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FORM NO,$
TOWN OF $OUTHOLO
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, NoYo
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission Is hereby granted fo:
....... P.~(3.V..~ J~{:;~ ...~.~;~IP .........................................
....... ;~.~...~ ~:.T.~I~;~...B.q ~,.~ ................................................
....... ~; .T~J.~ ~:.T....,tJ,,7.;~.~ ~, ..............................................
to.....1~ F~J~I;.T... ,'~.. ~E~I~ICE~.. ~E~...~1~. E. I E.D...EIQI~...~lO...(;QN~ I .T. I OblE~.. QE....T. I~,LI~ .T.E.E~.. E.P.B.t~QVAL.
at premises located at ................ ~.;S.5O.....O~.I~W.QOJ~..J~F~ ........................................ ~O.LI.T.~O~.D ............
County TaxMap No.....~.7.~;.8.8.?. ...... Section ..D. ZO .............. Block ....0.0.3.2 ......... Lot No. 0~.1. ................
pursuant to application doted ...1':1.~.~ .................. 2.~ ........... i.... ......... 19.....~.7. ...... and approved bythe
Building Inspector.
Fee $ ....... ~.5.,.~.0. .....
.................................... ~;;~;;;or ....................
Rev. 6/30/80
Albert 1. Krupski, President
John Holzapfel, Vice President
Jim King
Martin H. Garrell
Peter Wenczel
Town Hall
53095 Main Road
P.O. Box 1179
Southold, New York 11971
Telephone (516) 765-1892
Fax (516) 765-1823
May 30, 1997
BOARD OF TOWN TRUSTEES
TOWN OF SOUTHOLD
Mrs. Providence Sacino
1350 Oakwood Dr.
Southotd, NY 11971
RE: SCTM %70-12-31
Dear Mrs. Sacino:
The following action was taken by the Southold Town Board of
Trustees on Wednesday, May 28, 1997:
RESOLVED that the Southold Town Board of Trustees ~rants a
waiver to construct a split rail fence along bothsides of her
property starting at the landward side of the reeds.
If you have any questions, please do not hesitate to contact
this office.
Sincerely,
Albert J. Krupski, Jr.
President, Board of Trustees
AJK:jmd
FORHNO. I
TOWN OF SOUTHOLD
BUILDING DEPARTHENT
TOWN HALL
SOUTDOLD, N.Y. 1197]
TEL: 765-1802
D~ sapproved a/e .................... . ..............
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC PORH ...................
HAIL TO: ....................
Date ................ ,19 ....
a. Ibis application must be cempletely filled in by tyl~vriter or ia ink ami antxaitted to the Building Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan sl~wing leeation of lot and of buildings on premises, relationship to adjoining premises or public
streets or areas, ~ giving a detailed description of layout of property ~ust be drawn on the diagram viaich is part of
this application.
c. The w~rk covered by this application may ant be comrenced before isanat~e of Building Permit.
d. Upon apprcrval of this application, the Building Inspector will issue a Building Pemlt 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 vYaole or in part for any purpose whatever ontil a Certificate of
Occupancy shall, have been granted by the Building Inspector.
APPLICA'rI(li IS t~flY HAlE to the Building UeparUmnt for the isle of a Building Pemit poranant to the
Building Zone Ordinance of the To~ of Southold, Suffolk County, l~v York, and other applicable L~s, Ordinances'or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein
described, lhe applicant agrees to canply with all applicable l~ras, ordinances, building cede, housing code, and
(Signature of applicant, or haut, if a corporation)
(Mal~4ng address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plunher or builder.
..............
of of premises ..........
If applicant is a corporation, slpt~re of duly anthorised officer. 765-1802 S AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
......................................................... FOR POURED CONCRETE
(N~e and title of corporate officer) 2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4, FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
I. ~ocation of land on which proposed work will be done ..............................................................
Builders License No ..........................
Plumbers License No ..........................
Electricians License No ......................
Other Traders License No .....................
Subdivision .................................... Filed Map No Lot
(~)
2. State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ............................... , ............................................
6+
II.
12~
15.
property lines. ~ive scree£ a~)
interior or conmr lot.
ta;llt.-e of work (d~ck ~dch api)ticahle): Nc~ Ihdlding .......... ~klition ...... ~.. Alteration ..........
]f garage, t~r of ear8 ...2 ..................................
If I~mi[ma8, ~n]ereial or mi~l ~]lmt<y, Sl~elf~ mature alii ~tent of each ty~ of u~ ......................
llin~n~i~s off ~inti~ ntz~mt~re8, if any: ~C ................ ~ar ......... ~pch
Dmenai~s of 8~m 6tn~re ~ith alterati~m or ~klitions: Front ...............
I~pth ............... , ..... I~[~t .................... K~l~r of Btorie~ ...............
Dinensi~m of ~ '
Si~ of lot: I%~t ................... ~ar .................... l~pth ....................
I~iCe o~ ~JFcha~ ............. 'i ........ ~ of IrOrl~Y ~[~r
~m or u~ diatrlet in ~id~ ~r8ni~ are alt~t~l ..............................................................
~aa of ~mr of p~M~s ...} ........ , ................ ~kkess ............... ; .............. H~ ~) ..............
~x{e of ArcJdt~t ............ { ........................ &~ress .............................. H~m ~ ..............
~m~ of ~tractor ...........
Mklress ............................... H~ ~) ..............
'la this p~mrty within ~ f~t of a tithl x~tla~]'l * H~ .......... ~ ..........
PLOT DIAGRAH
(Co. tractor, agent, ,corporai:e officer, etc.)
of said o~.r or ~cs, at~l ia duty ~ti~orir~l to lx~rform or h~e IxarForn~ I.he 8aid ~rk m~] t.o ~ke ami file this
ap[)l }cation; Llmt: nH sLat~nts c(~}tpi~l in this al~)l, lcati(~ are
{hal: tl~e ~)rk will 1~ I~rfon~l in th~ nua.~r ~t fort.h in the nppl icnClon
....... .... ,,
·
(Signal:ute of ^ppticant)