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HomeMy WebLinkAbout22262-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........................AUGUST...16.. .3.................. 19.94...... N2 22262 Z Permission Is hereby granted to; JOHN & HELEN BERDINKA .......................................................................................... 1330 FACTORY AVE. .......................................................................................... MATTITUCR, NY 11952 .......................................................................................... to ......CONSTRUCT..A..FENCE T0,,CODE..AS.APPLIED ,FOR.................................................................... ................... .. ........... .... ........ ..... ............... ....... .................................................................................................................................................................. .................................................................................................................................................................. .................................................................................................................................................................. .......................................................................................................................................................I.......... at premises located at.....,1260 FACTORY..AVENUE. .,...1�IATTITUCK .. ........ ........ ... . ............................................................................. ...........................................................................................:.................................................................... County Tax Map No. 1000 Section ........142........... Block.......I.......I........... Lot No. ............8.............. pursuant to application dated ........................�tY..27a................. 19.....9.4....... and approved by the Building Inspector. Fee$ . .. ................... ... .. ..,,,,,...,,............. Building Inspector Rev. 6/30/80 BOARD OF HEALTH . . . . . . . . FORM NO. 1 7 SETS OF PLANS TOWN OF SOUTHOLD SURVEY I ,?I BUILDING DEPARTMENT CIIECI: . . . . . . _ _ - . . . . _ . . . , TOWN HALL SEPTIC FORK p SOUTHOLD, N.Y. 11971 - - - - `'`� TEL.: 765-1802 NOTIFY : Examined ,ls. . . . . . . . . . ., 1�9 CALL . . . . . . . - - - - - - . . . . �Z� t•IA I L TO : Approved . /.a. . . . . . 19y�Permit No: . . . . . . _ _ . . . . . . . . . . Disapproved a/c / " ' " . . . . . . • . . . . - - / . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t . . . . . '. ( . . . ` (Bui ding pector) APPLICATION FOR BUILDING PERMIT Date . .G5:a.'. . .� . . . :, 199 . INSTRUCTIONS a. This application must be completely Filled in by typewriter or in ink and submitted to the Building Inspector, with 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 stieeL or areas, and giving a detailed description.of layout of property mast be drawn on the diagram which is part of this appli cation. C. • The work covered by this application may not be comm _i; ,fore issuance of Building Permit. d. Upon approval of this application, the Building Inspector M a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the ' . e. No building shall be occupied or used in whole or in art for an shall have been granted by the Building Inspector. P Y Purpose whatever until a Certificate of Occupancy 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary specti s. . . . . .-. . . . . . . . . . . . . . . . . . . . . . . iSignature of applicant, or name, if a corporation) .. . . . . . . . - (Mailing dress of applicant) State whether applicant_ is owner, lessee, 'agent, .architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . Name of owner of premises . . (as on the tax roll or latest deed) If applicant is a corporation, signature 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. . . . Loca, ion of land on which proposed work will be done. 1, 133 � . . . . . . . e0t . . . . . . .. . . . . . : . . . . . . . . : . . . . . . . . . . . . . . . . [-louse Nuniber Street � Ham . . ... . . . . . . . . . . . . . .. let County Tax Map No. 1000 Section . : . :. , •lo. Block . . . . . .�. ... . . . . : . . . Lot . . . . . . . . . . . . . . . . . Subdivision . . . . . . . ... . . . . . • Filed Map No. Lot State existing use and occupancy Of premises and inteniied use and occupancy of proposed construction: a. Existing use and occupancy ?y 1 b. Intended u se and occupancy • 1c.e -- i• . . • ;y�• ... :�r�t:?8'4$%�C'^Y:i'k�iYj}1i1t_..ow -3. Nature of work (check which applicable ): New Building . . . . . . . 'I iy' Repair . . . . . . . . . . . Removal • • • Addition . . . . . '-: Alteration _ • • • • . . • • • • • . . Demolition _.. . . . . . . . . . . . Other Work 4. Estimated Cost . . . . . zj'a- t'6 ov (Description) • . . . . . . . . . . . Fee . . . . . 5. If dwelling,number (to be paid,on,f;-ling-,this application) of dwelling units /• " kh ' If garage, number of cars . . N`umbcr of dwell., unit"s`oii eracti floor . . . . 6. If business, commercial . . . . . . . . 4. . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . or mixed occupancy, specify nature and extent of.each t 7. Dimensions of existing structures, if a aa: YPe of use . . . . . . . . . . Height . . . . . :-. • T any: Front . . . . . . . . Rear , , aa: �. . . . . Depth . . . s .� � '. . . Dumber of Stories � �• Dimensions of same•structure with alterations or additions: Front • • • • • • • • • • • .Depth . . . . . . . — Height - . . . . .!L.14. . . . . . . Rear . . . . � . . . . . . . . . 8. Dimensions of entire new construction: ' ' ' ' ' ' ' • • . • • Number of Stories . . . . • , •__. . • ' ' ' Height . . . . . . . . . . . . . . . Number of Front . . . . .�'liS�- . . . . . Rear . . . . . . . . . . . . . . . Depth . . . . . ' . 9. Size of Stories . . . . . . . • . . Of lot: Front . . . . .(o.to l Rear. . •0 ',• . . . . . . . . . . . . . . . . . . . . . . . . 10. Date of Purchase � : . . . ... . . Depth . . . !.`//•.• •G 3' . . . . . . . . 11. Zone or use district in which ' " ' ' ' ' ' ' , • • • • Name of Farmer Owner . . . .?°- �,` • , • • • ' ' Premises are situated . _ .12. Does proposed construction violate any zoning law, ordinance or regulation:. .ti o • 13, Will lot-be regraded ,,G c� -14. • • • • • ' ' ' ' ' ' ' • • • • • • • • • • Will excess fill be removed from premises: --}�. . • Name of Owner of premises•I'a!�!�, , ,�cc2�.A?A_,,�•4. . Address /33� Fac og o a No Name of Architect . . • • • �iAr #A- Phone No. Name of Contractor . . . . • • . • • • • • • . . . • • • . • . • , • •Address Address • • • � � • • . . . . . . . . . . . . Phone No. . . . . . . . . . . . • 15. * Is this property within 300 feet• of a tidal wetland? *Yes ' ' ' • ' • • Phone No. . *If yes, Southold Town Trustees Permit may. • _ _ . _ '• ' No• • • " • • • •. • • • • . • . • ' . • • • y. be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate' all set-back dime nsions Property lines. Give street and block number-or'description according'to deed, and show street names and indicate whetii,-, interior or corner lot. e ' �,F? �� • 'l)�V,, S EE: F; : lr.L i1".+aG, DE-PAR'"'r .ti lui @�� tt�� �t THE- I=t3;.._Q)VV Nf nAto REQUIRED � ?a 4"()@1Fi'E�? �91� RETE ?. POjCP - FRAE�3iii�ii t? PLUMBING 3. lNSW ATION' 4,. FINAL �,�BPv��I8LJCTION MUST BF, COMPLETE FOR C-0 . ALL as©IVw)m'ftal t.f lq.l'7 to SHALL Y'a6h�.G THE REQUIREMENTS OF THE N.Y_ T E E CONISTRUCTiO N & ENER . ;TATE OF NEW YO CODES. NOT RESo�C➢iVONI E FOR:OUNTY OF S.S DESIGN Oct COlalSTRUCTIt? ERRORS . . . . . . . being duly sworn, deposes and says that he is the applicant (Name o individual signing contract) Bove named. e is the . ... . (Contraactor, agent, corporate officer, etc:) ' ' ' ' ' ' ' ' said ;P-k when; that all statements contained in this application are true to the best of his knowledge and belief; and that the he irk will be performed in the manner set fort], in the application filed therewith. :orn to before me this . . . . . . � . . . . . day f. . 19'tary Publi r. ' -ounty .I01fCE&BTONER G�. 1... 1 New Yodt . . . . . . . . . . . . in8uflolkCou (Signature of applicant) Nov.3,1 SURVEY NO 87-063 ACE OLJNP V0 S: __.1!A V�l Tcjq1`_,'* 54 L 1 �Iz, .e,4 -IS ;v4S ;�S 7zi 8;_ISEL)rROM CO-'VCHt:-,E 3 R. Peter DISTANCE:ALONG 7.11f' pe Jr. If AJVJ;DEED DISTAV 4 0 G IdO Lj.vut!: 1;7EO I/A:OF WA LVU AVENUE. Cjxe OF to! (VORTHERfY 11VE O F TAX LOT a) fv Llo'vu UL LIP 0 AREA. = 9. 961 S.F. or 0.229 ACRES ON \/ forid UNAUTORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A o Ic -rR PROFESSIONAL LAND SURVEYOR'S SEAL IS A.VIOLATION OF SECTION 7209, ,jy 0 -rodr, SUB-DIVISION 2.OF THE NEW YORK STATE EDUCATION LAW. 3 GUARANTEES OR CERTIFICATIONS INDICATED HEREON SIGNIFY THAT THIS 4 SURVEY WAS PREPARED IN ACCORDANCE WITH THE EXISTING CODE OF PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. SAID GUARANTEES OR CERTIFICATIONS SHALL RUN ONLY TO THE PERSON FOR WHOM, THE SURVEY IS PREPARED, AND ON HIS BEHALF. TO THE TITLE COMPANY. GOVERMENTAL AGENCY,AND LENDING INSTITUTION LISTED HEREON AND THE -ASSIGNEES OF THE LENDING INSTITUTION. GUARANTEES OR CERTIFICATIONS ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS OR SUBSEQUENT OWNERS. FRAME COPIES FROM THE ORIGINAL OF THIS SURVEY MAP,NOT MARKED WITH AN "min ORIGINAL OF THE LAND SURVEYOR'S RED INKED SEAL OR EMBOSSED SEAL Npy Rath SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY Nine GAR jo D, GN F n If a y -ritno sthay fri COUNTY TAX4MAP NO 1000-142.00-01.00-008.000 CERTIFIED TO 10HN SERDINKA HELEN BERDINKA Chicago T111a Insurance Company TItle No. 8608-08454 SURVEY OF LAND AT I filuck TOWN OF Riverhead I HEREBY CERTIFY THAT THIS MAP WAS MADE SUFFOLK COUNTY N`EW YORK FROM AN ACTUAL SURVEYCOMPLETED BYME Edward A. Bullock, Jr. BY: E.A.B-AW.-JQ. ON MAY 29, 198 i Professional Land Surveyor DATE: 6-1-3-87 "The Brook House 405 south Country Road SCALE.- 1 20- groohhaveg NY 11719 NEW YORK STATE LIC.4 1 (516)286-8558 FILE NO: looc-14?4-8 F214 NASSAU-SUFFOLK