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Home My WebLink About10214-z FOI~M NO. 2 TOW~ o~ ~*U~HOL* : 'row~ C~£R~'S o~mCE SOUTH'OLD, N, Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EM'.ISE$ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? ]02~ Z Permission is hereby granted to: ~,(.,.i.-/~' 77 ( /~^~6~L.~............~A I~f~ ..... ........................... ..~.,~SZ ......... .&!.~..:~J:.'.L ~-.f ......... ot premises Iocoted ~r ................ <.>...v ........................................... ~ ................. ; ...................................... pursuant to application dated .................................... ~::.~.~/~:..:...?, 19.Z'~.~,'., and opproved by the Building inspector. Fee $.....L.~..~ .... Building Ihspector :Town Halli ~, Southo ~t, N Y i~19~i ApPLiCATION FOR CER~IFI~,T~!OF ocCUpANCY Th~s ' ' ; ~~ ~ '' A. apphcat~on mu~t be filled in typewrite/O~ mb~ a~ s~bm tted i~ duplicate to the Building Inspec- tor ~ith the followiqg; for new buildings 0r ne~ u'se: ,- ~ 1, Final su~ey of p~operty with accurate I~bation of a,,I b~J!Bings, p~operty lines, streets, and unu~al natural or topogra~phio features. ; ~ ~ ,:. :~ ~ . 2. Final approval of ~ealth Dept. of water s, pp~y ,an~ ~e~e~e d sposJ -(S.9 form or equal). - :3. Approval of electr¢cal installation from B~a¢~ ~f P r~r~ters ~ , 4. ~ommercial buildings, Industrial build~n9~L M~ltj~i~¢~eences a~d similar bud rigs and installa- , ~m.ns, a certificate] of Code compliance fr~ t~e Arb~it~c~;or Engineer responsible for the build ng. ~. buom~t Planning Board approval of completed site pl~ r~q0iremen~t~ Where applicable. B. For existing buildings (prior to April 1957),:Nen-cbd~o(~ing~' ~ uses,~or' ' buildings and "pre-existing" land uses: ,t : : , ~ , 1. Accurate ~ey ~f peoperty showing ali p¢oPerty; ~n¢~¢ ~reets, Buildings and unusual na~ral or topographic features. ' ' 2. Sworn statement ~f owner or prewous oWner,,as,,to u~el O~cgpancv a~d cond t on of hul d nn~ 3. Date of any housihg code or safety inspection of bu ~d ~ or ~re~ ses or other n~,* tmn reqmred to prepare a ce~ffmate. ! ~ .:; ' C. Fees: ; '" : ~ 1. Ce~ificate of occupancy $5.00 ~ ~ 2. Certificate of occupancy on pre-existing dwelling or la~d ~se $$.00 3. Copy of certlficate~of occupancy $1.00: ' , NeW Building ... Old or Pre-existing Building~(~) ,~_. ..... j/Vacant Land Location of Property .~,¢_, ; i ' ; :; ' Ho ¢' '" " .... , , -- , :: ~reet ~ .' .... Ham/et Coqnty Tax Map No. 100~ Sect on ¢ B~o~ ~ · ................. .~ · , ........ .... Lot ......... , ,, Subdvson . -...,- ~.- ' ...... ¢ .............. ~.-~.-.m]eg~¢p!Fo; ..;..~.....LotNo ....... UnderWriteCs Approval .. ~ ................. :. ]].Pbnniln~ 13 Re st for Temporar rtificate ......... FeeSbbmittedS i' O~ ¢/ ~ ~ ':.:; ~ Cod~tructio~ on above described building ~' :O~ ¢ ~ Applicant · TOWN OF $OUTL!0iS] TOWN' EL '~ SOOTHOLO, N. ¥ ng , TEL. 765-1802 October 10, 1980 Walte~ Gaipa : Lakeview Terrace East Marion, New ¥o~k Dear Sir: If the work isi not completed and ~hei? not issued after the six (6) mo~th ~X than required ~o apply for a new bui! Very truly youbs, This is to notify you that Bulilding~P~r~it No.! 1.0214Z issued Ma~ 8..1 979 to ..~i ,sam~ i ~ .i ....~ will expire o~ November ~i, 1~80!~ ~ i ~ If more time lis required to c~mP~ete!~ ~' gh~Job a~d oNtain a Certificate og Occupancy, you, may ap,p[y~ .by leSter, For a six (6) month !extension. ~. ~ e 't~fica}e of Occupancy ~:.~on p~iod, you are i: g perm~t. Sr. Building ~sp,ecto~ GHF/mw FORM NO. 1 BUILDING ~P~R~N~ ,: ~ ~/ SOUTHOED, N.Y. '1 ~971~ TEL 765-1802~ Bx~i~ed ..... ~ ........ , lP ~ ./ : '~~~. ~ .... ~ ........ Disapproved a/c .......................... (Building Inspecto~)~ APPLICATION FOR BUILDIN~ ~ER~IT INSTRUCTIONS a. ~is gpplication must be cc mpletely filled in by t~p~wfiter O~ in,ink and submitted in triplicate to the Building Inspector, With 3 set~ of plans, accu rate plot plan to scale: Fee ac~ordlfi~ ~s~hedule. b. Plot plan sho~ing location c f lot and of buildings 0n ~re~ise~, ~el~l~onship t0 adjoining premises or public streets 5ption of layout of prope~y mu~t ~e ~rown on g~e dia~am which is part of t~s appli- cation.Or areas} ~ ~ving a detailed desc ~ ~ :~ c. The wbrk covered by this apl .lication may not be comm~n~ed b~efor~is~u~ce o~ Building Pe~it. ~' d. Upofi h~provfl of ~ application the Building Inspeafor wm'~ue~a Bufldmg~e~lt to the apphcant. Such pe~tt sh~ be ke~t~n the premises avafla] ~le for inspection through6~t ~h~ ~rk.~ e. No b~jld~g shall be occupiet or used in whole or i~ pa~ for ahg p~pose whatever u~til a Certificate of Occupancy shill have b~en granted by the Bull( lng Inspector. : ~pLIG~TION IS HEREBY MADE to the Building DeP'~tment f~rq t~ issuance~of a Building Pemit pursuant to the Buading Zoae; Oxd~ance of the T( ~wn of Sout~o~a, Suffolk Oount% ~rk, md ~thex applicable Laws, Ordinances or Re~lationl, :f0r the construction ~f bulldogs, additions or: ~lerati0n~ 6~ for remog~l or d¢molition as herein described. The.applic~t..a~ees. to comply wi~h. ali applicable. . laws,, o~d~ances ~b~ilc.., ng code, ~using code, and regulations, ~d to admit authorized respecters on premises and m bmld~ngs for necessa~¢sp ctions. ' '~ (Siena : : : ~ (Mailing address of apphcant) ' contractor, electrician, plumber or builder. State whether applicant is owner, llessee, agent, ~c~te~t~ en~neer; g~n~al Nmeofow~erofpremises ........ ............... ,,.~, ~t.; ................................... (as0n the [a~ ro~l or latest ~eed) If applicant is a corporation, signatt?e of duly authorized officer. (~ame and title of corpo~'ate officer) Builde~'~ License No ........ .................. : Plumber'S License No ....... .................. ElectriCian's License No ..... '~ .................. Other Trade's License No .... .................. Location Of land on which proposed work will be done ......... : .. ................................... . . ........................... House N~lmber i Street ,., , Hamlet County Tak Map No. 1000 Sectibn; ............... :.. Block .,, .~. ~ ...... .... . Lot ................... Subdivisi6fi ................ ; ..................... ed' I~ ~ ............... et ............... (IN am e ) State exis~ihg use and occupanc4 of premises and intended us~ a~dl0~cu ,incy of p~oposed construction: Existi g d ccup cy a. n use an o an .. .......................... .~.., ..................................... b. Intended use and occupancy i ~..TD.. ?-..)~..C~...--' .... 3. Nature of work (check which applicable): New Building . ~ .... '.. Addition .......... Alteration .......... Repair .............. RemOval .............. Demolition .............. Other Work ............. (Description) 4: Estimated Cost .... --~...tg-~-~.. '. ¥. r. Fee .................................. ~ (to be paid on filing this application) 5. lfdwelling, number of dwellingiunits .' .............. Number of dwelling units on each floor ................ l'f 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 ~ith alterations or additions: Front ................. Rear .................. Depth .................... i · · Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front .o~..~..O.? .... Rear . .~. {.0.". .... Depth . ./.c~..~..O. ~.~ ..... Height . .. ~.. {..(9.'t. ....Nunther of Stories ....... ~ .......................... ; .................... 9. Size of lot: Front ......... ,.. ........... Rear ...................... Dgpt.h. ...................... 1 1. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . ./~4. Ct ....................... 13. Will lot be regraded .... fi,Z.Oi .................... Will excess fill be removed from premises: , Yes Name of Architect ........................... Address ................... Phone No ................ Name'of Contractor ........................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly al! 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 :orner lot. COUNTY OF .'~~'~'~ ........... .~.. 4~-~....~ .......... being duly sworn, deposes and says that he is the applicant (Name of individual ~[t~ning ~ontract) above named. He is the .................... ~. ....................................................... (Contractor, 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 ail 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 Notary Public ...... ~.,~. · ........ County t~.~'~-~OTAR¥ PUIILIC, State of 1~ Ye~,l~ (Signature of applicant) ~' Suffolk tgount~ No. 52-5~2805