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Home My WebLink About23671-z FORM NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERAAIT MUST BE KEPT ON THE PREMISES UNTIL FULL COJ~PLETION OF THE WORK AUTHORIZED) N.° 23671 Z Permission is hereby gr?nted,~o: / /' ' /~/,~ ~ ~ / / ~....~ ...i~...~.~z~ ........................ - - ...~~~..~,_~...,...zc~ , ro . ~ ~ ~* ~...' ' ~' ~--.-.~..-.z~....-~~~_~ .......... ~.~...... ................................. .................................. ~un~ Tox ~o~ ~o. I000 ~ction ..... ~ ....... Bilk ......... .~ ......... ~t Uo ........ Zd .......... pumuant to ~pplic~tion dot~ ....~ ..................................... , 19~ ~nd oppr~ ~ ~ Building Insp~tor, Fee $..~~ ~~~ ................. Rev. 6/30/80 FORM /~/0. 1 TOWN OF SOUTtlOI. D BUILDING DEPARTMENT TOWN tlALL SOUTIIOLD, N.Y. 11971 Disapproved a/c . .. ' · (I~'fihling~r~sp e c to r ) APPLICA'I'ION FOR BUILDING PERMIT B~ARD OF IIEALTI! 3 SETS OF PLAITS SURVEY CIIECK ................ SEPTIC FORH CALL HA~L TO: INSTRUCTIONS a. Tiffs apI~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wi ~,ets of plans, accurate plot plan to scale. Fee nccording to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this al cation. ¢. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any pnrpose whatever until a Certificate of Occupa shall have been granted by the Building Inspector· APPLICATION IS ItEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinance Regulations, for t~se construction of.buildings, additions or alterations, or for ret/royal or demolition, as herein descril: Tho applicant agr,:es to comply with all applicable laws, ordinances, building ¢~/c~ housin~code, and regulations, and admit authorized inspectors on premises and in building for necessary ir~pection~'~.K ..----~,~, ~,¢ ~ i~ ~... -- / Lh ~ ' State whether applicant is owner, le~ect,~ engineer, fenerai contractor, electrician, plumber, or build (as on the tax roll or latest deed) · ; 1. mea~jl t/tleofcorporatelEfficer) B dder s Lmense No .......................... Plumber's License No. Electric'an s License No. Other Trade's License No ...................... Location of land on ~vlffch proposed work will bc clone .............................. ltousc Number Street llam:ef County Tax MapNo. 1000 Section ~..:...~ ........ Block ..... ( .... :.) /~ ...... State cxisling USC and occupan~ ofpremiscs and intendud Usc and occu, ,. , ~ ;. 3ogiruCtJcn: ,' ,. :'i~in" Seandoccu :nc ~ ~ . X .' .3. Nature of work (check which applicable): New Repair ....... : ...... Removal EstimatedCo,t. ' '~ /~'~--~ ......................... ~. ........... Fcc .... .......... Alteration ........ O t h '.:' r Work c~..~., gr~ (Dcscrip i EEo he ' I o.. qicatim 5. IF dwelling, number of dwelling units ~ Nmnl)cr of dwelling tm,,, ~,,, c.tch lluor . .. If garage, nmn bet of cars ............................................................... 6. If business, comnlercial or mixed occupa~icg, specify nature and extent of each type of rise ............... 7, Dhnensions of existing structures, if any: Front ............... Rear .............. Depth lteight ............... Nmnbcr of Sto6es .... Dimensions of shine stmchu e with alterations or additions: Front ................. Rear ............. Depth ' ...................... Ilcight ................... ,.. Number of Stories ......... '.. 2.. 8. Dimensions of entire new constmctkm: Front ............... Rear ............... Depth ....... tleigbt ............... Nmnber of Stories ' 9. Size oflot: Front ................... 2.. Rear 10. Date of Purchase ..................... I)eptb ................. ........................... .. Name of Finn er Owner ....................... I 1. Zone or use district in which premises are situated..~ .... .; ............................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ... ~.0 ................... 13..~¥ill lot ~regraded ...... ~ ...,.~ ......... ~:~.. Will excess fill be removed from premises:~ Yes IWflllle Ol~Xrc l tect ' Address 15.' I~ this property within 300 feet of a tidal wetland? *v~= - ~,l~ , 'r ''' . If yes, Southold Town Trustee~ termit may be required. ' ~ , PLOT DIAGI~M ' " " Locate clearly and dis'tinctly ~1 buildings,'x4hetb'er exisCng or. proposed., a~d.'indicate all set-back d~ensio6s .,.,perry Hnes. Give street.~d.block number or desc~ption according to deed, afl'al'show street names and indicate '" 'or or corner Io~?' ' p~Cu.h. . APPROVED AS'NOTED DATE:~B R, ~ 765-1802 9 AM ~ 4 PM FOR THE ' 1. FOUNDATION ' ' ~O REQUIRED FOR P~RED CONCRETE 2. ROUGH, FRAMING & PLUMBING 3. tNSU~TION 4, FINAL CONSTRU~IoN MUST BE COMPLE~ FOR C,O. , ALL CO N STRU C'I3~j~_MEj[y~ ATE CONSTRUCTION & 'ENERGY ,, ....... .... ............. coo...o (Name ~'~ in '~wid ual signing cont,act) zisthe ..'~ ....... . ...... ~ ........................ · , (Conttaclo,~, ,qtlen LI, c)(nl)oratc, of hoer, etc.) ',, sa~d owner or oxvners, and is duly authozized to per--have performed lbe sa;,I work ami [0 make and fild plication: H~at all statements [~qlaincd in lhis application are. hue lo thc best of his knowledge and belief; and that nk will be performed in the manner set forth in the application filed therewith. 'om to before me this ....... ~ ...... :,y o~. :..'./~.%h.. h.., l 9 .% .' I I % ...... ...... ....;:.': ........... .' ~mi~n ~ires u~m~r 8, 19 ~ . f, ppI~ca~