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HomeMy WebLinkAbout23511-z FORK xo. s 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) I N® 23511 Z Date .............Y/. .. ,7............................, 19.--• Permission is hereby granted to: ..-:1©?A)......(:Rjg;aA) ....................... .....�, '.. .s ......�°......................... ....... r.�: a. ......... :..../.l. . to F1'e':l—..... ...... � s%k =- ,.. .f .. G;!i�-... �....: fj�G� �. ....... f ...... ....:... : ...... ..s......... ���..:--o........ ..... ............. at premises located at ' ........��.. :. . -.......... .................................................................. ........................................................ : .................................................................... ................................................................................................................................................................. County Tax Map No. 1000 Section ...1 f..0.......... Block .....0(iP.......... Lot No. ..1-3.............. pursuant to application dated .......��... ......���.�................. 19�O, and approved by the Building ,.Inspector. Fee $........................ .......... ............ Id . � J- .�. r......................... i Rev. 6/30/80 U r5 BOARD OF HEALTH . . . . . . . . . . . . . . . U FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . Q TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . MAY 2 4 1,9 BUILDING DEPARTMENT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN HALL SEPTIC FORM . . . . . . . . . . . . . . . . . . . SOUTHOLD, N.Y. 11971 BLDG.LEPT. �ata� - N OF 5019T'dOLt3�_.mow TEL: 765-1802 NOTIFY TORN CALL Examined......!P./. ..... 19.Cl)J. r° MAI' TO: Approved........����...., 19. '� Permit No. .������ ..... .......... ........-- Disapproved a/c .................................. ......... ..._........... o � r1�3� ...................................................... (BuildinIf APPLICATION FOR BUILDING PERMIT ..Date. . 19. ! ?'. 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 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 HEBY 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 promises and in boil ing for necessary iurtions. (Signature of applicant, or name, if a corporation) ............................................. �5 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrici ,r or-builder. ........... �:1 --. .. ....... ...................................... -- Name of owner of premises (as on the tax roll or latest deed 1 + If applicant is a corporation, signature of duly authorizaRPROND AS(NOTED OLD OEPT'OLD w DATE: TOWN OF SOVTF4 •(Name.and•title.of'corporate.officer)••..'•-.-.-•• FEE: '�� 81°• _ NOTIFY BUILDING DEPARTMENT AT 765-1802 9 AM TO 4 PM FOR THE Builders License No. FOLLOWING INSPECTIONS: 'I. FOUNDATION - TWO REQUIRED Plumbers License No. ......................... FOR POURED CONCRETE 2• ROUGH - FRAMING & PLUMBING Electricians License No. ..................... , 3. INSULATION Other Trade's License No. .................... 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. 1. Location of land on which proposed work will beA CON6.I=RYOT-14N• S HA kk--MEET................................ �j THE RE L!IF�1 M:-.I lTS OF THE N.Y. ........w..........�1..........f�:v !::......STATE— p T � � �.Z .ENERGY ............................... House Number Street CODES. NOT RESPONSIBLE FO � t CountyTax No. 1000 Section ....�.�U......DE Bllock GN R-.�ST.w..... Lo ERRORS/................ ....-- Map •• ... Subdivision ...................................... Filed Map No. ............... Lot ............... (Nam) 2. State existing use and occupancy of prI/emises and /intended use and occupancy of proposed construction: a. Existing use and occupancy .......J.! l• ?1s;�;�16�7...................................................... b. Intended use and occupancy ...................................................................... .... 3. Nurture of work (check wl►icl► applicable): New lluilding .......... Addition ........... Alteration .. . Repair ............ Removal ............. De olition ............ Other Work Gf.J�F �1;�?�� ;��i�r�r•ht'/vc (Description) 4. Estimated Cost ...................... fee ........................................... (to be paid our filing this application) 5. If (kielling, mvirer of &yelling units ............ Nurber of dwelling units on each floor ................. If garage, umber of cars ...................................... 6. If business, c(mnercial or mixed occupancy, specify nature and extent of each type of use.................. 7. Dimensions of existing structures, if any: Front................ Rear ............... Depth ................. Ileigl►t ......................... Nurber of Stories ...................... Dimensions of sane structure with alterations or additions: Front ............... Rear ............... Depth .................... Height .................... Ntnber of Stories ............... 8. Dimensions of entire new construction: front ................ Rear ............... Depth .............. Ileight ......................... Nurber of Stories ..................... 9. Size of lot: Front .................... Rear .........,......./.I.. Depth .................... 10. Date of Purd►ase ..................... Name of Former Owner --�� hl�J..................... 1. Zone or use district in which premises are situated ...P eSl d .,- / ..• •.. - _ _. . 12. Does proposed construction violate any zoning law, ordinance or regulation: .A U , .- .. ..•- .--• 13. Will lot be regraded ................. Will excess fill be removed from premises: YES NO ,l b IN arc lei. Nanes of Owner of premises�')."7%/N,....�17`l!`� ._- Address .............................. Nione No. ......... ... Name of Arcl►itect .................................... Address s .... I'trone No. ...... ...... Nane of Cbntractor ................................... Address ...... ......................Phone No. .............. f 15. Is this property within 300 feet of a tidal wetland? * YES .......... NO .......... *IF YES, S(XT KN1) 1CllN `li(USIFL,S PERMff MAY BE. RE(XLIR1-. PL.01' DIAGRAM Locate clearly and distinctly all buildings, wlredrer 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 wliedier interior or corner lot. "'i � r iL// ��-J /`-�"i /� /u"l a i]��T/"✓`"v- .�/h.. l��i'�/l�-�MJ j� r /v w lLi., ••7i 6 1 - SrnlE U. MV Y llt, ss � CXAINIY (lF 7....... -. � .......being duly sworn, deposes and says Lhat he is Lite applicant (Natte of individual signing contract) above rutmed, Ileis Lire ............. ....................................... .........,............. (Contractor, agent, corporate officer-, etc.) of said oxnrer or owners, aril is duly authorized to perform or have performed Lite said work and to make and file this applications; that all statements contained in this application are true to die best of his knowledge and lxil.ief; and LhaL Lite work will be performed in Lite manner set forth in Lite application filed therewith. yworn to . bef(orZ—day rite this � ot- ... .. .19..Notary Pub . .. ........... ......... �� �R� V CLAIRE L.GLEW (Signature of: Applicant) Notary Public,State of New York No.4879505 Qualified in Suffolk County Commission Expires Decen.--. 8,19 Z P FOUND N/F MCKILL OP S 0.7- WO.e' N84026'40"E I OVER 0.2' FD. CM.-� SM•d t-- ER 0.6, LEAN/NG 6A H Fe A } ASPHALT DRIVEWAY • D L� C� � Od � r �{� .. MAY 2 4 199� I_.'. BLDG.DEPT. 0 TOWN OF SOUTHOL _._... ` 0 h. Op G� 29 U- 16• m O�G• F� .. G p 0 q►. 0 W �0� e1 O 4� 2 y G � \�9 4 W 6 a � Z ( �( 65.9 S 85°58'30"W a 28. 49' 80 01,0oil - ROAD S6 i EAsr T4/000-//0-6-/3 SURVEY OF SURVEYED /6 FEBRUARY,1995 DESCRIBED PROPERTY SCALE /"= 20' Guarantees indicated here on shall run SITUATE Copies of this survey map not bearing only to the rcrs-,n fcr whom the survey the land Surveyors embossed seal shall is pr•=r%c'rcd, and on his behalf to the CUTCHOGUE, TOWN OF SOUTHOLDnot be considered to be a valid true ,;,► ccn, :;ny: a:• ri::�:r:l ,"ge:ncy, SUFFOL K COUNTY, N.Y. caov. iisa;i hereon, and io i'r, cri•�nees c lh_ lennJing institution. Unau hcrized attcrction or addition to this Guarcntees crc r survey is a violation of Section 7209 of c-i trc;;,s!rr�ule to the New York State Education Ulm institutions cr su P.bs!:ctuent owner&RVEYED FOR ✓OHN CURT/N ANNMAR/E CONTE—CURM GUARANTEE TO: SURVEYED BY: ✓OHN P. CURT/N STANLEY J. ISAKSEN,✓R. ANNMARIE CONTE—CURT/N P.O. BOX 294 CHASE MANHATTEN MORTGAGE CORP. NEW SUFFOLK. N.Y.,//956 fmr AMERICAN TITLE INS. CO. (5/6)734 583h TOWN OF SOUTHOLD 1 LICENSE" L W459273 N.Y.S. L/ '. NO. 95R560