HomeMy WebLinkAbout23438-Z FORM NO.3
TOWN OF SOUTHOLD 1,D
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.... /3........................................... 19.g. .
N2 23438 Z
Permission Is hereby granted to: 4
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at premises located at..... �Z—
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....................... ................. � .. - ....
County Tax Map No. 1000 Section .... ........... Block.... ................. Lot No. .... /.,...........
pursuant to application dated ..........1�. ........................ 19�ai��....., and approved by the
Building Inspector.
Fee$.../.s1 .....
Building Inspector
Rev. 6/30/80
pF SOUjyolo
Town Hall,53095 Main Road Fax(631)765-9502
CA
P.O.Box 1179 G • Telephone(631)765-1802
Southold,New York 11971-0959
�yOOUNT`I
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
February 27th 2007
Goose Island Corporation
Peninsula Road
Fishers Island, N.Y. 06390
RE: Central Avenue (doors to deck) 2"d NOTICE
SCTM: 10 18 1
To Whom it May Concern:
Please be advised that your Building Permit#23438 issued May 13th, 1996 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit,please submit a fee of$150.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions,please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
pF SO�ryOlo
Town Hall,53095 Main Road Fax(631)765-9502
P.O.Box 1179 G • Q Telephone(631)765-1802
Southold,New York 11971-0959
IrDUNT`I,�``�
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
February 27th 2007
Goose Island Corporation
Peninsula Road
Fishers Island,N.Y. 06390
RE: Central Avenue (doors to deck) 2"d NOTICE
SCTM: 10 18 1
To Whom it May Concern:
Please be advised that your Building Permit#23438 issued May 13th, 1996 has expired.
According to the Code of the Town of Southold, a Certificate of Occupancy must be
issued prior to use of the structure.
To renew your Building Permit,please submit a fee of$150.00; at that time we can
schedule an inspection by one of our Building Inspector's.
If you have any questions,please call us at 631-765-1802.
Respectfully,
SOUTHOLD TOWN BUILDING DEPT.
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BOA90 OF HEALTH . . . . . .. . . .
FORM NO. 1 3 SETS of PLANS . . , , . . , .
TOWN OF SOUTHOLD SURVEY . . . . - _ _ . . . . . . . . . . . .
BUILDING DEPARTMENT CIII:CK . . . . ... _ . . . . . . - - - - - - -
TOWN HALL SEPTIC. roars
SOUTHOLD. N.Y. 11971
TEL.: 765-1802 NOTIFV :
Examined . /�?�. . _ . _ . . . w, eIAIL . - : - • - - - • . . + . . .
• 19 // MAtL x(j '
Approved . { - _ . . . _ . , 19 yhpermit No. 7� . . ' . . . _ . . . . . . . . • . .
Disapproved a/c . . . . . . . . .
. . . . . . . . . - - - . . . _ . . . . . . . . . . . .
uil Inspector)
APPLICATION FOR BUILDING PERMIT Date . . - .L a . . _ . . .' 19:pp
,
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
tr areas, and giving a detailed description of layout of.property must be drawn on the diagram which is part of this appU-
-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
Iuilding Zone Ordinance of the Town of Southold, Suffolk County, New, York, and other applicable Laws, Ordinances or
:egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described,
'he a0plicant 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_
Co��or� n _ . . .
(Signature of applicant, or name,if a corporation)
. . . . . . . _ J7
(Mailing address of applicant)
state whether applicant is owner,.lessee, agent, architect, enjineer, general contractor, electrician, plumber or builder.
. _ . . . . . _ . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . _
lame of owner of premises . • . GQ12S\.5—. Cam,
• . . . . . . . . . - - • - - - . . . _ . .
(as on the tax roll or latest deed)
'applicant is a corporati on,.Signature of duly authorized officer_
(Narne' nd title of corporate officer)
Builder's License No. . . , . , , :T l �_[ �•
Plumber's License No. , , , , . , • „ • „
Electrician's License No. _ . . . . . ,
Other Trade's License No. . . . . . . . . . . . . . . . ,
Location of land on which proposed work will be done. ._. , . . . . , .
. • . .
. . . . . . . . . . . . . . . . . . , . . , . . . . . . ? ,. �.�e_. , , F .e!� . �� , `yJ1
HA .
,,.Se Number ,trCet , - 7 ` - • •
Hamlet
County Tax Map No. 10(]0 Section , _ . (� _ . , - , L g I
. . . Block , , , . Lot . . -
Subdivision . . , . . . . , , . . . , . - , - . , , . . , . Filed Map No.(Name) . . . . . . . . . , . , Lot . . . . . . . . . . . . .
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
n r
a- Existing use and occupancy . . -� �'e 5 .L;(pn�. • 3 �'1 on-JL
b- Intended use and occupancy . . . . . . . . , • , S.o` {�. ... . . . . . . . .
. . . . . . . . . . . .
3St d SG�JVMQ3:�l A03Q13SNf1S GT8L88L9Z9 09:60 966Z/80/be
04/08/1996 09:50 5167887819 SUNSETDECK R:EDWARDS PAGE 03
3. Nature of work (check which applicable): New Building, Additi �-
Repair . . _ - - - . . . . . . Removal . , . . , . . . ' . on . • . . . . . . . . Alter2ttion � . . . . . .
Ccn}' WA�� 0 � " " ' Demolition , .•. , - • , , , , • , Other Work _ . . . _ _ . . _ „ • , _ ,
5 �t of �v.��c���q - .p _ q
4, Estimated Cost . _ . _ , ,V ��• f Sw�nVl^g �� ��`�� �� (DescLj lr�iption)
� .OC,p. . . . . . . . . . . Fee . . . • -`to"be paid,on filing�this applica4C,tl) . . , -
5. If dwelling,number of dwelling units . . . . , . , -e
If garage,number of cars . . , , , .e • • Number of.dwelling units on each floor, , , , , , , , , , , , ,
6. If business, commercial or mixed occupancy,specify nature • • ' " " " , " , " • -
7, Dimensions of existing structures if a a d exten.t of each typ of use . �S,�neSS-"Resk&b env+
Height . . . . 2 .'�'' `. . . . . Number any, Front . . . y$ . : . . Rear $. . .• Depth . . _ .16, .: .•. . . . .
of Stories ,F?nE, �-� . .� «�•��.
• Dimensions of same structure with alterations or additions; Front • • ' " " � • • � ' ' ' " '
Depth . . , . . . . . . ems. pPna f. . . . . . Height . . . . . . .�a.r� �o► t. . . . . . ear . . . o� (`n . . .
9. Dimensions of entire new construction: �-' ' • Number of Stories , . , . , " , , . ,
Height , . . . Nu ber of t ront : +(lQ . 4ear . . . . . . . . . . . . . . .. Depth . . . . . . . . . . .
9. Size of lot: F l S ones , , • , , , _ . , . , - _ " .Front � hear gyp,
10. Date of Purchase . . . . . 8�2q�.��. . . . . ' . . . . . . . . . 'Depth BOO .� • . . . .
. Name of Former Owner .IR ,�K1.)V--��.
1 1. Zone or use district in which premises are situated _ CAlMV\i`�ptil, • '
l2- Does proposed construction violate any zoning law, ordinance or regulation: , , _ - _,. , " '
13. Wi]1 lot be regraded . . . . -�1 x1 . . . t; NP. . . . . . . . . . - - . . .
. , . Will exc ss fill be resnoved from premises: Yes No
14_ Name of Owner of premises ,�arrS'e-, , Address 4
Name of Architect , . , , • , • N1-Phone No. 5,t6'78-7, •l•�
Name of Contractor • - • • • . • . . . . . . . , . .Address • " ' " " " " " - .Phone No.
• • • • • • •. •
• • • • .
15. Xs this property within 3. . . ' . . t c ' ' • . . • Address . . . , . .Phone'No. . . . . . . . . . . . . . . .fee f a tidal wetland? *yes„�.?<. . . No. . . . . . . .*If yes, Southold Town Trustees Permit may be required.
PLOT r)T kCRAM ,
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.
Pro ea5e4 800(S �c,'-�roo�nS S'c ,0o
TATE OF NEW YURTC, S.S Wp09C�e�RQ 2
'OUNTY OF . . . � �
. . . . . . . _ f� . being duly sworn, deposes and says that he is the applicant
(Name of individua signing contract)
3ove named,
e is the . . . . . . . . . . . . . . . . .`:
(Cur tractor, 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
tplication; that all statements contained in this application are true to'the best of his knowledge and belief;and that the
ark will be performed in the manner set forth in the application filed therewith.
mom to before me thisay 0
.,
Mary Public, . . . . .'' a�r�t -
�►�1� ,
CH 6ERKOWITZ - , _ , _ ►Jl�
NOTARY PUBLIC,State of New York No.4975859 (Signature of applicant)
CuafTOed in Westchester County C�
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