HomeMy WebLinkAbout10150-zIIUIUNNG DII~ARTMIINT
'I'¢~N CI,IEK'i OFFIC=~
SGUTHOLD, N~ Y.
(THIs PERMIT MUb-I' BE KEPT ON THE PREMISES UNTIL FULL
CON.'LET~N OF 'r~ WOrK AUTHORIZED)
No. 1O150 Z
Permission is hereby g~,~d ~:
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to ...}. .......................................... Z ..............................................................................
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m' pr~ntses located at ....................................... ; ....................................................................................
Building Imi:~ctor.
F. ......
t~00 - 3-1.~- 76
Building Inspector
TOWN OF SOUTHOLD
OFFICE OF BUILDING INSPECTOR
TOWN HALL
SOUTHOLD, N. Y. 11971
TEL. 765-1802
Peter Stoutenberg
310 Ackerly Pond Lane
Southold, New York
Dear Sir:
~his is to notify you that Building Permit No.
zssued .... ~/3/79 to P. Stoutenberg
will expire on 10/3/79
10150Z a/c Olag Lee
If more time is required to complete the job and obtain a
Certificate of Occupancy, you may apply, ~y letter, for a
six (6) month extension.
If the work is not completed and the Certificate of Occupancy
not issued after the six (6) month extension period, you are
than required to apply for a new building permit.
Very truly yours,
GEORGE H. FISHER
Sr. Building Inspector
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN C:LE~,K'S OFFICE
~UTHOLD, N. Y.
................. ,*....7 ..
. ~ ] 7~- rm,t'o /0 I ~0 ~Application No ..............................
~proved .............. L~.~ ........... , 19 ........~Pe ' m ....... h ............. ; .........
Disapproved a/c ......................__ ~~ .......................................
................................................................... ..................
(Buildin~ In~poctor~
APPLICATION FOR BUILDING PERMIT
o .....
ate ......................... 1 ..................... ,
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 ofproperty must be drown on the diagram which is part of this application.
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 nec¢~s.sg~r~_ inspections;.
/ /
State whether applicant is owner, lessee, agent, architect, engineer,
Name of owner of premises ....................................... ; ........................................................................................................
If applicant is a corporate, signa~e o~Jl~:~ut~'~t'~rcer. '
(Name and title of corporate officer)
Builder's License No ...... .~. ..........................................
,
Plumbers License No .................................................
Electrician's License No .............................................
Other Trode's License No ............................................... (~ ~ ~/O, ~,~~. , . /'~. ¢
Location of land on which proposed work will be done. Map No: ....;~5~:;~,i.~:~,' .............. ..,~~ ...............
Street and Number ...,~. ................... ..~.,) .......................................... ~f~..,,,~.~.~.,, ................................ .~..,.~.,,~,...
State existing use and occupancy o~rembes and in,ended use and occupan-c~of proposed construction:
a Exisiting use and occupancy ./ ............ ~: ............................................................................................................
/
b. Intended use and occupancy/ .................. ~,.: .............................. ~ .........~'"'r,'~ ..................................................
property lines. Give street and bi.acC
whether interior or corner lot.
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................
Repair .................. Removal,. ................. Demolition .................... Other Work ...................................................
(Description)
4. Estimated Cost ....... .O..~..f~. ................................. Fee . .
, J(to be paid on filing this application)
5. If dwelling, humber of dwellling 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 ex~stmg structyres, ~f any: Front ............................ Rear ................................ Depth ....................
Height ........................ Num~ber of Stories .................................................................................................................
D~mensions of same structurb with alterations or additions: Front ....................................Rear ...........................
Depth ................................ Height ................... ' ......... Number of Stories ................................
8. Dimensions of entir~ new coinstruction: Front .; ......... ~.. ...................... Rear ....... /......~. ......... Depth ...... /.,Z ...........
Height ....... ~....J.~.. Numbe'r of Stories ............... /.. ...................................................................................................
9. S,ze of lot:. Front ............~...."'.~../. .............................. Rear ...... ~....~-~.~. ....................... Depth ...... /...~./..~1 ..............
10. Date of Purchase ................ i ........................................ Name of F, ormer Owner ........................................................
11. Zone or use d,str,ct ,n pram,scs are s,tuated ......./~...~...-,~.t...~.. ~.~.~.~
12. Does proposed construction ,)iolate any zoning law, ordinance or regulation: ............ ~ .0. .......................................
13. Will lot be regraded' .....~..:~',.~ .......... Will excess fill be removed from premis~e.s: ( ) Yes (
· JO/,-- '
14. Name of Owner of prem,ses '"i ........ :"~' "q"'"'C,/~''''~'''''~ .......... Address ...,:.~....?,~....~..v;.,. Phone No ...........
Nome of Architect ,,.,,,~,,jl[,~l,ltf! ........{,.~ .................................. Address ................ .~.~..~. ......Phone No. ~...2..~...~...
of ontractor Address Phone .o.
PLOT D'i~AG RAM
Locate clearly and distinctly dll buildings, whether existing or proposed, and indicate all set-bock dimensions from
number or description according to deed, and show street names and indicate
~.y....:;,. ................. being duly sworn, deposes and says that he is the applicant
Imng/conrracr)
He is the ....................................... , ........ .~-~ ...... ~ ...............................................................................................................
i ~_~ontractor,~agent, corporate officer, etc.)
of said owner or owners, and is duly a"at~U, er4zed to perform or have performed the said work and to make and file
this application; that all statemen}s contained in this application are true to the'best of his knowledge and belief; and
thor the work~ill be performed in ~e manner set foffh in the app~ion filed therewith.
Sworn~efo,~methiSdoyhof /~' ~ ~ /~ ~ '
1~0~ NO. !
TOWN OF $OUTNOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined .................. ~ ........... ~ 19 ........
// '
Approved ..................... ./.....~ ........ :.~.', lg...":.¢ermit No ......... ./..(......./.....(?.....~
Disapproved a/c ............ /. ............. '~ ................................... _
..................................................................................... .........
,. '? .f
(Building Inspector)
Application No. /4 / -~ ·
APPLICATION FOR BUILDING PERMIT
Date ............. W ................................. ,
a. This applicatiol
Inspector, with 3 sets ~
b. Plot I:
areas, and giving a
c. The work covered
d. Upon approval of
shall be kept on the
e. No building shall be
shall have been granted b,
be completely
, accurate plot plo
lot and of b~
layou
Hication
available for
)ied or used
INSTRUCTIONS
in by or in ink
relationship
,rty must be drawn on the
be commenced before issuance of
ng Inspector will issue a Building
throughout the work.
~le or in part for any
ining premi or public streets o~ %.
J which is rt of this )lication.
lit.
to the )licant.
until a Ce ~
APPLICATION IS HEREBY
Building Zone Ordinance of
Regulations, for
The applicant agrees to
admit authorized inspectors on
to Department for the issuance a Building
of Suffolk County, New York, e Laws,
or alterations, or for or demoliti~ as herein
le laws, ordinances, building housing code, and
for necessary inspecti
(Sighature of applicant; or if a co~
r ' ' (A,cld,less of ~licont)
State whethor applicont is ownor, I~s~oo, agent, architect, engJneor, geritol c~troc~, electrician, plum~r or
~om8 of owner o{ premises ....................................................................................................................................................
If applicant is a co~orate, signa~ o~ duly'authorized'of~cer.
(Name and title of corporate officer)
Builder's License No ...... ...~./.. ........................................
PI ' L L.,, ' /
umber s icense No ..................... : ..........................
Electrician's License No .............................................
Other Trade's License No ...............................................
1. Location of land on which proposed work will be done, Map No.: ............. :...h.; ...... ,:,,:L;:.. Lot~No..~,.~. ........
Stre%t and Number ...~--~.. L,, · .., .
' . ' ~; .................................. ;%J '"': , '"'t"*
,-. / Mun,ci~al,ty
2. State existing use and occupancy o~mises and intended use and occupanc~of proposed construction:
a. Exisiting use and occupancy .~'. .............. [ ........................................................................................................
b. Intended use and occupancy 't ....................~'; ...... :':"':; ............ :";~"'"";'"""i' .........................................................
3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ...............
Repair .................. Removal .................. Demolition .................... Other Work ...................................................
(Description)
4. Estimated Cost ....... ................................ Fee .......... ................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units .............. ./. ............ Number of dwelling units on each floor ............................
If garage, number of cars .............................................................................................................................................
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. Dimensions of,~,__entire new construction: Front.....,.............,................/~' Rear ........ ~:~....'~. .......... Depth ........ ~ ...............
Height ........ Number of Stories ................ / ...................................................................................................
9. Size of lot: Front ...................... :'~..: ............................. Rear .......................................... Depth ....... l .......................
10. Date of Purchase ........................................................Name of Former Owner ........................................................
1 1. Zone or use district in which premises are situated .......... .~....i.........:....: ....... J ....... , ......................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~..~..~:~ .......................................
13. Will lot be regraded .....!..~....: ............... Will excess fill be removed from premises: ( ) Yes (
14. Name of Owner of premises ............. ;i.~,.~ ....... iii~....:,....~ ........... Address /~,) ' '- ! Phone No. ~ ..... "
Name of Architect ..... ........................................................ Address . ~i~,. r'. . Phone No.
, v ......................... ,'~'"'~"'/'"?"
Name of Contractor ..i,...:.:,.~ ....... i\. ¢..,,.....~......',....,~...L, ..... Address " '~ ~ :
,,~ "-"ok'='=-'-',,.?:'.',.'" Phone No. 'r', ..................
PLOT DIAGRAM
Locate clearly and distinctly all 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.
/
STA/~-~)F NEVy'~)q, RK, ,~ / I c~
C 0 ....... ~
-~(~Name of individu~ si~ning contractO
above named. /
duly sworn, deposes and says that he is the opplicom
He is the ............................................. ~.........~.. ..............................................................................................................
~agent, corporate officer, etc.)
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 wor~ will be perfor~r ;clin the r~anner set forth in the appl~zg, tion filed ther,~(ith.
Sworn~t~,be~re me this / .~......, ..... da ... . .............. , 19.~.~ /~ ~ r~ ' ~
.... c .........................