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Home My WebLink About24205-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN ~ SOUTHOLD, N.Y. 24205 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date,,., g. IJhll~ ............... ~; ............................ 19..~7 ..... Permission Is hereby granted to: ....... [,. ,~.~D.T..T.,. ,~...I~ ~ D.~.~ .T... ,H/~I~.T.I~ ....................... ....... ~.O,....~I&T~.,.~,~L ,,~I~,Y, ...................................... ....... I~D U.T.H..CIL.Q,. b! .Y...,t .-1, .~Z ;I,., ....................................... to.... JE F~ C.T... ~.. F..EI~ICE.. mS...6P..E L f ED...E D.B .................................................................................... at premises lc)coted at .................... gO..... M¢.T. ERS...E~BE.. ~.Y. ........................... ..~Q LJ.T. bl.C)LD ............ County Tax Map No......4.7.;~8.8.~ ...... Section ..~88 .............. Block ....O.OQ.5 ......... Lot No. 054. ................ pursuant to application dated ...g.UNE ......... , ........ .5 ......................... 19.....9.7 ...... and approved by the Building Inspector. Fee $ ........ ;~ ~5.,.O.Q ..... B~1'ding Inspecto~J Rev. 6/30/80 i. FORMNO. t' 3 SETS OF PLAITS ....... BUILDING DEPAWFMENT ClIECI ................... TOWN IIALL SEPTIC BLDG.%oF $O. D [:?'[ ir) ~] SOUTIIOLD,TEL.: N.Y.8 11971 enniippro~e .... . ....I ... No. Disapproved APPLICATION FO~ BUILDING PERMIT CALL HAIL TO: Ddt . ', ·, ......~ 1 INSTRUCTIONS Tiffs apl~lication must be completely filled in by typewriter or in ink and submitted io fl~e Building Inspector, with FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING · 3,INSULAT{O~ 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONS'rRUCT~ON & ENERGY · llamlet Couhty Tax Map No I000 Section :~ Block ' ........................ Lot ............... Subdivision. ' ' (Name) ., ................ Sl.~te existing use and occupancy of premises and ii, tended usc and occupanc~of proposed construction: Fvktino, Use and occupancy .... ,dcd USe and occup3ncy "' ' Builder's License No ......... . ........ ' .... . ...... Plumber's License No ......................... Electrician's License No.... .................... Other Trade's License No ...................... Location of land on which proposed work will be done ........... llouse Number . SIreet sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings ¢n premises, relationship to adjoining premises or public stinter, or area5% and giving a detailed description of layont of property mnst be drawn on the diagram which is part of this appl/ 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 w/Il issued a Budding Permit to the applicant. Such permit shall be kept on thc premises available for iuspection throughout the work. '. ¢. No building shall be occupied or used in whole or Ju part for any purpose whatever brittl a Certificate of Occupancy shall have bccn granted by thc Building Inspector. APPLICATION IS HEREBY MADE to the Building Dcpartmant for thc issuance of a Building Permit pursuant to :~e Building Zone Onlinance of-the Town of Southold, Suffolk County, New York, and othei' applicable Laws, Ordinances or Regulations, for t!~e construction of.buildings, additions or alterations, or for removal Or demolition, as herein described. The appUcant agrees to comply with all applicable laws, ordinances, building code, housing Code, and regulations, and to admit authm!zed inspectors on premises and in building fornecess ryins ct' . · ,. (Si~. pplicdnt~'or name, if a corporation) ~ . (Mailing address of applicant) ' State whether applicant is owner, lessee, agent, architect, engineer, general ·contractor, electrician, plumber or builder.' (as on the tax or.latest deel l ll0Vl D If applicant isa corporation, signature of duly anthorized officer. ?B5-1802 ~ AM TO 4. PM FOR THE '3. Nature of work (check whi applicable). New Building Ad ition ......... Aheration Repair ~ Removal I)cmolition Other Work 4. Estimated Cost . . .... Fcc ~ (to be paid on filing this application) 5 If Iii b f I Iii it ' . dwe IIg, I1UIO ere twe llgltll S ............. ~'llllllbcrofdwc iigHilitSolleach eof .............. Ir garage number of cars ~ . 6 If busbmss commercial or mixed occul)a,cV specily lmtme ami cxte,t of &~ch lype of usc 7 ' ' ' if any: I:mnt Rear ' Depth lleJght Number of Stories ' i DiStCI1SiOIIS 'O~ShUle StlUCtHI~ with allerhiions or addiliolls: J:ront Rear ' ' Depth ' llcight Number of Stories 8 D' Is of Fron R i D ti llcight Number of Straits 9. Size oflot: Front ...(~.~ .... . ......... ~ r .................. . i. .. 'Depth .~ ................. , 10. Dale ofPurclmse . .[ ........ Name of fo]mcr OWner .~.D~ .~.~t~ ...... . Zolle or u listrict in which premises are situated ................... '; ...... ................ ......... 12. Does proposedconsmtctionvioatea~yzon g aW ortim 'ceor e,t lo~" . ' . . Name of Arch tect . . ' A(tress . i .: ' /I},;,,~M ' 15. Is this property ~it~in.300 feet of a tidaI wetland'/ *v~'l . · '.~,.~ q~'... .' "' ':''' ,,~r yes, Southold Town Trustees Permit may be requir,ed.' Locate clearly and distinctly all buildings 'whether.existing or,~roposed, a ~d.'indicate all set.back dbnens ohs fret : .,' ,heft} hnes. Gwe street, and,block number or descnptmn accord ~ g to deed duly sworn, dr!poses and says that he is the apphcant iS le ..~ .......... < ............... ;. . . . . · .~ ) ' ': ',,, ',.'c . (¢ ollll'actor~ a[Icll[~ colp0lalc' ol['icer, c . ,} , said owner or owners, and is duly authOrized to perform m bare lmrfmmed Ihd said wink .ami t~ makb.tmd fi~ plicalJon: Ibat all statements ~gnJaincd in lids application are, tree to Ibc best of tis k~3owledge and belief; and that the ,d: will be performed in the rental'er set forth in the application filed tbmewitb. " 'om to before me Ibis