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Home My WebLink About8761-z F~RM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8761 Z Permission is hereby granted to: W~eCer. a~,~..As~,~c!~.t.es...~.~.~ ..... A/,~,,.~:o,,~u.,.o~ Southold ............ .~..z..z..e..L.~.?.s.~ ....... .~.....z.....,...~.:.~.: .... pu,~uant to application dated .................... ~...'~,..e. ..... .8. ................... , ]9~.~...~.~ and approved by ~he ~,...~,;~;~ Building Inspector. - ..... :~: TOWN OF SOUTHOLD BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT Apphcation must be filled in by typewriter OR m mk and submitted in triplicate to Building Inspector, with: a. Health Department approval to construct private well and sewerage dmsposal system, OR approval to hook up to pubhc water and sewer system Jf avamlable. Accurate plot plan TO SCALE showing ail lot hnes, streets, buildings, unusual natural features, exact size of lot and proposed buildings, and ex~stmg buildings, elevations and other topographical information, Subdivision name, lot and block number etc. Plot plan or survey must be signed by person or engineer or surveyor preparing same. c. The plot plan must show the actual shape, d~mensions, radd, angles and area of the lot on which it ms proposed to build, or add to an existing building. d. The dimensmons of all yards, setbacks, distance between proposed building and ex~sting buildings or structures on same lot must be shown. Plans for proposed building OR addition to exishng bu,ld~ng must be clear and legible, submitted ih triplicate. One copy of each filed applicahon, plan or document will be returned to applicant for their records. f. Where required, copy of approved special exception from Board of Appeals and/or site plan approval from the Planning Board must be submitted w~th application for such building permmts. Apphcation for s~gn permits wdl use same forms and procedure as for~ buildings, however separate "plan sheets" g~wng outlines, dimensions, exact Iocahons and other detailed pertinent information may be submitted. : Permits expire in twelve (12)months from date of ~ssue with exceptions as noted tn building zone ordmnance. As soon as o foundation for a building OR for an addition to a bu ling is completed and before any first story framing is started, an accurate "foundation survey" showmng accurate distance from foundatmon to all property and street lines shall be submitted tc the Bumlding Inspector and approved before further construction is permitted. j. PERMIT FEES: New dwellings~$25.00 plus 5~ per sq. ft. for all buildings over 1,000 sq. ft. floor area; Additmons and alterations to dwelhngs -- $15.00, resmdeptmal accessory bumldmngs $1000 plus 5~ per sq. ft over 850 sq. ft. floor area; Additions and alterations to such acces- sory bu~ldmgs--$10.00. Hotels, Motels, Business and Industrial bull.dings -. New Construction-- $50.00 plus 10~ sq. ft. for over 10,000 sq. ft. of floor area; Additions and alterations to such buildings----S25.00 plus 5f sq. ft. for over 1,000 sq ft.; Business and mndustrmal accessory buildings and additions to same--SIS.00; Farm build;ngs--$15.00; all other s}ructures--$15.00' Signs 25~ per sq ft, minimum--S2.00. k. Permits may be revoked for cause as outhned in the building zone /ordinance. I. Stop orders will be issued under conditions outhned in the zoning o,rdmance. 2 Certificate of occupancy must be applmed for, and are required for all new and exmsting buildings, land use, etc., FEE $5.00· Inspection of existing building and ~ssuance of certificate Fee $5.00 3. Regradmg of building lot or premises, removal of excess fill from such grading, cellar or basement excavation, cesspool excavation, driveway construction, etc., must be applied for at time of building permit and permmt ~ssued by Bumldlng Inspector (sand, gravel & excavation ordinance). FO~ NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. No. /z_ Approved t ~f,/ ~ ~-1 c~ "~'~' ....... l ................... ' Permit ................................... Disapproved ~ ...................................... ' ........................ Date .......................... ~T.~e ...... 8 ..... , 19.~.~ .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildin_~ ~nspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddmgs on premises, relationship to adjmmng premises or public streets o areas, and giving a detailed descnption of layout of property must be drawn on the diagram which is part of th~s application c. The work covered by this apphcation may not be commenced before issuance of Buddmg Permit. d Upon approval of this application, the Building Inspector will ~ssue a Building Permit to the apphcant Such perm~ 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 Occupanc; 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 Building Zone Ordmance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterahons, or for removal or demolition, as here~n described The applicant agrees to comply with all apphcable laws, ordinances, buildmg code, housing code, and regulations, and t, admit authorized ~nspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or builder Architect Name of owner of premises .... ~ot.~-~n_..zaf...S~l.'~.t~.o~,d ........................................................................................ If applicant is a corporate, signature of duly authorized officer. Builder's License No ..... ..~..*.~.*. ...................................... Plumber's L,cense No.F.,...~.~t~.e,~',,~o~..f~.oz'~ ........... Electricmn's License No .~D.Q~.~.[[ ....................... Heat & Vent Other Trade's L,cense No ...... ~p'echell...~.~C, ........... Location of land on whmh proposed work wdl be done. M~p No . . ..~.~ .....~1 ........... Lot No..Z;T.~ .............. Street and Number .~,[~J..-~[~..~.T~.~d...~..~...[~.~Tt.. ~b&.Tze ........ G~13.~,~....};.o.~r ................................ Municipality State existing use and occupancy of premises and intended use and occupanc' of proposed construction: a Exisiting use and occupancy ....~.°.~...g~.9..e... b.~il.~.ipg ...................................................................... b Intended use and occupancy ...... s~..~,~..~..~c~'l Ot~ ............................................................................ 3 Nature of work (check whfch applicable) New Building .................. Addft~on ...~ ...... Alteration .......... Repair ................Removal .................. Demolmor .............. Other Work ....................................... (Description) / _ ....... 4 Estimated Cost ......................................................... rea .................................................... (to be po~d on filing th~s application) 5. If dwelling, number of dwelhng units .......... .0. .............. Number of dwelhng units on each floor .......................... If garage, number of cars ......... .0 .............................................................................................................. 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use .......................... 7 D,menslons of exist,rig structures, if any Front ........ !})-~.,~.~'.! ....... Rear ....)~,.~'.! ................ Depth Height ........................ Number of Stones .... ~ .................................................................................................. D~mens,ons of same structure with alterations or additions' Front ....................................Rear .................. Depth ................................ Height .......................... Number of Stones ............................. 8 D:mensions of entire new construct,on: Front ..... .'[.1.8.,..~.,..0J~ .......Rear '~ J'8~l~'[',.0~ ..... Depth P~.~.t....O~. ..... Height .................Number of Stones .f~D. et ............................................................................................. 9. Size of lot Front ..... 22~,,.~'~ .................................... Rear .... ,~.~v°.o.cJ2 .......... .~ ............ Depth2.~,.<::)./...2.~.Q ......... 10 Date of Purchase ..................................................... Name of Former Owner '.l~.~.es.by.to,r.:;Lc~..C, hl~,~c~,..<~. 11 Zone or use district in which premmes are situated ~:Z:~-I t~ 12 Does proposed construction wolate any zoning law, ordinance or regulation ............ T~ ..................................... 13 W~ll lot be regraded ....... ~'.~.~ ............. Will excess fill be removed from premises: (Z) Yes ( ) No 14 Name of Owner of premises .TD:~?~...O£..~io.~t,b.~)'] d ............. Address ......~o~+~}~;z-'l-r]. ...... Phone No ....................... Name of Architect .WJ. eCl-ez'~um..Ass~c. .................... Address ....l~'a, lJle. E...S~t. ea~'hone No ....................... Name of Contractor Ger_l. ee.z~_..Cozz:t;~, G o.C o .......... Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~st~ng or proposed, and indicate all set-back d~mens~ons from property hnes Gwe street and block number or description according to deed, and show street names and red,cate whether interior or corner lot See Filed Plans STATE OF NEW YORK. [ e e COUNTY OF .... ~.I~.~.].~ .......... } ~ ~ .............................................................................. be:ng duly sworn, deposes and says that he is the apphcan (Name of ,ndlvidual sigmng contract) above named He ~s the .......... S~..c~lqiI.u(~.~ ................................ (Contractor, agent, corporate officer, eta ) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and this application; that all statements contained m this applicat,on are true to the ~est of h~s knowledge and behef; an tha~ the work will be performed ,n the manner set forth ,n the apphcation filed therewith.. Sworn to before me this /" , '~ · ...................... day of .................................... , 19...~7.(q. ~ ~ Notary Pubhc, . ............... ~...1~.. ~.o..1...~. ................... County ...................................... i ................................................... (Signature of applicant)