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Home My WebLink About16406-z l~OZt~ NO. ~ TOWN OP $OUTHOI.D BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) · 0 0 L pu,suo,t to opp,cot,o, do,,~ ...~~,~.....~~-' ........ , ,,~...I..,-- ond oppro,~ Building Inspector· ~~ Building Inspector Rev. 6/30/80 P S LD Southold, N.Y. 11971 (516) 765-1988 October 15, 1987 Mr. Lewis L. Edson, President Mr. George H. Fry, Vice President North Fork Country Club Main Road Southold, New York 11971 Re: Site Plan North For ub ~1000-109-4-1,3,4,7 Dear Messrs. Edson and Fry: A field inspection of your property was made with regard to the above mentioned site plan and compliance with same for a certificate of occupancy. It was noted that there is a substantial amount of landscaping work to be completed, particularly the street trees and fence along Moore's Lane (Linden Avenue). Northe~ythe ingress and egress from Moore's Lane has not been marked with arrows. It was also noted tkat the parking layout was modified from the approved site plan. Would you please, therefore, submit an amended site plan to reflect the modifications. Would you, also, a~vise our office when the landscaping and pavement m~king has been completed so we may make a final inspection. Very truly yours, BENNETT ORLOWSKI, JR. CHAIRMAN SOUTHOLD TOWN PLANNING BOARD cc: Building Department~ Examined ~.~¢'~.~'.~., 19~. ?. Approved .(~~., 19~..'/. · FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL,: 765-1803 BOARD OF HEALTH ...... 3 SETS OF PLANS ....... SURVEY .......... CHECK .......... SEPTIC FORM ............. : NOTIFY CALL ................ MAIL TO: Disapproved a/c .............................. . ...ff'7~ ............................... ...... (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 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 ins~octions.. ~ w--- ,'; ,~ ~. ~-'~.,~ a, d d rj~ p ~li c a}f~ ~ ~,/ . State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. · . (ason the tax roll or latest deed) If applicant 'ra--a-cgrForation, signat~ 6'f duly a, uthorized officer. ~~rporate officer)- ~ ;~- :~"~ ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No .......................... - Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No .................... ./ of land on which·proposed work will be done./..(~h~....]?z~..~.,. ¢..~... ~ 1. Location ~;~e' ~q~i~ ~;r ......... ~ .............. ~ir~i .......... Hamlet lO2 ' ' .......................................... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended hse and occtipancy of proposed construction: a. Existing use and occupancy ...~..~." ...... i ............. b. Intended use an~l occupancy ~'..~.. ~ .~.~K.. ~.~.q~ .~ ~.. 3. Nature of work (check which applicable): New Building . ' .... Addition . .. Alteration .......... Repair .............. Remloval .............. Demolition .............. Other Work ............... ' (DescriPhon) 4. Estimated Cost .t~'..~..~y~.. ..... i .......................... Fee ...................................... *' (to be paid on filing this application) 5. If dwelling, number of dwellin~ units ............... Number of dwelling units on each floor ................ If garage, number of cars .... .................................................................... 6. If business, commercial or mix{d 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 With alterations or additions: Front ................. Rear .................. Depth ....................... Height ...................... Number of Stories ...................... Dimensions of entire new construction: Front .......... ..... Rear ............... Depth ............... Height ............... Number of Stones ........................................................ 9. Size of lot: Front .................... i.. Rear ...................... Depth ...................... 10. Date of Purchase .......... . ................... Name of Former Owner ............................. 11. Zone or use district in which piemises are situated ................................................. ~... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ! .................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ............... Name of Architect ......... : .................. Address ................... Phone No ................ Name of Contractor ........ i[ ................. Address .... : .............. Phone No ............... 15. Is this property locatedlwithin 300 feet of a tidal wetland? *Yes ..... No ..... *If yes, Southold Town Trgstees Permit maybe required. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, an& indicate all set-back dimensions from ~ropcrty lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ;TATE OF NEW YORK, ~' S.S 2OUNTY'~ ............... ,~' .... '~.%~'- - --"~-~;z~ ' ' '~' ' ' ' 'r'~- ' /~" ............ being duly sworn, deposes and says that he is the applicant (_ ~44~me of indivi~tual sigr~ing contract) above named. He is the . . . ' ' ' (Contractorl ~gent, ~o~porate officer, Itc ) ' ' . of said owner or owners, and is du!y authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworu to before me this ............ '~"'~''~./ h-/' tTl~' //'day °i' '~ ....... 19 .~..,~ Notaryeublic ....... ~......~..../~..~..~ Coun{y ~ "."~..~--'~. ~, . , ._ ~.[~x~Sr~[~ ~,~l~t~W~ .~~ -.' ~ ~ .~t (Signature o~ applicant)