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Home My WebLink About22290-Z FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD,N.Y. ( X BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N2 22290 Z Date............. ............ ..��.................... 191te. a V � � � � Permission is hereby granted to: �lU . .........:....x.... ......1 ................ .......... �...................... ... ............. ............. `.. .......� . to ................ .. ... '. .�` .......... a........ ................. '. ................................... ......... ........................ ...... .c.'. 'so.... �SSS` .. ..........................................................................................................................................................I....... .................................................................................................................................................................. ...............................................................:.................................................................................................. ....................... ....... / ............ ...... .......................... at premises located at.........!��.7..............................................( .;X` C - . ..... .. ,......',., `.:../....+........................ County Tax Map No. 1000 Section ...... ..... ..... . Block..........� .....� . ........... Lot No. .......... pursuant to application dated ..... . .. .......12 , 19.5.Y.., and approved by the Building Inspector. Fee Building Insp or Rev. 6/30/80 I-t7 U•I ' . [J A JUDATION ( 1st) J1IDATI011 (2nd ) �' Q JGH FRAME •PLUMBI11G m :ULATION PER N. • Y. II • • .� g� STATE ENERGY +I \ CODE • I T ' V •FINAL I -- ADDITIONAL COMMENTS : CT3 • 8 0� - -. .i.f��.J'•v'.:!!^_'rY�•L�+i.`+r►il'.r-.a- v...•I l`v.3Lti'..:.w.l'•a (. .• � .. -_ _ .. .. •• ' ` . .� ... ..• ... .. � •-�s. HE. BOARD OF HEALTH . : : . . . . - U j , FORM NO. 1 3 SETS OF PL.�. : . TOWN OF SOUTHOLD SURVEY t� BUILDING DEPARTMENT CHECK . . . • • . _ . _ . . . DEFT. TOWN HALL SEPTIC FOR:I _ _ - BLDG. _.. SOUTHOLD, N.Y. 11971 - • - � • - TpWNOFSOUTHOL?) TEL.: 7G51802 NOT IFf Examined . . - �� %1 . CALL . . . . . - - - - • - - • . . . ., 19 U • . l�9 F6j� ttn I L TO Approved :• - - - . • mit No.UC � - - . . . . . . . Per Disapproved a/c . . . .-. . . . . . . . . . . . . . . . . . . . . . . . . . . ,�/ . . . . . . _ - - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Building Inspector) P L( .4TION FOR BUILDING PERMIT • Date Aa cL.. . . :, 19 !. INSTRUCTIONS., UCTIONS a. This application must be completely filled in by typewriter or in ink and subm s.:ts of plans,accurate plot plan to scale. Fee according to schedule. itted to the Building Inspector,with b. Plot plan showing location of lot and of buildings on premises, relationship adjoining , or areas, and P to � g premises or public street, 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, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary insp ns. . . . ( gnat re Sib applicant, or name, if a corporation) - (Mailing address of . plicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . .��. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Fame of owner of premises . . . :�, t .� . .�.! . . . . . . . . . . . . . . . . . . . . . . (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.' •', . (Name and title of corporate offcer). . . Buiider's License No. Plumber's License No. , , • , • , . Electrician's License No. . . . . . . . . . . . . . . . . . . . . Other Trade's License No. . . . . • , • • . Location of land on which proposed work will be done. • cisspi_ �. r. .. . . . . . . . . House Nuns ber Street . • • • • • • . • - Hamlet � !l County Tax Map No. 1000 Section . . . :. .`� . ... . . Block .� . as . . . . . . . . Lot . . . . . . . . . . . . Subdivision . ,fa(,� • 'o'��`l�ts . . . . . . . . . . . .'. Tiled Asap No. l.�?� Lot ,�,p� (Name) . .// 1. Statc cxistin,' occupancy p • h use and occu .�nc of remises and intended use//and occupancy of proposed construction: a. Existing use and occupancy . . . . d1!1.S.S.07 gq .,. r-. P.4?.4-67AV-d are . . . . . . b. Intended use and occupancyR ?,� r `r 3: Nature of weak check which applicable): . . , . . , • , , , •�' , , ( pp. icable): New Building Addition Alteratio . . Repair . . .: . . . . . . . Removal . . . . . . . . . . . . . . Demolition . . . . . . . . . . . . . . Other Work . . �tio*r) ? (Desc 4. Estimated Cost . . . . . . . . . . .Z.gq . . . . . . . . . . . . . . . . ... Fee . . . . ... . . . . . : s . . . . . . . . . . . . . . . . . (to be paid on.filing this application) S. If dwelling,number of dwelling units . . . . . . .. . . . . . . . Number of dwelling units oil each floor . . . . . . . . . . . . . . Ifgarage, number of cars . . . . . . . . . . . . ^. . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6. If business, commercial or mixed occupancy, specify nature and extent of each ty of use . . . . . . . . . . . . . . 7. Dimensions of existing structures, if any: Front . . . . .8.. . . . . . . Rear •. . . . . . . . Depth . . . . . . . , , , Height . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :. . . . . . . . . . . . . . . . . . Dimensions of same structure with alterations or additions: Front . . . . . !" . . . . . . . . . Rear ... . . . . . . . . . . Depth . . . . . . . . . . . . . . . . . Height . . . . :" . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . ... . . . . . . . 8. Dimensions of entire new construction: Front . . . . . . . . . . . . Rear . . . . ."': . . . . . . . Depth . _ . .'.'.`. . . . . . . . .Height . . . . . .r-. . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front . . . . . . . . Rear . . . . . .l. b .jam... . . . . . . . . D Pth PO. . . . . 10. Date of Purchase. . . . . Q V. . . . . 1. 4. . . . . .. me of Former Owner . ' 11. Zone or use district in which premises are situated . . .lYR55,o;GC .Fear"f. y.t 2�G�a. • . . . .12. Does proposed construction violate any zoning law, ordinance or regulation: . . . . . . . . . . . . . . . . :. . . . . 13. Will lot be regraded . . . . . .. . ' . . . .'. . . . . . Will excess fill b emovec from premises: Yes �y 14. Name of Owner of premises .l.Q.2�{l:�l�Gwtpr4t^A(Address �'��,l� f Mtt ..Phone No. 7t?`t Name of Architect . . . . . . . . . . . . . . . . . . . . . . . . . . . Address . . . . . . . ... . . . . . . . . . .Phone No. . . '.1 . . . . . . . . Name of Contractor . .Address . . . . . . . .Phone No. . . r'. . . . . ... ��. . 15.* Is this property within 300 feet of 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner Iot. t/du.C�G 6CeLU co Q t1ius ;•' l I - x a yJ o ,Z'c N i u 1•• Ln40 CY CO z x C'_ (D - O591 Wt` - - —. ..._._ oo ! r.• '�� .�Y�� 0 .�U r0: �� to 44 3U - Y.Of . v�n� l�. . . . S.S . �P .. . . . . ,li •!ti -..�. l . . . . . . . being duly sworn, deposes, and says that he is the applicant (Name of individual signing contract) ove named. Owl isthe . ... . . . . . . . . . . . . . . . . . . . . . . . . . .r W . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this flication; that all statements contained in this application are true to the best of his knowledge and belief;and that the rk will be performed in the manner set forth in the application filed therewith. orn toj before me this j� . . . . . . ./. ay f ,� -- F19 / , �� / ary Public, County �+ / ROBERT SEOTi,1R . . . . �. . . . . . . .`. . . . . . . . . . . . . . . . . . . . . NOTARYPU LIC,StateofN.Y. (Signature of applicant) No.4725089,Suffolk Term Expires May 31.19_.... 38 NOTE: ° CAKRET7 <� a LOT MUMBE;RS SI40WH VEPLV TO (69.0MAP OF NASSQU FARM5 " FILED IN ca 2t f _._ " :iY14C SUFFOLK COUNTY CLERK'S SF{Enx f`—"SA NCE- OFFICE AS 5 •�tP' TOGKDE E �� MAP :No • l �~ . { 179 �- 2 tOR FR.µt)U5L lu^g' y y t�^�G� �t�•6mlV"r ', n�yy1�J Q L5 U co I wJj - s' '/ �i `� Nif! LA""� E fit , ' x 0 U L I �, � r 1TJ �T C �PJlNP:1 0 S0 T I L a , � MAP ; 'OF PROPURTY - ---- o a,. d � a �G) �• . S U R V E Y ED FOP. jj ALFRID J . & MAR fAK-ROi7- SITUATE AT �i. o Z %• P C: U N 1 C ; TOWN OF SOUTHOLT) - S C.A L_E o 0'- 5.87 UI' 20�"•W. j i 16, 1E. L'/ 1 L0 1 ° rl� t` w L� (,� `y l l^ •r+i c •£4'••rtj�^A^F�!:''•,ir..� 1 � — 1 K��V T�I r � • ^.' I T- J E R 5 EY av 1 �. et^,h^�aar• r r Lu �` �' 1 •Wj;.1:'::.E'�.,,p..rr !.:•ii a?.'1 J x CUAVANTEED TO THE CkIC GO ? ITLE: '�ld �'-� � s` � cn4�^^�.+-;r;��tr..�;nar h�r�l�rirs.rr:f u ,(�� .c,z C�l`.9Nr!t ?rrnrnrf. ( NSURAIJCE COMVAN`! AND THE ,NORTH w cm � rl�z •< j,- .rt. h-r:artrh:iln,:� FORK BANK 441) TRUST COk1Pj1t�};Y • .Y — INC m C2 L] V �' a cl11 n tlir. r^.nn(r r vriiam thn rva tn!f `/ �/C, f n ;sT dnnhi.. 5URVE: 1ED o �T�EL Fr w 4. r,, r-ti.ryi_-, n r..l!.!5 to tt+.� A I13 , 191Z y�j, C{9 � Cis.' '�;. _:. 4f9!^:�rnnr. ;� �r.:-rmnnis:la�;;n:yora� _ _ i ! cri-zC L" M ` [i (wnz ov'I t ution li?tol har.,on Gr+d VA I \! I �� Q, Q 2 0 Lu ,�,C C) � to:i{?•ass;rt as of thF 1"nc'inb irrrii- `y 7 L t i.' - ti,.�m Gir;�ntAr.;t!r,,ntrt Iran, arrb!o ,/r_ t;,. lii.'.r:, for..AnfthutionserSuta:rquont � ^ �� — BAY � C C. �� "'r .. � ;M LICENSED LAND SURXI YOVZS �= P T . WGW YOT?u. A�� tiIL� E� ® �� f- a � ° � 5IiT7 •, A,p{ZIL 20, I972 GttEE=N 0R"