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Home My WebLink About15411-z FO~M NO. ~ TOWH OF $OUTHOLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, N. Y. I~UILDING PERA~IT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15411 Z }t~reby granted ~.~.~....~.~...~ ............... ~_~.~.~,....~.:.~;......~.L.t ~..~ ............ to ...~.~....~....~.~.~.....~..~......~ ......... at premises located at ~.~~....~...-.c~1~!4~ ........ ~ ...................... County Tax Map No. I000 Section ..... .0...~..~ ......... Block ..... ..~...dJ .......... Lot No......~...~.. .............. ~ }- .~. , and approved pursuant to application dated ..~ ........................ 19.~..~.., by the Building inspector. Building Inspector Rev. 6/30/80 OUNDAT~ON ( 1 s t ) OUNDATION (2nd) OUGH FRAME & FLUMBING iNSULATION PER N. Y. STATE ENERGY CODE FINkL ADDITIONAL COMMENTS: 765-1802 BUILDING DEPT. INSPECTION FOUNDATION JST FOUNDATION 2ND FRAMING ROUGH PLBG. INSULATION FINAL 0 U ! L..O T' 26 E,,~'~ '%X/.[ N D,J AM K4 (=- 12- ,,..j ¢-,,, · THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000121 BUREAU OF ELECTRICITY ~- ~'~ 85 JOHN STREET, NEW YORK, NEW YORK 1003~ THIS CERTIFIES THAT only the electrtcat e(t~¥me~t az described beJow and introduced b~[~t.h~., eppllcant named on the e~ove {~pp~ieetio~ n~rnber ~n the pr~ernises of ~[ichael ~l~ 1050 Yout/§s Ave,, ~outhol~ z~,Y, a~s examiaed o~t and found to be in compliance tt'ith the require.tents qf this Board, FIXTURE FIXTURES RANGES OVENS DISH WASHERS EXHAUST FANS 4 6 DRYERS OTHER APPARATUS: PANFg~OARD~: l.-6cir, ~ 125 amps. i-G,F.C.I. ~0RB DBTF~ T0~{ S-1 I C AW(}, OF HI-LEG E 275 Town tL~rbor La. Southol~, ~Y. 11971 lic. #282E COPY FOR BUILDING DEPARTgENT. THIS COPY OF CERTIFICATE, M~ST NOT BE 'ALTERED IN ANY ~NNER. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved .~ ~..,3..~.., 19~. Permit No../..~-.~.1./..~_.. 1986 ,:"/ ' 19 Disapproved a/c ..................................... ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. Tkis 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 ~ Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MAaDE 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 inspections.,, j / /) /~ - (Signature of alSplicant, or name, if a co potation) · ............... ..... (mailing address'of'applicant)' ' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ~..~....'Z ~ //zYP~d ~ ,~/Y'/f~ ~ d~.~..c..~r. (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 LicenseNo ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. o2 s:.x . ...... .... .............. ..................... House Number Street Hamlet County Tax Map No. 1000 Section .... . .~..~','J..~ ...... Block ..... .~:~..~. ......... Lot...'~'~. ............ Subdivision .................................. Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ~./..~/.~. ~. ~?.~.. ~,,,~>~. .... 6.~.~.~4..~...~.~. ..... b. Intended use and occupancy ................. ,..,... ,.. ,,.. ~ ......................... 10. 11. 15, Nature of work (check which applicable): New Building .......... Addition ..... Alteration Repair .............. RemovOl .............. Demolition ............ Other Work ................ (Description) Estimated Cost' Fee ; (to bo paid on filing this application) If dwelling number of dwelling ufiits Number of dwelling units on each floor If garage number of cars . q~~c~d. .~. .............. If business, commercial or mixed Occupancy, specify nature and extent of each type of use .................... Dimensions of existing structures; ,f any: Front ............... Rear .............. Depth .............. Height ............... Number of Stories .... e~ ................................................ Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ..................... i. Height ...................... Number of Stories ..................... Dimensionsofantire new eonstru.ctmn: Front ..... ~. 14..~.... Rear . o%?/.-~.tr ...... Depth . 1.7 ....... Height . 1o~..~,~. ....... Number of Stories,..2 .~.~g-, ................. .~, ....................... Zone or use district in which premises are situated../,~t. ~/~.c~ ....................................... :.. Does proposed constru~ct~qn violdte any zoning law, ordinance or .regulation: ~.e--&': .~. fl&/.. · .~'..~..~.&..~..~.~.~;~. Will lot be regraded ./V.O. ...... : ............... Will excess fill be r0moved from premmes: Yes Name of Architect ~.0f~g.~.~'~....~..e~..47 ......... Address ................... Phone No ................ Name of Contractor ......................... Address ................... Phone No ................ Is this property locate, ~ithinl.0O feet of a tidal wetland? * Yes ..... No~... If yes, Southold Town Tru ~tees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, an&indicate all set-back dimensions from property lines. Give street and block oumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF...5~.O.F..~....1~....,' S.S ...... /~t~)~4'~r.~..~....~'~...~ .t~_.. ............... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the .................... , .................................................................... ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is d~ly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application am true to the best of his knowledge and belief; and that the work will be performed in the manher set forth in the application filed therewith. Sworn to before me this ....................... day .'of ..... ,19 Note~ Pu.M. IO, State of New York · · : no. 4811949 QulMlfled In Suffolk County _.~ Commlss)on Expire~?O, I9.-.~~ ,/"~/;-~'~b~- ~/~Signature of applicant)