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Home My WebLink About24555-zFORM NO.$ TOWN OF SOUTI'IOLD BUILDING DEPARTMENT TOWN ~ $OUTHOLD, N.Y. 24555 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission IS hereby granted to: ALISON ROSS 11 RIVERSIDE DRIVE NEW' YORK~NY 10023 to ERECT A FENCE AS APPLIED FOR IN REAR YARD. SEE ATTACHED SURVEY. at ~r~m~ ~,~,~1 ~t 2840 GREAT PECONIC BAY BLVD LAUREL CountyTaxMap No ...... ~.~..3.~.~.~..... Section ....~.~ ............ Block ..... O. gg.~ ........ Lot No....0.~.~ ............... pursuant to application dated.... ~.O,~.~,~,~...E..~..,....~ ........... . ............. 19 ...... .~ ..... and approved by the Building Inspector. ........ .... Rev, 6/30/80 i BGG POI SIG-298-SB41 *BTTITI_CI' FIRE DIST FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 ,8£DG. DEPT. - TEL.: 765-1803 Examined L k;~__..T~I~OFSOUTHOI~*'~ Appro,,e . ,, ?;;erm,t No. Disapproved a/c .................................... Bb,\RD OF tlEALTII 3 SETS OF PLAHS ........ SURVEY ................. CIICCK .............. CALL ....... flAIL TO: ' APPLICATION FOR BUILDING'PERMIT INS'rRU(~TIONS a, This application must be completely filled in by typewriter or in ink aud submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule, b. Plot plan showing location of lot and of buildhlgs on premises, relationship to adjoining premises or public sti'eet' or areas, and giving a detailed descripfion of layout of property remit be drawn ou the diagram which is part of this appli cation. c. The wolk covered by this application may not be commenced before~ issuance of Building Permit. d. Upon approval of th's ap >1 cation, tile Building Inspector will i~sued a Building Permit to the applicant. Such permi~ shall be kept on the premises available for inspection throughout tile work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan% shall have been granted I.)y the Building Inspector. APPLICATION IS HEREBY },'lADE to tile Building Department for tile issuance of a Building Permit pursuant to ibc Building Zone Ordinance of tile Town of $outh01d, Suffolk County, New York, and other applicable Laws, Ordinaoces 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, bnilding code, housing code, and regulations, and to admit aulborJzcd inspectors on preluises and.in b~ilding for necessary~ . . . ' - - . '~' '~7 'xff' '~4' ' '~:'-'~' ' (Sig a~r9 of applicant, or na~ne, if a corpo'ration) ' ' ' . (Mailing address of applicant) ~ arch tect, en ineer enerai'contractor e~p~jj0~j[jj~Ij J~lJ'r[J} . State wheth~.r applicant is owner, lessee, agent, g , g , (as on tim tax roll or latestl~ II~lW~llO~: If applicaut isa corporatiou, signature of duly authorized officer.' '1 : (Name and title of corporate officer) Builder's License No.../2.2.. 7.~. 7.d./ ............ Plumber's License No ......................... Electriciah's License No ............... '7. ..... Other Trade's License No ...................... 2. ~ ? ~ & PI/III~ING $. INSUIJiIION ,, 4. FINAL - CONS?RUCTIOI~ ]Must BE COMPLETE FOR C,O. , ALL CONSTRUCTION SHA~ MEET THE REQUIREMENTS OF ~ ,N,Y. STATE CONSTRUCTION ~'E~RGY .CODES· NOT RESpON~OR DESIGN OR CONSTRUCTI~ ~Rb~S Location of hmcl on which proposed work will be 'done ..................... i I louse Nuluber Street llamlet 7,. e,. ' {o . Courtly Tax Map No. 1000 Secfiou , ';. Block " , .... Lot... I .... Subdivision ' Filed Map No Lot (Name) Stale exJslillg ose and occupaucy of premises and inleuded use and occupaucy of proposed constetlclioll: a. Existing use and occupancy ..... I~,,.~..{ ~.%.0,<..,~., , b. Intended use ami occupancy ....... ~.~,,~{~' ...... .. 3. Nature of work (check which aPPbcabh/: New BuiJdbtg Repair .............. Removal 4. Estimated Cost ...... ~.~/.~...~; . 5, If dwelling, number of dwelling ~mits AddH~,on,.. ,... .... Alteration .,. * ........ Demolition ..... : '.';, ......Other Work ,~..~"9~. ...... , (Duscr phc.) ............. . Number of dweJ]ln :~l~-~eh JJoor.. · if garage, number of cars ..... i .......... 6 If busin.~ss i I or mixed o cut .......................................................... . , COlllnlerc a . c )altcy, s )cc fy llatur~ alld extetlt or.each type of use .............. 7 Di .smnsofexlsting tmclur ~ lEnity:Vt t '" · Ille S e , on ............... Rear .............. Del)th ........ Ileighl Nullllber or,Stories ' ' ' ' Dilllellsiglls of S~lllte stl~-tcture W I aJteratloll$ or a I[lOnS: Frollt ................. Rear ............... Depth .... ' Height ........... . ......... ,., Number of Stories ................. 8, Dnnenslons Of elltlre flew co StFUCtlOII' Frollt " -- ' ' llelgltt ............... Number of Sro 'les .................. · . te o/Purch,ase, .: .... . .....t ........ ' ......... Nc,ne of Fort mr Owner .../'. ....................... I 1. Lone or use disl.ct m wi)ich ,prel, nises are situated, ~,,:, ,' .......... ~ .......................... ~ ..... 12. Does proposed constroc[lOlt violate ally zolfing law ordl la ~ce or re-u al. .... 13. Wdl lot be tegraded ,. ~et~.. ,, .... ' ' Nalne of Architi~ct . . ' .... , .....~..~j ...... ~, Address ................... Phone No ................ tS.' I.s this property within39o£eet of a tidal 'wetland? *Yes ........ No ......... · If yes,'Southold Town Trustees Permit may. be required. ' PLOT DIAG IL~dM Locate clearly dud disti.ctly all 6u'ldmli's, ~heth'er existing or Proposed, mid, Indicate all set-back dimensions from property Hnes. Give street and block nbmber o~r description accordb~g to deed, and show street hanes and indicate whether "' IHt :)0 /',F~:~,',A ~}I~{~TL~ ,';~ 1Al ~ ' '~ TM '~ "' ~ ~ .......... (Naula o~ individual sjBIljn~con~rac[) ~OVO Ilallled. J .... being duly sworn, deposes and says that I e Is the apl)licant Is tile.. ............... .~ .. . ~ ' gent cor'ltora't~ ....... filter etcA .......... , i , · said owner or ownels, and is duly aUt~orm or have performed Ihe mild work ami Io make, d fde II.s I cation; Ihat all S[{llylllelltS co.{ai.e~ Jn this applicalton are true to Ihe best of his knowledge and belief; and that the nt: will be performed u, Ihe man,er se[forlh hi tim a,pplicatlon filed therewith. ' ,'om lo before me this, ~ ~ .......... day o ..... ~ 19 ..... : ....... .............