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Home My WebLink About15521-z FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 15521, Z Permission is hereby granted to: ~...:...~....~.:....u...~.~..! ......... . ~ ~o.~.....~.~.~.......~..~..~ ~ ....~~ ............................. ..~ at located at . County Tax Map No, 1000 Section ...... .(~...~....~ .... Block ...... ...(~.....~. ...... Lot No ..... .J..! ................ pursuo,t ,o opp,co,on doted ...... ig..~.~......L.~ ....... , ~9.~.1,., o,d o~pro,~ by t~e Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 1 Town OF 8OUTHOLD BUILDING,DEPARTMENT ~, ~0~ I91986 "' · TOWN HALL $OUTHOLD, N.Y. 11971.. TEL,: 765-1803 xamined , .t0.~..&..~., 19~.~. ,,,~ ~ , Received ........... ,19... pproved .~. , 190 ~, Permit No./.g ~ ~{ .~,~ t ,, ,isapproved a/c ...................... , ' ~ ~ ................................... ~ .......... ~ ~ ? ,~ ~ , ,. ' l. ' (Building Ii~spectSr) T/~?;:7~- APPLICATION FO~ BUILDING PER~II I~sTRucriohs a. TNs applicition must be coinpletely filled in by typewriter or in ink ~nd submitted to the Building Inspector, With 3 ts of plans,.accurate plot plan tO scale. F~e according to schedule. b. Plot plan showing locatiod of lot and of bu Id ~gs Oh premises, relationship tO adjoining premises 0r public streets areas; and glv~g a detmled descnptmn of layout of property must be drawn on the dmgram whmh ]s pa~ of th~s appli- tion. ' ' c. The wo~ Covered by this application may hot be commenced before issuance of Buiid~g Permit. d. Upo~ avbtoval of this application, the Building InspectOr will issued a Bulldog Pe~it to the applicant. Such pemdt all be kept o~e~g~as,~va~ahle fei inspection throughout the work. e. NO btul~tlg~8~l ~ ~}¢¢up{e~'or used In whole or m part for any purpose whatever until a Certfficate of Occupancy all have been gra~t~,~tfi~,~ulldl~g Inspector. . "."~%0,'./"., . . ~ - . APPLICATION IS HEREBY M~DE to the Building Dep~t~ent for the issuance 0[ a B~lding Pe~it pu'nuant to the dlding Zone Ordinance of the Town of Sofith01d, Suffolk County, New York, ~d Other applicable ~ws, Ordnances ¢gulations, for the construction of b~ildings, additions or alterations, Or for'removal.or demolltion, as herein described. ~e applicant agrees to comply with all applicable laws, Ordinances, building code, ho~sing code, and regulations, and to mit authorized in~pecto~ on premises and in building for nece~saw inspections. --&~..e,. ~ ~..V~.~.. S ~ ~.,~ ~ .......... (Signatt~ of applicant, or h~e, if a corporation) (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~me of owner of premises ...... n.~.~.~ ..... o ....................... (as ~ the tax roll or latest deed) applica,t is a corporation, signature of duly authorized of fleer. (Name and title of corporate officer) , ~ulJd~r's License No ....... .'C'. :g L~ ............ Plumber's License No ......................... Electrician's License No ....................... Oilier Trade's License No ...................... Location of land on which proposed work will be done] ........... .q..bo, ........ ................ IIouse Number Slreet Hamlet County Tax Map No. 1000 Section ...... ~ ....... Block ................ Lot .................. Subdivision ..................................... Filed MapNo .......... .. ... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: ,. . , , .................. 3. Nature of work (check which applicable): New Building ....... Additim ..... Altera[~ll ..... ~ · · · Repair .............. RemOval .............. Demolition ........... Other Work, Estimated Cost ............... If dwelling, number of dwelling units .... . .... , ~, .- ._ (Description) " (to be paid on filing this application) . .. ....Nnmber of dwelling units on each floor ............... If garage number of cars ' 6. If business, con~mercial or mixed occ),~p~i~,.~y nature and extent of each type of use 7 Dimensions of existing struct.uT~'~ronT'.-.,.~,t.%~.., Rear ' Depth Height Dimensions of same st~g~_,[~,i[t~,~lt%r~.~a]cli, t~t[~.~[~~ ..- ~.v~ ~,u:- __ ~,t- ~ ................. Rear ................ Del, th ............. ..-,.~'O~'.:.--'~'~Iel~f .~.~I~,XlIO ·~ ...... Number of Stories .................... 8 L)imensionsofentirene$~j.~.let~_ct~g~i~lq~roltt~,~? " Rear Depth tteight .............. [ l~t~i~[~]t~ ri e~'.~ % ~ .............................................. 9. Sizeoflot: Front ..... .l~.~li.~.'~..:,.%~l~l~fll' .................... Depth ................... It) [)ate of Purchase I'-- --~l "%,.-. f,, .~D~.I.'~'- Name of Fenner Owner I I~ Zone or use district in whic[~'~'e~r~'L'qffe situated .................................................. 1 2. Does proposed construction~q61ate any ~oning law, ordinance or regulahon: ........................... 1'3, Wdl lot be regraded ........ i ....... .............. Wdl e~xcess fill, be gcmoycd from premmes: Yes - . ' . ,~r ~ oo ~, m%~ be) f, 1.,~ ~e.~' . 14. Name of Owner of premmes~Y.~h .°~..[JQ.o.q~. ~,~.<J. Address .~,.~-~ Nanle of Architect ....... ... } ................. Address ......... Name of Contractor~.~>.,:~% ~.~n~°--. .~i\~.-c.e~. Ad~dressP. q ~inPiliX ,~o~.~ .~.. Phone Ne.r2 ~':. a O.q O.. 15, Is this property locaCe-~iw±ghln 30{) face of a tidal wetland? · if yes, Southold Town Trustees Permit maybe required, i PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions property lines. Give street and block, number or descntmon according to deed, and show street names and indicate whorl mterinr or corner lot. AS a,oT NOTIFY BOLt)lNG ~EPARTM~T AT 756-1~2 9 A~ rO 4 PM ~R THE FOLLOWING Ik~PECTIONS, F~NDATiO~ TWO I~Q~RED FOR PO~ED COMCFtETE ROOG~ FRAMING a PLUMBING A, ~tNAt. CO~i~TRtlCTION. MUST, B:' CO~t?LET~ FOR C.O, A~:CON8TRUCTION S~LL~ MEET THE REqUIRemENTS ~ THE N,Y .,iMMEDIATELY" u.o. BEFORE ,WA'I'Bn · ;TATE OF NEW YORK, ; S.S :OUNTY OF ............... ; ' '. being duly sworn deposes and says that he is the applica (Name of individual sig0ing contract) ti)eve hauled, te is the ......................................................................... .............. (Contractor, agent, corporate officer, etc.) ff ~aidt owner or owners, and is duly authorized to perform or have performed the said work and to make and file ti ~pplication; that all statements eoniained in this application are true to the best of his knowledge and belief; and tha.t ti 9ork will be performed in the manner set forth in the application filed therewith. iworn to before me this ~ .... (Signatu?6 of applican i