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Home My WebLink About11300-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 11300 Z Permission is hereby granted to: ..... A4~J...,.~z~ ~o.~ .~......~,~,u~, ........... C~ OTc_,~, o~ Az'. ~ at premises located at ............................................................................................................................ County Tax Map No. 1000 Section ........................ Block ...................... Lot No ......................... pursuant to application~ited ........................................................ ' ~ ,/~,~~/ i i1~/' 19 ......... and approved by the Building Inspector, ......................... Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL PLEASE TAKE NOTICE that your application dated . g~TF./~.~2~ .... /...~. ......... 1 9.07--../... for permit to construct ~/~//~. ~. ff~M~) ................................. at Locat,on of Property,. ~: ~~.. ~<~¢ ~..: ...... ~~7~. ~ ~ ~ouse No. 1 1 .~ / / Street ~am/e~ Count~ Tax Map No. 1000 Sect,on . .~/~ ...... ~lock ... :)7 ....... Lot . ~/~ ...... Subdivision ............... Filed Map No ................. Lot No ................. is retmned herewith and disapproved on the following grounds. .'~t57.<C~'~.4..~../.~..~...~. ,tf~.>-5,~) ~ Braiding Inspector RV 1/80 FORM NO, 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD. N,Y. 11971 TEL.: 766-1802 Exalnmcd ................ , 19... Approved ................. 19 . . . Permit No ............ Disapproved a/c ....... ': ............................. %. Application No ................ (Building Inspector) ~ APPLICATION FOR BUILDING PERMIT INS7 RUCTIONS a. Th~s application must be completely filled iix by typewriter or ih ink' and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according te schedule. b. Plot plan showing location of lot and of buildings on premises, relabonsh:p to adjoining premises or public stre~ or areas, and gwmg a detailed description of layout of property must be drawn on the diagram which is part of this apt carton. c. The work covered by tins application may uot be commenced before issuance of Building Pem~it. d. Upon apprc.'al of this apphcation, the Building Inspector will issue a Buikimg Permit to the apvlicant. Such peru shall be kept on the premises available for inspection throughout the work. e. No bm[drag shall be occupied or used in whole or ~n part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION IS ttEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buddings, additions or alterations, or for removal or demolition, as herein describe The apphcant agrees to comply w~th all applicable laws, ordinances, building code, housing code, and regulations, and adnlit authorized respecters on plendses and in buildings for necessary inspectiOI.]/{~?....~. .'. ~~,.~......... (Signature of applicant, or,nam~if a corporation) .............. (M~dmg address of alCplicant) State whether applicant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build. ... ................................................ (as on the tax roll or latest deed) If applicant is a corporatmn, s~gnatur~ of duly anthonzcd officer. (Name dud title of corporate officer) Builder's License No ......... .~..'. 6/ ............ Phnnber's License No ......................... ELctriclan's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed workwillbe done..~p.~ !.P.a.f.t.....d?.o.~..~....¢/...¢~.~.4~..,~/...~/..~-... County Tax Map No. I000 Section ...... }~.. ....... Block ''I ............... L°t ' 'l' '~' ........... Subdivision ..................................... Filed Map No ............... Lo't ............ (Name) 2. State existing nsc and occupancy of premises and intended use and occupancy of proposed construction: ..... .... ............................... b. Intended use and occupancy ......................................... Nature of work (check whict, applicable): New Building .......... Addition .......... Alteration .. ~ ..... Repair ..../>,, ........ Removal .............. Demolition ............. Other Work ............... ./~.. ~. c%,' (Description) stimated Cost .................... Fee ........................ 0- ........... (to be paid on filing tt~is application) If dwelling, number of dwelling 9mis .............. Number of dwelling units on each floor ................ If ~arage, number of cars ...... . ............... ~ .................................................. If business, commercial or mixed occupancy, specify natnre and extent of each type of use .................... Dimensions of exisnng ~tmctures, if any: Front (.,)... Rear .... ~. ,.9. Depth ~ ......... tleight Number of Stories Dimensions of sa~e structure wi,th alterations or additions: Front ..... .2F. 61 ........ Rear .... ~.~ .......... Depth .................. lle~ ~t ................... Nmnber of Storms .................. Dm~ensmns of entire new constr¢ction: Front Rear Depth }tm..fl~t ............... Number of Stones ........................................... ,,, ........... Zone or use district in wtuch premises are situated...].~..~ ~' ...................... .:... ::. ........ : ........ Does proposed constrnctmn, vlolete any zoning law, ordinance or regulation: .... /~.O. ...................... Will lot be regrad~d ..... ]l-f~ .-"~.. ..........~ ...... Will excess fill be.,j;emoved from premises: Yes Name of Archm:ct ........................... Address ................... Phone No ................ PLOT DIAGRAM Locate clearly, and distinctly MI ~buildings, whether ex/sting or proposed, and, indicate MI set-back dimensions from roperty lines. Give street and block mm:her or description according to deed, and show stieet names and indicate whether tenor or corner lot. ..... .~ff~/,///./:,:g A't~... ~/./~,i ... ~:!:~/O~.¥... being duly sworn, deposes and says that he is the applic~.nt (Name of indMdual sigMng contract) )ore named. ~ said owner or owncr~, ~d is du~~m~ or have pm~formed the said worl, and to make and file this >plicanon; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manne~ set forth h~ the application filed ~herewith. worn to before me this 1 ............. ......... .... ~ Jl ~ ~. ~ ~ ~lA~Pl~lc,S~teofNewYork''~ .................. ~_' ..... ( ' ' lo t Ex,.es t~larch 30, 1~ ~. / ~Oz :~o ~o>~ ~z ~ 0 .%