HomeMy WebLinkAbout24698-zFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
24698 Z Date FEBRUARY 20, 1998
Permission is
hereby granted to:
CHRISTINE HUNT
PO BOX 376
CUTCHOGUE,NY 11935
for :
CONSTRUCT AN ACCESSORY 4 FT. HIGH TRELLIS IN THE FRONT YARD OF A
SINGLE FAMILY DWELLING AS APPLIED FOR.
at premises located at 5700
County Tax Map No. 473889 Section 111
pursuant to application dated FEBRUARY
Building Inspector.
VANSTON RD CUTCHOGUE
Block 0010 Lot No. 013.001
2 1998 and approved by the
Fee $ 35.00
Building Insp~or
ORIGINAL
Rev. 2/19/98
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION IST [ ] RO~H~PLBG.
[ ] FOUNDATION2ND [?~I~ULATION
[ ] FRAMING [/_/] FINAL
[RE]M~IRR~iACE~~H~ ~~
DATE
YORt4 NO. I
TONN OF SOUTHOLU
BUILDING DEPARTHENT
TOIJN HALL
SOUTHOLD, N.Y. 11971
TEL: 765- 1802
BOARD OF HEALTH .... ...........
3,SETS OF PLANS ......... ' ......
SURVEY '"
CIIECK '
SEPTIC FOR14 ............
CALL .............. .. . .
14AIL TO: .... ' ................
a. 'Ibis application mast be completely filled in by t)q~rCiter or in ink and sehnitted to the ll~lilding Inspactor witi
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b'. Plot plan she~ng locatian of lot and of buildings on premises, relationship to ..adjoining premises or public
streets or areas, and giving a derailed description of layout of property vamt be drawn on the dlagran ~hid~ is parr of
this application.
c. lhe ~ork covered by this application raay ncc be cameaced before issuance of Euilding Permit.
d. Upon approval of this applicarlan, tim l~uilding lnspectur will issue a Building Permit to the applicant. Such
permit shall be kept an the premlsea available for inspection thrunghe~t ttm ~ork.
e. ~o building droll be occupied or used in ~hole or in pert for spy purpose ~,hatever until a Certificate of
Occupancy shall Imve been granted by the E~ilding Inspector.
APPLICATICiq IS I~t0~l$~f ~ to tim nuilding Depertmmt for tile issuance of a lluilding Perm|t pursuant to the
I~ilding Zune Ordinance of the To~n of Sonthold, ~uffolk County, ~ York, and ether'applicable Laws, Ordinances'or
llngulatians, for the cotmtructlee of buildings, additions or alterations, or for reaovM or demolition, as herein
described. Yhe applicant agrees to comply with all appllcable laws, ordinances, building code, housing code, anal
regulations, aed to edait antburlz&l inspectors on premises and in bu~itng for .ee~eesary inspections.
...... ..~.......................¢ ~'
(Signature of applicant, or nem~, if a corporation)
(14ailing address of applicanV)
State ~mthur applicant is o~aer, lessee, agent, architac~, engfseur,'general em~ractur, ~lectrieian, Olt~her or builder.
1~ of o~aer of premises .........................................
(as on klm tax roll or latesV deed)
III appllcan~ is a eetporarion, slgnatur~e off duly antiorlzed officer.
title of ~rpar~ie'o~fi:er) .....
Builders License Ho ..........................
Ph~bers License Re
Electricians License No
Ottmr Trade*s License No .....................
I. location of 1~ on ~/nich prc~osed ~ork will be ~ .......................................
s -o ' .... · ' .... ....
I~ ~r fitr~t
~ivisi~ ....... ~ ......................... ~fl~ ~ ~ ..... { .......... l~t ................
2. Stare ~i~t~
.... ~;~~~W ~. ....... :L,.:.,.::}'..~.~. ......... ........
.... ..... ........
, --
'
garage, ~i~r of ~r~ ' i
~ of Arddt~ ..... ~,;'.~.,;;i[, .................... ,. ~ress ....,....... ............ .. .... ~m ~ ...............
[ t PLOT DIAGRAH
(~e of i~zl[vldual si~mlug contract)
..beitq; dul.y aworn, deposes aed .says that lie ia tim applicant
ned in U~is ap~licatlc,~ are tree to U~e best of his k~o~ledge a.d bdliefl
man,mr ~t forth'in tim appl. ie~tion filed
(Signature of Applicant)
applieatlc~l; that all staterr~otS eonta
that the ~*or~ ~ill be ~rfo~ in 'tile
~m to l~[ore m
.......
lie ia the
(C~tractor, agent, c~rporate officer, etc.)
of said o~er or o~rn~ra, aed ia duly auLhorlr~d to ~rfom or h~ [~rlb~ tl~ ~id ~ ~1 to ~ a~ file this
HAIL TO: . .
a. 'Ibis application must he 'c~npletely filled in by type~iter or in ink and suhnitted to the Building Inspector
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 ~ndjoi~i.ng premi.se.s or. pchlie
streets or areas, and giving a detailed description of layout of property n~mt he dra~n on the diagram ~tuch ~s part of
this application.
c. 'H~e x,~ork covered by ~his application r~y not he ctramnced before issuance of lhilding Permit.
· d. Upon approqal of this application, the Building Inspector will issue a B~ilding' Permit to the applicant. Sud~
permit shall he.kept on the premises available for inspection through~t tile ~ork.
e. NO building sim11 he occupied or used in ~ole or in part for any Parpose ~hatever until a Certificate of
Ocohpancy shall lmve been granted by the Building Inspector.
APPLIC23'HI/ IS ~ ~ to the Building Uepartn~nt for the issuance of a Building Permit pursuant to the
Ihilding Zone Ordinance of the Toan of So~.thold, Suffolk County, Nee York, and other applicable Lg~s, Ordinances'or
lk~gulatians, for the construction of buildings, additions or alterations~ or for rem0val or dem~litian, as Imroin
described. The applicant agrees to ccmply with all applicable la~s, ordinances, building code, housing cede, and
regulations, and to ~l~it authorized inspectors on prendses and in ~-l~!ng for naeesgary inspections.
(Sigr~ture of apphceet, or nde, if a corp~ratlon)
(Hailing address of ~plicaoO
State ~/mttmr applicant is o~er, l~ssee, agent, architect, engiseer,'§eeeral contrac£or, electrician, ph~her or builder.
(as on tim tax roll or latest deed)
If applicant is a corporation, sil~ature of duly antimrized officer.
(Nam and title of corporate officer)
l~filders License NO ................ .... ... · .-
Ph~hers License Ro ...............
Electricians License l!O ................
Other Tr~le~s License No ............ .. ... .. . .
I. I~cation of land on ~,ifich proposed ~ork will he done ................................................... ~ ..........
5 coo ............................... ., ...... :... .................
ltonse Ix~nber Stxeet Itanle~ ,
St~xlivision ......... ' ................... Filed Nap I~ ........... t ...............
(~)
2. State existing use and oecupa~, ~f premi~e~,,.~ ~./~ :and' i~nte ,nd~d. u~e~ and occupancy o? pr°k~,.~s~t .constmction:~
3, l%Lure of ~ork (d~ck dalch apphcable): '14e~ ~nldlng .......... ~i~i~
l~lr .......... '.. ~al .... ~.. ........ l~lltlm.. ........... Other ~ ..'..;~.~.~..~..~ ........
4.
...... ,~ ...... ~ ........ ..... .................. ~.J-...~,....~ ........
5. Tf' ~lhng,~' '~';'~x~t~r o["~1t!~~ ..... ,~m~ts ............ ~l~r o[ c~l hng ~irs
If garage, ~r df c~ra--',.--I ................................
6. If Imslr~ss, ~reial or ~ ~, s~ei~'~ure ~ ~enE o[
7. l}i~mnsi~s of.~isEJ~ st~m~s, if any: ~E ........... ' ..... ~ar ............... ~pEh .................
I~i~E ................ ~ ....... I ~r of S~ories
Din~noi~s of ~ s~m~re with alterati~s or ~tEions: ~ ............... ~ar ...............
lO ~te orb d~ ' ' ~ fFomr
II. ~ or m dtstilct in ~dd~ pr~i~s am si~t~ , .........................
12. ~s ~o~ ~tlm~ vlol~te any ~lng 1~, o~i~e or re.latin:
16. ~s o~ ~r o[ ~s . .....
..... I ...................... ~ress ........................ ~ ~ ...............
~ of Cmtr~tor "
............. ,.. ..................... ~rea8 ............................... H~ ~ ........ : ......
15. Is this p~r~ wifldn. ~ f~t] of a till xmtl~? * ~ .......... ~ ..........
PLOT
DIAGRAH
I~ate clearly ~ dlsttmtly ail ~ild~, ~flmr ~stmg or pro~, a~ ~Micate all ~t-l~ dimnslons
~an p~rty.li~a. Oi~ st~[~ ~I~ ~r or ~scrtptim ~co~ing to ~, a~ ~ strut ~s ami i~icare
~fl~r interior or co~r lot,.:,: ,' ~. ,
(~trnetor, ngent, eqr~rnte~ offleer, etc.)
of enid ~mr or ~rs, nmi is dulymlthorl~l' ' to ~rfom or have [mrfom~ tim ~ic[ ~rk taxi to rake a~ file th{s
aiqflmatx~; that nil stat~mets ca~ta[M m this aMdicati~ are tnn to fl~e I~st of his k~l~
that the ~r~ will I~ imrfo~l 'in ~the~mmr mt forth'in fl~e a~l. icatlm fil~ tt~r~O~.
~ r ~bll=; S~ of New Yo~