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Home My WebLink About13938-z FOR, H NO. fJ 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) No_ 13938 Z Permission is hereby granted to'. ~.. ~.~...~..~.~.b...~..~.~.. .~.~..~!.~.~ ................................................ ,o ..~.~....~....~.~,......~~..~,....~...~....~ .......... ~.~~.~.....~...~.~,.~. .......... ~ ............. : ..... .; ........... ~t premises located County Tax Map No. 1000 Section ....... ;.!.~ .......... Block .....~.,,,,~,. ......... Lot No ....... .~. ............. ~u,uo,t ,o opp,,cat,o, dated ........ ..'bq.....~.~ ......................... . ,~.~.~, ~n~ ~,,,o~ ~ ,~, Building Inspector. Building Inspector R~v. 6/30/80 F i~3LD INSFECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY O~ODE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined. · '.~ .%.]..~ .... 19.~.~7 Approved....~.% }.Q .... 19~}~ Pe=it No. ~ .~ ~.~ ~ Disapproved a/c ..................................... ............................. (Building Inspector) APPLIC~TIO~ FOR BOlLDI~G PERMIT INSTRUCTIONS a. This application must be completely filled in by Wpewriter 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 applicaiion 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 ~ 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_~ ,9 f. , ...........*--,,-. ................ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, enl~neer, general contractor, electrician, plumber or builder. Name of ownex of premises ............................ ~., ~ · ~ ......................................... (as on th~'t~x roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. .3 D._ ......... Plumber's License No ......................... Electrician s License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ........ ............ ......................... House Number Hamlet County Tax Map No. 1000 Section .../!~/. ........... Block .... /.'.~7. .......... 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 .... .~.~..~..~... ?.~ ..... :..'7~ ....... 'i ....... :~ .................... b. In encleo use ano occupancy .... v/p/'.v.~.vg~.,¢- ............... ~ ............ .... - ........................ 3. Nature of work (check which a Repair .. ,~ .,.~;;.. Rem 4. Estimated Cost ........... 5. If dwelling, number of dwellin If garage, number of cars .... 6. If business, commercial or mixe 7. Dimensions of existing structut Height ............... Nm Dimensions of same structure v Depth ................... 8. Dimensions of entire new consl Height~ . .............. Nm 9. Size of lot: Front .......... 10. Date of Purchase .......... 11. Zone or use district in which p~ 12. Does proposed construction vk 13. Will lot be regraded ........ 14. Name Of Owner of premises .. ) ' Alt ~ cable: New Building ........... '... eration .......... oval .............. Demolition .............. Other Work ............... ~ (Description) ~ Fee ....... ~' (to be paid on filing this application) Units ............. Number of dwelling units on each floor ................ occupancy, specify nature and extent of each type of use ................. if any Front Rear Depth ~er of Stories ........................................................ h alterations or additions: Front ................. Rear .................. ·. Height ...................... Number of Stories ...................... ~ction: Front .... /.~. 2/.~,: .....Rear ../~. './.~. ....... Depth .x/OC.../.,3.~.: [.~..~. )er of Stories ........................................................ ' i ........... Rear ...................... Depth ...................... ......... : ........ Name of Former Owner ............................. raises are situated ................................................... [te any zoning law, ordinance or regulation: ................................ ................... Will excess fill be removed from premises: Yes No ' Address Phone No Name of Architect · .I '. . Address . Phone No ................ Name Of Contractor ........ ~. i ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly ajl ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and bloclf humber or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW YORK, ~ COUNTY OF .................. ..........................(Name of individual siq':n.lng .................... contract) being duly sworn, deposes and says that he is the applicant above named. He is the .................... of said owner or owners, and is d~ application; that all statements coq work will be performed in the manO Sworn to before me this 19 .. , ............... county NOTARY PiJ[ll'lC, Stat~ [ N~w York No. 4707878, Suf[o Comity_ lOrlll kxp,es FAarct~ ,0, 19~ (Contractor, agent, corporate officer, etc.) y authorized to perform or have performed the said work and to make and file this iined in this application are true to the best of his knowledge and belief; and that the r set forth in the application flied therewith. (Signature of applicant) 15' 14' NOTIFY ~ ' ~'~X'G ~PA~,~"~NT AT 755-!8"2 ~r ~ ~*'" TO 4 P~ FOR TF',E FO~ :;"' EL~ C.~NCR -,AN F,- ,_ . . . - .... ' ' ,4 ,L~S ~ E:" ,'-~,, ..... E 7.,'~~,., ,,., ALLf C"N~ '~ ;S3'~O~,~ $'~'7~ L t'/,~ET THE' REm~ ~:~,.:h,,b C7 Y. . EN ~) 'W/~LL OF D~cK NOT RES, ON~ ~. ~OE OE CONSTRUCTION AT R[AR OF I-tOLIg£ '700 New ~n+f!f~ck, Ne~' Yo~k