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Home My WebLink About22939-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) Date................ ...... ,9.. . ...................... ....� NP 22939 Z Permission Is hereby grata d to; . .�0,61,zerX�... ..................................................... . �. ...... a �...M9 ................ to .... /' :. .. . ../ ........... ........ . ......�r ��r............. �........ ��°�-� '........�� .:................................ ...................................................................................................................................:................................ ............................................... . . ..... ...............A............ ....... at premises located at............. ..../....... ......................... ......................................... ..................... .....................................:�'` .... ....................... , ............ County Tax Map No. 1000 Section ...../ ........ Block....... ....... Lot No. ...........`................ pursuant to application dated ...... .!. p ..,f. �?................. . 19..,E . and approved by the Building Inspector. c� Fee$.:........':........... ........ ............... :.. l� /••............................ Bu'ding Inspector Rev. 6/30/80 BOARD OF HEALTH . . . . . . 3 SETS OF PLANS . . . . . . . FORM NO. 1 SURVEY . . . . . . . . . . TOWN OF SOUTHOLD CHECK . - . . . . . . . -^U TI996 BUILDING DEPARTMENT SEPTIC FORM - - - - - - - - - - - - - - TOWN HALL NOTIFY SOUTHOLD, N.Y. 11971 -WIS. TEL.: 765-1802 CALL MAIL TO Examined . . . .�, • • , , , ,, 19 ,r 0 C}C 939 �Approved . . . . . f . . . 19 !J. Permit No. . . . . . . . . . . . Disapproved-a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(Buil in spe/C;l 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 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 '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 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 demolition,.as herein described. The applicant agrees to comply with all applicable laws, ordinances, b . ding code, housing ode, and regulations, and to admit authorized inspectors on premises and in building for necessary i pectionss . . t . . . . . . . . . . . . . . . . . . . . . . . . (Signature of a cant, or name, if a corporation) -ji C-. 'l.. .!!S�. . . / (Mailing address of applicant) State whether applicant is 'owner, lessee, agent, architect, engineer, genera contractor lectrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Z � p Name•;of owner'of piemises . AAA 1 1,��. . . . �Q ^. . . � �. . . . . . . . . . . . . . . . . . . . . . : . . . . . 5 (as on the tax roll or latest deed) If applicant is a corporafi'on, signature of duly authorized officer. . . . . . . . . . . . . . . . ,rr(Naine,and Title o •coipbrate officer) {. AI:L=:CO:NT'RAC;T.q'R S..M.U. S7 '�E UFFOLK COUNTY LICENSED �. "Btiil''c(er's'License,;No:��o 7 /`�.. . . . . . . . . . . . . . . . . Plum be,r's,,ALicensd No. ,, Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which propoid work will be done. . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. �.o. . . . . . . . . . . . . . . . . . . . . . . . .. . . . .. . . . . . . . . . . . /rcl:�r:( . . . . . . . . . ... . . . . .. House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . 1&777 . . . . . . Block . . . . . . . . . . . . Lot ,, o�. . . , . . . . . . . . Subdivision . . . . . . . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . .. . . . . . . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . /4v ..�1 . . ... . . . . . . . . . . . . . . . . . . . . . . !'✓. . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . 3. Nature of work (check which applicable): New Building . . . . .*. . . . . Addition . . . . . . . . . . teration . ; , • , , . . Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . . . Demolition �er qt d� (Description) 4. Estimated Cost . . . . .! ` . . :. . . . . . . . . . . . . . . . . . . . . . . . . . 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 . . . ... . . .... . . . Rear . . . .". . . . Depth . . . . . . Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . . . . . . • . Rear . . . . . . . . . . Depth . . . . . . . ... . . . . . . . . . . . . . Height . . . . . . . . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . ... . . . . S. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . Depth. . • • . • . Height . . . . . . . . . . . . . . . Number of Stories . . . 9. Size of lot: Front . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . .:. . . . . . . . 10. Date of Purchase . . . . . . . . . Name of Former Owner . . . . . . . 11. Zone or use district in which premises are situated . . . . . . . . . . . 12. Does proposed construction violate any zoning law, ordinance or regulation:. 13. Will lot be regraded . Will excess fill be removed from premises: . Yes • • • . No 14. Name of Owner of,premistes . . . . . . . . . . . . . . . . . . . . Address . Phone No. Name of Architect . . . . . . . . . . . . . . . . . . . . ..! . . . . .Address . . . . . . . . . . . . . . . . . . . Phone No. . . . . . . . . . . . . . . . Name of Contractor . . . . . . . . . . Address . . .Phone No. . . . . • . . . . . . . . . . 15. Is this property located within 300feetof 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 frorn► property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. d AA 1 14� p ,i ,y rl . i 1 ' A I OA rya pEQp, OR�1E �� 0001 ot 9 PM 10 oNS. 60010.O 5�'�CiCAD Fes- '' rob D Ay G%1 0r , l*o g1NQ Ors foL� ZNOA'sr, coNca& M M 4..F�N�Mp pN SHADE 8E Ng�Hv g CF EHE4dY A� c0 pWpNE�t1ON .lh T-G6 E p'Cw ��CONSESppN STATE OF N EYOI 'x 8 O®� NOT1 _Ou"N'TY OF D.� . . . . . S.S. C f _/ being duly sworn, deposes-,a d says that.he,.is ythe applicant (Name of individual signing contract) lbove named. ieisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contracto , agent, corporate officer, etc.) )f said owner or owners, and is duly, authorize perform or have performed the said work and to make and file this pplication; that all statements contained in this 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 me 'this . . . . . . . . a.�. :� . . . . . . . .day of. . . . . . . ., ;ota Public, . . . . , .. _c� • . . Count ELIZASET ANNNEALLE . .i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Notary Publi State of N-_w York No.52-8125 50,Suffolk Co + (Signature of applicant) Term Expires October 31, 19 TOWN SOUTHOLD PROPERTY RECORD CAR® OWNER STREET 'YCI VILLAGE DISTRICT I SUB. LOT FORMER OWNER _J o N E ACREAGE S W TYPE OF BUILDING RES. � SEAS. VL FARM COM""' I IND. I CB. I MISC. LAND IMP. TOTAL DATE REMARKS ld ef) all v v�/,br- f-ic�z 5r 1 .5( - 7ti,. 2� � V .l3 G COLD I 1 i — 10 =I C. c r ` ,,,yORMAL ELOW 2 2 B -VE �J C• r Farm Acre Value Per Acre Value ��• �,�, ��.� ?�L� �,�, Tillable 1 �`__ Tillable 2 Tillable, 3 /`J� C�, ��' vZ `l✓�S �,� Woodland Swampland 5 p J • y / Brushland /�EA17-YCvVP /o T- I"I- )_ooDfN -1 DNS. House Plot 94_$P'- I 7 COw1 5,, (' Tota 11,7 Ul- ........... 2� 17 Both Foundation Floors M. Bldg. Basement Interior Finish Extension Ext. Walls Heoit Extension Fire Place Attic Extension Porch Rooms ist Floor Porch Rooms 2nd Floor patio Breezeway Driveway Garage O00% y ' N O N .G O - J m � N O \ � O z NK MURPHY NCO/F N CENTER GARpE zoo 0. C11- CIN Z C n IN ROAD `s% � • `" �. OLDMA / z o SfK. n t•- D sr� Z o W o . o W P SURVEY OF PROPERTY A T MA T TI TUCK TOWN OF SOUTHOLD Sfk SUFFOLK COUNTY, N. Y. N "00� 1000 - 122 - 07- 3.1 Scale: 1" = 40' April 3, 1995 o� 4. 288.26'' 0 bal� h6•g�g' , f Moir '42'l0' W. 2 / S. 84 ' ei. 2a o2 ROAD , OLD MAIN ANY ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION s�r OF SECTION 7209 OF THE NEW YORK STATE EDUCATION LAW, 1 N.Y.S. LIC. NO. 49618 EXCEPT AS PER SECTION 7209-SUBDIVISION 2. ALL CERTIFICATIONS 1 HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF << SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR El C13"^ d YORS, P.C. AREA = 3.00 Acres WHOSE SIGNATURE APPEARS HEREON. rslsz=�+; -m ozo DDITIONALLY TO COMPLY WITH SAID LAW THE TERM ALTERED BY' P, , '._ 909 AI ELEVA TIONS ARE REFERENCED TO MIUST BE USED BY ANY AND ALL SURVEYORS UTILIZING A COPY MAIN ROAD AN ASSUMED DATUM. BRANOTHER UGHT TO DATE' ARE NOVEYORS AP. TERMS SUCH AS 'fiVSPECTED'T IN COMPLIANCE WITH THE LAW. AND SOUTHOLD, N.Y. 11971 s 90 -168 R