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Home My WebLink About11674-zBUiLDiNG DE'P~R'I~ME ?r TOWN HALL~ SOUTH'OLD, BUILDING PERMIT' · (THIS PEP, MIT MUST BE KEPT ON THE PI~E~]S~S UNTIL COMPLETION OF THE WORK AUTHORIZED) , 1;1 Z Permissio~ ~reby granted tO ..~ . . .-. ..................... '7 ~. · ~ ~/~ w/t ,, 4 I '~ ................................................... '**"""~'~'"~"t ....... '~' ...... t'"'"' ......................... ........................................ // ......................................... ,. ........................... ,.~ ....................................... p~:em,se~ at ................................................ ............. ,...~.,~ .................. ~ ....................................... ...................................................................................... : .......... :,...:t: ....... , ........ ~. ............ ~ .......................... "':' ............. ~ ..................................................................... ~ ......... ~'"'t'"' .......... ~?'t .......... +"'~ ............... ' t ~ D / -~ ~ t ~ Cou~ Tax Map No. 1000 Section ....................... Dl~k ~ ~: '~ . ~ot No purse*hr tO- opplicotion datod ......... ~ ....................... ; ......... ...5 ; 19 ~ i ~nd Opprov~ by th~ Building la~ebtor. : ~o~ $ ......... ;.: ............ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File_~ ............. _._: ................ Date PLEASE TAKE NOTICE that your application dated . ,~..d.~r,Q, 5. .... .¢~..~. .......19,0t~-.~., for pe~it to construct. ~~'~..~~ ~- ~ . at ~ouse ~vo. Street / ~Hamlet County Tax Map No. 1000 Section Z~ Block Z ff Lot ~/~ is returned herewith and disapproved on the following grpunds . .~..O.C~...~.. v~'.~.~'?.~. ~./..../.~.. RVI~0 INSPECTION FOUNDATION (1st) COMMEN'I'~ FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FORM NO. 1 TCWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 .... Applicatio~ ............... . ~ppro,,~ ~.7..'~, ~ 9 .~~o' //~7~Zadd~ ........... ...... ...'... (Building Inspector) APPLICATION FOR BUILDING PERMITDate INSTRUCTIONS a, This application must be completely filled ill by typewriter or in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strc or areas, and giving a detailed description of layout of property must be drawn on the dia~am which is part oPthis ap 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 issue a Building Permit to the applicant· Such per. 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 Occ~par shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Bnilding Department for th~ issuance of a Building Permit pursuant to Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein desc~ib The applicant agrees to comply with ail applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessarv.-inspections. (Signature of applScantTor name, if a corporation) · ..... .,/¢ .. . (Maiiin address - State whether applicant is oxvner, lessee, agent, architect, engineer, general contractor, electrician, plumber ox' build Nmne of owner ofprcnlises.. , . .~.. . .................. . ................. ..... .. · (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder s License No ...... '~ ........... Plumb s Licens~. = ......................... Elactrician's License No.' ...................... Other Trade's License No. -- 1. Locatiou of land on which proposed work ',viii be done ................................................ House Number Street Hamlet 3 ./. ':5.. County Tax Map No. t 000 Section .................. Block .............. Lot ........... Subdivision -~ -' Filed Map No ~-' Lot (Name) 2. State existing use and occupancy of premises and intended usq, and occupancy of proposed construction: a. Existing use and occupancy - :-- ,b.- Intended use and occupancy /9._t~p~.,~ t~3/ /?/'Si/ .~. Nature ofwork (check which applicable>: New Building . .~...O¥~...~tf Addition ...... Alteration . .~. Repair .............. Removal . .~ ............ DemolitionV ............. Other Work ............. Estimated Cost . .. ~. : ............... : ................ Fee ......... ¢ ......... " $ ( (to~e paid on filing this application) 5.If dwelling, number of dwelli1{g units .~ ............. Number of dwelling units on each floor ....... ....... If garage numbcr of cars ; If ousmess, eommercml or m~ded occupancy specify natt re and exte ~t of eec zty e of use .. ~ . . . · ~ · . . / , ~ ............ ~t~ ...... .~;/m ..... ~ .... m~,t ..... Rear .... ~ ......... Depth ........... Height ~ ' ' ............... ~unlbor of Stone~ ................................................ ' } Rear D~pt~ Size oflot: Front ' · Date o'f Purchase ~ Name of Fommr Owner Zone or use district in which promises ire situated ' ":. Does proposed construction violate an~ zoning law, ordiaanee or regulation: .......................... Will lot be regraded .......... . ....~ .............. Will excess fill be removed from premises: Yea . Name of Owner of premises ........ i ........ Address .... ph o n e No ~ rT~g..~6'~.. Name of Archi[eet : ' Address Phone No Name of Contractor : } Address Phon~ No PLOT DIAGRAM ' Locate clearly ~d distinctly ~1 buildi ~gs, whether ~xisting or proposed, and. indicate ~I set-back d~ensions fro~ numbe: or description according to deed, and show stre=t names and indicate property lines. Give street and bock ;nterior or corner lot. ,\ .} ..... / 0~,v ~]FATE OF NEW ~'-ORK~ ...... =med. aC- T "7 u si '" ' ' c~ . being duly sworn, deposes and says that he is the applican fie is the ..................... ~ .................................... ; .............. ' ' (C ffi ) ' ~ ontractor, agml[, corporate o car, etc. of said OWner or owne~, and is dt~dy authorized to perform or have performed thc said work and to m~e and application; that all statements con!tainted, id~ tliis application are true to the best of his knowledge and belief; and that th- ~'ork will be performed in the manner set forth h~ the application filed therewitli. ~orn to before nle this ......... / or ....... .... ' ~* Public, .~.~... ............ , ........ , ..... '"'~' ..... ~, ,,',:,:' -:',.-. [ - ........... ~' s ...... -- .c" '-..'. ' - PP