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HomeMy WebLinkAbout13229-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y, BUILDING PERMIT ~HIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13229 Z Permission is hereby granted t~: /~/~ ,~ ............................................... County Tax Map No. 1000 Section/,.,/,..,,©, .......... Block ...... ,.(~,.~ ....... Lot No ......,.~,./,.,~ ......... pursuant to application dated ..~-~.....~..~... .................. , 19.~....~.., and approved by the Building Inspector. Fee $./...~. ................ Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,, SOUTHOLD, N.Y. 11971 TEL,: 765-180:3 Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter 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 grantqd by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Departme~nt 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 inspections~ , , .¢..... .......... '(Sigr/'ature of applicant, or name, if a corporation) . . l g . . . . oJ.¢ b.o .N.,.55....u.g. '.3..6" (Mailing address o1' applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporation, signature of duly authorized officer. E · . ' .............................................. 765-1802 9 AM TO 4 PM FO~ ' (Name and title of corporate officer) FOLLOWING INSPECTIONS: ' Builder's License No...-T-Ix~C~ ~..6>~c-..~. ~-~ }. FOUNDATION _ TWO REOI ............ FOr{ Pc'URED CONCRETE 2. ROUG,L/ _ FRAMING Plumber's License No ......................... 3. INc..ui AT,ON PLUMP,) Electrician's License No ....................... BE C~rvtp, CON',$-FRI. ICTi~N ALL ET~ FOR C. O. Other Trade's License No. THE CONSTRUCTION SI-IALL M?T ..................... REOUIRFMENTS OF THE N '" STATE CONSTRUCTio 1. Location of land on which proposed work will' be done ............. CODEs.. - · 'NOT' '-w~:-;-[-~a~ ' &' "'"" ,DESIGN OR CO NS House Number Street Hamlet County Tax Map No. 1000 Section ..... /. (. (-~ t~) '~ Block .................. Lot ....... ~. .......... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: b. Intended use and occupancy ......... ' ................... '. ....... Nature of work (check which applicable): New Building ;.:~. ?.*..'.. Addition .......... Alteratiop~ .... ~... Repair .............. Remgval .............. Demolition ............. Other Work...~C~g/~.. ~ ' (Descriptio~ (to be paid on filing this application) 5. If dwelling, number of dwellinglunits ........... 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 w~th alterations or additions: Front ................. Rear .................. Depth ...................... Height ...................... Number of Stories Dxmensxons of entire new construction: Front . Rear .. . Depth . . , 9. Saze of ........... R[hr ...... /. ~.4C. ........... Dept ............... 10. Date of Purchase . Y..-..~.~.. ~. ~./. ........... Name of Former Owner L,¢ont*c4..~od.. l~.ec,/}..~te~k. 11. Zone or use district in which prgmises are situated ..... ~ ........................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . :'g~-O ........................ Will lot be regraded ...... ~ ....... Will excess fill be removed from premises: Yes 0 ~ Name of Owner of premises ... .............. Address ................... Phone No. 7~x,~.-: .~,..,yR..~.. Name of Architect ; Address Phone No Name of Contractor ~ Address Phone No PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block :number or description according to deed, and show street names and indicate whether interior or corner lot.. i . .. STATE OF NEWS(~, .~/ ,a( SS COUNTY OF.. ~'"'~': i ', (Name of individual sign!ng contract) above named· ·. being duly sworn, deposes and says t~e is the applicant e is the ....................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dul~ authorized to perform or have performed the said work and to make and file this application; that all statements contfiined in this application are true to the best of~wledge and belief; and that the work will be performed in the manne~ set forth in the application filed therewith· Sworn to before me this ................ ...... .... Not a,,ry/eu~ic .... ~ ./75 .... ounty g / N~~'~"~i~ York (Signature of applicant) No. $2,8125850, SUffolk Cou~y/ Term ~r~