HomeMy WebLinkAbout11785-zPermissio~ is hereby granted ;~o:
TOWH ~0~ ~
sOuTH'OL~D,
B?ILDING? PERMIT*
L
{THIS pERMIT MUST Bt: KEPT ON ~ITI,E
COMPLETION OF THE WOR~ AOTHORIZE )
.~,UNTIL I
Bia: ~d ng Ihspector.,
F~e $'~'"'~T? ..............
ULL
iLot NO. ;..~/~.. ........
'~nd !approved by the
FIELD INSPECTION
1.
FOUNDATION (~st)
FOUNDATION (Jnd)
2.
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
~ODE
FINAL
COMMENTS
ADDITIONAL COMMENTS:
June 7, 1982
Town Gf Southold
Building Department
Main Road,
Southold, NY 11971
Attention: Mr. Hindeman,
Thank you for your verbal OK on the fence for my Greenport
property. A check for $15 is enclosed to cover the £ee¥
Your help has been much appreciated°
Enclosure:
Check for $15.00
Sincerely,
Kathrine Fart
P.O. Box 568
Greenport, NY 11944
June 7, 1982
Building Department
Town of Southold
Town Hall, Southold,
NY 11971
Attention: Mr. Hindeman,
Please accept the attached permit for a fence on my Greenport
property, which has been filled out according to your instruc-
tions to me on Thursday June 3rd.
If there is any cause for delay in issue of the permit I would
appreciate your advisement at this time.
Sincerely yours,
Kathrine Farr
P.O. Box 568
Greenport, NY 11944
(516) 477-0124
FORM NO. 1 '
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL '
SOUTHOLD, N.Y. 11971
TEL.: 765-1802'
Examined. ~/y.. ~.' ..... 195~'~
Approved./f-Z./.7...~.~ ..... 195'~. !Permit No...//. 74~.~..~ //
Disapproved a/c ....................... ,/'/. ........
· r' ':~ 'e~;~;7~W .......
I, DUllcnn~, inspector)
APPLICATION FOR BUI LDING PERM IT
INSTRUCTIONS
Application No./../t.~/~ ........
a. This application must be completely filled in by typewriter or in ink and submitted.i,~-~_'_.-_~t_~ to the Building
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 streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
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 permit
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 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 Southotd, 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 regulations, and to
admit author/zed inspectors on premises and in buildings for necessary inspections.
... ....................
(Signature of applicant, or name, if a corporation)
,~., .,~..,:¢...~ .~.~...~....~....~T.. ?v~..//.
(Mailing addresS' of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Name 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 ..........................
Plumber's LicenseNo .........................
Electrician's License No .......................
Other Trade's License No ......................
Location of land on which proposed work will be done.../b/.../~r?~...c-A~....'-~?.~.~..~2¢...~...~r~a4-~... ...................
- ........ ...........
ttouse N Hamlet c/
County Tax Map No. 1000 Section . .~. ~. ........... Block . .~... .......... ,. Lot...~. '.~./. ...........
Subdivision ................ ... 7. ........ ........ Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and in tended use and occupancy of proposed construction:
a. Existing use and occupancy ........................... .~..~.~.. ff<4-<*~a.~ ...................
b. Intended use and occupancy .... ~..~.c<_~. .....................................................
3. Nature of work (check which applicable): New Building .......... Addition ..... Alteration ..........
Other Work....~.-~..
Repair ........... i:~RemOval .............. Demolition .~. ...... (Description)
4. Estimated Cost ........ .~'...". ......................... Fee . ;.? ...............................
(to bejpaid on filing this application)
5. If dwelling, number of dwellinglunits ............... Number of dwelling units on each floor ................
If garage, number of cars .... ~ ...................................................................
6. If business, commercial or mixe.d occupancy, specify nature and extent of each ty~e 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 ................... i · · Height ...................... Number o:' Stories.. 'i ...................
8. Dimensions of entire new construction: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ...... ~ ................................................
9. Size of lot: Front .... .Rear ...................... iDepth ......... ; ............
..... t./.[~..~....i.iiill .. Name of Fenner Owner>'! .57..~%~...~>,~d+~..~..
10. gl)ate of Purchase /.~.'/}'" ....... . ...
1 1. Zone br use district in which premises are situated ........................ i ............................
1 2. Does proposed construction violate any zoning law, ordinance or regulation: ... ~ ............................
13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes No
14. Name of Owner of premises .. ~ ................. Address .................. Phone No ................
Name of Architect ......... ; ................. Address .................. Phone No ................
Name of Contractor ........ ! ................. Address .................. Phone No ................
PLOT DIAG RARI
Locate clearly and distinctly ail buildings, whether existing or proposed, and. indicate all set-back dimensions from
property lines. Give street and block:' number or description according to deed, and sho~w street names and indicate whether
interior or corner lot.
STATE OF NEW,YORK,, ' S S
COUNTY OF..~.~¢.~.'g~9.I.~. ...... ! '
· t~' '~' '~k' ' · '~-f~' · '~' · · '('-" "~' · '¢" ..... i .................... being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ..................... ; ...................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duiy authorized to perform or have performed the said work and to make and file this
application; that all statements confained in this application are tree to the best of his knowledge and belief; and that the
work will b~ performed in the manner set forth in the application filed therewith.
Sworn to before me this
~+r~ ' ~ ,.
........... [. ...... , .....da¥of,~ .................... , 19~..
No.1469091~ · · · ~'"¥.""/'Y¢+"~.--'~, · .... ,,,(. ·
Qualified in Suffolk County
Commission Ex~ites March 30, 1.9~ ~
(Signature of applicant)