HomeMy WebLinkAbout15049-z irORM NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDit*;G PEIU~IT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL PULL
COMPLETION OF THE WORK AUTHORIZED)
15049 Z Date 4~ ~...~. ............... 19.~.~..
.~.~..~...~.~..~. ...............................................
..~.~~...~.~.....~..~.~.~ ........
..~~....~....~~.. ~.~..~.~....~...~
.~-:~ ~..~ ~~ ...... : ......................................................
County Tax Mop No. 1000 'Section .... ...~,...'~..3. ..... Block ...... ..O...J, ......... Lot No ..... !...~ ..............
pursuant to application doted ...~.....:.):), .................... , 19...~..~., and approved by the
Buildir~g Inspector.
Rev. 6/30/80
VICTOR LESSARD
PRINCIPAL BUILDING INSPECTOR
(516) 7654802
FAX (516) 765-1823
Town Hall, 53095 Main Road
P.O. Box 1179
$outhold, New York 11971
OFFICE OF BUILDING INSPECTOR
TOWN OF SOUTHOLD
November 3, 1989
Nick & Anne Theophilos
387 Broadway
New York, N.Y. 10013
Re: Premises - 2200 Sound Drive,
Oreenport, N.Y.
Surf. Co. Tax Map #1000-33-1-16
Building Permit #15049-Z
Dear Mr. Theophilos:
In checking our records, we find that the above building
permit has expired, and the swimming pool has not been built.
If you wish
application.
be advised that we have voided the building permit.
to re-apply at a later date, please submit new
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
VL:gar
Victor Lessard,
Principal Building
Inspector
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
· TOWN CLERK'S OFFICE
SOUTHOLD, N.Y.
NOTICE OF DISAPPROVAL
Date..(~~... lJ ......... ,
19. ~..~
To ~.~ ' ~,,'~.~ .~"~...'~.. ~'~
i. ~.~.~ I..~ .........................
PLEASE TAKE NOTICE that your application dated .....(~/..~...)./. ........ 19 .~.(~.
for permit to ~.~...~ . ,~.~ ~.A-~..~...~[...v.~ ............ i ......... at
Location of Property . .~-..~r..~.? ..... ~.~.~... )~..~.. ~ .... ~..~ ~. csrt~.~.. ....... ;.
House No. b'treet V Hamtet
County Tax Map No. 1000 Section ... O..~ .~ .... Block .... ~>. / ...... Lot ...J.~. ........
Subdivision ................. Filed Map No ................. Lot No ..................
is returned herewith and disapproved on the following grounds..~ ~..~....~.~' · .
~.~ .~ !/.?:....~ .).~ .....¢.,..o~....~., .~.,, .~..~....~...~., .~...~ ~ ......
·
~....~.. ~., .~ ~v~ ...¢~.. ~...~......~+..t)..~..c;. ~. ~...~......~..
Building Inspec%or
RV 1/80
TE COM 4E,~TS ~- '
FIELD INS[~ECTION
1.
FOUNDATION (1st}
FOUNDATION ( 2nd )
ROUGH FRAME &
PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONA'L COMMENTS:
· , ,/?
/
~cAL~ .............
~O~c~ VAN ~Y~ P. C.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1803
Examined. ~ .~..~..., 19 .~.~.
Approved..~ ~-.~..., 19~.(t. Permit No./,~.~..~..~...~
Disapproved a/c .....................................
.... .........
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
Received ........... ,19...
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 auth°rized inspect°rs °n premises and in building f°r neces:~7, i::~tFy.~.~/J..F~/...~~. ..........
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant)
State whether applicant~_o_9~w.u ssee, agent, architect, engineer, general contractor, electrician, plumber or builder.
(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 License No .........................
Electrician's License No.. /~. ?..7 .............
Other Trade's License No .... 3"~..7 ............e~d~don~e.(~)..~.~.f_/~,//~..i/.~//o,,,~_~ ~.~./
1. Location of land on which proposed work will b .........................................
House Number Street Hamlet
County Tax Map No. 1000 Section ...0.7.2. ....... Block ...... / ........... ............
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 . a fi/..~'.ca~_. ...................................................
b. Intended use and occupancy .................. ~.~./.~ .....................................
3. Nature of work (check which applicable): New Building ..... ' ..... Addition . .~ ........ Alteration ........ i.
Repair .............. Removal .............. Demolition ........... i... Other Work ...............
/~/fid.) i (Description)
4. Estimated Cost ... t/d/.t~ t~. ............................. (~ Fee .......... ............................
' (to be,;paid on filing this application)
5. If dwelling, number of dwelling units ............... Number of dwelling uniis on each floor.. ~.. ~'.'; ........
If garage number of cars ~.
6. If business, commercial or mixed occupancy, specify nature and extent of each ty_ce of use '~
7. Dimensions o/f ¢,xisting structures, if any: Front...?. ? .~. ..... Rear . .'.~...O ....... Depth ...... ~. .......
Height .../..,k~ ......... Number of Stories .... /. ....................... i ............................
Dimensions of same structure with alterations or additions: Front ~ , Rear
Depth Height ~ Number ot~ Stories
8. Dimensions of entire new construction: Front f--- Rear -"~- Depth .~..~-~.
Height ....... . .--~-. i 7. i ~ Number of Stories . .w-:. ...................... :
9. Size of lot: Front ...^.../. ~.q ............ Rear.. ~/~ ............... ' .......... ~1'~ ...............
10. Date of Purchase ..~.[/~.~.~.~...~..~-7~.. ....... o~s Name of Former Owner..~.................,......,.D~epth .~.. ...................
11. Zone or use district in which premises are situated. ~. ~.,..-~7.. .............. , .....~.. .....................
12. Does proposed construction viol~a~te any zoning law, ordinance or regulation:
13. Will lot be regraded ..... .~.-- .................... Will excess fill be remove~ ............................ from premises: Yes
14. Name of Owner of premises .................... Address .............. i Phone No.
Name of Architect ........................... ~.~,, Address ............... ;.... Phone No ................
· ~/g..~,. ~.e)k/9..P~¥...Address ............... !.. Phon~No ...............
Name
of Contractor
15. Is th±s property located~w±th±nl,00 feet of a t±dal wetland? ~ iYes .~.. No
· If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, lmhcate 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 Y'~K, ~ ~ ~ i
COUNTY OF...(~.....~.~ ,
~v~'~;~2~(. .......... being duly sworn, deposes
and says that he is the applicant
He is the .......................... (~ontractor~c;;~;;a't;
and to make and file this
e and belief; and that the
of said owner or owners, and is duly authorized to perform or have performed the shid work
application; that all statements contained in this application are true to the best of his
work will be performed in the manner set forth in the application filed therewith.
NotarySW°rnt°bef°remethis~~ ~ ~~
........ //. ~. · .~. ..... day of, .: ......... , 19 ,<~,
Public, . ..... ~.~. ............. County ,.
(Signature of applicant)