HomeMy WebLinkAbout15577-zOUNDATION (1st)
OUNDATION (2nd)
OUGH FRAME &
PLUMBING
~NSULATION PER N.
STATE ENERGY
CODE
FINAL
bMMENTf
FO~ NO. 2
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
NB 15577,
Z
Permission is hereby granted to:
_.x .........
.... ~.9..~.2 ........... ~ .......................................
..... ~.d~-/o ~ ..~.~ ...... ~.?.~ .........
at premises IOcoTea or . ,.'ef...~..'d~ .................... o~ ...................................................................
County Tax Map No. 1000 Section ....... ..c~....~....~'. .... Block ........ .I ............ Lot No ...... ]..:....'~... ........
pursuant to application dated .... ~..~....;~.~ ............. 19.~..~.., and approved by the
Building Inspector.
Fee $..~. ..................
Building Inspector
Rev. 6/30/80
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 765-1802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
Southold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
DATE:
NAME: JOHN & CORINNE BEDNOSKI
ADDRESS: 34570 C.R. #48
PECONIC
RE: BUILDING PERMIT # 15577Z
SEC. 75 BLOCK OI
This Buidling Permit has expired.
violation of the Town of Southold
Please contact our office,
rected.
JANUARY 9, 1989
LOT 1.2
YOu are now in
Zoning Code.
this matter must be cot-
Yours truly~
Victor G. Lessard
PRINCIPAL INSPECTOR
· :..' FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
?,eOUTHOLD, N.Y. 11971
TEL.: 765-1802
Examine~..~ .~., 19 ?.~.
Approve.. !.~., 19 .~.~. Permit No..I. ~.~..~.7.'/...~
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
2 Z11986
',Date .";. ................ 19.
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 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 pumuant 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.
(Signature of applicant, or name, if a corporation)
State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or i .
Name of owner of premises .. . ~.. .! { I I
(as on the tax roi1 or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ..... 6~.¢r~. ~.. ............
Plumber's License No .... /.0 .~. ,/.~ ...... ff..~..~/'~ 3j~
Electrician's License No..~.~//~ .~' .... ~..~.~.~.'.o..~'~/~T~'; ~
Other Trade's License No .................... ... /~ / /~ · i~
Lo¢ onoflan onwhiohproposedworkwill e one.
...................Hame'-l't ....... ................
Street
County TaxMapNo. 1000Section ...~.~ ....... Block. .........../. ... .........
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed ~onstruction:
a. Existing use and occupancy ..... t' '<~'Q?~Y~-'tI~ ...... .~.(.t[ ./M..~ .................................
b. Intended use and occupancy .~... 0~.b....~..~...~...~ ......................................
- ! 3. Nature of work (check which appliqable): New Building ........... Addition ...... Alteration .........
pai
Re r .............. Removal .............. Demolition ........... ~.. Other Work ...............
(Description)
4. Estimated Cost ..... ~./~/. d:-.zrO ........................ Fee . .~.~..'..CRY. ............. ...... : .... ....
' ii )
.~. (to be paid on filing this applica on
5. If dwelling, number of dwelling units .......... Number of dwelling uniti on each floor ................
If garage, number of cars ........................................... i ..................... .... · .
6. If business, commercial or mixed occupancy, specify nature a,~nd extent' of each typ'e o~f use ............. ;,~ ......
7. Dimensions of existing structures, if any: Front ...... .~ ...... Rear ..... ~& ...... Depth ....~..Z~... ....
Heigh. t ............. Number of Stories ' . /. ................... i ............. ~...! .......
Dime/t~io,~n,s, of sam~ structure with alterations or additions: Front ............ : .... i 'R~ar . ~.*~ ~..,~..
Depth ;../.~J~X,I, ... ............. Height ...... · .....~ .......... Number of ~tories. 1 .....................
· .' Otb~
~ ~ '.De
8. Dimensions of entire new construction: Front ..... Rear ........ ; ..................
Height Number of Stories
9. Size of lot: Front ........ ~ ....... Rear ...................... Depth ......................
10. Date of Purchase ............................. Name of Former Owner . i ...........................
11. Zone or use district in which premises are situated ..... . .~:..~.
12. Does proposed construction ,vijalate any zoning law, ordinance or regulation.--./9~. ..................
13. Will lot be regraded ...... .~_~ ..... .~, ......... ,Will excess fill be remove~d from premises: _
14. Name of Owner of pre,mists COUP..l-.'I .-;~..~ddress Z~$..'?.O.. l~O.q.O~... Phone No..~7~.~.'t/~Ot~0. ....
Name of Architect . ~L .l~.. .................. Address . ~.,. ~-~., ..... i · · · Phone No ........ : ........
Name of Contractor ~.~.. ................. Address .. ~'~.{20/I,/~(7,e... [... Phone No ........ ........
15. Is this property located withinl,00 feet of a tidal wetland? * Yes ..... No . .~m<f..
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and~indicate all set-back dimensions from
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
COUNTYOF ................. <~t~M¢ D~C~C.-
................................................. being duly sworn, deposes and say. s .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 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'
' Ic~ .~ ...... dayof: ..... '..~...0%~. ........ ,19 ~s~'
Notary Public,. .... ~j....~.~..ff~.t,?e,.~ .... County_~( ,
~1~ I~l~[~t~l~n Y~ ( I ' (SignatUre,of appiicant)
. NO 4707878, Suffolk ~ ~ ~ ' L
. B.P ~
:,NOTIFY' BUILDING DEPARTMENT AT
OCCUP, NCY'OE
WffHoUT CE~iFICATE:
O~ OC~u P~r~c~ ~~ '
OY C. SCHO ,.L:~TI-1AAI~ ,, ~r
. : , . ENGINEER :-,, .: :,
OF-.I~,I~A L.
PLoOp-._
?L. AM
ROY C. SCHOENH/~C,R
ENGINEER
CUTCHOGUE, N.
pr_oPosRp APPtTio~]
I
ROY C. SCHOENt-IAAR
ENGINEER
CI]TCHOGUE, N, .Y,