The URL can be used to link to this page

Home My WebLink About11778-zBUll !N°. ~1778 Z ~r~ni~$ion i~ hereby §rented to: BUILDING P, ERM!T (THIS PERMIT MUST BE KEPT ON ~ ~THE COMPLETION OF THE WORK AUTH~Ri'ZED) I$~S~UNTIL F~ULL ot~em,se',oco.e.a. .............. /..~.~..~.~. ......... ~'.:..~ ~../.~. ....... ~ ..,,;., ......... ; ............................................................ ..~ .~..~ ............. ........................... COUbW Tax Map No. I000 Section ...... ]., · ~ .~,~. BI~, ........... ~.. ]'Lot NO~;L.~Z.~.. p6~shant ia application *dated ~. ............... :.....}... el ~'*:'', ~'';~ r:q',' J~''~ and Opprov~ by the Bo~lding IOSpector, ~ ~ : : ' , ,: :Braid,rigor Rev.:6/30/80 , ~ ~ ~ ~ ' FORM NO. 1 TCWN CF SOUT',~GLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, 11971 ~ ./' , TEL.: 765-1802 Examined -~ ~.19 ~ Disapproved ~c ....... :..~ L .................................... . .... : ........ :~:(q~Z./:... (Buitding APPLICATff~i F, OR BU1LUING PERMF1 ^pp,icat,on No. / ! 7 78- INSTRUCTIONS a. This application must be completely filled in by typewriter Dr in ink and submitted in triplicate to the Build Inspector, with 3 sets of plans, accurate plot plan to scale. Fee accord!nh to schedule. b, Plot plan showing location of lot and of buildings on premiseS, relationship to adjoining promises or public s/re or areas, and giving a detailed description of layout of property must be drawn on tke dia~am whick is part ce'this ap: cation. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon apprc.'al of tkis application, the Building Inspector will issue a Building Permit to the applicant. Such per:. shall be kep~ on tim premises availabIc for inspection throughout the work. e. No buildh~g shall be occupied or used in whole or in part for a/~y purpose whatever until a Certificate of Oecupar shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for th~ issuance of a Building Permit pursuant to Building Zone Ordinance of the Town bf 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 descdb The applicant agrees to comply with all applicable laws, ordinances, building code. housing code, and regulations, and admit auHmdzcd inspectors on premises and in buildings for necessirysinspection$. (SignaturOof applicant, or name, if a corporation) ..,. .. (Mailing address of applicant) State whether app!ic:mt is o~vner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build N[unc of owner of premises ........................................................................ (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. ~...~...~.t..~. ........... Plumber's Licens'. Nr. ........................ . . El::ctrician's License No.' ...................... OtlmrTrade'sLiccn}eNo ...................... .~._._w] ,. ~}.,~_, , ,. ..... .b/ "2/ r-'" I.n / .~/ /2/ /1 -'"~---~ '~ - .... .../.'..e...?.'r..o ..... .... ............................................ House Number Street Hamlet County Tax Map No. 1000 Section ....L / 7 ....... Block .O..~. '" .~.~..~. ..................... ~k,ot ......... Subdi ision Filed Map No Lot ~' (Name) 2. State existiug use and occupancy of premises and intended use,. and 0¢cupancy of propel, ed cO~struetion: Existing use and occupancy - , ' ...... ,.b. Intended use and occupancy ~,.,'w.., L~~--'~ ~ ~,~Y,~.~o~.~¢o~,~,;~ ' ., · · ·; ......... ;/. .................. ~;~g~.~O.~l .................... lC'. II. [4. Nature ,,f work (check whicl, applicable): New Building .......... Addition .......... Alteration ........ Repair .............. Removal ............. D,;molitlon .............. Otlier V/ork ,~'/l~r .... I .~.~..~. 0 (Description) ~ Est,,nat 'o,t ................... Fee : ............... ......... (to bo paid on filing this application) If dwellDg, number of dwelling units ............... Number of dwelling units on each floor .............. If garage number of cars If uusmess, commercml or nuxed occupancy, specify ature and extent of each type of use .................. Dimensions of existing structures if any: Front ' Rear Depth Height ' Number of Stories Dimensions of same structure with alterations or additions: Front Rear Depth ...................... I:lei~t ...................... Number of Stories ................... ' construction: Front Rear Depth Dimension~ of b. ntire new .............................. . . ..... Height Numl~er of Stories Size of lot: Front ' · ' Re,ar Depth ~ r',.. ' ..... .~. f . _~.te ~fPtucl ........................... !. ~. Name o l=ormer Owner ........................ Zone or use district in which premises are situated ' Does proposed construction vi.elate any zoning law, ordinance or regulation: ....................... Will lot bo r.o. ad~d ............................ Will excess fill be removed from premises: Yes Name of Ox:'ner of premises ~ Address Phone No ~ '~ Name o, Arclur.ct .~. ...... , ......,,,.. ....... ,.y'. · Address .:.~.....a ....... , .....Phone No .... ~ .......... Name of Contractor ~.~tR,.~. ~ .~_.,g-r~... Address ~ff!~., [2?~:~_J~.,,g1,0 tI£.,~,. · .~hone No.7C~9 ~.'7.~. ~/~.. PLO'/' DIAGRAM '"' Locate clearly ~d distinctly all btdldings, whether ex/sting or proposed, and. indicate all set-back dimensions fro: street names and indicate wheth, property lines. Give street and bloclk number or description according to deed, .and ~.how ;ntcrior or corner lot. ~0p, t...~:-,....~ -~ ' -- ~'rA"FE OF NEW YORK, ~' S .............................................. being duly sworn, deposes and say~ that he is tim applicat~ (Nanie of indMdual signing ~).~ above named. reis the '~-*~*~ .~,,t eornorate officer, etc.) '=[' ~.dd owner or owuc?s, m~d is dhly authorized to perform or have performed the said work and to m~e and file applicatio6; that all statements co,rained in this application are true to the best of his knowledge and belief; and that Work w/Il ~e performed in the manner set forth h~ the application filed therewith. ~wom to before me tliis