The URL can be used to link to this page

Home My WebLink About22263-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,...................., 19..94.. N2 22263 Z Permission Is hereby granted to; JOHN & HELEN BERDINRA .......................................................................................... 1330 FACTORY AVE. .......................................................................................... HATTITUCR, NY 11952 .......................................................................................... to CONSTRUCT A FENCE TO CODE AS APPLIED R ................................................................FO............................................................................ .................................................................................................................................................................. .................................................................................................................................................................. .................................................................................................................................................I................ .................................................................................................................................................................. at premises located dt.......1330 FACTORY..AVENUE. . ,..M1 ATTITUCR. . . ......... .... . ........ ........ ... . . ............................................................ ................................................................................................................................................................ County Tax Map No. 1000 Section .........142 Block...............I.......... Lot No. ......:..................... pursuant to application dated ..................JULY...�......................... 19......94...... and approved by the Building Inspector. Fee$...� ......" ........ �a .,�,�,,.................. uilding Inspector Rev. 6/30/80 0 FORM NO. I BOARD OF HEALTH 3 SETS OF PLANS . , , • . - TOWN OF SOUTHOLD SURVEY - • • • - • • BUILDING DEPARTMENT CIIECR - 7' ,)O� ,2 71994 , TOWN HALL SEPTIC FORK - . . - . • . . . . . . SOUTHOLD, N.Y. 11971 1 TEL.. 765-1802 t:DT I Fy Examincd DUTH- CALL . . . . - - _ - - • • . . . . ' MAIL TO : Approved , 19 . . . Permit No_a ?-16 3�. . . . . • • - - �. . y . . . . . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . - - . - - • . . . . . . (B ilding ector) APPLICATION FOR BUILDING PERMIT Date . .� . . a�. . . :, I99/v. INSTRUCTIONS a. This application must be completely filled in b ewriter 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 street, or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cat�.:.:n. The work covered by this application may not be commenced before issuance of Building Permit. S 'Tpon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit' sha'. ?.:rpt 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* ertifcate 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing addre . ss of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general.contractor, electrician, plumber or builder. • . Name of owner of premises � .�(( � . . • . • • • • • . . • • m (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. . . . . . . .�f.•�. , , . Electrician's License No. h� Other Trade's License No. V , Location of land on which proposed work will be done. House Numbe� D. . . � . ... . ... . . Street Hamlet County Tax Map No. 1000 Section YO 'v0 . . . . . . . . . . . Block . . . .4/, 0.0. . . . . . . . Lot . Subdivision . . . . . . . ... . . . . . . . Filed R1ap No. (Namc) . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . State existins use and occupancy of premises and intended use and occupancy Of proposed construction: a. Existing use and occupancy . . . . b. Intended use and occupancy . . . .1�?dt/r;�� -3. Nature of work (check which applicable): New Building Addition - .Alter Repair . . .. . . . . . . . Removal . Demolition. . .. ' . ��i n . . . . . . . . . . ... Other Work . . . 4. Estimated Cost — .3 S �o (Description . . . . . S.° . . . . . . . . . . . . . . . . . . . . . . . . . . Fee _ . . . . . . . . . . . . . 0 . . . . . . . . . . . . . . . . . S. If dwelling, number of dwelling units / x (to be,paid onFaClins-'this application) Number of dwelling,u.._';" If garage, number of cars . . . . . . . . . . . • , g' nits oi_t e3cl _ oor.. . . . . • , • , , , . . 6. If business, commercial or mixedoccupancy, s•ecif • . � • • , • , • • • p ' ' ' ' ' ' . . specify nature and extent of-each t • • • 7. Dimensions of existing structures if type of use . . . . . . Height . . . . . . . T any: Front . .�� • Y. � . . . . . Rear . . ��:•.Y. !. . . . . D ,.3 Sr . . . . . • . . . . . . . Dumber 1- epth 3!. Dim or • • • • Dimensions of same structure with alterations or additions: Front /. . . . • • , . , , .Rear . . . . . . . . Depth . . . . . . . ! . . . . . . . . Height � " " 8. Dimensions of entire new construction: ' ' ' ' ' • • .. • • Number of Stories . . . . .— , ; ruction: Front Rear Depth Height of lot: . . Number of Stories . . . . . . . . . • • • ' • • • • '• -- 9. S •Front . . . ,(, . . . . . . . . . . . . . — �. . . . . . . . . . . 10. Date ' ' • . . . . . Rear. . . . . . . . .�.�. . . . . . . . . . Depth .�`�!�:3 fir. .'t;. Y/..i 7 of Purchase �-�—• . Name of Former , ��,,,,• - I L Zone or use district in w1i& ich r • . . . ' ' inner Owner , . , . • . p emises are situated 12. Does proposed construction violate any zoning law, ordinance or regulation: • . • • • • • • • • • • • • • ' ' ' ' ' ' ' 13. Will lot be regraded . , , • ti . . . . . . . . . . . . ..M a, . , , , , . . . 701y;, x-�• • • • • • • • • • • . . . Will excess fill be removed from premises: Yes • • • N 14. Name of Owner of premises'. . , He--c t= B�• 'e-�"v. ' • • Address l,4.i Name of Architect o .4� FacT��e y, • •e t •phone No. . . . . .' ' ' ' Name of Contractor . . . . . . . . . . . Address . . . . . .�^' • • . . . . . . . . . . Phone No. . . . .� . . _. . 15.- Is this property within • ' 'eet' ' ' ' . • • • •Address . . . . . . . . . . . . ... . . . . . Phone No. . . . ~ • . • • ' - 300 f a tid • • • • • • • • • *If yes,' Southold Town Trustees Permit may be required. of al wetland? ,� • • •'• • No• • !(!�" " PLOT DIAGRAM_ Locate clearly and distinctly all buildings, whether existing or proposed, and.property lines. Give street and block number or description according to deed, and howrst street catic namesand indicate whctthe interior or corner lot. � eh ED AS NOTED NGFI1=Y Ul- II G. UEP',AR-r v , "I AT 9-A NI 10 4 P, 1`01 I THE r'o)1-LI).P4li! I SPECCTION:9': 7. FOLJNID/�TiS• kl 'PA10 REQUIRED f C R POURED d,PONC6'RETF— ' 2. RO`. � s'^RAA%NG 1%. s''.l.t.lMRlNG ItL�Ju L t,tT ioi 4. FiFAL - ti> NI TR UCTION IV USs -BE CCrfi iPLETE FOR C.O. ALL f ONIS•h RUCTICrN 8I.1kLL €9,IEET THE lE REQUII�EIlf E T S OF THE I�1.�1: STATE CONSTRUCTION 8r ENERGY �:.t tlaa 3. NOT RESPONSIBLE FOR - DESIGN OR CONSTRUCTION ERRORS - �TATE OF NEtiV :OUNTY OF . . . . . . . . . .S.S . . . . . . . . . . . ��-- �� "�"`' • • �� . being duly sworn, deposes and that says(Name of individual signing contract) Y the applicants Dove named. - ' ire .-. .�.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . (Con tract or,,asent, corporate O&j'cr etc:) -e `ft -er owners, ' atiara; that all statements contained in this application are true to the best of}iis knowledge ork will be performed in the manner setortlr in the application filed ilrere�vit}l and belief, and that the :orn to before me�th}i�s` . . . . . . . . . . . .dday o 19?. Mary Public, . \• ounty - STENER NOTARY A. York No.4 75122 . . . . . . . . . . . . O.ualified in Suffolk Coun ..(Signature of applicant) C6MW!Aft;i Fvnires Nov.3.19 a/- ap n If ko fir J. AREA 9, 325 S .F. or 0 .2L4 ACRES UNAUTORIZED ALTERATION OR ADDITION TO A SURVEY MAP BEARING A PROFESSIONAL LAND SURVEYOR'S SEAL IS A VIOLATION OF SECTION 7209, SUB-DIVISION 2.OF THE NEW YORK STATE EDUCATION LAW. GUARANTEES OR CERTIFICATIONS INDICATEDHEREON SIGNIFY THAT THIS SURVEY WAS PREPARED IN ACCORDANCE WITH. THE EXISTING CODE OF �qrL PRACTICE FOR LAND SURVEYS ADOPTED BY THE NEW YORK STATE ASSOCIATION OF PROFESSIONAL LAND SURVEYORS. SAID GUARANTEES FOR WHOM THE "g, .9,TOW 0 if OR CERTIFICATIONS SHALL RUN ONLY TO THE PERSON 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 31 CERTIFICATIONS ARE NOT TRANSFERA61LE TO ADDITIONAL INSTITUTIONS vt OR SUBSEQUENT OWNERS. D. COPIES FROM THE ORIGINAL OF THIS SURVEY MAP,NOT MARKED WITH AN ORIGINAL OF THE LAND SURVEYOR'S RED INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY n if CERTIFIED TO JOHN BERDINKA Chicago Title Insurance Company Bethpage Federal Credit Union SURVEY OF LAND AT /V 07 /7 TOWN OF Southold I HEREBY CERTIFY THAT THIS MAP WAS MADE SUFFOLK COUNTY NEW YORK FROM AN ACTUAL SURVEY COMPLETED BYME Professional Land Surveyor DATE: 6-13-87 "The Brooh House" 405 South Country Road SCALE: 1 20' ' ./ '! x^oSAuouFFoLK . ] � �!