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Home My WebLink About23830-Z FORK NO. 2 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) N° 23830 Z Date .!1:K7............................................ 19A Permission is hereby granted to: 4� ......64; . .. .. ..................................................... ......... . . .....,.. � ..{..... . .. �. to . 1. .�.. '. � :........ ...64 ........ ....... ......... � ............. -- .. ... ............................................................ at premises located at ................. �............i%" .................... ...:.............................................................. ........................................C"'..i!••C`........t.. r............................................................................................ ................................................................................................................................................................. eor County Tax Map No. 1000 Section ..... � ..... Block ...::��............. Lot No. ..... :............... pursuant to application dated ........................................, 19. p.., and approved by the Building Inspector. Fee $.. ,/. C� .. ... ...... .... L:.............. ... .. . ..... Bui g Inspector Rev. 6/30/80 T LA tj 13 E r 5o 9.16 ff 5.,3 4.4. 14.3z A,If, -A CE 4 IKII -MV7 ✓ Wcll 7 7.3"A I c I 'Z' w It 9 r 29 y'j' • Zto DR. 54AVW2W WAY U01 .0 AW x —25 I'D Aw SUFF0t'S AV 4. .t A td t • GREEN WAY ` U %\ 3. A \ t / i s' la•ro J ......... •2.o A 2.0 A 29AAW y. s Ai� 21 4)3 )001 'C. —c' -.CEL s" OC3 E E St.JA SEE SEC s StE SEC N" ly sfuWM-o COUNTY OF SUFFOLK To.moFSOUTHOLD — KEI.11 "I" — 10 Real Property Tax Service Agency I'll 1 109 Legend Centel NsTRICT�.1000 County :'d"L I. y-'k E— PRO PERTY MaP ...... R—rh AEL BAKER.JR. -It 115 j � F JJ All Y 1 - I� • r 1 If -r 57 s ID ` ',v� i,`1` F Lu'4T �y. ��::� .:..r-.�t•+ss""''>�'�--'e-"d"�q'`.;'°�' �"' C O/ ;,! - ( --- FORM NO. 1 3 SINS OF PLANS 1 TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . .BUILDING DEPARTMENT CHECK NOV _ 6 t • ^ TOWN 11ALL, SEPTIC.FORM. . . . . . . . . . . . . . . . . . . .I ��O'O --' ;; SOUTHOLD, -N.Y. 1 197 1 _ TEL: 765-1802 NOTIFY: CALL . . . .T,v. . . . . . . . . i's�uaninecl��/ �........., 1 MAIL TO: . Approved..� �7...••... 19 Permit No. ..................................... Disapproved a/c ................................... ....................... ............................................... ...... . 0 fil. ig Inspector) APPLICATION FOR BUIi.DING PERMIT . . . . . . 19� INSTRUCTIONS o a. Ibis application must be completely filled in by typo-iriLer or in ink and submitted to the Wilding Inspector. wit 3 sets of plans, accurate plot plan to scale. Fee accarcling to schedule. b. Plot plan slxxaing location of lot and of: buildings on premises, relationship to adjoining promises or public streets or areas, and giving a detailed description of layout of property mist be draran on the diagram which is part of this application- c. lbe work covered by this application my not be commenced before issuance of Wilding Permit. d- Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. .Such permit Shall be kept on the premises available :for inspection throughout the work. P. No building shall be occupied or used in wtxile or in part for any purpose whatever until a Certificate of Occupancy slial_1- Have Been granted pry the IWIding Inspector. APPLICKrION IS 11ERE15y MAUL to the Building Department for the issuance of a Wilding Permit pursuant to the Building 7xone 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. 'llie applicant agrees to comply with all. applicable' laws, ordinances, building code, housing tale, and regulations, aixl to admit authorized inspectors on premises and in building for necessary inspections. (Sigrw^^Lure of- applicant, or name, if a corporatini) 1� 2 S� 77�,41.0. (Mail.zng address of applicant) State wiredrer applicant is owner, lessee, agent, architect, engineer, general contractor, elecLrician, p'hwTber or luilder. . ?. ..........................................................................................••--- Nam- of owner of premises �vu,(U%R,'-,vr.....�LLI�..................... (as on the tax roll or latest deed) If al4il.icant is a corporation, signature of duly autirori7Rd officer. ........................... (Name and title of co officer)po e o Cite ) Wilders License No. Pludrers i.icense No. ......................... Electricians License No. ..................... Wier Trade's License No. I. Locaattion of land on wliicpr propose(] work will be done............................................................... ✓.✓.��. ................... �L�le�......!`7...................... .%.c./ �.c�Gl�(.`L......... ikxise iAidx_•r Street Witilet County Tax Map No. IWO Section ..�(�� r.(PP.... Block ....U.S•.-QL)... i,ot .......OIr;l,�� c�v subdivision ...................................... Filed Kjp No. ............... Lot ............... (Name) 2. State existing; use arxl occupancy of: rem/ises aril intended use and occupancy of- pmpx)sed construction: a. Ex i s t i rug ►ise and occupkancy ... �. � !�Q.U� 5��:..................•............................ v1 b. interxkd use and occupancy .... r' ... .................. i i 5 1. N•Ilure of work (LAW& wl►icll al)l►licahle): NLI%J Iklililiril, .... .... . ArklfLion AIl'er►Cioii .. . .. Repair ............ Ila► wal ............. DenioIiLion'..... . Ol.11er (•k►rk ,f l`n............ j � ((k�sc:rfpticx►) 4. Esl:iurrted Cost ......1 ........... fee ... ....................... (l:o lie paid on filing Lhis appl.icaticx►) 5. It th,xal inl;, rxni►er of 44ell ing units ............ tillII)er of ch�el l ing iu►ils cx► each Floor ................ if garajge, timber of cars ...................................... (►_ if Ixrsiuess, camiercial or mixed occupancy, specify nature wind extent of each type of use...................... I /. Dimenslolls of existing atn►ctures, if any: Front:.. .............. Itear ............... Depeh ................. Ik ij;lll Nlnl►er of SLories ...................... Dinlen x►sirs of scale stnrcture withalteraticxis or rxklit:ions: Front ..... ...........Rear ............... Depth .................... Below .................... IAnI)r of SUorie. ............... it. Dine:nsicx►s of: entire new consLnv.-i:irx►-. Front Itc:ar Ikpla► . ............. Ikil;J►t: ......................... Uviller of Stories ........i........... .. ). Size of lot: Frrx►t .................... Rear .............'I....... I'A ptII .................... i 10. Dace of lAirchane 14axlr: of. Foriler Owl►er ..... ...... ............................. II. !Ax►e or use district in %A►icI% premises are situated ...... .................................................... .. 12. lkx:s pro(x►:uxl coostnx-Lion violat:e,any zoning law, orclinac►ce or regulation: ........................ i 13. Will lot: be regraxied ................... Will excess frill he raloved frcxn premises: YES tJO Ill. Manias of. ()<ar►er of premisesNAr..k49 L��..�aii e T g.Y.C&4N F ..I�Lt T�.�I Q.�. ........ N►ax No. / .✓7`-('. � Naar: of Arcl►itec:t .................................... Address ........ . ..................... Mor►e tan. ....... ....... Mme of Coot:ract'or ................................... Arklrlless ...............................11►oc►e No. ....... ....... 1`i. Is this property Within 3M feet of a tidal areLlalxl'? * YE' .......... IX) Al....... *If YES, 9(1lJnan ,inn 'lli ma.s ii-D r MAY lut lU4J11U:1). P(A'1' DIAGRAM lnc:ate clearly and distinctly all lxrildings, wl►ether existAing or prolx►sed, aril itxlicate all. set-back dimensions frcnl property lines. Give street and block rrnher or description' according to cleed,,arx1 sl►w street rwlnes arxl imlicate ►,Iletller interior or corner lot. 30 11 y3K, L.P. N 3 ✓ ^,;E y'7 II$a° BUILDING iwf.l I Ir�d�i�GjPMZM'� AT s';;!.as 'A 13ii!"•l, INSPECT'ONS: a i.Si°�d;..43?l•1�1`! M0 aEQw.I..lMED FOfl POU"RED CONCRETE :2, t oquGH - FRANiSl (3 . Pl_1�i�n iaal i BE CONPLETE FOR C.O. ALL f,0Kl 13 tRLJG"!10K1 SHALL PviHt u NIE-F tREQiilRE-ME9°TS OF THE s� i. STATE 'CONSTRUCTION & UqER(-',Y NOT RESPONSIBLE FOR .C,N OF,CoIklgrRUCTIOit)ERRORS 5�i I (IlAIMIY (A? S�r.� Uri /G.... ZV. •/�/�e� ��=v......... s../`t' f�.�..6.lx!ing duly svxjrn, delx►ses awl says Thal he is Llle applic:alrl I If ilxliviclu<ll signinj; contract) arlx7ve I►a lled, I . .. �Ik: is, lire .. 57 .............- -•--....._--•--i. .......................•---................ ((k)Iltractor, agent, corlx)nWe officer, et.(.-.) of. said owner or owtier.s, awl is duly authorized to per.f'onn or have (x:rfonied l.he said work alxl Lo ni<dce arxl file Thin a ppl icaLion; Chat: al.l. sLatements contahled in i.his application are t:nx: co the best_ of his knowledge aixl Ix'Jief; ar)(l IhaC Lhe ux►rl( wi11 be I)erfonrled in the ar►nner set fort.It in Ole allpl.ication filed therewiLl►. fk;or'n to Ix:for-e Ilr: this .. . [4.. ...........dary of s Notary ('ubli ! f ... I LI DA F.KOWALSKI ..J' ............. Notary Public,State of Newyork ( il nature of Applicaln. No.624524771 Qualified In Suffolk County Commission Expires Nov.30,10