HomeMy WebLinkAbout8396-z FORM NO. 2
TO~N OF $OUTSOLD
BUILD)NG DEPARTMENT
TOWN GLERK'S OFFIGE
SOUTHOLD, N. Y.
BUILDING PERNIIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 8396 Z
Permission is hereby gronted to:
Fee $~ ...........
......... ~al~ya, ........ ll,,~.. ..... ~.t~9.1~ .....
~o ..... ~l,¢.~,..~...~,l~,.:.,~.,,~tal ....................... :,..: ..... ~ ..................... ~ ......................
L ot premises I~et~ et .... ~..~~':~.~~ ~ ...................................................... :':: ..............
................................................ ...... ........................................................................
~$:: "- pursUaot to application dafe~ .: ............... ::..:.~::,:;.,~,.; ...... :.:,-~/~:., o9~ gpp~y~ by ~.b~ '~.; ~'
FORM NO. 5
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
ORDER TO REMEDY VIOLATION
Date ...... .~...A~.q.~.....3. J..~ ........................ , 19 ..... ~. 6
TO ...A~Aa~as.io~ Kor~to~eoz~ ......................
(owner or authorized agent of owner)
(address of owner or authorized agent of owner)
]]200
PLEASE TAKE NOTICE there exists a violahon of
Zoning Ordinance Chapter ] 00 . .A~.t ..... )ZT3Z .................
Other Apphcable Laws, Ordinances or Regulahons ...~JTAp. t~e.~,'....5.2....r....H..o...u..s..ing Code
at premises here,nafter described in that .~,orz~t, ru.cJ~ioD...P.f....clw¢.~,l.~Dg...un..d..e.~'....B..u...i.~.~Dg
(state character of v~olat~on)
· Perm.i..t_ ~.8396Zdated March ] ! ] 976 is being. ,performed in an unsafe
....... YOU..ARE .I{ER~iBif...QI{D~i~.,..TQ...~.Q~...W. QR~...g~..i .~....t .h...i..s.., .h..a...s...b~.e...n. corr ec ted.
Article IIi - Section bZ-3U A. B, Houszng Code .................
in violation of ..S~ctio~..l.Qg..-.]..~L3....~..~or~ing...QrdiAAA~.¢. .................................................
(State section or paragraph of applicable Jaw, ordinance or regulation)
YOU ARE THEREFORE DIRECTED AND ORDERED to comply with the law and to remedy the
conditions above mentioned forthwith on or before the ..... ,AT...Q~C~ ....................................
day of ..................................................... , 19 ..........
The premises to which this ORDER TO REMEDY VIOLATION refers are situated at
E/.S Lighthouse Road~ Southold Count
............................................................................ y of Suffolk, New York.
Failure to remedy the conditions aforesaid and to comply w~th the apphcable prows~ons of law
may constitute an offense punishable by fine or imprluent or both./
Building Inspector
t
TOWN Of SOUTHOLD
BUILDING DEFARTMEHT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Application Ho ................................
or. in ink and submitted in triplicate to the Building
INSTRUCTIOIqS
a. This application mu~'-t be completely filled in by typewriter
Inspector, with 3 sete of plans, accurate plet plan to male. Fee aocording to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining promises or public streets az
areas, and giving a detailed description of layout ofpraperty must be drawn on the diagram which is part of this application.
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 issue a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the w~rk.
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 regulatlam, and to
admit authorized inspectors on premises and In buildings for necessary inspoctio~s.
(Signature of applicant, or name, if a corporation)
...
....................... · ·
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name of owner of Premises .....~.
If applicant is a corporate, signature of duly authorized officer.
(Nome and title of corporate officer)
Builder's License No ...... ' .......... ~ ......... ~ ..........
Plumber's License No. ~
/oeo- 0~b-~- ~-~ ~
Electrician's LiCense No ........~ .......... ~'
Other Trade's License No ............................................... ~ ~/~
Location of la~ on which p~ ~ will ~ ~e.. Map No.: ............... ~...~......~... ~No .........................
Street and Numar ..... ~.~.~~.....~.~.~ .............. ~ ...............................
State existi~ u~ and ~cu~y of promises a~ intend~ u~ and ~cu~ncy of p~ c~i~:
a. ~isiting use a~ ~cupan~ ............ ~ ~
b. Int~d~ u~ ~ ~e~m~ .; ........................................................................ 2 ................
3. Nature of work (check which applicable): New Building'~.. .............. Addition ................. Alteration ..............
Repair .................. Removal .................Demolition .................... Other Work ....................................................
c~ ~ (Description)
4. Estimated Cost .~. ......................................................... Fee .........................................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................
If garage, number of cars .............................................................................................................................................
6. if business, commercial or mixed occupancy, specify nature and extent of each t~pe of use ............................
7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth ....................
Height ........................ Number of Stories .................................................................................................................
Dimensions of same structure with alterations or additions: Front ....................................Rear ............................
Depth--- ............................ Height .......................... a,~c;Nu~ber of Stories ................................ ,~'~)/
8. DimensiOns of entire new construction' Front ....... ~..~. .................... Rear ..~:.~..:.. ........... Depth ......~...~..'" .......
! ,
Height ...... .~ ........... Number of .Stories .................................................... ~-: .............................................................
9. Size of lot: Front ........ /....u....~. .................................... Rear ....... ..~.~: ........................ Depth ..~...,~......~... ........
10. Date of Purchase_ .....~..~M~...~...~./.~..~...~. .................. Nome__~......~ ~ ~ ,-'- ~.-,~., ~.~-'--°f ForLer Owner ...7~...~...~.~...~...~.lh"...~...~l.~..~..t:'...,~....0....~...~J~.t ~
11. Zone or uSe district in which premises are situated ...... .'~...~.Z.~....r.¥.......~....rT......°....¥....~.....~....r-~...~....~..r.~.., .........................
12. t~es proposed construction violate any zoning law, ordinance or r~ulation: ...~....~.. ................... ~./ ................
13. Will lot be regraded ....... .../~......O..,. ......... Will excess fill be removed from premises: ( ) Yes ( ~ No
Name of Owner of premises ~..~..~..~..~..~./'..~.~' ~'~r~ ~.~..~...'?/....~.~1~,~ N~...~...-~...~..~
Name of Architect .............................................................. A{ktre~ ................................ ~hon~ No .......................
Namo of Contractor ........................................................... ^~lre.~ ................................ ~ho~ No .......................
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fram
property lines. Give street and block number or description according to deed, and show street names and indicate
whether interior or corner lot.
STATE OF NEW/¥OI?~F II. , ~SS
COUNTY, OF :.~_~-,,~/7.G..~....~' --
........... ~.~.~(~.....~~ ............ being duly sworn, d~ose, and says t~t he is the applicon,
(Name of individual signing c~troc~
above name.
He is the .................................... ~..~..~ .....................................................................................................................
(Contractor, agent, co~orate officer, etc.)
of ~id owner or owners, and is duly aut~rized to perform or h~e perfo~ed the said work a~ to ~ke and file
this application; that all statements contain~ in this application am tree to the ~st of his knowledge and belief; and
that the work will be perfor~d in the manner ~t fo~h in the application filed t~r~ith.
Swam,to ~fom me this ~ ,
.......... ,.,o, ........... ........... ,
.......................... ....................
~A~y PUBLIC, State of New
~, ~2~50. Suffolk Coumy
ATt l,r, NLt,,$ ~ 05
'7'~-~4 lOTM ~V_f'
150.0