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HomeMy WebLinkAbout23001-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) 9 9.� Date .......................... ... ............................ 19........... SIP 23001 -Z Permission Is hereby granted to: f� ........... ' f ................................Sim l �1/�.� . ..... ....... 5 ..:..................................................................................................... .................................................................................................................................................................. ...................................:....................... ........... ..................................................................... at premises located at..................l00....../ rzl .....Ji7 /.,...................................................... d'!..r .r/.. c�L/C............................................. . ............ County Tax Map No. 1000 Section ......11.2.......... Block........�.......... Lot No. ....421............... pursuant to application dated .....,��y. f...........1.................... 19...gr.., and approved by the Building Inspector. Fee$... � .. ... . ............................... Building Inspector Rev. 6/30/80 r••kUl. .05PECTiON R17POIlT DATE COMMENTS -------------------------- ------- - - -----�-- 1'OUNDA_TTON ( IST) -_- j�-----II - ----- - - 1Y II FOUNDATION (ZND) ------------------ ------ -------- ----= ------------------------------------------------- * ROUGH FRAME & -i� - --- --- I PLUMBING II � ! II I H j� INSULATION PER N. 1 . STATE ENERU, it 1, I II II I, I r7NA1, - -il -- -- - ------------------------- - _------------------------------------------------------ ------------------------------- ------ 0 AUU.TT.IONAL COMMENTS: O ---------------- BOARD OF HEALTH FORM NO. 1 — 3 SETS OF PLANS . . . . . . . . . • TOWN OF SOUTHOLD SURVEY BUILDING'DEPARTMENT CHECK . . . 4 . . _ _ . . . . . . . . . . ; SEPTIC FORM TOWN HALL i . . . . . . SOUTHOLD, N.Y. 11971 (�9 TEL.: 765-1802 NUT I FY 0 CALL . . . • • . . . . . . Examined . . . . . 19 HAIL TO Approved . . . . . 9 Q, . , 19 Kermit No. . .�300�i�, . . . . . . . . . : . . . . . . . . . Disapprovedafc . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . // . mg I spector) 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 ets 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 . )r areas, and giving a detailed description of layout of property must be drawn on the diagram which is pat of this appli- :ation. 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 hall 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' hall 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.. ' 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws;'Ordinahces or Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition', as herein described. -lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections (Signature of applicant, or name, iiff�a� /corporation) / (Mailing address of applicant) hate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber.or builder...-, a. . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,,Iameofowner.ofpremises . . lvl1 � . . . .4;� V C,&/, . . .^VA , , , , , , , , , , , , , , , , , , , , , , , , (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authorized officere. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ (Name and title of corporate officer) Builder's License No. . . . . . . "" . . . . . . . . . . . . . . Plumber's License No. AUG ? ,1 1995. Electrician's License No. . . . .`�. . . . . . . . . . . . . . . . Other Trade's License No. Location of land on which proposed Work will be done. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �'v. fG! . . ' :1... . . .�OJ. C. . . House Number /Street Hamlet County Tax Map No. 1000 Section . . . ,�9. . /. . . . . . . . . Block . . . . 16. . . . . . . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . Lot . . . . . . ,. . . . . . . (Native) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy /` -fir. . . . ... . . . . . . . . . . . . . . . . . . . . . . . ... . . .. . . . . . . . . . . . . . . ./ b. Intended use and occupancy . .SJ � ��- 1 . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . Addition . . . . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition . ... . . . . . . . . . . . Other Work . . . . . . . . . . . . . (Description) 4. Estimated Cost . . / . /, rJ . . . . . . . . . . . . . . . . . . . : . . . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..... . . . . . (to be paid on filing this application) S. If dwelling, number of dwelling units ... . . . , 1.,. ... . . . 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 . . . ."- . . . . . . . . . Rear Depth Height . . . :- . . . . . . . . . Number of Stories . . . . . .r. . . . : . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . Rear . • • . . . . . Depth . : . s. . . . . . . . . . . . . . . . . Height . . . . . . . . . . . . . Number of Stories . . . . . . . :. . 8. Dimensions of entire new construction: Front het �' j Rear ` , � r, : Depth . . Height . . . . Number of Sto f®®o� es . . . . . . 9. Size of lot: Front . . ©:3y,fQ:7,`, �7., Rear . • � r'. , , Depth �. , , , , 10. Date of Purchase . . . . . . . . . . Name of Former Owner 11. Zone or use district in which premises are situated . . . . . ��, 12. Does proposed construction violate-an . zoning law; ordinance or regulation: 13. Will lot be regraded . . . . . . . ... . . Will excess fill be removed from premises: • .Yes . • • No 14. Name of Owner of premises !% V� 4.4'�� !gii��y ddress V t RRY<f�7 PE-, Phone No VIP Name of Architect ,TARM� 9 . .. . ... . . . . , , Address No. . . Name of Contractor w • �. 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. STATE OF NEW YORK, S.S COUNTY OF . . . . . . . . •. . . . S- . . . ... . . . . ... . . . . . . . . . . . . ./ being duly sworn, deposes and says that he-is the applicant (Name of individual signing contract) �rbove named. leis the . . . . . /iQGff��` . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,. . . . . . . . ... (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 rpplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the .vork will be performed in the manner set forth in the application filed therewith. ;wom to before me this /. . . . . . . . . . .day of. . . . . 19 X45, Jotary Public jj .�. . . . . . . H. ounty %�I ! i LfNA FOROSICW : .. . Nolmy Public.State of Now York . . . . . . . . . . • . . . . . . . . . . . . . . No.4985 A Suffolk County (Signature of appiicatit):;."` 7orm Bon Sept.3.19 + SAMUELS STEELMAN ARC 780 P02 AUG 31 '95 09:49 Olin R x 7 LU 'AUG 3 11995 77 f R•�►�.I.D �F Fs�C l�f 1�6� ?-4 rri M AvviZ'51. c!5 cn . E•.aGN I iJ�{ POOL toll . yltjl0� 4 :sUFFi)ul Cowrly DF..i Ajj 1-kiENT OF H -M SF. ICE, ' FOR APPROVAL(IF CA11, NOTON OF Prc ji�6t hJa 4•+g, i,� Orav,6 By; UT JUL -77 Chl.rkecl By: 'j''F, APPRO 0 MIRES`fH'RTE YMS FJjr A ID�Ayc. "ApF�E�i(A Sc2 le ,.�Q, ��o,•.J►.� PLEASE NOTE Sheet Tiile: It I� thlnaadplicant®a reaponalbllity to 1131TE ma nto aquat.� sanitary di$tanca between all water supply and $ewe.p� F`LAN dis oral facilities. 01 Min P...EASE ...Al. - imam distance between well .moo She at Nc. and cesspool is to 15 106T'I JO loo Q + SAMUELS STEELMAN ARC 780 P03 AUG 31 195 09:50 SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES WASTZWATER MANAGEMENT COUNTY CENTER RIVERHEAD, N.Y. 11901-3397 852-2100 **rex*•k,t****w,�x**ic•k*,e,rrrkieie*•��.�****•k•R,t�•x,t•k**,k*��**tic**�.*�*�c•k�**�r�r***•k•k•r;k*�ru*,!*�*�e�r DANIEL W. & TA,CQUELINE MURRAY 21 PROSPECT PLACE RIVERHEAD NY 11901 CASH RECEIPT Date Received.: 05/26/95 Receipt #: 13435-P-8860-10033 Hdref No: R10-95-0078 Fee: 9,330.00 Received From: JACQUELINE. MURRAY $330.00 Amount Paid: Check Number: 3116336 Project Name: RESIDENCE @ S/E/C KING FIFTH STREETS Location: S/E/C KING & FIFTH STREETS AUG 3 1 1995 �. �S 1�16TANG E 'Tc� ►sEIc,HtboWal6�' WeI.L f c� LE'T °...., ITS'. DATA' ENE K n SCTM # � 1000 - 117 - 8 - 1 �° K I �>. . PROPERTY: 60 King Street -- t NORTH Po K ,Marsh P} IY COUNTRY wpr ADDRESS New Suffolk, N.Y. 11956 s. ccue Est =: OWNER: Daniel & Jackie Murray.: I Y FUTu�� trxt�.�151�N - °' : 21 - Prospect Place " I __ `. __ . 1 L. G►-11�tc� r��1- ___�! curcHo�u 01 Riverhead, N.Y. 11901 / !��vvpos+=d t�IN I-loFT' H, F'1' c� o 0 Old cove HARBOR Tel # (516) 727-8231 ' s t-r,�•►i-� 'A LIG E" To LJ W -- - plz G���, GONG, p D I�g FF 'T L — �_--- - — XMOJ� n , k ti f op` zs '. S SITE: 0.7 Acres a �T Z LAGHINO� ��� --- ------ - - - ,�. oo _ W Y AREA . 30,557 sq. ft.' rains -' .,e,,� I - 12 Di HGrN yc LP �-� �t G-rI►�N , ^' `v J 6 H Gt NEW SUFFOIK SITE; L r F ZONING: " + R - 40 Jj J I 1 1 ' © IN' SURVEYOR: Roderick Van Tuyl p+zo �s� ~ �3 =, �lrr�-;-lG -r^r 4K_ \ I Noo►•!�-ram( } Green ort �N.Y.-11944 Rey 1 De>J j . i ( n-u►t�H k: License # LS 25626 E , \ Dated: 6 123 187 P:^CP1 U 1 '` U 1 '� j7KZl /�{ JAY`'• `4 I �> NOTES: Elevations shown are p>zoNosEt7 •• � LU . ' bused on National Geodetic t - . Vertical Datum of 1929, and mean sea level. Public water is not available within 500 ft ' Pc TEST of property. 111 . >0 The locations of wells and cesspools shown hereon are from field observations and ' or data from data obtained LF. Ft.io from others. t , ' d T -' U) HEALTH "I am familiar with the DEPARTMENT standards for approval and = o©' t z oe 5 , 1, STATEMENT construction of subsurface I I -© -t' I t` � � � Z sewage disposal systems for NSF ': `� a w. 1 G .O GIB I single family residences and will abide by the conditions , O set forth therein and on the permit to construct." ` fr •, SIGNED: elf LS�`tvD I �' 70 `',, I � - -• ..__ �..,.�s2 1.lN� ! ;z ou Z . t d •, ^ � ' ' T�.et:"s To ,¢ral�*1►� �o � ,�-��pr�pe,�® w"�"u''raR� `�.: x , , M o W y 1 /, 1mx12+ LZ � x Q E 1 \ I . M J " O /14 ! J �ETR�^cK - P_;.Q. ! DL 6 �F � 1'Ir.lG NEIGH ' cn n • k / r A. w c3 • i '1_.•' �' V/ !cam � �`0 � 2�' 1 ' Project No: cr*z c�, �•. _ '\ � �I /yam 1 f / r°3v_,''.ry^ � °'a:•": ±.R+:..9r-••`;�,9 ¢•wse,;�n�5 y�` e+ ,/' 'i J •'� t � �Lr✓{ � ' , V .y"#, v4 -'.i.ew >�i':t.WeJf A •.',Y Z'h"1^`..,ry a i'4t;::! By: OJT �•1 ' g' o p— i n iF_JUL 0.5 Wuo.R/U-°15-d0�9 Drawn w • � 71 - r {Rry5 p � Checked By: 'T'�► ff,�,dJ V l.16 ,.aC Al 1 ti'A9 r!_:a w6p. ?; !r ?'.¢`W"6" P_T`+ fl "R•A^y! ,p Vie+ ..a Date: �_ :l �_.i•- j .... m-a�_ Scale: A e s�rra w►rt G PLEASE NOTE f Sheet Title: It is the applicant's responsibility to ' maintain adequate sanitary distance y SITE between all water supply and sewe.V% PLAN . disposal facilities. _• PLEASE �tf3T-E.. Min"tmum distance between well Sheet No: _. and cesspool is tO be 15 - i � T(�[�77 t � {.VV4l .1�:,� 5}t7°JfIC1 `1t�3H AI:I 1d3Q n , , ,