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Home My WebLink About14953-z FOEM NO. O TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, Iq. Y. BUILDING PERARIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) N.o 14953 Z Permission is hereby' gront,~,'t to: ..., ........... ,..:.? ....... 7 7.~ '~./ . ~. ~.,/...~.. __ ..... ...~/....~ ...... ~..:....: ....... ~....: ........ ~.....~ ....... ~:~..;..-~...:....~:~ ~ :'~ .............. .... ~.~ ...... ~,=~., - -' :.~: ........ ....,..,..,~.~.~:~ ........ ~~...~~...~ ........ co.~ T~ M~p No. ~000 S~t~o~ ....... ].~..~ ....... B~k ............ .g. ...... Lot No ....... ~ .............. Bui]dlng Inspector. Budding Inspector Rev. 6/30/80 FIELD INS[JECTION 1. FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY COMMENTS CODE FINAL ADDITIONAL COMMENTS: TOWN OF $OUTHOLD OFFICE OF BUILDING INSPECTOR . P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 June 19, 1986 Andreas Michael 77-01 21st Ave. Jackson Heights, N.Y. Dear Mr. Michael: Enclosed please find a copy of check which you gave us in payment of your Building Per- mit ~14953Z~ The check has been returned to us for insufficient funds. Ail work must stop on the house until this matter has been cleared up. Please stop into the office as soon as possible. CH:bcd Yours truly, Cur%is Horton Building Inspector APR ~ 198~ PlO ..,. L,., 14 I0 k,,/. I00.0 S,C. D8% OF HFA[TH ~ERVI6[S hq F:N DOZZ./N CANO, FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL gOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved ~..~.., 19 ~.~. Permit No..[.q h .~..~..;~. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT TOWN O~ 'SOUT~OLD Received ........... ,19... 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 inspections. (Signature of applicant, or name, if a corporation) .2.7..-..o.{ .... ~.t.8..v.~. ..................... (mailing address of applzcant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .... ................ ................................... Name of owner of premises .......................................................................... (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 .......................... Plmnber's License No ......................... Electrician's License No .... O. b,~..~..~.~ ......... Other Trade's License No ...................... I. Location of land on which proposed work will be done .................................................. 0. ..... .... ................. ................... House Number Street Hamlet County Tax Map No. 1000 Section ..... f. t ~ ......... Block ....... ~... ~'. .... Lot'~ . . . ~ ............. ~ Filed Map No ~ Lot Subdivision ................................................................... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy V~ ~ ~ ~.q,~ ...................................... ...... ..... ~ ~ ~,~ q~ b. Intended use and occupancy ..... /. ~ ~.'. l/., ~ g [/~ .~.~ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ....... Removal ~?~ ;~ ......... Estimated Cost ...... 4. O.. 5. If dwelling, number of dwelling units... If garage, number of cars .... ' .... ~,2.. ....... Demolition .............. Other Work ............... (Description) (to be paid on filing this application) ·...] ....... Number of dwelling units on each floor ................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... , 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ ....... Rear Dimensions of same structure w~th alterahons or,a_ddit~ons: Front ................................... Depth , Height ~ Number of Stones' /i~ 8. Dimensions of entire new eonsiruction: Front ...t.(~. O. P.* .... Rear .... (~,/~.~.+.... Depth . .~,~1~ ./~+ ..... Height . .~.~..~..-/r .....Number of Stories ..... ~L ................................................ 9. Size of lot: Front ...... I. fCC. ~.~. ....... Rear ...... I.~.Q .~.~. ........ Depth ... ~. ~.O./0.~. .......... 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction viOlate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ! .................... Will excess fill be removed from p~.mvises (~-~"~ No Name of Architect ........ ~ .................. Address ................... Phone No ................ Name of Contractor ....... , .................. Address ................... Phone No...: ..~ ........ 15. Is this property located withinliO0 feet of a tidal wetland? * Yes ..... No .+~... · If yes, Southold Town T~ustees 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. STATE OF NEW YORK, S.S COUNTY OF ................. · · .~ .............. being duly sworn, deposes and says that he is the applicant (Name of individual si~ning 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 thts application are true to the best of his knowledge-.and belief; and that the' work will be performed in the manfler set forth in the application filed therewith. Sworn to before me this .............. ~. ...... day;f .............. Notary Public ..... ~F~.......~.'...~/..El..~...~-77... County , (Signature of applicant) : S.C. l)8~f. OF HEALTH ~RVICES n' ~ 9 -! r"- ..... 85 ^-C.. N61239 D~os 2.EP..~OS OP.I E-I~"T;I'O,¥. ilqS' ,? ROE)ERtCK VAN TUYL, P,C, LICENSED LAND SURVEYORS GREENPORT NEW YORK SUFFOLK CO. HEALTH DEPT. APPROVAL H.S. NO. STATEMENT Of INTENT THE WATER SUPPLY AND SEWAGE DISPOSAL SYSTEMS FOR THIS RESIDENCE WILL CONFORM TO THE STANDARDS OF THE SUfFOlK CQ DEPT. OF heAltH SERVICES. is) SERVICES -- FOr APPROVAL OF CONSTRUCTION o~CY DATE' Ak;;4ov o:" 8iN~ ~ F~4 Y SUFFOLK CO. TAX MAP DESIGNATION: DIST. SECT. BLOCK PCL lO00 ,~_ '7 OWNERS ADDRESS: DEED: L..:!.¢ c,'~ Pm TEST HOL. E STAMP SEAL i OCCUPANCY OR USE IS UN~WFUL ' SUPPLY WITHOUT CERTIFICATE EXCEED OF ~UPANCY ? ' ' : ' C-: I. ;,?; ", i', ', Z~ FL O~ GUERtN,O , '--'- '"t ,:~' L OkTY, ELEV 'i 'I 7 r r