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Home My WebLink About12270-z TOWN OF {OU~GI~D BUILDING TOWN ?HALL SOUTHOLD, N. ¥. BUILDING PERMIT~ CT'HIS PERMIT MUST BI= KEPT ON WORK AUTHORI~ZED) COMPLETION OF THE N.o 12270 Z Permission is hereby granted : ~- .~ ~. L~/ ~7~ ..~ ............. at premises I~ated et ...... ~..~.~..~.~ ...... ~.~~~...~..~.. · ...~...- , ... / C~ TaX Map No. 1000 Section ......... ng spector, , .... ReV, :6/30~80 ; TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 d To Whom This May C~ncern, We are unable~to complete your Certificate of Occupancy because,of the following reasons. /~//An application for Certificate of Occupancy is not on file. /5/ No Underwriters Certificate on file. /Z/ The check is(outdated/not on file.) /Z//No Health Dept. Approval on file. /~/ No final inspection has been made. Please contact our office on this matter. Thank you for your cooperation. Building Permit ~ ~_ ~ ~ ~ ~ Z Building Dept. ***/5/ No Plumber Solder Certificate on file. ( all permits involving plumbing being issued after April 1,1984 ) FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date . . .(./. .... /.( ............ 19?. .~. · File No ................................ ff . . .......... PLEASE TAKE NOTICE that your application dated . .~~. · · ~ ..... , 19 ~ for pe~it to const~ct.. ~~..~. ~- ~ .... ~ ................... ~ ..... at Location of Property ..~ ~[~..~ ~/~../~ '~ ~'~'' '~~ ~ouse N~ Steer~ Ham/et co..~ ~ ~ ~o. ~oo~ s~o. .... /~ ~. ..... ~o~ .... ~. ....... ~ . .z ~. ........ ~uSd~v[sio~ ..... -~ ...... Fi]ed ~ap No ......... - ........ lot No .... : ............. Building Inspector RV 1/8o FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Approved ~..~.. ~.~d. .... Disapproved a/c ............... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 dialFam 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 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 regulations, and to admit authorized inspectors on premises and in buildings for necessa~.inspectio~,s. /J /k · . ~q~./' ~ I/'/~.~/?/ (Signature of appyant,' / --~"/oFi~ame, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 ........ '~..~' 7 ............ Plumber's License No ...... ~-~. 7. f ............ Electrician's License No. , ~ O t~ Other Trade's License No ...................... "·_. :... · .:/:::/:?.5 .- ........................... 1. Location of land on which proposed work will be done· . ' · :/:,(. :,?.. ,.'i :. ......... ......................... ':..: ............................ House Nmnber Street Hamlet County Tax Map No. 1000 Section ./}.7 .............. Block .. ?. .............. 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 . .°.<.~[.~.~(~../.'~/~.~..7/.~.g ................................................ b. Intendeduseandoccupancy &./~. .¢/) /; /~ .~. 522/~74 /f~. ~/S/y ?~//l - -~a. f.~-4 C.._.%q ~O.t! j~ ........... ................................. ' 3. Nature of work (check which applicable): New Building ~ Addition ....--. ..... Alteration , . (Description~ 4. Estimated Cost ....... : ............................. Fee ............................. i (to be paid on filing this application) 5. If dwelling, number of dwellingiunits .... % ......... Number of dwelling units on each floor... '7 ............ If garage, number of cars . .o/Yff ................................................................... 6. Ifbusiness, commercialormixedoccupancy, specffynatureandextentofe~c.h, typeofuse: . ' ~ d-~ # ' ~ f ~ .......... 7. D~menm%ns of ex~ting st~ctures, ff any: Front.. ~...~ ....... Rear .~.. :2. ....... Depth. ]~.. Height ~.. ~) [# .~.~.0.F./~.~'. Number of Stories . P./'/g ........................................... Dimensions of same structure with alterations or additions: Front . .~./~../~ .......... Rear .. t~./.F. ......... Deptk .~/~./~ ............ ~. Height ~. .................... Number of Stories..~2~. 2¢~.. ............. 8. Dimensions of entire new construction: Front . .5.'//;WY./~~. ...... Rear . f./Z~.~.~ ....... Depth . .,~.~.~ ....... 10. DateofPurchase ............... fFormerOw r .............. I 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..................... ',~?N ...... 13. Will lot be regraded .... #P. ~ .................... Will excess fill be removed from premises: ~ No ' ' ' . .................. Phone No ................ Name of Contractor .. ,ii.. .~J~.~. f ...... Address ~ .................. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate all set-back dimensions from property hnes~ Gwe street and block number or description according to deed, and show street i~ames and indicat9 interior or corner lot. ~-~ ~ o ¢ ~-~ t{ , _ STA'FE OF NE~i~OR~. m ~ S COUNTY O~... i ~' (Name'- o f individual signing contract) above named. , He is the ................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d)ly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith· Sworn to before me this ........ o2/.~-. .... day 9f... ~ ~ ..... 19 .'~7~ Notary. Pub? .......... ._ .....i.~.. County ////~// ~ ' NOTARY PUBLIC, State ~f NeW Y~lrl] / , i ilo. 52-8125850, 'Suffolk Cou. Q.ty ' ! i '~,,m E~oires March 30, -I F15 IH j~2' C)