . . . . . . Subdivision . . .. . . . . ... . . . . ... .(Name) Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . 1 State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .. . . . .fwvS .. . . . . . � i' . r ?y :}t r�i i.•.k7p�it? . ''yd* 3 . . . . . . . . . . . . b. Intended use and occupancy /F'EsiOc•c� �`a'J " "?"'D''! �z•. w,�+; d3• •�'z,•, 's�'-.3yti��, ,�,"•72bt'• . . . . . . . . . . . . . . . . . . j. 14A,ul, l,l Ilk"A, �lu.,W. 1.11111-14 c1111/11l.dU1e): 1�ew 1ju11U1119 . . . . . . . . . . Addition . . . . . . . . Alteration . . . . . . . . Repair . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . Other Work 4'l•� �yS E C!y�r�r� (Description) 4. Estimated Cost . . . . . . . . . . .! 3P,:00 ... . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . .I . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . . . . . . . . . . . Nuniber of dwelling units on each floor . ... . . .. . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of•eacli type of:use . . . . . . . . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . : . . Rear . . ... . . . . . . . . . . Depth . . . . . . . . . . . . . . . I-leight . . . . Number of Stories . . . ... . . . . . ..... . . . . .. .. . . . . . . . . . . . . . . . Dimensions of same stnlcture with alterations or additions: Front Rear . . . . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . . . . . . Height . . . . . . . . . . ... . . . . . . . .. . . Number of Stories . . . . . . . . . . . : . . . . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . : . . . Rear . . . . . . . . . . . . . . . Depth . . . . . . . . . . . . . . . .Height . . . . . . . . . ... . . . . Number of Stories .. . . . . . . . . . . . . . . . . . . . . . 9. Size of 16t: Front . . . . Ao?.,7y. . . . . . . .: . . Rear. . . . . . 20 r•.4"L. . . . . . . . Depth �oG.3 3 I0. Date of Purchase . . . . .:'.��` . . . . . . . . . . . . . : . . . . Name of Former Owner . . . '^'G� . . . . . . . . . , , , , 11. Zone or use district in which premises are situated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . N. . . . . , . ... . . . . . . . . . . . . ... . 13. Will 16t be regraded . . . . . . . '. ? . . . . . . . . . . . . . . . . . Will excess fill be removed from premises: Yes to 14. Name of Ownier of p.•iemises suq tstNfoe�. ..�/�Kqucc Address . .9`!ar souw?v!s.v �`'EPhone No. /�. �7�: s'66°. . . Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . ....; .T. . .. . . 'Nr. . 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. T£NCE L1u16 0 i4'CTb.Ck4�D SuF,14IE ( ARP VEDAS NOTED , DATE: L"E l�.P#� �� e FEE: BY NOTIFY I3UILOING OE ENT 765-1802 9 Alin TO :I FOLLOtf101NG INSPECTIONS: THE . FOUNDATION - IWO REQUIRED- FOR POURED CONCRETE 2. ROUGH - FRAMING 8: PLUMBING a. 1t4tSbLATICN 4 FIINAL CONSTRUCTION MUST COMPLETE FOR C.O. ALL CONSTRUCTION SMALL MEET THE REQUIREMENTS..OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW YORK S.S COUNTY OF . . . . .. �P(�.-, . . . Sf1N o � .4N/-J CfC , , , , , , , , , , , , , , , , being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) above named. lieis the . ... . ... . . . . . . . . . . . . . . . . . . . .OWIv /V-1 . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized :to perforrn,or.have perfoynied the said work and ro.m$ke and file this application; that all statelneiits coiitairied in this- lication 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 pre this r.• `% d, :� ay fr , 19�. Notary Public, . . . . . County ROBE IT I.SC/T. .i . . . . . . . . . . . . . . . . . NOTARY PUBLIC. .Y. (Signature of applicant)No.4725089.Su, Term Expires May 31.19 TITLE NQ, ll$ -5593 /'ins �r�^" �.C..�t�-1 fra.iaf N�.•�c��•d.. N'x,;� ro Gz/ferec b q , 40 AVON •' TOP of BLUFF ♦.1 \yf'"�' 4L to Ole 00 era Ism LL lb . 1 1 . q MAR 1 31g96 INSET . ,►, ,( —__f ��C�. I: f �..�-- \ , \\,i $1JAM FOR 0a' 17,I985 SANFORD:HANAUER. & SUE 8. HANAUER OCT 11" g� \� JULY 2, W4 AT MATTITUCK DATE: JUNE 12, 1984 �w TOWN Of SOUTHOLD SCALE; I" a to& SUFFOLK GCOUNTY* NEW WIRK NO, 64-604 M yMAVTMDRii*D ALTARATIOM 09 ADOi/1ON TO TMIS GUARANTI< A TO; aURVLT 4 A VID�ATIQM QF iLCTiO« 7jOy Df TMs FIRST- AMERI ,iiA�I"' URANCE ivgw YORIL STATE EOUGATIOM"w �•l�lji NC4Plet 4F VWS �,MtVEY MOT HAR04 THE"NO COMPANY } SuAVEYQN'Y *no UAL OR S11*QaSED UAL MALL �p NOT U COMaibeR90 TO.K A VALID TI<UE COPY NGUARANT"ll INDICAT&D "COON S"L♦r RUN QKV v O a HCA6,TW 0EFARTMENT-DATA FOR APPRUAL TO Ct?M13TRUCT Tic am Ws bop wMow THE iTL9 Y is F Tt40t0 AND 41 Nt1F K1iNd � INC TITLE CO+iMrir.sfDvrllM- � M M�IRfZsT 1/ITi71 aNiM MI.±40 SOURCE OF wATRR6 PRMIC PW9 "090 . AND TQ wd 1141 INS Ii OF V YIOM LIlT'60 1I:%G0. TALI MAP 0i*'y=.jROTi4 Mi.I+AGx AL.LQT 1ASTITM,4NQ T4 RA ICLI2 A1119 OF VMS 4SMDtIN 4TMLAit ARi M4 OW4LLMIBa T+ITNIMi I99 F190 Of TW* PROP(RTT' TOST�TIONAL, W&T T4T"Ill 04 llyf LNT�ir,L DYNIM YN^$Too$( allowo ""ION. awki9*5 N yMi"Argo suPrttl AND MiMA" DiOMA4 IvIllY.RJR TNI#AtSI09— �DIpYsRCA>i 11NOVO MEitEOM 9kod P*OFERtY `IMS>F � ,6 wiL{ GQIiFONM To 10A SVAwG0mX1 OF TML sUFFOLK GO1WTV OEPANTMLMT YO E111STima aTRYCT pelt ANE FOR A a/'EI<IFiC pr tI(AI,TM ;ERVICRi. PURPOSE AND ARa NOY Y0 SL I/SED TO CATANLISM v jAM 0S4Sr AA�IGAM7� /pgl;RtY LINES ON 0104 THE 9A6CTIQM IX /ZMCres AOOAEAS YOUNG & YOUNG R,VE° T "NEW YOa E NOTE; r=MONUMENT Q = STAKE ALDEN W.YOUNG,PROFESSIONAL 66IN$$lt RE; LOT ND.2,`MINOR$tieDIVI$pN PLAN,FOR ROBERT$ AND LAND SURVCYOR N-%&UCLNSE NO,12845 BANE LENZNER KOWARD W.YOUNG, LoHD SURVEYOR �ITNE r.or�ITtvI or�rtLLcMl.sepTICTAwitsTls uaswolslfdl+)ilI4WM►IEAdiai N.Y.S.LICENSE N0.45003 AaC mW/ig4a Q& MRIYItiONS W OR DATA QATAIMLQ ORION OYMERS "c"DIS 4 SONS Rt1G, IG46