The URL can be used to link to this page

Home My WebLink About13032-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13032 Z Date .. ~ ........... Permission is hereby granted to: ..~...~..!...~..~ ..................................................... ,o ...... - ~ ~ --~£..~...~.~..~.....~......~.~....~ .... ~...~. .... ................................................................................................ ~- ...... ~..L..~. ..... County To× Mop No. 1000 Section .... ~.:.~.~...b.~. ..... Block ...... ..~. ........... lot No. ~,,,,o,, ,o o,p~,co,o, dot~ ..... ..C..~.....L..~ .................. , approved by the Building inspector. Rev. 6/30/80 DAVAL TENTS & PARTY SERVICES, INC. 22 Jagger Lane, Southampton, N,Y, 11968 (516) 283-8812 North Road (Rt. 48), Southold, N.Y. 11971 (516) 765-9212 YOUR COMPLETE PARTY SERVICE CENTER FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 ' Examined .... .~_ · Approved . .~k~O~.~.' .I.~..., 19~1.~. Permit No. }'~ '&&% Disapproved a/c .......................... ' ........... Application No .................. (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 gjving 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 issue 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 Occupahcy 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) ·, ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ,~,;sc ~ .................. Name of owner of premises ........................................................................... (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 .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... /7L-~9~_~- 1. Location of land on which proposed work will be done .... .~..~-.: . ff. ~.o(...~....~.~.Q .~.~..~.~.~:~. ................ House Number Street Hamlet ' C;i~nty Tax Map No. 1000 Section ~...~-...'~.... Block . O ~)~ Lot ~ { G. Subdivision .......... ~. .......................... Filed Map No .... fi5 ......... Lot ..... ~. ........ (Name) '~ 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~"5~ ' ¥'; ~! ........................................... 3. Nature of work (check which app~licablo): New Building .......... Addition .......... Alteration · · ·, ...... Repair .......... Removal .......... Demolition .............. Other Work . .... ~ ~ -- - (Description) e>o : F ... 4 Estimated Cost ......... ~ ................... ee ................................... · ' .... n fir g th' ppli i ) (to be paid o m is a cat on ; Number of dwelling units on each floor number of dwelling Units ............... $. If dwelling, ............... If garage, number of cars ..... i ................................................................. ;ness commercial or mixed! occupancy specify na~ture and extent of each type of use .................... 6 . · ' ..... ' ~ ' ./.~..o. / Rear Depth 7. Dimensions of existing structureS, if any: Front ............................... Number of Stories '. ............................................... '" " Height ............ Dimensions of same structure wiih alterations or additions: Front ................. Rear ................ Depth .................... !.. Height ...................... Number of Stories ..................... ' Frbnt Rear Depth of entire new construction 8. Dimensions ........................................... ~ of Stories ........ Height...............Number ............................................. : Rear Depth 9. Size of lot: Front ........... ~ ..................................................... i ' Name of Former Owner of Purchase ............................ 10. Date ............................. ' pr6mises are situated 11. Zone or use district in which .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation:l Will flu be removed ............................... from premises: Yes 13. Will lot be regraded ...... exc,ess ~. · ' ': ................... .&,. ~.//.r~...~f; 14. Name of Owner of premises F.'~.a.£YF.~. · .~.?.'~ Address . .,1 · · · Phone No. 2'~/ ~'~ Name of Architect .......... , ................. Address .. ~o.~,~-,~ca Phone No. Phone No Name of Contractor ......... ................. Address .................. ' ................. property lines. Give street and block interior or corner lot. PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and, indicate all sot-back dimensions from number or description according to deed, and show street nam0s and indicate whether DATE: ~_J.)~.l~t[ B.P..-~.=~)'~J'"¢') NofJk~"~f~ii:b(NG DFPARTMFNT AT 765-18~2 9 AM TO ~ PM FOR TF'~ FOLLOWING IhJSPECTIONS: 1. FOUNDATION - TWO REOI IlRED' FOR P~URrD CONCRETF 2. ROUGN FRAMINr: ~ p~MBING ALI_ C¢'~ .......~-IqN qt,gl[ THE [U:r .... '; ~.~"F"F~ ~F m~ .... N~ y STATE CONSTRUCTION CODES. NOT RESPONSIBLf' FOR DESIGN OR CONSTRUCTION ERRORS. STATE OF NEW ~rR'I~, ,,~,.//~j~ S.S COUNTY OF.. ~g>C~iffg.¢4'.~ ....... . ...... being duly sworn, deposes ~d says that he is the applic~t (Name of individual si~mng contract) above named. He is the ....... ~ .................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is dBly authorized to perform or have perfomed the said work ~d to m~e ~d file this application;that ~1 statements cofltained h this application are true to the best of his knowledge and belief; and that the work will be perfomed in the m~er set forth ~ the application filed therewith. Sworn to before me this : ........... "" 'T. ........... .......... ....... (Siva' ~ '~uro of applic~t)