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Home My WebLink About15051-z FOK~ ~0, ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERtv~IT CTHIS PEPd~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Z Permission is hereby granted to: ..... .~-- .............. ~...~ ................................. ~ .. . ...~...~...~.~.....~~...~.:....~. County Tax Map No. 1000 Section ..... .~...L}....~..~.. ..... Block ....... .~)...~. ......Lot No....(~1.....~... .......... Building Inspector. Fee approved by the Building Inspector Rev. 6/30/80 TO BUll SOL l~/~, .,,,, ,,,o.., Ill II ~i'i~ DEPARTMENT IL~ EL.: 76§-1802 ~6~ 4o ~MO.L I 'Da'lB J Examined ................. 19... Received ........... ,19... Approved ................. 19... Permit No ............ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... 19... IN STRUCTION S 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 pr, em~es and in building for necessary inspections. /~ c~ r~[~ ~dl cc.c_ ~ F ~zra C ~_ (Signature of apphYdtnt, or name, ifa corporation) · .5..~. ?.r'....o...%......t.~..,.:.:..~....,~.. ~ ?: ~,. .......... ,. ~ (Mailing address of applicant) State whether applicant is owner lessee, agent, architect, engineer, generaI contractor, electrician, plumber or builder. Name of owner of premises . .~.' .[.(~--~C q.C..~.....-~...C-.K. ?.~..~'. '. ............................................ (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 ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done~ ....... .7. .37 ............ ........... ......................... House Number Street Hamlet County Tax Map No. 1000 Section ...... . .~.S..~. ...... Block ..... 5(. ........... Lot.. ~ .............. 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 ................. property lines. Give street and block interior or corner lot. ' 3 Na[u~re of work (check which appiicabie!). New Bufldin~ ' Addition ~t'rm · ·, ; , ~. ~ ................... Alter_.lv, .......... t) ~ Rep'air ...... ~ ~,, .. Removal; i..~.,.lll~l.;a... Demolition OtherWork '' ' .............. ..... '4. E~t~matedCo~~ [~-~'~'~o."~C f~o~ ~/~.~ ............................ :, . ~ ~ ~'.,o ~ ~ ....ri ~ .... ~ ~ (to be paid on filing this application) 5. I~wdBlng, number of dwelling u~its ........ ~ ....... Number of dwelling units on each floor ( If garage number of cars ' 6. If business, commercial or mixed 9ccupancy, specify nature and extent of each type of use . .~.T~ ............ 7. D~ensions of existing stmctures,~if any: Front.. ? ............ Rear .............. Depth .............. Height ............... Number of Stories ........................................... j .......... Dhnensions of same structure witfi alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories .8. D~ensions of entire new construction: Front .......... . ..... Rear ............... Depth ............... Height , .............. Number of Stories ................................................... 9. Size of lot: Front ............ ~ .......... Rear ...................... Depth ..................... 10. Date of Purchase .. [q~.~ ..................... Name of Fomer Owner . A~qTJ .................... 11. Zone or use district in which premises are situated 12. Does proposed construction viola(e any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded .......... ; ....... . .......... Will excess fill be removed from premises: 14. Nmne of Owner of premises ~[~fi~.~. Address~ ~~ ~m~ ..... o l~.. Phone No. ZG.ff 7.~./~b .... Nmne of Architect ........... [ ............... Address ................... Phone No ................ Nmne of Contractor ' ' .......... { ............... Address ................... Phone No ............... 15. Is th~s property located within 300 feet of a tSdal wetland~ ~Yes ..... No .~ ~Kf yes~ Southold To~ Trustees Perm~ maybe ra~uired. ~ PLOT DIAG~M Locate clearly and distinctly ~1 bhfld~gs, whether existing or proposed, and, indicate ~1 set-back d~ansions from [mber or description according to deed, ~d show street names and indicate whether 3TATE OF NEW YORK, ~OUNTY OF ................. APPROVED AS NOTED NOTI~ BUILDING OEPARTM~T AT 766-1802 9 A~ TO 4 ~ ~R THE FOLLOWING IN~PEC~ON~: 1 FOUN~A?ION ~0 ~QUIRED FOR POURED CONCR~'r~ 2 ROUGH FRAMING & pLUMBING ............................... .................. 'being duly sworna.d~Rstfl~Rltlk~ys that he is the applicant (Name of individual signin~ contract) 4, FINAL. CONSTRUCTiON MUST ~.bove named, i ' B[~ COMPLETE FOR C.O i ALL CONSTRUCTION SHALL MEET ~e is the ...................... ' ....... ~ E I ENTS OF THE N,Y · .......................... R .QU PlaN. ......... ~ (Contractor, agent, corporate officer~'t~.~E CONSTRUCI~tohj j~ ,f said owner or owners, and is dulY *uthorized to perform or ha;e performed~~~F~R1)R~his lica i ' · · "'" '"' pp t on; that all statements contmn~d m tins application are true to the best'(~'l[is knowledge and belief; and that the /ork will be performed in the manner s~t forth in the application filed therewith. .worn to before me this .......... q~...'~-...., ..... day of..i...~ ......... 19 .~..~