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HomeMy WebLinkAbout10227-z FOI~M I~0. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 10227 Z Permission is hereby granted to: ~ ......... ............. >'~ ...... ./-A:~'~...../~.~ .~ ............................ ......... ,~.~.~,~.~.,,-..,¢z...~ ............... . ~ ~--- _ ~ ~.~ ~ .~ ~. to .... ~.&.~:~:(~.~....~.....~ ............ ~.~.~ ..... ~ /~D ..... ~...~,~....,~ ................................................................................................. at premises located at X,,:K.....~~.....~.:~:~..,rC&~-.f...~~.~: X~. ............................................................................................................................... ~/~.~-~ ~. ~... ~ .~~/~:~:~......~ ........... ~. ~ /~.~.~ ..... pursuant to application dated ............ ~-....Z~ .............. , 1~..., and approved by the Building Inspector. Building Inspector TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 October 10, 1980 Joseph Fischetti Hobart Road 8outhold, New York Dear Sir: .This is to notify you that ulldlng Permit No. issued_ _May 18, 1979 to same will expire on November q6, 10227Z Zf more tLme is required to complete the job and obtain a Certificate of Occupancy, you may apply, bY 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, Sr. Building Inspector GHF/mw I i L Z', ,%~ F) © lrO~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLEKK'S SOUTHOLD, N. Y. E~a~,ned ~- / ~.~ ~ ~,=.o~ ~o.~'.d~ .............. ~o~ ...... ¢..~.~z ........... ~. ~~~'~°'~~"~' ..... .................. .................. ...................................... ~::::~:.:...~... '~..~y~. ...... ~ .... ~ .................. .............. ~~~~ .......... APPLICATION FOR BUILDING PERMIT / / . ...~-~.~.....~......~ ...................... , 19 ............ Date // INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 [ocatiOnr of lot and of buildings on premises, relationship to adioining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn 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 Southotd, 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 ~ .//~ ir~ buildings for necessary inspecJJ~ns..~ ' 'g'f ............. ;:'i'f";'"~';';~"o':~';i';;;i ........ .............................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,~o.~ /~ :,~/~ ~,' ' ................................................................. Nome of owner of premises ................ ~ ............ ,~ ......................................................................................... If applicant is a corporate, signature of duly authorized officer. (NQme and title of corporate officer) Builder's License Na...~.~ ....... Plumber's License No ................................................. Electrician's License No ......... = .................................. Other Trade's License No ............................................... tc~u~cJ,"v$ 1 Location of land on which propos~.?ork ~ill ~ done. ap N .: ...................... ~ .............. Lot No., ......................... Street and tNumoe .......................................................................................................... Municipali~ 2. State existing use and occupancy of premises a~d ~tended use and occupancy of proposed construction: a Ex st ng use and occupancy S~ f~,~ ~, b' ~,~d~O u~oo~d o~ ~ .......... ~;?"SZi ....... ~'""Tri'~' ...... 5:"~i'; ........................................... 3. Nature of work (check which applicable): New Building'. ................. Addition ......... ; ........ Alteration ................ ' ' rk pc(~ I ~ Repair Removal Demolition .......... Other wa .......... .................................... (Descr pt on) 1t , - 4. Estimated Cost ~/_ C' .Fee ...... ~. ...................................................................... ................ (to be paid on filing this app cat on) 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 ............................................ ;'"C /~ ¢.' ~"J ............ ' '-'~ ! -.-"(' Depth~ 9. Size of lot: Front .......... /....:. ...................................... Rear .................................... ;'t'" 10. Date of Purchase ........................................................Name of Former Owner ..... ;, ......................................... 1 1. Zone or use district in which premises are situated ...................................................... )~)~'i ........................................ ~2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ W'" '-' ~e re"reded /')~' W excess f be removed from premse,s.. ( ) Yes (,X.) No 13. -'~' )': ~'~ A44ress ./!.!~:L.!.t~.'/ ......... Phone No ....................... 14. Name of Owner of premises ..~;....; ........ :' .................................... " Name of Architect ............... ~.'.!.! ........................................ Address ................................Phone No ....................... Name of Contractor ............ .~...~.! ......................................... Address ................................Phone No ....................... PLOT DIAGRAM Locate clearl and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. G~e street and block number or description according to deed, and show street names and indicate whether interior or corner lot'. .-- / ,:., j ,7 t-~ ICJ ',W' ', -~ .... ~, ~.' I," ', COUjXLLa¥ OF .1 ........ .xZo~r.'~.v~,: ....... ;.. ............... bein~ccJulv ~sworp, ,deoases~-apd says that he Js the applicam ......... h~'N~b~-~'~'~iv,auav s,gn,ng contract) ' above named. He is the .,~..,'~ ................. ?.~. ........... ~;;'~f;Z;;'/';~;'f ............................................................... ......... (Contrqc~b'~, aaeo ~ ~[p~rg~,.., c ' , .... ......... ~: ~ ~J-~ ~r ~e ~erformed the said work and to make ~na THe ~ ~p~iro~ ~e~ ~e~Yc~n'~'~'~c~i,~il~~f h,s knowledge and behef, and ~rr~h~ work wW_be perfo~ ~d in the manner s~t foffh in the pp~A~ ~ ~ ~' .' / ....... ' , .....' · ..... . ................... . .......................