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Home My WebLink About23377-z 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) f Date.................... .... /.. (,,�......................, 19........ . NP 23377 Z Permission Is hereby granted to: �� 5 ..... .';% ......... �5. ................... ... ...... : ......................................... to ....! .......... ?✓........... . .... �..4 ........ �.� .. .......... � . ............... .. �.......... .................................................................................................................................................................. ........................................ ... ........................................................... .. ... at premises located at............11lr�........�..... ..........yf.��....................................................... ....................... ...................................... � Q x ....................................... ........... County Tax Map No. 1000 Section ..,,1 .5............ Block.......� ........,.: Lot No. ....® .............. pursuant to application dated 4: � and approved by the Building Inspector. Fee $.JV....'� ..... .............. .B/Inspector Rev. 6/30/80 ` ' -O. � �ulit/IU[X I Ilc '"""' o' /v// n x x -- ------------- 4 * ---- '-_- '----' ----- � n �_'---_-_----_----__--__'---_-_--_--_-- "-`� -_-_---_'-_--_---_---_-----_--_--'-'_--'_--_--'. ` ' '------------'---------------'--____-________ d .,� _'--'-'-'----___'_-'-----__-'--__..................._--_------''_--'______---___-----_-__'__--- -_'�� tj ' _-'---'------_---------'-_-----_- � ' ' - ---_'--_�----_'_-----'--� - _�-_- '---� _-----'---'--__-_-----._--______-__ ' ' - '--------'--'--'--_- ----�__� Q ,��' _-'-_''_ -'_-'_'-----_-_---_---_'---_--- �^� | d ao P J��• 6. O - s ( o MQ P� 5. Q V �� I c OQas�44 _0,, 00 " /o 1 di J� 9b �o �Q� ?� �J��• �J Jy0 4 a o2 bJ y O C -�-- O - BOARD OF HEALTH . . . . . . . . . . . . . . . .I,RFORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . .,TOWN .Qr S UTHOL D SURVEY . . . . . . . . . . . . . . . . . . . . . . . . ILD;IN�i D ARTMENT•::_..- -.. . --C-IIECK : . . . . . . . . . . . . . . . . . . . . . . . 'i;'•�?',:?;!{. .,�. T-0 }P II LL 7.'��!:S IC iFORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11 29J1 TEL: 765-1802 0 N � Y: Examined.....��....., 19.CC1��.1� O O II. TO: . . . . . . . . . . . . . . . . . . . . Approved.. .... ........ 19!..� Permit No. �37 ..... � ................................. Disapproveda/c .................................. ® ................................. ...................................................... .. ...... (Build' Inspector) APPLICATION FOR BUILDING PERMIT Date. . . . 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 n>ust be drawn on the diagram which is part of this application. 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 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 BERM- MAIZE to the Building Department for the issuance of a Building Permit pursuant to the Building Zane 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) -_.<2V.A. W........... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...........................................f............ ...................--•-....VPR0 0ASMOTED.....--•- Name of owner of premises ....... �..i ll.1$!-.C..lt"CL�fL� �. .......DATE: ®•P• a3` j (as on the tax roll or latest deed) FEE�.S �- - BY: •• •• - - NOTIFY BUILDING DEPARTMENT AT If applicant is a corporation, signature of duly authorized officer. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: , • .0CCtJPA9�1CY OR 1. FOUNDATION - TWO REQUIRED (Name and.title of corporate•officer) .. FOR POURED CONCRETE-.. USE IS UNLAWFUL 2. ROUGH - FRAMING & PLUMBING Builders License No. ................WITHOUT CERTIFICATE. 4. "N4L'--LAT CONSTRUCTION MUST OF OCCUPAIVCY ALLE COMPLETE FOR CONSTRUCTION SHALL MEET Plumbers License No. ................ � Electricians License Imo. .........: THE REQUIREMENTS OF THE N.Y. ........... STATE CONSTRUCTION & ENERGY Other Trade's License No. .................... CODES. NOTE RESPONSIBLE FOR 1. Ivcation of land on whichproposed work will be dog. ?. ll�L�,l� ....IGN OFj/CB1�ST IJ,ZEIION R$ ...........1p..........-0/1A aK..Av,.._...._. L :1;(-;-,#Pi a ..................... ....................... House Nud)er Street Ilanlet Canty Tax Map No. 1000 Sectionn.... ..... Block ....../;?...... Lot ./.......... Subdivision . aU.%5. /:��lV. /�1?J�5.......... Filed Map No. ............... Lot ..../.0....... (Name) 2- State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........14.1rl.�, 174ve: . ' .!��' •'4� �ii2./.......................... b. Intended use and occupancy ........... _ �- .maplcoz .....��.. ... .....l�(=............... .1. N•mture of: crurk (dmec:k wimicam ahlmlicable): Nrtw lkrildinl; ...x..... Addition .......... Alteration .......... Itepair ............ Removal ............. Demolition ............ Other Work .................................. (Description) 4 /� 4- (;st hiiated Cost ........:�Jok!k........ fee ....... ................................. (to be paid on fi"Ling this application) 5. if dwelling, nuiiher of draelliry; units ............ timber of Ahelling units cx► each Floor ................ Ifgarage, rxnlmer of cars ...... ............................... 6. If business, cammercial or mixed occupancy, specify nature and extent of each type of use...................... 7. Dimensions of existing structures, if-'any: Front................ Rear ............... Depth ................. lieidit ......................... Nrndmer of Stories ...................... Dimensions of sane structure with alterations or additions: Front ............... Rear ............... llepLh .................... lleigl►t .................... Number of Stories ............... 8. Dimensions of entire new construction: Front ...... hear ....AR t'.... n6ptii height .........O.f.* ......... Muter of Stories .................... ,. 9. Size of lot: Front .....A) ....... Rear ......... Depth 10. 14m1:e of Nmrcl►ase ..................... tlammme of l cirmimer Dwner. .................... ............._... I1. 7xx►e or use district in wlmich premises are situated .....'/7 ,12.,.......... .........'................ 12. Does proposed ccx►struction violate any z"Ang 'law, ordinance or'regulation: ...i/YQ.............._ _ is 13. Will lot be regraded ....................... .................' `Will'exre's)s fill"be resrmoved from premises:..-; � �YGS Vi Hammes of Owner of prenises ./.�+9/.'�/,4r'Q. 1X�SlS,.. Acklress .�D /!'-7 y-.,:t {. -;'PD'mocie No. N:nme of ArchiLect .................................... Address ................... .fir..._. P1)o[ No.^ ... . ... Name of Contractor .................. ......... Acklress ............ ....Phone No. ........... 15. is this property within 300 feet of a tidal wetland? . * YIDS .......... NO a+ *IF YES, SOUIIYX ) IUM TRUMMS 11CRM['r MAY IIC RIWIRM). PLOT DIAGRAM locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-hack dimensions from property lines. Give street and block rxnmber or description according to deed; and show street names aril indicate ►,lmether interior or corner lot. SPADE (T N;W Y(>I(K, ( �� SS 0(IIINIY (A' .... �..�o ... ....................being d►mly sworn, deposes amxl says that he is Lhe applicant (Nr■ne of individual signing contract) above rknmed, SIk! is time ......................OA NW.q................................................................... (CxiLractor, agent, corlxrraLe officer, etc.) of said owner or owmmers, and is duly authorized to perform or have performed the said work and to make and file this appl icaLiou; that all. statemenLs contained in this appl ic:aLion are true to the best:- of his kmx)wl.edge and belief; amxl that the work will be performed in the nranner set forth in the appl,i'cation"T iled:Lberewith. `worn to before ume this .......... .......day 19q.!01 ... NoLary Public .. .......... ... 1 ROSE .SC NOTAR UBuc.State of N.Y. (Signature of Applicant) Suffolk Cou t No. 5089. , T xpires May 31.19-46 Y O 0 �� 0 Z:zj N e�4b' ti s 9ti P T iT �0 AQ 0l Q N i�'ie O� �hti ��y,� SS9400 Y ^ �0 Pti r Q, % �OQD a6 0 OQ- ` ve, , C;P' JP L NOTE: ELEVATIONS SHOWN HEREON WERE APPROXIMATED FROM TOPOGRAPHICAL MAPS PREPARED BY OTHERS AND ARE REFERENCED TO MEAN SEA LEVEL DATUM. SURVEY FOR BA RBA RA ORLOWSK/ ,UEErauk ElbUNIFY WAiRTMBNT OF MEAL-Th _SfkVl:. LOT NO. /0, "BIG GREEN ACRES AT CUTCHOGUE DATE: NOV. 7, 1994 FOR APPROVAL OF CONSTRUCTION ONLY TOWN OF SOUTHOLD SCALE: I = 50 SUFFOLK COUNTY, NEW YORK NO. 94-0635 DATE HS REF. NO - *UNAUTHORIZED ALTERATION OR ADDITION TO THIS ('� SURVEY IS A VIOLATION OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW / APPROVED *COPIES OF THIS SURVEY NOT BEARING THE LAND Q` .�1(11 F �� 0, SURVEYORS INKED SEAL OR EMBOSSED SEAL SMALL l' NOT BE CONSIDERED TO BE A VALID TRUE COPY * O *GUARANTEES INDICATED HEREON SHALL RUN ONLY TO HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT THE PERSON FOR WHOM THE SURVEY IS PREPARED AND ON HIS BEHALF TO THE TITLE COMPANY,GOVERN- NEAREST MENTAL AGENCY AND LENDING INSTITUTION LISTED * NEAREST WATER rDI T /00 _ *SOURCE OF WATER PRIVATE�LPUBLIC_ HEREON,AND TO THE ASSIGNEES OF THE LENDING J N SUFF CO. TAX MAP piT 1�SECTION 103 BLOCK 1Z LOT�_ Q *THERE ARE NO DWELLINGS WITHIN 100 FEET OF THIS PROPERTY INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEOUENT (` OTHER THAN THOSE SHOWN HEREON. 4999 OWNERS N THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FOR THIS RIM IDENCE *DISTANCES SHOWN HEREON FROM PROPERTY LINES '`•=w WILL CONFORM TO THE STANDARDS OF THE SUFFOLK COUNTY DEPARTMENT TO EXISTING STRUCTURES ARE FOR A SPECIFIC OF HEALTH SERVICES. PURPOSE AND ARE NOT TO BE USED TO ESTABLISH APPLICANT- PROPERTY LINES OR FOR THE ERECTION OF FENCES ADDRESS v TEL: YOUNG Ek YOUNG RRIIVOERHEAD, NEW YORK OSTRANDER E NOTE ■ = MONUMENT FOUND •=STAKE FOUND A DEN W.YOUN PROFESSIONAL ENGINEER SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF AND ED LAND SURVEYOR N.Y_S.LICENSE N0.12845 SUFFOLK COUNTY ON ✓ULY 12, 1972 AS FILE NO. 5757. HOWARD W.YOUNG, LAND SURVEYOR *THE LOCATKINOFWELL(W),SEPTIC TANK(ST)BCESSPOOLS(CP)SHOWN HEREON N.Y.S.LICENSE NO.45893 ARE FROM FIELD OBSERVATIONS AND OR DATA OBTAINED FROM OTHERS BRANDIS & SONS INC. 1046 }