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Home My WebLink About13377-z i~R,Bf NO. S TOV/N OF SOUTHOLD BUILDING DEFARTMENT TOWN HALL SOUTHOLD, bt. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 13377 Z Permission is hereby .rante~ V/~' ~ ........... :.~.~ ................ ; ...................... ............ et premises located at ............................................................................................................................ County Tax Map No. 1000 Sectio/n~...O..~..~. ....... Block ....... L..~ ........ Lot No ........ ..~.. ............. pursuant to application dated ..~....~....~.~...........'~......'~...~ ........ , 19.~...~.,-" end approved by the Building Inspector. u ding nsflector Rev. 6/30/80 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN HALL ,, SOUTHOLD, N.Y, 11971 TEL,: 765-1802 e .~..~.{ ", kpprov ff-,~.~. ?'. ]'"~., 19~..~. Permit No./,'~. ~,' Y. ?. 9% )isapproved a/c ..................................... (BdJ"~nl~'I~spe') APPLICATION FOR BUILDING PERMIT Received ........... ,19.,. INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 *ts 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 ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application ~nay 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 hall 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 hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building PerInit pursuant to the luilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or {egulations, for the construction of buildings, additions or alterations, er for removal or demolition, as herein described. ?he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to dmit authorized inspectors on premises and in building for necessary inspections. ............ .~. ?., .~9.a.~. F~N.cF..og,~,v]~,~y .......... (Signature ofl~Plil~tn{;7t~vr n~lif~o~rporation) Mattituck, NY 11952 .............. ~.: .q.27.'2 .................. (Mailing address of applicant) State whether applicator is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ..................... ................................................................. Name of owner of premises ...~t{'. ,¢...~(tW..P-O (:'. ~ .7-?..t ~-..~ ............................................... (as on the tax roll or latest deed) Ifk.~¢ g~ '2"~applicant is a corporatio~.,~nature of duly authorized officer. . ....... ..... (Name and title of corporate officer) Builder's License No .... : .'~. · .J?]'~ .............. Plmnber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be (lone .................................................. .4.4 /~o ~ re ................................................... House Number Street Hamlet County Tax Map No. 1000 Section .................. Block ...... ............ Lot ................... Subdivision .......... . ...................... Filed Map No ............... Lot ............... (iq'ahi~) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..................................................................... b. Intended use and occupancy .................................................................... 3. Nature of'work (¢,Aeck which applicable): New Building ..... ' ..... Addition .......... Alteration ...... ,,_... Repair ....... II ...... RemOval ............. Demolition .............. Other Work.. ~-~.A(..d. q,.,. 4. Estimated Cost ..~: ....... l...: ...................... ee ....... /...' ........................... (to be paid on filing this application) 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 structure~, if any: Front ............... Rear .............. Depth ...... . ........ Height ............... Numiber of Stories .......................... - ............................. Dimeusions of same structure with alterations or additions: Front ................. Rear ................. Depth ....................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth .............. Height ............... Numlber of Stories ....................................................... 9, Size of lot: Front ........ /. ,o.O, .......... Rear ........ /.Q~B. .......... Depth ...'-~.., .*']) .............. I0. Date of Purchase ............................. Name of Fenner Owner ............................ ! 1, Zone or use district in which premises are situated .................................................... 12. Does proposed construction violhte any zoning law, ordinance or regulation: ................................ t3. Will lot be regraded ......... ................... Will excess fill be removed from premises: Yes No 4. Name of Owner of premises ~'.~ ¢.~¢.~.z7..x'.t.¢/.¢ .... Address l $~5'?....T~.q:~.~f~.~. c.... Phone No. '.7(~..,~. 7-..~..?.~... Name of Architect ........................... Address ..... .~'f.~./~. f.~'. ...... Phone No ................ Name of Contractor Tf~/.t,/../..~O.~. ~.~.%¢.p. ..... Address ,~'~' .4(.7. fO.. At..~..~TT.... Phone No..-?f¢.~:..4/.77,~. .... PLOT DIAGRAM Locate clearly and distinctly all buildings, whetl~er existing or proposed, and, indicate all set-back dimensions from >roperty lines. Give street and block number or description according to deed, and show street names and indicate whether nterior or corner lo~. ::' ~ 5 NOTED FEEL ).~: ~ BY: _-- NOT[~ B~ HL~ING ~EPARTMFNT AT- 7654 802 9 AM TO ~ PM FOR THE~ FOLLOWING iNSPECTIONS: FOR pOURED CONCRETE 3. INSULATION , , 4. FINAl.. BE C~aP~ r:TF FOR C O. ALL CONfiTRiJCTION SHAI_T. THE REOU~2~&~ENTS OF TH~ ~T~TE CONSTRUCT]ON ~ E~C ~ODES. NOT RESPONSIBLE ~IG~ OR CO~S~T'ION ERRO~I ,TATE OF NEW Y~,RK~ :OUNTY OF... ?.t~f..~7o.. !/.ct... S.S .... d, /.,~. ~ .... ~' . ~Ge~.~.'.~ .. being duly sworn, deposes and says that he is the applic~t (Name of individual slgging contract) bove named. Ie is the ........................................................................... (Contractor, agent, corporate officer, etc,) ~f said owner or owners, ~d is du~y aut)orized to perform or have performed the said work and to m~e and file t~s pplication; that MI statements conta~ed m this application are true to the bes~ of his knowledge and belief; and that the zork will be perfomned in the mm~n~r set forth ~ the application filed therewith. ,worn to before me this .... ............. lotaw Public, ........... County NOI~ ~0aUC, s~at, o Ne~v V0~t (Signatu~ of app~ic~t) No 4~7878. S0llolk