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Home My WebLink About23494-z FORM NO. f 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 U Date .. , �r 19.��..� 23494 Z ......................................... Permission is hereby granted to: ........ ... ........................... ... .1 ' ...... . ... - .fir . ..... . s �- to . . . . . ..�... . .LZ::.... . , ........... ......... .V.....C:11A�e............. .................. .. ...... ...... .,..... ..... .�. �,,,� ........... .�. rr�� .� atpremises located at .�T� ...........�kp'� ,".�`u...,��.................................................... ................................................ . ............................................................................. ................................................................................................................................................................. County Tax Map No. 1000 Section .../.?'/........ Block .:... ............. Lot No. pursuant to application dated ... ....................................... 19...�"kand approved by the Building Inspector. d Fee $ .�`.l.s ... r ilding Inspector Rev. 6/30/80 BOARD OF HEALTH . . . . . . . . . . . . . . . FORM NO. 1 ,,3 SETS OF PLANS E ('�=AY3 'TOWN OF SOUTHOLD �URVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING DEPARTMENT /'CNCCR . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . -� SOUTHOL D, N.Y. 1 197 1 TEL: 765-1802 NOTIFY: ELDC. DEPT. CALL :�e('("i P�LJLi� ��- H Tp1Nf' G S �JT}iOLD . - - . . ,,//�� pp F�rl 19_99 MAIL TO. . IRSUU'C'S �l�t.�l�t/cGl Approved....��. �! ...., 19,52L Permit No. �� e. 11�AID..l.0G.L' .!' `�....... Disapproveda/c .................................. ............ 45. ........... ...................................................... (Buildin .In r) APPLICATION FOR BUILDING PERMIT 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. A 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 application. c. The work covered by this application PW not be conurnced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector i•7iTl 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. APPLIC11rION IS HEIEM 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 inspec ions. (Signature of applicant, or name, if a corporation) - ( r S_W ezY..�qhom. (Failing address of applicant) Z 1 cf!� State when applicant is yner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......... r .1.N. ......................................................................................... Name of owner of premises ..�. 1`- /_1... J .. \ ................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. ......................................................... (Name and title of corporate officer.) Builders License No. .......................... Plumbers License No. ......................... Electricians License No. ..................... Other Trade's License No. .................... 1. Location of land on which proposed work will be done.............................................................. Tt7„lvZ � ..tJ f ..................................... ............ .. .�� House Number Street ff D I WN"Igt County Tax Map No. 1000 Section ...:1. ..!..... Block ................ Lot ....®.. ....... Subdivision ...................................... Filed Map No. ............... Lot ............... (Name) 2. State existing use and occupancy of premises pand intended use and occupancy of proposed construction: a. Existing use and occupancy . ....!��:!....��......�t�.... ....... n:.�� . :�C./..... b. Intended use and occupancy ..... ......l �.'........ ......... ... ....... 3. Kiture of work (d►eck whid► all)licable): New Ikuilding Acklition ... -Al teral:4,6ip Itelku il i r ............ Mn►oval ............. lol i t i on _........... Other Work P� �J I! _':'11, lem (1)escrtpCicx�) 4. Estim►ccted Cost ..�.J....:-........... fee ...................................... ...... (r.o he paid on filing this application) 5. If chaell ing, ►xndcer of dwell icy; units ............ Nu►ber of d,ael l ing units cx► ead► floor ................. If garage, cxnber of cars ...................................... 6. If. lxusiness, co►m►ercial or mixed occupancy, specify nature and extent of earl► type of use...................... 7. Dimensions of existing structures, if any: Front................ Rear Depth ................. lkeigl►t ......................... Nud)er of Stories ...................... Dimensions of sane structure with alterations or aciclitions: Front Rear ............... IkepLh .................... Ileigl►L .................... RA)er of Stories ................ 8. Dimensions of entire new construction: Front ................ Rear ............... DepLh .............. Ileiijit ..... Mid er of Stories ..................... J r 9_ Size of lot: Front ._.' !:[.�.... Rear ... ..... Ik:pth ..�.......�...... 10. Dare of Hrrc3►ase ..... �:!. ...... Name of Former Owner .._.. �?.Un. ................ II. 'Lone or use district in wl►id► premises are sft uatecl ............................ 12. Does proposed construction �violate any zoning law, ordinance or regulation: .......;(N.U........... j 13. Will lot be regraded ....................... Will excess fill be renoved from premises: YES NO Ili. Naves of Owner of premises I�l .�.��.... Address Z,VkG� A0J�' !.�. Phone No.J �. Name of Architect .................................... Address .............................. PI lone No. ............ Nave of Contractor ................................... Address .............Plxme No. ............ 15. Is this property within 300 feet of a Lidal wetland? * YES .......... NO .s .... *1F YES, S(XIIIKXD 7DWN '11111SIMS PERMIT MAY BE RE(X11RI'.II. PLOT DTAGRAM I<x:aLe clearly and distinctly all buildings, wliether existing or proposed, and irxlicate all set-back dimensions from property lines. Give street and block nid>er or description according to deed, and show street- naves and indicate %d►ether interior or corner lot. , , AP RpV AS NOTED FEE: RY: NOTIFY DEPAR T 76 5-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: I. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - F11.44INyG & PLUMBING 3. INSULATION 4. FINAL - CONSTRUCTION MUST RE COMPLETE FOR C.Q. ALL CONSTRUCTION SHALL. MEET THE REQUIREMENTS OF Th E N.Y. STATE CONSTRUCTION & ENERGY s[nn: (A. t� WC'(.> ' �' /� CODES. NOT I RESPONSIBLE FOR cam\ - �C DESIGNS OR CONSTRUCTION ERRORS C�c...........P6" ...........................................being duly sworn, delxuses and says that he is the applicant (N.rne of indlvld►lal. signing contract) above ►aiied, Ikeis the ................ .(.N.(. '� �......................._..._......................................... (Contractor, agent, corporate officer., etc.) of: said owner or owners, and is duly authorized to per.fonn or have performed the said work and to make and file Lhis appl ication; that all sLaLemetits contained in O►is appl icaLion are true to Ole best of hi.s knowledge and luel.ief; and lhaL the work will be performed in the nkux►er set forth in Lhe appl.ication filed therewith. .9wo rn Co I>eaf�c - n►e this ........1 ......clay o .�19.. Notary Prcblic ... .. ........ ......... ...................................... CLAIREL.GLEW (Signature of Applicant) Notary Public,State of New York No.4879505 Qualified in Suffolk County Commission Expires December 8,19 117L[f--- NO. b,3US9808--04 0 pi g 6pet cc/Ul C-L 1-5 5�'t a 4 y- viood: poste n d.; r '� 1iV S T� A A f? ►A b All c O'JJ'20 E 167.45 J r`, STEPS 1 Z o zs.�' i rn � Ld " \� o 103.5' i 11.6' 27 2' 'n v ;�i.'4iLfE FR!�li•!E � V. "WED GAR11 GE 74.7' 1•R^SHED 2.8 J r1 DOWN �O Z A . 33,606 S.F. a 0.760 Ac. ' • MAY 1 31996 lAAv N/F i9t l BLDG.DEPT. I TOWN OF SOUTHOLD CERTIFIED TO: ALL STATE ABSTRACT CORP., SURVEY OF FIRST AMERICAN TITLE INSURANCt T " COMPANY OF NEW YORK. PR O PERT Y TERESA PADULA FEDERAL cAIiiVrS AND l OAN SITUATE' AT IIiIATT/l'UCK TOWN OF. SOUTHOLD SUFFOLK COUNT;; • NEW YORK SCALE 1" = 40 AUGUST 8, 1994 EASEMENTS AND/OR SUBSURFACE STRUCTURES RECORDED OR UNRECORDED ARE NOT . GUARANTEED.UNLESS PHYSICALLY EVIDENT AMERICAN ENGINEERING SERVICES ON THE PREMISES AT THE TIME OF SURVEY. GUARANTEES INDICATED HEREON SHALL RUN ., IdnC>r siirveVd s — civil engineers ONLY TO THE PERSON FOR WHOM THE SURVEY IS �CL�rLGGJ"CLLxJe LarclZ2tects PREPARED. AND ON HIS.BEHALF TO-7HE TITLE COMPANY, GOVERNMENTAL AGENCY AND 34B A46fi!e Av6 i66: 76 Un1017 Avenue LENDING INSTITUTIONS LISTED HEREON, AND• O VVesf iur N.Y 115 Pd3 komd, N.Y 07,79 THE ASSIGNEES OF THE LENDING INSTITUTION. y' �F '~ ' GUARANTEES,ARE NOT TRANSFERABLE TO �5 6) 876-8908 ��'. ,Epp^p, 0A, 516) 98 I—506.3 ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWPIF;;! A o ` �L ? C-) THE OFFSETS(OR DIMENSIONS) SHOWN HERF_GIr �j1 FROM THE STRUCTURES TO THE PROPERTY._LINL; ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT INTENDED TO GUIDE THE ERECTION OF FENCES,,RETAINING-WALLS, POOLS t PATIOS, PLANTING,AREAS, ADDITIONS To r BUILDINGS AND ANY OTHER CONSTRUCTION. 31 S.C. T.M. DIST.1000 SEC. 141 8LK.01 Lori. 1 4i� AiiU9 4 c_"' "%9487 12\0894M .