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Home My WebLink About24289-z2428~ ~ FORM NO,3 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HAU. SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .....~,U, ~ .u...S.T, ............. ~ ............................ 19.~.7. ..... Permission Is hereby granted to: ....... .s..~ .N...F..O.,.R..D....~....S. ~.E;.....H...A..N..~ .U...E.~ ............................... ....... .P...q ...~g..x.....1..4...~..o. ........................................................ ....... .H..~T...T.~.T..U...C..K.....N..y....i...Z.~.5...2.~ .................................... ........ ,E,.,~/~,.T,~I~.,. g. ,FT, ~.~ ~.CLN,,...L.. ~, N, ,g, ,., ................................................................................................. at premises Ioooted at ............... _4..1...0..5........s.g. ,U..N...D.?..~,..E. ~...~?..E., ................................................................ CoLInlyTax Map No..,,..4..,7,~.~.,.~.~ ...... Section ,..0.?..,4, .............. Block .....0...0...0.~ ......... Lot No..o...o..z.......o...o.z ..... pursuant to application dated ,...,g...U..L..¥. ................2...1. ......................... 19......9...7. ...... and approved byfne Building Inspector. Fee $ ......., ,3, ,5, .:,.0...0, ..... ~"Buildlng Inspe~ffor Rev, 6l;~0J80 ' I ~'-- .... ~ i: TOWN OF SOUTHOI.D BUILDING DEPARTHENT · JUL 2 ~ 1997,, Town ]]ALL , ~ ..... ~ SO~JTUOLD, N.Y. 11911 ' ? =ELDG. DE~T, ~L: ~65- 1802 BOARD OF HEALTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALL 7.17 MIlL TO: .................... APPLICATION FOR BUILDING PERiilT INSTRUCTIONS a. lhis application rmst be mmpletely filled in by typewriter or in ink and st~mitted to the Building Inspector 3 sets of plans, aectrrate plot pla: to scale. Fee according to schethfle. b. Plot plas showing location of lot and of buildings on pr~nises, relationship to adjoining pr~nlses or public streets or areas, and giving a detailed description of layout of property ~ust be drawn on the diagram which is part of this applicat ic~. e. The turk covered by this applicatim ~ay not be ~ed before issuance of Building Permit, d. Upa~ aa)t'oeal of this application, tie Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept om the premises available for inspectim througlmt the ~a~rk. e. No building shall be occupied or used in ~nole or in part for any parpase whatever ontll a Certificate of Occut~q~ shall have been granted by the Building ln.~ector. API~ICATIC~I IS I~I~Y ~ to the Building Depar~ent for the issu~ce of a Building Permit pars~nt to the Building Zoae Ordinance of the T~ of ~o~thold, Suffolk Cotmty, New York, and other applicable Laws, Ordlna~es or P~lations, for the cc~stroction of b~ildlngs, additions or alterations, or for removal or der~litiom, as herein described. The applic~t agrees to co~ply with all al~licable laws, ordinances, building code, housing code, and ~r~*gulations, and to admit anthoriz~.~l inspectors on ~,ises and in build__essay, s.. (S~gnatm~e~f ~mpphcant, or na~e, if a ....~..~.... ! ~Y.....~.d..~.< .~.a..4~.... ~ $6.. 7Jf~.. 6Mailing address oI applicant) State whether applicant is ouner, 'lessee, agent, architect, engineer, general contractor, electrician, plt~ber or build (,as on the tax roll or latest deed) ~ ~ ~E~I~I~ENT AT If applicant is a corporation, signature of duly authorized officer. ~-l~10~ [ 18~ ~O 4, ~ FO~ THE (Nane and title of corporate officer) ~~[~[~"~ Builders License No .......................... 4, [c[NAL - CONS'eNd,ON MUST ~E COMPL~IrE FOR C.O. Pl~bers License No .......................... ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. Electriclanm License NO ...................... STATE CONSTRUCTION & ~NERGY Other Trade's License No ..................... C~DES. mot ~S~ON~9~I.~ ~OR OE~IGN OR CONSTRUCfflON ERRORS 1. Location of land on ~idch ~ ~ will be done ............................................................. ............... ..~il~.~. .... ..~.~ ~ .~.. ?. ,?...~. ...... ~o.~ ....... ~t ~..'r. t..~.¢~. .................................... Hou~ Nm~ber Street Bamlet Tax ..... .... .... ........ Subdivision ................. ._.~ ................... Filed Map No ................ Lot ............... 2. State existing use and occt~ax:y of premises and intended use and occupancy of proposed construction: a. Existing use and occopa~ ........... ~¢.W$..~. ......................................................... b. Intended use and occupancy .................. [.~'..~..~.~.?. ................................................. 3. N,'lture of uu[k (d~ck siddt al~flicable): I'L~ IkHldi~ .......... &~iti~ ....... ~d Alteration ........ I~l~fir ~al l~t~liti~ Otter ~ ~ ..... .~1~...~ 4. Est iunt~l C~st ...... ~ ............ f~ ............................................ (to 1~ ~id ~ filing this a~]icati~) 5. If ~lli~, ~tmr of {~lli~ traits ............ t~t~r of (k~lling ~mits ~l ead~ Hmr ................ if garde, ~lmr of cars ....................................... 6. If I~mifmss, ~rcial or mi~ ~;~, a~i~ ~Lure a~ ~tent of ead~ ty~ of u~ ...................... 7. Din~nsi~m of ~isti~ atnmtu~a, if a~: [Cml ................ ~ar ............... ~pth ................. I~iOlt ......................... ~r of Stories ...................... 8. I)in~nsi~d~ entire i~ ~:it~ti~l: l~t ................ ~ar ............... ~pth .............. I~iO~t ' ~r of Stories ..................... 9. 8i~ of lot: ~t ...~P~;~% ........ ~ar .... ~.,.~ ....... ~pth ...~Z~ I I. ~ or ~ district in ~dd~ pr~i~s a~ si~t~ .............................................................. 12. ~a propel ~mt~ti~ ~iolate any ~ming 1~, ordis~e oc regulati~l: . ..~ ................. 13. ~ill lot t~ regr~ ........ ~ ........ ~{1l ~esa fill t~ ~ fx~ ~i~s: ~ ~e of Arddt~t .................................... ~resa .............................. ~ ~ ........... ~ of C~tr~tor ................................... ~re~s ............................... H~ ~ ........... 15. Is this p~rty within ~ f~t of a timbal ~etl~l? ~ ~ .......... ~ .......... PLOT BIAGRAH I~cate clearly and distinctly all buildings, ~t~ether existing or proposed, m~l i~xlicate all set-luck dimensions property lines. Give street iud block t~t~er or descriptic~ according to ~le~l, ~nd c~log street m~nes ar~l indicste ~mther i. nterior or cot~rs~r lot;. sx,~rn, deixmes ntxl mays that he is tl,e apl)l leant Itc iS Ihe ........... .-~..'~.~.-~7..~e. ................................ ., , .............................. (O. nttractnr, agent:, cotI. .~ate officer, etc.) of ~qid (~r or ~rs, m~l i~ duly mlthoriv~ to I~rform or h;~e [x~rforn~ id ~tk a~] Lo nuke a~xl file this al~dlcatio.; that ail stat~nts c~aR'ail~ in ti]is nl~)licati(m are tr~ Lo the I~ ~of his ~x~l~ that the ~}rk will }~ i~rfon~l in tho ,~{la~r ~t forth in the appl ication fil~l tl~ ~m Ln I~fore n~ this ~ ~ ~ .................. d ~ o[ ............... 9 .... ~,. ~i~ ~. lO, 19~~ v~t'Oo f~ SANFORD:HANAU£R. & ~UE B. HANAUER ~ " ~UCY 21 SUFFO~ COUNTY, NEW ~ ~O, ~-G04