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Home My WebLink About15516-z ~O~t3~[ NO. ~ TOWN OF SOUTHOLD BUILDING D£PART~ENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT CrHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15516, Z Permission is hereby grunted to.~ ~, ~ : ^~ ~ ~.. _-, t ~..'. .............. o, premise, ,ocoted at ..~.~.=......~/~-.~...'....~ ........ ....... ........................................................ County Tax Map No. 1000 Section ...... ~...(~....'~.. .... Block ........Q~.....~ ....... Lot No....~..~. ................ pursuant to application dated ..~...~....~t,~ ...... /....~. ........... , 19.~.~:~., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~°OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ./0 ~ .~.~., 19 .~.~. Approved ~..~..~...&. ~., 19~.~. Permit No.J. 4'7~.'-.}.O..~.. NOV I 9 I fi ': Received ........... ,19... Disapproved a/c ........................ i ..... ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date.No~mb~;..~8, .... 19B.& INSTRUCTIONS · 9. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 ~sets of ptans, 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 inspections. ....... L¢~,~v~n .Sattd .& .Gt,~,e~,..f~c ........... (Signature of applicant, or name, if a corporation) ~lffff l~aLrt Road - fl. qx. 7.2. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~eneraZ £on~ac~or /~uiien /~o~o~ta [~r~or owner - Daniel £~r~0¥~ of owner of premises (as on the ia× roll or I test., ' If applicant is a corpor~,tion, signature of duly authorized o flicer. FEE' ...... ~. ..... g~.n ......... ~.a..e.~.L.d.e..n~... NOTtI~f BUILOING OEPARTMfiNT AT ' itle of o ,orate officer) Builder's License No.. ~/~ F~NDA~I~N TWO ~EQ~RED .................... FOR PO~D CONCRET~ RO~G~ ~qAMIN~ & P~UMBING Plumber's License No. ~/~ ' ....................... 3, ~$ULAY ~. P~NAI. tXJNSTROCT~ON MUST Electrician's License No.. ~/d ................. Bf C:O~ ~;T[ 6OR C O Other Trade's License No, ~/d ................. T~ REQOI~NTS ~ ~E N,Y STATE CONS~UC~ION & ENERGY 1. Location of land on which proposed work will be done. Co~a~e ~ac% EO~ ~8~SI~E ~R House Number Street Hamlet County Tax Map No. 1000 Section .... ~¢ ............ Block ...q! ............. rot ..... (g ............ 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 ..................................................................... b. Intended use and occupancy ...~. ~. ....................................... 3. Nature of work (check which applicable):New Building .......... Addition;. Alteration Repair Removal Demolition XX Other Work (Description) 4 Estimated Cost Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number of dwelling finits on each floor ................ If garage, number of cars .......................................... .............................. 6. If business, commercial or mixed occupancy, specify nature and extent of each ~ype of use ..................... 7. ,*Dimensions of existing structures, if any: Front ...... ~ ~ .~ ......Rear ..... :2. .8 .' ...... Depth..4.6. I .......... Height Number of Stories 1 Dimensions of same structure with alterations or additions: Front .......... ....... Rear .................. Depth ...................... Height ...................... Numberl of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ... ~ Depth Height ............... Number of Stories .......................... i ................... . ........... 9 Size of lot: Front Rear ' Depth 10. Date of Purchase ............................. Name of Former Owner ............................. 1 1. Zone or use district in which premises are situated ..... .B.u.s.~.n. ?.s.s..... ' 12. Does proposed construction violate any zoning_ law,~ ordinance or re'-,lati~)~ved ................... fromN~)' ;..Prm. isds '': ~e~ 13. Will lot be regraded ......... .N.O............ .... Will exces : No 14. Name of Owner of premises Mullen Motors Address ......... Phone No. Name of Architect ........................... Address .... ......... ~ . Phone No.3. NameofContractor Latham Sand & Gravel AddressOrxent, NY' ..... ~' ¢'8'~ .... ....................................... . ...... Phone No .... ? ......... 15. Is ~his property located withinl;00 feet of a tidal wetland? i* Yes ..... No ~X~. * If yes, Southold Town Trustees Permit may be required. . , ... PLOT DIAGRAM i Locate clearly and distinctly all buildings, whether existing or proposed, and, ~ndmate all set-back dirnensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. Also attached garage w/room Front 30' Rear 30' Depth 30' STATE OF NEW YORK, ~/~ COUNTY_OaF.__~.. $*3g.~OLK.. S.S (Name o~individual signing contract) above named. sworn, de ~oses and says that he is the applicant He is the Corporate Officer . (Contractor, agent, corporate officer, e{c.) of said owner or owners, and is duly 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. Sworn to before me .this, . ........ day 0 ................. , Notary Public ................ /.-:-.¥~-.f~...o~,~r....,~.... County ,,~ NOTARY PUBLIC, STATE OF NEW YORK ......... .................. ... ' NO. 52*46G?dO~ ........ ot2At/mr:'D t~ S(~e~Ot/r COt~tvr~',,~,, / (Signature of applicant)