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Home My WebLink About12326-zBUILDING OI~PARTMI~N? TOWN HALL $OUTHOLD, N. Y. BUILDING PEI~41T · (THIS PERMIT MUST BE KEPT ON THE PRE~IS~S COMPLETION OF THE WORK AUTHORIZED) 2326 Z Dote ........... ~ ....... ...~..... UNTIL FULL Rev. 6/30/S0 :Lot No......~.~ .......... ~, and ~pproved by the 'i, : ffUildlng !Inspector County Tax Map No. 1000 Section ...... ..~...~. ........ i. Block ,~...~..~.'. .......... pursuant *o application dated .............................. Bull~lng Ihspector. ~ $ ......~.~ ............. Permission is hereby granted to: .... ............... ,o ..... ~ ~.~ ~aT .... l:t.a.~.~.~. ...... S.T~..~.LL~.....~,.~zh.~ ' .................... at promises I~ated at ,,~ ................................ ~ ..................... ~ ........................ · · · FIELD INSPECTION COMMENTS FOUNDATION (~st) FOUNDATION ( 2nd ) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: One Horse MATERIAL LIST LUMBER SIDES PLAN MISCELLANEOUS 8'COMMERO&L CONNECTORS FRONT REAR ~1' I~ 136 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ................. 19... Application No .................. Approved ................. 19... Permit No ............. Disapproved a/c ...................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS )__.~3a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets ~l~in__~, 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. e. The work covered by this application may not be commenced before issuance of Buildhag Permit. d. Upon approval of this application, the Building Inspector will issued 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 building for necessary insp, ec~n~s. _ .. ........ (Signature of applicant, or name, ifda-<~rpor~ition) · ...... (Mailing address of applicant) ~essee, agent, architect, engineer, general contractor, electrician, plumber or builder. State whether applicant .... .... ................................. Name of owner of premises (as on the tax ro olL_o_r. Xatest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..... ~: ........... .. · . Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ...'..~.: .......... Block...7 ............. Lot .... ~..~. .......... Subdivision. r~.~' .c~..~.t'.'T. 4N. ai~) ............... ~ Filed Map No. ~.~-'~..'..7 .... Lot...fl.~..~. ....... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....~..~. ~ .d.% .Ad. ·~. ~ .............................................. - b. Intended use and occupancy ....... -d. ................. 3. Nature of work (check which applicable): New Building . ~... Addition .......... Alteratiol! ......... · , . . ~ , ~a~,2 Repair .............. Removal .............. Demoht~on ...R ...... , ....Other Work. ~ ~.~ ~ ~ , , ~ . cc,/ ~ _ (Description) 4. Est ated Cost .... Fee...( J. 5 ................. (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................ If g~age, number of c~s ..... i ................................................................... 6. If business, commercial or mixed occupancy, spec~y nature and extent of each type of use . .~ .............. 7 .... if any: Front Rear Depth . D~ens~ons of exlshng structures, ........................................... Height Number of Sto~es - D~ensions of same structure with alterations or additions: Front ................. Rear ................. Depth .................... :.. HeiSt ...................... Number of Stories .............. . .' , 8. Dimensions of entire new construction: Front · / ......... Rear .~ ........... Depth ....... ~ ~ Number of Sto~es ~.~ Height ............ ~ ................................................. 9. Size of lot: Front .. ).; ...... ~ ........... Rear ...................... Denth .............. 10. DateofPurchase ........................... Name of Fomer Owner ..~./~.~.~ .~'~ 11. Zone or use district in which pre~mises are situated..~.*/~ ................................ . .. 12. Does proposed construction violate any zgging law, ordinance or re~lation: .~O ........................ ~ [3. Will lot be regr0ded ,..~ .~. ............ ~ ....... Will excess fill be removed from premises: Yes ~ 14. Nme of Owner o f premises . ~ ~ .~ .... Address .~ ~ff~4 ¢.~ Phone No. :2 6 ST 7l ~ G.~.. Nme of Architect .. ~ ..... Address ................ Phone No ~. , . Nme of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly alii buildings, whether existing or proposed, and. indicate all set-back dkmensions from property lin'es. Give street and block number or descnphon according to deed, and show street names and indicate whether interior or corner lot. STATE OF N~EW'Y-)ORK, -- , ...... /..~.~.-'~:.:,: .~ · -./~ · .V: ,~-~e./ ....... being duly sworn, deposes and says that he is the applicant (Name of individual gign'mg contract) / above named. H)e is the ...................................................................... _ / (Contractor, agent, corporate officer, e~c.) of said owner or owners, and is duly 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 ~..~':d f 1 ~...~. ............. ay o .... l .., County ~ ~ ' '~(Signatg/e of appli~ 'a t3