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HomeMy WebLinkAbout22256-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 ................ ......................... 19..94..... N° 22256 Z Permission Is hereby granted to; LINDA SCHEER .......................................................................................... ..........P,O,...BOR..198....................................................... CUTCHOGUE,.. .......!.!935.................................... to ...CONSTRUCT A FENCE TO CODE AS APPLIED FOR. ................................................... .................................................................................................................................................................. ..............................I................,.................................................................................................................. .................................................................................................................................................................. .................................................................................................................................................................. at premises located at.......2490,PIKE..STREET.L.MATTITUCK ..................................................................... ................................................................................................................................................................ County Tax Map No. 1000 Section ........:. ........ Block...........8.....I....... Lot No. 2 ............................ pursuant to application dated ........... ........................... 19..94......... and approved by the Building Inspector. Fee$... �} . ild ng Ins ector Rev. 6/30/80 j - aT71 f t- -01 IL h LL!_J .II C\! 17 b T 5J I .— JNAUT"ORTYED ALTERATION OR A'DT)f , - -- - . !, - --- - - - - --- TO THIS SURVEY IS A VIOLATION Of •� 1 ' -- SECTION 12C9 CF T;:E NEW YCRK STAT( 1 EDUCATIOr7 LAW _ ':I I t 11 ,1n �•;.I. .._r r, T:-1,. a1� •r,;^ � I�a-4 � `'.` r'�- -,_ t COPIES OF THIS SU„V:Y r.;AP NOT BEARING ------ ----•--: C�1 i r: r.-f�� -r----- -�------- �-- -- I -- -.- ----THE LAr:D SL'..V_. : - D b OR ��:i i I-1C %✓U :'I':J L_i/ sfy•f—�'•:',c EMBCSS:D SEA:c.••U ..- :AL TO B[ _i E_ 3-NS@EZED a r-r r r-♦. -•.T�.• 1.-'- :r•.~ .►.� A VALID T u5 ti.ie_ IL•_�_� a� - i_.) _ •----..._1, ! 1 :ES q:DLAT_D`S,CiI SHALL PUN."J ONLY TO T!L Tfk SURVEY IS PREPARED. H:S IO,i TJ THE I e TITLE COt.!^A.aY,'G^ A:;LNCY AND -j _LENDIIIG IP:57iTJI1'vaU.4 1 TO THE ASS:C;p:::5 OF TI:E LINDW INSTI• - ' ! TUTION.GUA:,gru,� c - -- -'---•-_.-____ - �-_ J- --_..__ _— _ _ , A:.NOT SR ANSFERABLE - NSTITUTioNs olz SL*,LQUEnn I; • I BOARD OF HEALTH . . . . . . . . . n FORM NO. 1 3 SETS OF. PLANS IVr SURVEY TOWN OF SOUTHOLD - BUILDING DEPARTMENT CHECK . . . . . . . _ . . . . . . . ` n itl! 251994 TOWN HALL SEPTIC FORM . . . . . . . SOUTHOLD, N.Y. 11971 .�''e S'.f'.Z.S� BLD DEPT. TEL.'• 765-1802 NOTIFY G. 7 tl — p�JOWN OF SOU OLD � ; CALL . . . . . . . . . . . . .. . . . . . Examined . 9 MAIL TO : Approved19!�j�/ _ermit No:- L�.2 i5'6 . . . . . . _ . . . - • . . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ftBUIL� °y I � . . DA, EB.P �—9 S:FE: Bye ild Inspecto �,ICMDEPAR � - AT b 76 -1802 9 AMI a0 4 Peifi 'FOR KNIELICA ION FOR BUILDING PERMIT FOLLOWING INS€ECTIO.k'S. 1. FOUI'+IDATION - s��al1�REQUIRED Date . . . . . . .�J. . . . ., 19 .a FOR POURED CONCRETE 2. ROUGH - FRANNNIG tx PLUMBING. INSTRUCTIONS 3. INSULATION a. T4aisFh}�licatioiCFMl BUrc6M�l&f&49Tfilled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plan§)laQt WS pT6tFp"l t&scale. Fee according to schedule. b. PXd&p1ffiW5 i 4bbatfotlA&irIN of buildings on premises, relationship to adjoining premises or public streets or areas,W,B g1fyIh1Fdd lT8 c crrtNov. layout of property must be drawn on the diagram which is part of this appli- cation. STATE CONSTRUCTION $a NERDY c. T i@ k-A re R may not be commenced before issuance of Building Permit. d. iil� �$J �catFi®� 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, bu g code, hous', code, and'regulations, and to admit authorized inspectors on premises and in building for necessary"ns.+ . . . . . . . . . . . . nt, or name, if a corporation) '(Mailing address of applicant) I C+8 . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . Lam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. . . . . . . . . Name of owner of premises . . .�.�.Ilrlo1-. . . . .�J C-k'1 �:-��. . . . . . . . . . . . . . . . . . (as on the tax.roll or latest deed) If applicant is a corporation, signatuie.of duly authorized officer. (Name and title.of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No.. . . . . . . . . . . . . . . . . . . . . . . . . Electrician's License No. . . . . . . . . . . . . . . . . . . . . . . Other Trade's License No. 1. Location of land on which proposed work will be done. . . . . . . . . . . . lc �I-fi �' plc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . ��--: . . . . . . Block . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . . . . . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . ... . . . . . . . . . . . . (Name) 2. State existing use and occupancy of premises and intended use /I and occupancy of proposed construction: a: Existing use and occupancy . . . . . . . .rev . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . Addition Repair . . . . . . . . . . . . . . Removal . . . . . . . . . . . . Demolition . . . . . . . . . . . . . .-Oth'er=Work . . . (Description) 4. Estimated Cost . . . . . . . .31500. . . . . . . . . . . . . . . . . . . . ... . Fee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . rr (to be paid on filing this application) 5. If dwelling,number of dwelling units . . . . . . . . j. . . . . . Number of dwelling units on�eacli floor . . . . . . . . . . . . . . . . Ifgarage,number of cars . . . . . 6. . . , , , • .. . . . . . . . . . . . . . . . . . 6. If business; commercial or mixed occupancy, specify nature and extent of each type of use . . . . 7. Dimensions of existing structures,if any: Front . . . . . . . . . . . . . . Depth . . . . . . . . Rear p Height . . . . . . . . . . . . . . . Number of Stories . . . . .Xc} . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front SYe. . . • . . , • Rear .Sah� . Depth . . . . . . .. �a.C=. . . . . . . . Height . . . . ..:5KV —2 -. . Number of Stories . . . �42 . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . Depth Height . Number of Stories _ 9. Size of lot: Front . . . . .lex)./ . . . . . . Rear . . . . . . . . . . . . . . . Depth . :.10�.,, ,�!• . . . . . . . . . . 10. Date of Purchase . . . . . . . . . /.I�V . . . . • . . . . . . . . . Name of Former Owner rV.. 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 14. Name of Owner of premises dam\ a`J. S e y Address �770�� .5 ��4du�Phone No.� aM. . . . . . . Name of Ardhit8ct X?e-)n-e . :Address . Phone No. Name of Contractor eS.�1 u . Address�ry mcl *ahftck.Ph .No.`7v�15. Is this property within 300 feet of a t dal 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. P ev, /0 C STATE OF NEW Y' G� COUNTY OF . . . .� 1�:. , , S.S • �`n�`� .• j•�c=. . . . . . . . . . . . . . . . . being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. - SHe is the .'� . . . . . . . . . . . . . . . . . . . . . . . . .. .O.u?N-?n1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief;and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . . . . . . . . . . . . . . day v�Y. . . . . 19 t�. Notary Public, . . . . . County p RO®ERT 1 TT,JR. NOTARY PU ,State of N.Y. (Signature of applicant) No.47 ,Suffolk Cou Term res May 31.19