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HomeMy WebLinkAbout24645-z i 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.....ff;AWORY........s7........................... 19...9.R.... 24645 Z Permission Is hereby granted to; A.N...I,.j 0.R Y.5 Z................................. ...... ........................................... ................................... to .....F.RF.QT...0...F.RNQF...IN..RFAR...YARD..AS...AP..PJ-I.ED...F.QR................................................... ................................................................................................................................................................ .................................................................................................................................................................. .................................................................................................................................................................. ............................................................................................................................................................. at premises located at....I..............175.....CLEARV I EW AVE ,,,,,,..............�,QU H,Q[,V .... ..................................... ................................................................................................................................................................ County Tax Map No. ,,,,473889,.... Section ...070............. Block .....0008,,,,,:„ Lot No. OAP,,,,,,,,,,,,,,, pursuant to application dated ....JANUARY........... ...................7 19......98..... and approved by the . . Building Inspector. Fee$........35.00..... r ................... . ............. ilding Inspec r Rev. 6/30/80 r BOARD OF 11EALT11 . . . . . . . . . . . . . . . -FORM NO. 1 3 SETS OF PLANS . . . . . . . . . . . . . . . 'TOWN OF SOUTHOLD SURVEY M1' 7 JA)v g BUILDING DEPARTMENT CHECK . . . . . . • . . . . . . . . . . . . . . . . . . 'TOWN ]TALL SEPTIC FORM L—L SOUTHOL.D, N.Y. 11971 BLOG.1)EPT. TEL: 765-1802 NO'fTFY:0—eQ�b L302-YS-"- Town�of Sou T HOL® cnLl. =7�5-• -( I• - lixtminecl. /�� 19G,/..� MAAIL TO.S. e-x-e*- -� c . .�. . W W k. . P..!� : Approved... � !,: ..., 19 Pezmi t Na. •... ii Disapproved a/c .................................. . Sc�......OL.L�-) ��s . ��� l ...................................................... (Building; It) - ctor) APPLICATION FOR IIUILDING PERMIT ..Date. 14 - - - . . . . . . . 19 �1� INSTRUCTIONS a. This alailicalion must be completely tilled in by typecwriLer or in ink arxl suixnitted to Lhe isuiiding Inspector wii r 3 sets of: plans, accurate plot plan to scale. Fee according to sdiedule. b. Plot plan slxming location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram wluicll is part of Uris application. c. the work covered by this application may not be connrenced before issuance of Building 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 thrrxugl,out 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. t+PPI.l(',AI-LON 1S I0ai--MY IW1E to tree Building; Department for the issuance of a Building Permit pursuant 1:6 the Wilding'lone Ordirkance of the Town of SouLlrold, Suffolk Carney, New York, and other applicable I•nws, Ordinances or Regulations, for the construction of Ix,ildings, additions or alterations, or for resTuval or demolition,.as herein described. The applicant agrees to comply with all. applicable laws, ordinances, building code, housing code, and regulations, and to a(imit authorized inspectors on premises and in building for necessary inspections. ......................................:.............. (Sigrk tore of applicant, or name, if a corporation) .................................................... (Mailing address of applicant) P ROVED AS NOTED Skate whether applicant is owner, lessee, agent, arclr.itect, engineer, general contractor, e c r�4y p ur ,ergo 'i- d( 7� .......................................................... DAT B.P.# /` /! .......i� �l �.. 1J ©2`t . Z N .70 . ° � BYP E T AT Ig<rm o f owner of.•premises .-- --,---••--•-• NOTIFY.JElUil.l?I Ct.QF A. _ (as on the tax roll or latest deed) 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: If appl icant is a corporation, signature of: duly anuLlxor.ized officer. 1 FOUNDATION • TWO REQUIRED NIA-....................................... . - - -- - FOR*OtIRED_C"ONCIME 2. ROUGH • F RAMA8i1G A PLUMBING (Name and title of corporate officer) 3. INSULAIM 4. FINAL • CONSTRUCTION MUST ll BE COMPLETE FOR C.O. 1krilders License No. .�.I.`` ................ ALL CONSTRUCTION SHALL MEET Pluriuers License No- """""".... THE REQUIREMENTS OF THE N.Y. A' STATE CONSTRUCTION rIC ENERGY Electricians License No. .!".� .............. CODES. NOT RESPONSIBLE FOR N I DESIGN OR CONSTRUCTRON ERRORS Other Trade's License No. ....._ 'Q I . Location of: larxl car which proposed work will. be done... .. ��1�d2 1� ...�1 Rue, �6u�dW ........................................................................................................................ pause Rxiber Street //��//rr•�� �( /� /�`��1,jinnl�et/t� Ccxrnty Tax Mrrp No. 1f000 'Section O. D t.OQ._ Block .03!.0.0... Lot 0 J.�l.�VCD0 ,,ulxlivi ,ra. ...................................... Filed Kap No. ... Lot .......... .. 2. State existing use- and occtrparxy of: premises and interxled use arxl occupancy of proposed construction: a. Existing use aril occr,lkvucy ....5 f .�Z'�-��.. .. ES/.i!�C' ............... b. Lrterxled use arx] occupancy ..' .. ..�'"� .. . "/�,� .....!../.�J� !.Y.� �!.. I t .. ..._, Z. tvitine of warlc (checkvAifd► applicable): New Ik;ildinl; .......... Acklition ...^�/... AlteraCio .......... Itc pa i r ............ Itennval ............. Dow)]i Lion ............ Other Work Cyr dlAf.4111 1� ..1 . ......... (I)escri pLeion) /i. list:itwit.ecl Cost AxPLIC e............ fee .............................................. (l:o lie lk-iicl on filing LI►is alil)IScat'ion) If: AA--ling, ixniier of ckaelling uniLs _ i .., Umber of: ckaelling unila on each--floor :. �/�..... 1 f. l;arage, rxi ber- of cars ._....�/ ......................... Q l 6. If IxmliM_fin; comercial or aifxnxl cx:ruluirx-y, specify nature mul extent: of each type of urte...... ........ i 7. biensions of existing sl'nic_Lrires, if any: Front...//.19 hear ..IV119..... Depth ...IV1�..... Ik!ill►L ._......... ..... ... Mnlrer of Storiea' ..................... Dim¢nsicxis of.saine sL'rcu:ture with all:eraticx►s or a(kliL'ions: Front ............... Rear ............... Deptl► .................... lleiglit .._.._.........I.... tfkxiber of Stories ............... 11. Diun:llido a,.61' enl.ire Front new ccnArivaionFront ..A//�----. Rear ............... Depth .............. IleiI)iC ......................... Usib.r of Stories ..................... 9. Size of lot:: FrOnu �.Q./.......... Rear .....� 1........ Deptl► .....Q�t3�...... 10. Mile of 1'i11-4:hose �196...AP m rrY: of Fortier Owicer ..V.P. SV t....�r�14:1<?!`�'1.�...... I. Zcxie or use district,' in wliidi prouises are situated ............................................................. .. 12. 1k)es proposed constmeLionviiolaat4te any zoning law, ordinance or regulation: ..,:..!! .-1............. H. Will lot be regraded ....L�:l.l.'......... Will excess fill be repavecl from premises: YES ND M. CLn,es of (anier of prr�nises(.c `le� dress .. 1 1'Icaie No. SDU`J7-�UL�>wdu,`�t Nrnrie of Ardiitect .�.��., ... ... . Acklress ....... ........'o..`. I'fioiie iJo. ...........Q.. ld:nie of (ontr, :or D ram...!.. ..I.. CD [�l�r''ikklressf: '. 1�(��C:!���1...11101)e No �'(.(. 15. is this pmpoilLy within 300 feet of a Lickil iaetland? * YES .......... NO .�.... *1F YfS, 901111KXD IMN 'I1111SMS PBIMIT MAY Rli UE(il IM1,D. y PLOT DIAGRAM icx:ate clearly arxl distinctly all ixiildings, whether existing or proposed, and indicate all set-back dimensions frcxu property lines. Give street and block rr■iber or description according to deed, and show street naiiies six] irxlicat:e ►.Acether interior or corner lot. S;er-> :5L)/Zx UMIUORP (WIT tr 13F�;�:4��d«�1 l� *3`�Ni1F.tni.'�'•�.'QL'R•�'F$P►�lJ_+y�,d� .:k tt �}} gyY�, R� $7�.NR 9F9..9t:�'4.+•'.eAi.•.� duly swcirn, delxises aril say;; LI►at he is Lhe appl.icanl: "t�:iiKw.ir i i'iicl,iiu:iili�i<il�,isi:�;�i"iaj' r2�i.�lr,;�iit) � • alxrve ►urmxrd, Ik! i:. Ow .......... ................................................................................... (('.cn)tractor, agent, corlxirale officer, etc.) of said omier or ciwix!rs, and is duly authorized Lo perform or have lierfornr-d die said work and Lo mike aixl file this ;rppl icat:ion; Lhal: all. sLalenenL•s contained in Lhis appl icaLion are Lroe Lo the Null: of his kwul.edge and Ixil.ief; mxl that. the work Will be perfonned. in Ow nvinrpr seL forth in Ow appl.ir.,;l:ion filed therewith. .'kmrn In I fore ur! tl;is dri rkiLary N;it is ........ (Sif;nature of Appl.icat L} . Notary Le d N ew York � Cutl In ComrnUsfon�itw ---� • Z� E\.. u%.a ¢IrL L\J Sl,f4ON\Sr,ou Sv \' <.o N TY TAtt MQP 't OOi7 G, O 0.001 • � GJUR�C• ( � 1. 4oTqp1 Cite Ir Go VRb1E - .�. ® 3 4.. laN.W,4 p - } r � (v, Lp 10 n 3 , 1 _` Lp ,) r LIP F TAT L Q % �� 0 LP j (� t' L f ,rtii1 �' E I•.0 ro 40,E !. d r 4Ty 1 Q a, .q%Y Y. iChr,Y� 1 2.gp S,of y4 NCE " o' �. J 5S'T° 1 �x%6vI ra4 f co Ste p. OOP 4 /-+> d � 7t.: -.Y •,`..., � • yy •AMA',[. 14 .. C(+ w •�. � W� t' 44 mue Q of ry ew 1 SAY. � wC<< � 3 ? 3 4 No.�a �O 1� i aT Rt sEp VA K J �/ f'sI0NA1,/ E.R = AV'1 phl." \\..1 b.ii: vJ \TN 'r'*Ac �LST►T,>!0 xcros OT 18 APP\.\GAYaZ •. ►TP0.EaVA.L Ol= 1p%-ba"S AE.10 Go►s�rTQJIJVTvo►�- AV.% •c�►E 1•�\o.P o ><_ '•S!LZ\pN C?INIL CAP-0.\R-S sZ. yt'WAyQ, O\�PoSM�- SY'T�MS �� F:A1RV 1EH/ PA0.1�G.� 4 FR\-\x t>rt.c�. �n.�\\%.--f cZcy\os., ccs" ��ao w\\..` Agtor■, 9R1rr.fit # \ .8 AU .CA, \' 1 P1k: Qi4L- ` D`[ THc GoNp\T\Im—b SEZ F0%LT%k V'%%33g8 �\.aY \Ito p.►ip mto t-yE P6RH t Tfl Go a35TILvC.•r . S 1 T v!•'C E Q ta.T � UNAUTHORIZED ALTERATION OR ADDITION T0 V \ .O `� TO THIS SURVEY IS A VIOLATION OfLf;r P\.\G�.A��I.� S L1 N��V Q+�• M SECTION 7209 OF THE NEW PORK STATE 5 l [ F r O C.0 ` ,V"T ' �' EDUCATION LAW. V !� `%I( COPIES OF THIS SURVEY MAP NOT BEARING a THE LAND SURVEYOR'S INKED SEAL OR EMBOSSED SEAL SHALL NOT BE CONSIDERED TO BE A VALID TRUE COPY. GUARANTEES INDICATED HEREON SHALL RUN . Z, ART\,k V Q kV E V fE, ONLY TO THE PERSON FCR WHOM THE SURVEY ya L V P c 11J•� �..L.y. i in\S IS PREPARED AND ON H15 BEHALF TO.THE 7 1 TITLE COMPANY, GOVERNMENTAL AGENCY ANC PHONE V 3 �Z D 9 V=Wvl, �t=' LENDING INSTITUTION LISTED HEREON. AND ' 5 e_s14-+f�• l"� 4c� v.k-r E AL FPV- Z O)\�UT O XLIA'tANTEFS AssiNfES F AREENOT TRNANS ERTABU �►iGE elVT P c' QoPq SE£O iLES, Nv. �� I ,.I •T Ns �� ,. ti:in:FOl�c� , Lo ctwT'eir R!S, U N D E1L LvN itR V 1*.C-. 'Z\, \CA g46WNFQS, CaUAae,.JTEEb 'To'• GIIERAQV, To -T\T\_B \N S. Go. of RN if A¢ A• L O E 2 o O. SQ';. :, . . 06TI.•c�^t, A.S•c. •v.Q.kw