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Home My WebLink About13631-z FOB3J NO. Il TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 13631 Z Permission is hereby granted to: ...... .z~....~.~Z.c..~c~........~... ...... ~: ....... .z.;~.....~7.~. ....... ...~ x~ .... ,~'.~.z;z. ~..c~=...~:.~. ....... z.z.?,~ to ............... .~... ....... ~ .~. ....... ___________________~c.~. ....................................................................... ............................................ .. ................... .~.~.~...~:'z~.~.~.~....~/~.~ ....... / ~- at premises Ic~ated at .......~..~ ...... ""~'"~' '/'"'/~'~'"~"~""~'"'/~'"~'~'~7~_ ............................... pursuant to application doted ..~.~/~.../....~..'...., 1~ end approved by the Building Inspector. Fee ,..../.~ ..... Rev. 6/30/80 FIELD INSPECT..~N COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY C,~DE FINAL ADDITIONAL COMMENTS: 'FORM NO. 1 TOWN OF SOUTHOLD ~ BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 · TEL.: 765-180~ E×amined ^pproved me it Disapproved a/c ......................... (~. ......... ~ · .; .¥: (Building Inspector) APPLICATION FOR BUILDING PERMIT 'tOWN OF SOUTHOLD , Received ........... ,19... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted 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 of property must be drawn on the diagram which is part of this appli- cation. 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 issued 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 building for necessary inspe¢~ions. ~3NIN FORK FENCE;~oMpAN6}* ~:? :~= .~_ .......... '~ '~:c..~' ': ", .... .EO Box - e m a corporat~onj Mattituck, .~ly..1.177.~.' ........... e~..~...~. '...~...~../..~. ......... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder. ........... .67:.c7 .w. T .~..rt..c 77.x-.. ' Nmne of owner of premises ~o~,,~, ~ ....~....~..~.,g. !?.~ .~ ~ .~..~..~.: .~. ........................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer· (Name and title of corporate officer) Builder's License No .... ~D~-~. ~.. .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ....... 71...~. :~.': '... Block ....... ~. ......... Lot...~..~. ............. / Subdivision ..................................... Filed Map No ............... Lot ............... (Name) .. 2. State existing use and occupancy of premises and intended use and ocqupancy ofgtoposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy . . ./~//tlg .... ~.~C/..o.5. qar:< ........................................... 3. Nature of work (check which applic[ble): New Building .......... Addition .......... Alteration .......... Repair ..... [' [. m;val! .............. Demolition .............. Other ..... ,r~ ,._ ! .i ~ _ (DesCription) 4. ' . ri ~] ~'- (to be paid on "fit~gthls application) z~s[una[eu cos[ ..................................... vee ................ . ....: .... : 1 ...... 5. If dwelling, number of dweiling iunits ............... Number of dweiling units on each floor ....... i ......... If garage, number of cars 4 6. If business, commercial or mixe~ occupancy, specify nature and extent of each type of u,u,u,u,u,u,u,u,u,~ ............ I ......... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth .~ ...... i ......... tteight Nuznber of Stories Dimensions of same structure ~ith alterations or additions: Front ................. Rear ......... ~ ......... Depth ..................... Height ...................... Number of Stories ............. i ......... 8. l)imensions of entire new const uction: Front Rear Depth Height ............... Nu~ tber of. Sto~s ................................................ I ......... 9. Sizeoflot: Front ..... /..~,? ............ Rear ..... /..°7q. .............. Depth .../.x? ........ 1 ......... 10. Date of Purchase ............... ............ Name of Former Owner .................... i ......... 1 I. Zone or use district in which pr ,~mises are situated ........................... 12. Does proposed construction vic .ate any zoning law, ordinance or regulation: ....................... i ......... 13. Will lot be regraded ........................... Will excess fill be removed fromm premises: Yes No 14. Name of Owner of premises q/o~. -..$a/~ ~,.. :,... ...... Address ~. t~ .~>~.* ........... 2 ~ ~arro~m Phone No ....... ? Name of Architect .......................... Address ................... Phone No ....... ! ......... Name of Contractor .......................... Address ................... Phone No ....... i ......... PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and, indicate ail set-back dime~ sions from property lines. Give street and blocklnumber or description according to deed, and show street names and indic~ :e whether interior or corner lot. STATE OF NEW YORK, IS,S COUNTY OF ................. i .......... .X/?. ~. 9 .... .~:....~.??~.c.~t..~.~.~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual sig~ing contract) above named. He is the.......,.............°w'W~ncf"O, .............................................. '"'''""" i ......... ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duiy authorized to perform or have performed the said work and to make nd file this application; that all statements contained' in this application are true to the best of his knowledge and belief; grid that the work will be performed in the manner set forth in the application filed therewith. Swonl to before me this .... ...... /.Sr..~. .... ....day o} ..... .t~)..-a'N~.. ....... /., 19 ~..~ ' Notary Public ......... Count ~qOrA,¥ POI31.I¢. St~o of Ne~ ¥o,~ (Signature '-f applicant) blt~ '~707878. Suffolk Com/t~" I