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HomeMy WebLinkAbout23823-z IIINVIXI loll lol.rol(f 1)Al V gt.It j L 1 ON F 1)AT 10 N 2 HD cl FRAHR KS 111.1it-Ill I NG, tj STATE. F I I IA L • ------------- ------ - ------- A D D 11,1 Ml Tll." 0 IM1.HTS., FORK NO. 2 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) N? 23823 Z Date ...........4V...&.................... Permission is hereby granted to: 1re- 1/24!.. . .. . ...... ........ .... ................. . ..... ...... ...... .............. �K ..l....1193S . ..... ........... ................J0.0. . to &7�p' 0 ... .... . . . . . . A ................ ................................. ,:....... .. ...... . ........... . .... ... .......................................... ............. .................... 4; at premises located at .....................A6 . .... ..... ... ................. ................................................................ ................................................................... .... ................................................................................................................................................................. County Tax Map No. 1000 Section ........A6-fl. Block ........//....... Lot No. ............... .. 11 4-0 pursuant to application dated ..................... 21. ..... .......... 19..Y4 and approved by the Building Inspector. Fee ........... .. .............................................. Building Inspector Rev. 6/30/80 BOARD ' OF RIIEALT11 . . . . . . . . . FORM NO. 1 3 SETS OF PL,%NS TOWN OFSOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . ',i C1\! BUILDING DEPARTMENT C1IECK . • . - . _ . . . . . . . . . . TOWN HALL SEPTIC roRM ._ . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 - = TEL.. 765-1802 NOT IF Y — - CALL Examined . . -�. ., 19 MAIL TO : Approved . . . ... . . . . . . ., 19 Permit No. C ,lv Vey IV�. U7 �, Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector PPLICATION FOR BUILDING PERMIT Date OAT.. : a. . . . . .. 19 76 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 oil premises, relationship to adjoining premises or public streets or areas, and givitng 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 small 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 d tnolition, as lierein described. The applicant agrees to comply with all applicable laws, ordinances, build' code, housi g ode, and regulations, and to admit authorized inspectors on premises and in building for necessary in p ions. -- (Signature plhcatnt, or name, if a corporation) . . . . . . . _01d (Mailing address of applicant) State whether applicant is owner, lessee, agent, rchhtect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises 1�I �17. . =. �lir l .b3r_kr). . . . . .. . . . . . . . . . . . . . . . . . . . . . (as otn the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. r . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Name and title of corporate officer) Builder's License No. Plumber's License No. . ... . . ... . . . . . . . . . . . . . . . . . Electrician's License N'o. Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1 . Location of land on which proposed work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �� �c �rs. . . �� . . . . . . . tcic� vim. . . . . . . . . . . . blouse Number , umber Street Hamlet County Tax Map No. 1000 Section . . . /10-�. . . . . . . . . . Block . . . . . . . . . . . . .. . . . Lot . . . .v� . . . . . . ... ... . . Subdivision . . . . . . . . . . . . . . Filed Map No. . . . . . .. . . . . . . . Lot . . . . . . . . . . . . . (Name) T. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy CrJI.�IC�l�7�� .. . . . . . . . . . . . . . . . . I . . . . . . . �. , . . . . . . . . . . b. Intended use and occupancy . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -3. Nature of work (check which applicable): New Building .•. . . . . . . . . Addition . . . . Alteration X. Repair . . . . . . . . . . . . . . Removal . . . . . , , : . . . . . . Demolition . . . . . . . . . . . . Other Work . . . . . . . . .. . . . . . . (Description) 4. Estimated Cost . . .��.�1�,O.C�o . . . . . . . . . . . . . . . . . . . . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (to be paid on filing this application) 5. If dwelling, number of dwelling units . . . . . >/. . . . . . . . .. 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 type of use . . -- 7. Dimensions of existing structures, if any: Front . .�o .� . . , Rear �.q,� Depth . ... D.Height ; . .� �. . . . . . . . Number of Stories . . . . . . .� . . . . . . . . . . . . . . . Dimensions of�sanne structure with alterations or additions: Front , Depth . . . . : n. G� �. . . . . . . . . . . Height . . . . r Rear . ��p 4? . . . . . . . . . . g •. • • • • . . . . . . : Number of Stories . . . . . 8. Dimensions of entire new constriction: Front . . . . . . . -. . . , Rear Dept}n — Height . . . . . . —. . . . . Number of Stories . . . . . . — . 9. Size of lot: Front . . 6?�'.1 Rear. . . . . `��. . . . . . . . . ,,Depth . . . . q.�. . . . . . . . . . . . . . 10. Date of Purchasef . . . . . �/.1.q�1•��• • • • . • . . . . . . . . Name of Former Owner11�G.1 1 1. Zone or use district in which premises are situated . .12. Does proposed construction violate any zoning law, ordinance or regulation: . nc, 13. Will lot be regraded . . . . . . ./.-).a. . . Will excess fill be removed from premises: Yes ON ' 14. Name of Owner of premises N)4��Ad ddress r . . Phone No.73 :. T.g Name of Architect J?7t?"j �/ �r=: ,/�1,2./ ddressc2S2-16. P I i o n e No. Name of Contractor :f0. Ck-krh71t't'-cl. . . . . . . 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. atl,:,,- �urv-y � f f ' STATE OF NEW✓ YO <, -OUNT.Y OF . . . . . .s.s A , , , , being duly sworn, deposes and says that lie is the applicant (Name of individual signing contract) .hove named. /' leis the . . . . !7-RC . ! . 7E. C. . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .•. . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) -f said owner or owners, and is duly authorized to perform or have performed the said work and to make and File this pplication; that all statements contained in t}ris-application are true to. the best of his, knowledge and belief;and that the /ork will be performed in the manner set forth in the application filed therewith. worn to before rne\tlris . . . . . . . . . . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . ., 19 9. . lotary Public,( �� n�i 'County LINA r0ROSI01 i 1i1� . . . . Notary Public,State of New York % ''' Ho.4989863,Suffolk Counly (Signature of applicant) Term Expires Sept.3,19917 5897-zx_ I i - w LOT 290 s•49 2s SO�E.'- .4M7 t;L AC 16 T,p Dom'!J e ----=r:{, ---t } — --- r Ln A Q LOT p89 00 •� E � war rz�- 33- �� � /L . r~ � — � MNttAMtlr�r+►.+++�+rv11M..r �/�.. to this survey'rea�inlmlon of CL s$ v 1 _*action 7208 of thn New Vnrfc srta• F;dueation Lone Copies c!'his survey map not bsari q r the Land surveyor's Inked seal or embossed seal shall not be considarw! to be a valid true copy. ¢ �q &Lliantees indicated hereon shag-, ory to the person for whom the s rvey rs prep.=red,and on his behalf to the --? _ the company,governmental agency arw y`< [[�� P fI/� T 'lending utstiV,gin listed hereon and �� �r —� �-� �� ' to the csslgaacsof the lending'etstb talon.Cua:an:ccs are not transferable ip t-ANO S SUCZVEYED F02 �10 additional institutions orsubsequtrtt : --CAL 60r=1'r - - ZL...ES r'_ } SU F TAj( MA 7I,x�=�l�g•i i-3. �2�-5� , t TL 0. 201 6.. . -- -- 0-HO JUMEN T ,C=PIPENDA BAFJON f : AT UO?E U165SAU POINT GUARAJITEED TO( r - FIDELITY NATI 01AL Ti TLE I PISU kAl�.iCE CO4 ..�T NC.,. c 1=E�? 1�O�MA.P C?F NItS�sAU FIDELI TOWN OF SOUTNOLI; f KJY. CNAARLES C.� fZtSON BELL C BARTCN PGiNT AMEt�GtG P'tApl1, FILLED IN �- - _-- ASSU2V�'YEL -- _ _ E SUF'F.CO.CLEUC5 OFFICE AS _ r NO.►s6.• ____ . ____ RODEnlCK VAN 7UY�PC __� L1C,LMJvSUQV YOQ5-- ___ _ .._ -..._,. .• .. r ., -.-> ...» ... - .. .. - r .•ra., r - s•r4. (EXIS7. ff z Q1 CA-E MF_NT z / Z`x G►6 LIJSi:-1 �,G. WINDdW / \� � • �xlsT wi „c�M I 2-�w I' ' \ rJ• 4El.4..:'.CA 5I Ida --a• , 0 414V - c ) L v NG c �Ar ' g�. REUSE c O z z 4 s 1. Q'I tC EX15T T- 10 STTF-P -r ,y� I l oow�t rE t,n N �, 71�' 13 �IEbJ 26.xioa I I� PINE RISER N ((1 ��T �� L I�.�TH t LFV 2. >=IRE _ a ?•?>< R75'1" NR•MINA t I RICaG� �' . r 2 L , I G1, 3 /4 Vl, 4 O . KUSE, ExMrs77 PNe •2 x � �,..'TU I C� cv I +>, I z ' OC I cp5o5 GXW Ig . PAN�L'G �W WIt .15 r , �r 0 W C4NG5L-. I REMAIN S 54% IF ( ► K N tiff __ _ ,� ---- - . MF�D. rw• Da' o I i gr QCIG7 STG NEw lzDoF .c l a t-2" gy x.. NEo NGJ fJorE: c.ENrER a..., �,.......,r•,�:. .• •K • '' ._f s`' GT• P057� UPPER-,j- �KTT•- 3 - F-52127-STATIC?N�'�12`� a m �I i✓owEa UN 3 w ZI 57-vENrINCa UNDERWRITERS CERTIFICATE REQUIRED a ,� - PR IDEbA �i NR. FIRE E �.; ' • .: cell _-._ _ . RATE SEPARATION 3 � a r ARATION TO z q w NI 11 PART.7�1T.3{fj{1 of M s ��- AP R�7 AS NOTED i1elbell non z 7M< � `�� DATE: �� '� �.P#a3 E , 'S UN � UIA ,Ill ' _�_ FEE' } ' It r 11 (oil NOTIFY. BUILDING DEP AT ° • � . 71a5-1802 9 AM TO 4 PM FOR THE NOT CE-IffiFMA SCAPEAS FOLLOWING INSPECTIONS: � � '� � �n �; REQUIRED B'Y*ART. 714� � W • � ` � I 1. FOUNDATION - TWO REQUIRED �' � !`� � ,���, �': N N.Y.STATE B�1 t � N 101 POURED CONCRETE �r ' �3 �� tDING CODE. ., ►t x PLilIVIBIi11G 2. ROUGH - FRAMING €II. PLUMBING ' tV + . ( ° ALL PLUMBING WASTE - • O Q H • V &WATER LINES NEED • INSULATION TESTING BEFORE COVERING • FINAL - CONSTRUCTION MUST S u1 M . NEJ -Y-4I 2- T-M- ,. ' \ ap " ��i��"2CX� 2xCo F Te-i�''oc• I �1 - � BE COMPLETE FOR C.O. eQ `7 X � v' v' • �', z ALL CONSTRUCTION SHALL MEET 1 THE REQUIREMENTS OF THE N.Y. ► STATE CONSTRUCTION & ENERGY N N GEILII�rc+ 1tE. I " • Used CODES. NOT RESPONSIBLE FOR I/8 U!",. if Copper tubing is •n DESIGN OR CONSTRUCTION ERRORS -- - c� for water d'+stnbut� g •piping shalt be R ..' �T y _ __ 1 _ a✓E F.XIS ti. System., r I100 5 of types K or L onl r f2AT(=H GYP 2)Q# P�<)F- I I _ A'Ts H . *�E. OF • I q - --�� RING�_Re". �,� 51D ~-� . ST PLU/VI13ER CERT/FICATIO��! NEL� "curl i,'lol:b= - ,ID • �Q t INC" NELJ WING�W� 2•G�.f IT'S ' cI�l-` + a0 ©�LEAD COIUTEI�T3EFORL' � {3Er.�R�MS P.,aa.TH CERTIFICATE OF 0CCUPAh/CY SOLDER USED IN WATER Y SUPPLY SYSTEM-CAl"�WO ' i EXCEED 2110 o I / LEA, . Gf'`�E - ----�• E� 16 SLAB oject N to Up I` .. 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