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Home My WebLink About11819-zBui~DI~ Pe~rmissidn is hereby grante~ to: df j)remis~ s located at ,.,~,,,~ Co nW ~suont: to oppl)cot)ori dated ,DQte .**. ,E~:UNTJIz~FuLL ~F~ INSPECTION FOUI/IDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N, STATE ENERGY C,ODE FINAL COMMENTS ADDITIONAL COMMENTS: TO~,qN OF SOUTHOLD ~UJLDiNG DEPARTMENT TOWN HALL SOUTHOLD, N.¥. 11971 TEL.: 765-1802 Examined ~...~. 1.., 19.~. ~ _ Application No~ .~Z.~,.,. ~..~.. Approved .. J.... 19~ermitNo. Ll.~/.~70CCUPA CY ' Disapproveda/c ..................................... ~S[ IS ~[~W[~[ ........................ CERTIFICAE Date'~../~..,19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted.~ 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 dia~am which is part of this appli- cation. c. The work covered by this application may not be com~nenced 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 bnilding 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 Build}gtg Zone Ordinance of the Town of Southold, Suffolk Coun.ty, New York, and other applicable Laws, Ordinances or RegulaiSons, for the construction of buildings, additions or alterations, pr for removal or demolition, as herein described. The apphcant agrees to comply w~th all apphcabte laws, or&nances, braiding code, housflz~code, and re~ lat~ons, and to admit authorized inspectors on premises and in buildings for n~' .~~~., ~// (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electi:ician, plumber or builder. Name of owner of premises ... ~..~ ..... ~~.~ ........................ ~~~' BY Builder's LicenseNo..~: . .. "~.2R~20~,~CONCR/TE Q ~D , ,'.'3. I~SULATI~kt ....... Plumber s License No ......................... ~,4FI}ii,'.. 3~ .... ~-,~k - CONSTR ~I~,,MIIST .3.. .i ....................... 4 ............ '.-~'. '. :-~: ......... ltouse Number Street Hamlet County Ta~ Map No. 1000 Section .. g ~.~ .......... Block .. ~ .t ............ Lot. ~.~ ~ .~.~ .... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~. ~.~. · · ~. ~ .~. · · ~.~. Z?~ ...... { ..... ~.,.,~a~d.~ ~nd o~u~an~ .......... &~.~. :~ ..... ~;~. ~~~~.. 4. Estimated Cost ........................ Fee ....................... (to be paid on filing this application) 5. If dwell'ing, number of dwelling Units ............... Number of dwelling units on each floor ................ If garage, number of cars ..... i ................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type 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 ...................... Number of Stories ...................... 8. Dimen!ions of,entire new construction: Front.,. ,. ........... Rear ............... Depth ............... Height' . ............... Number of Stories '..~ ...................................................... 9. Size of lot: Front ... ( ........ I ........... Rear ...................... Depth ...................... 10. Date o~ Purchase .. ~; . . .'.'...i ..... '., ............ Name of Former Owner ............................. 1 I. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. ' ' .... Wilt lot be regraded ......... ' ................... r. Vfill excess filltbe rerrwved from premises: Yes No 14. Name of Owner of premises~.~..~,~s .~/(., ..... Phone No..~. :~7.~.'.~..5. Name of Architect .......... i ................. Kddress C5~ .... Phone No ....... Name of Contractor ......... : ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly allj 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 show street names and indicate whether interior or corner lot. STATE OF !NEW/lYe ,RK*, , S S COU~~~j~LY OF ...... .~..~r"~l.' ... ~~r-77 .~': .................. being duly sworn, deposes and says that he is the applicant (Name of individual sigmng contract) above named. He is the ................. ~ .............................................................. : (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and file this apphcat~on; that ~11 statements contmned m th~s apphcat~on are true to the best of his knowledge and belief; and that the wdrk will be perfo~ed in the manner set forth in the application filed therewith. Swom4o before me this .............. ~A ~'...d~ ..... ~ .......... 19~ No ta~ Public. ~.~~ ,,,,.,,..,,~,. County. n , ~ / f / , '/ ..,,,,.,,.,.,0,..,._ ..... ~ ~ ~ ~ I~ ~ ' ~~ ' ' ~ '' '