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Home My WebLink About11486-z~o. li1486 Z Pe?mission! is hereby granted to: (THIS PERM T MUST BE KEPT ON, THE PREMISES UNTIL F~LL COMPLET ON OF THE WORK AUTHOR ZED) ~ , ~ , Date ~t'prem~so~ located' {at .......... ,,~;.~ .... ; Cou,t~ Ta~Map Uo. ~000 S,~t,o~ .... .~:~.... ~o~ .~..¢..~..,,.~ ~ ' ' ' ~ ~ 19 pUrsOant [o appllcot,on dated ... ~?R~.~.-, ~ Building I~spector. : ~ ~ ~ · .,......i.....~-.~..-~;~.;;~- Lot No. i.,,~-... ...... (., Ond ~pproYed by the !nspecto~ FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL File No ................................ To ~..~,~..~/~.,~..7: ............ ·. ~.~.. ~-2,,~o-..~. ~.-.. ~:~. ........ ...~~c.~,. ~..~... PLEASE TAKE NOTICE that your application dated .. ~O.~.. ~. ~ ........... 19 ~. for pemit to construct... ~.~f/(w.~ ......................................... at Location of Property oaas~ ~o. ~G~. . ~'t/e;i .......... ~r.~Z """"~Ham,o ~ :~ County Tax Map No. 1000 Section ...~ · · · Block .. ~ ....... Lot . ~.<~ ....... Subdivision ................. Filed Map No ................. Lot No .................. RV 1/80 FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, t.l.Y. 11971 TEL,: 765-1B02 Examined ./..~.~. ...... , 19 Approved d' .)~,/.~. ~. ........ I~../. Permit No. ~ r~ INST RUCTIONS Application No../.'./~..~. '.~. ..... a. This application must be completely filled in by typewriter or [n ink and submitted in triplicate to the Build 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 stre or areas, and giving a detailed descriptiou of layout of property must be drawn on the diagram which is part of this ap cation. c. The work covered by this application may not be commenced before issnance of Building Permit. d. Upou apprc,'al of this application, tile Building Inspector will issue a Building Permit to the applicant. Such pen shall be kept on the premises available for inspection throughout the work. e. No build Jug shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupar 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 Building Zone Ordinance of the Town ~f Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describ Tl:e applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and (oignature of applicant, or name, ifa corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, arc!fitect, engineer, general contractor, electrician, plumber or build o owner o pr ,n,ses .... ........................ (as on tile tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Budder s L~cens~ No.. ...... , ................... Plumber's License Nv..~.... Electrician's License No.' .~ ..................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done ................................................ ........... 0 c. .... ........... ........................... House Number Street Hamlet County Tax Map No. i000 Section . 0.~,.~.00. ........ Block .O.,g.O~ .......... Lot..."g~. ........... 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.. ~.Ct:o..~. .... /.,O.~.d. . ............ : ........................ Repair Removal Denioil;[oa Other Work (Description) ....... .............. ............. .......... (to be paid on filing this application) , p. ;. If dwelling, number ofdwellhig units .. /~ ........ Number of dwelling units on each floor .......... , ..... If garage, number of cars ...! .................................................................... i. If business, commercial or mixed~ occupancy, specify ~,ature and extent of each type of use ................... t. Dimqnsionsofexistingstmctdres, ifany:Front...............' , Rear .... .......... Depth. ........... . Height Ntim ber of Stories Dimensions of same structure iwith alterations or additions: Front ................. Rear ............... Depth Height Number of Stories ·..~.,,% rO ....... Rear ... ~'.d,r ~. ...... Depth ~..gO:.d.~. .... 1. Dimensions of entire new con~tnmtion: Front Height' f)c::*e.-'../6'' .N, dm ber of Stories . . t~.a.~. ....... , ........................................ - ' ). Size oflot: Front ...~ar,.~.q. ...... '.. ..........Rear . .f~.,~55 ............. Depth ~7~'(:. ~ d..,q(.' ....... ). Date 6f Purchase .Z).~z,. 7.,:..Y. ,7] .......... Name of Former O~vner .. b./,)'/,,im... ,~..~.~.*.t,~,r. ....... I Zone or use district in ~vhich premises are situated ' :' ' ' ' ' ordinance or regnlation: ' ) Does proposed construction violate any zoning law t. Will lot be regraded ....... !.... .................. 'Will excess fill be removed, from premises: Yes Nc L Name of Owner of prem tses ¢~/~. 4~fl.../(/e.~/.l,... .... Address g~' .FJ, j,o,,~. ~¢e../f.,-~-{~,(.. Phone No..Y.7.& :t 7.$~-. ..... Name of Archkect ....... J ................ '. Address ................ Phone No ....... Name of Contractor ' Address Phone No PLOT DIAGRAM Locate clearly and distinctly ~1 buildings, whether existing or proposed, and. indicate all set-back dimensions fron roperty IJnes. Give street and bIoqk number or descriptJon according to deed, and show street names and indicate whethe .terior or corner lot. rATE OF NE'~}v-Y~RK,, ,/z~: S S OUNTY OF .~k~f~-,,,~-~-~g~.x{*'.. i ' .... .................. . .... (Name of indMdual signing contract) )ore nan}ed. / e is the .] ............ ~~ ........................................................... (Contractor, agent, corporate officer, etc.) f said owner or owners, m~d is duly autho~zed to perform or have performed thc said work and to m~e and file ~plication; that all statcmants contained in this application arc true to the best of his knowledge and belief; and that th 'ork will be performed in the man act set forth in the application filed therewith. ~om to before me this ........ ....