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Home My WebLink About13123-z lvOl~d[ NO. ~ TOWN Of: $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT Ct'HiS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 13123 Z Date ............ ~./. ....... ~. ................... . Permission is hereby granted County Tax Map No~. lOOO Section ...... .~..~...!?..~ ..... Block .....~. ............... Lot No ......?J...L.:~ .......... pu~uant to a~lication dat~ ............. ~. ........................ , and approv~ Building inspector. / IB~ulldlna Inspector ~' Rev. 6/30/80 ~3LJtL~ING D~PAR1 ;~tEN 1 TOWN t ALL TEL 765-1802 I.~x;uuined .... I..~..., 19 . ^pp~oved .. .-.Y~.l.~...,19'~..PemritN~.)'~T!~'.~..~ } I)ts:q>provcd a/c ..................................... (Buildlng Inspector) APPLICATION FOR BUILDING PERMIT Application No .................. INSTRUCTIONS a. This application must be completely filled i~ by typewriter or in ink and submitted.~af~ to the Building h,~pector, with 3 sets of plans, accurate plot plan to ~cale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets m' :.cas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- c. The work covered b~this apphcatmn may,not be com~nced betbre msuance of Building 1 emnt. d. Upon approval of fl~s applicatioa, the Bfiilding Inspe~or will issue a Building Permit to the appticanl. Such permit ~hall he kept ou the premises available for inspection throughout the work. c. No buihling shall be occupied or used ~ ~hole or in pa~ for~ay pu~ose whatever until a Certificate of Occupancy ~hall have been grauted by the Building tnspectbr. API'LICATION IS ItEREBY MADE to ttle Building Departh~ent for tho issuance ora Building Permit pursuant to the Budding Zone Ordiuance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Rcgukffions, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descrH)cd. '1 he applicant agrees to comply with all applicable l~ws, o?dinances, building code, housing code, and regul~ons, and to admit authorized inspectors on premises and in buildings for gecessaw inspections. ~ { ' MICHAEL J. IIAi, L (Signature of applicant, or name, if a corporadon) Youngs Ave. - ~ ~ ...... S.~uth~.L~, . N.Y.... 11.921 ................ ~ (Mailing address of applicant) State whether applicant is owner, lessee, agent, ~chit~ct,~engineer, general contractor, electrician, plumber or builder. ~- APPROVED AS NOTED llenry & Marl. erie ~oetz N:,ne of owner of prcmmes ......................... 5 ............. ~EE:. ) ~. n ~- .BY.: .~:-.~'. ~ ........ (as on the tax roll ~T~[~dB~LDING DEPARTMENT AT H applic:mt is a corporation, signature of~ol~ Suthorized;officer. 765-1802 9 AM TO 4 PM FOR THE } ~ : , },~ FOLLOWING Ih~cPFCTIONS: ~ ~ } f [ 1. FOUNPATION .- TWO REQUIRED (Name and title of~orporate offi~r) ¢ 2. RO[IC'~' ~RAMING ~, pi UMBING Builder's License No ..................... . ..... 4. Flh~'' ' r .....: .........~N h4USl l'lumber's License No ..... 4 .... ~ .............. ~ { ALL ( ......... ' -~,x, c-.,A~ I MEET hlcctrmmn s L~c~ns0 ~o¢ .................... STAm~ C¢'' '~"~CTION ~, Ff',?RGY COmr'~ ~'"~ RESPONSIBLE FOR Olher Trade's License No .......... ' '~" ' " .... · · ' DESIGN ~" CONSTRUCTION ERRORS. I. I.oc,tion of laud on which proposed work will be done .................................................. no # County Road 48 Peeonic Ih)use Nunlber Street Hamlet ,06}8 04 019 County Tax Map No. 1000 Section ....... :... ........ Block .................. Lot .................. Subdivisiou ................... ~ ...... ;...~ ....... Filed Map No ............... Lot ............... (Nmne) 2. Slate existing use aud occupancy~ise~ and intended use and occupanay of proposed construction: · "~ ~' i: ! ~ Building . .~ ........ Au~,,,~on .......... R ........ ~.. Rem)vai ........... ~. Defilolition .............. OtherV, ...pest. ...... & rail.., fe~ee $500. $1000. . - ~ ,, S.00 (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 ca:rs 6, If business, commercial or mixed occupancy, specify nature and e×ten(, of each type of use ..................... 7. lhmensions of existing structures, if any: Front ............... Rear .............. Depth ............... lie~ght ............... Number of Stories ......................................................... Dimensions of same structure with allerations or additions: Front ..... ~ ........... Rear .................. Depth ...................... Height ............ ,, ......... N~mber of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear . ~ ............. Depth ............... l leight ............... Nt)~nber ?f Stories ..... ,. 0 .............. ~ .................................. · ~ 4~5 ~ , 71.1 9. Size of lot: Front . .a~.p,r.o.x... [2.2.5..~ .... i.. ~ .... : ' .... .... :...!.. ..... .... . .............. ....... ~.~llme el rOlTfl~r ~'~¥11~ ............................. I 1. Zone or use district in which premises ar0 situated .................. ~ .................................. 12. Does proposed construction violate any zoning law, ordinance or regulano~n,: ............................ 13. Wdl lot be regraded ......... n.o. ......... ! ............ Wilt excessTitl b. removed from premises: 14. N,ne et Owner ofprermses ............... Address 1/¢-r~_ 9rix Ave ....... Phone NO.~-.~_~ ..... Name of Architect ............. .............. Address .hl~j-~sJ:c'leo. I~. ~L1:}57.. Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ PLOT DIAGRAM ck:arly and distinctly all buildings, wh(~ther existin~ or proposed, ?Jnd, ~ndicate all set-back dimensions from I,ocatc .,)operty I'r es. G've street and block number or deschption according to deed, and show street names anti indicate whether See attahcod survey Owner wishes to erect post a<d 'rail front (south) proper%y line. I'ATE OF NEW YORK, OUNTY OF...S./} ~'I/.()J:K. ...... S.S MICIIAEI, J. JlA]I, : ~ b~ing duly sworn, deposes and says that he is the applicant (Name of individual signing contract) c is the attorney (Contractor) agent, corporate officer, etc,) f smd owner or owners, and is duly authorized to perform or have performed the said work and to make and file this ,)phcat~on; that all statqments contained in this application are true to the best of h. is knowledge and b~lief; and that the ~)) k will be performed i~ th~ manner set forth in the application filed therewith, wren to before me this ' ..~ ............. .......... ~ "'~' <~-~ _-- ,~~' ~ ,: (Signature of applic~t)