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Home My WebLink About23309-zFORM TOWN OF $OUTHOLD BUILDING DEPARTMENT '[OWN HALt. $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N_o 23309 Z Permission Is hereby granted to: / , ~~.....~.~....., .................................. , ........ ............. ~~..~.~ ........ .../...~...~ ,o....~..~.........~ ........ ~../...~...~.~...~...~..~..,~-~ ..... .............. .... .~-_,~' //.~ __.../-.//~ ~ '"/- ._ .- ~ Counh/Tax Map No. 1000 Section ............. Block .............. ~.. ........ LotNo. ,..~...~.....~,.~.. ............ pursuant to application dated ...................... ~,,.~.../,~, 19....~.~ ........ and approved bythe Building inspector. Fee $....~....~...~ Rev. 6/30/80 Disapproved a/c ...................... - FORMNO. 1 3 SETS OF PLANS TOWN OFSOUTHOLD '...' SURVEY BUILDING DEPARTMENT CIIECK TOWN HALt. SEPTIC SOUTHOLD, N.Y. 11971 FORH llOTI FY; I'IA I L TO; (Buildino Inspector) ICATION FOR IJUI-LDING PERMIT,', .................. . 19 INSTRUCTIONS : a. This application must be completely filled in by typewriter or in ink and submitted to tile Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b, Plot plan showing 19cation of lot and of buildings on premises, rela/ionsh p to adjoining premises or public streets or areas, and giving a detailed description of layout of properly must be drawn on /l~e diagram which is part of this appli- cation. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Bt ilding Inspector w 1 issued a Building Permit to the applicant. Such ;ermit shall be kept on tim premises available f~r inspection thrm,~ghot t,,~l)~ ~ork. ,' ~,.,. , ~ll~ llav~ t)OgH grantee oy Hie Hullomg Inspector. APPLICATION IS ltH~HBY MADH to the Building Department' for the issuance o[ a Building Permit pursuant to the Building Zone Ordinance o[ the Town o[ Soutbbld, Soffolk County, New York, and otl!er applicable Laws, Ordinances or Regulations, for the construction of buildings, addit ohs or alterations or for removal ~[ dentolition, as herein dcscribbd. The applicant agrees to comply with all applicable law~, orOinances, ~nildin¢ code, housing code, and regnlations, and to (Mailing address of applicant) State whether applicant is owner, lessee, 'agent, architect, engineer, general 'contractor, electrician, plumber or builder. .......................... .' ................................... . ........................... (as on the tax roil or latest deed) I[ applicant is a corporatioq, signature of duly autbori~ed officer. : ,(Name and tit e of corporate officer) Builder's kiceuse No .......................... t PI nd)er s L cense No ......................... Electrician's License No ....................... Other Trade's License No... .................... Localion of land on whicb proposed work will be 'done. : .......'' · ........ ..... ........... I louse Number Street llamlet Cou'nty Tax Map No. 1000 ~ection ... ;.. ~.~ ....... Block ...... ~ ' Lot .... ~. Jy7 ...... Subdivision..; ..... . ............................ '. Filed Map No ......... Lot (Name) ..................... Slale existing use and occupancy of premises and iulended lisa and o~cupancy of proposed construction: a. Existing use and occupancy ........ ~e,~ ~' ~ .~ .~t g ~?~; ,l taP80~ h. Intended ose and occupancy ...'~¢~/~ ~ C~ . ~'~) sh~'ff"~ ,P~O;Y2?b,e~ Repair ......... Removal ............ . Demolition . ~..; ......... Other Work ~t~tcS¢~ : ..... (Description) 4. Estimated Cost ........................... Fee ...................................... (to be paid on filing this application) 5. ff dwelling, number et dwelling units ..... ~ .......... Nmhber 0f dwelling units on each floor . If garage, number of cars ....................................................................... 6. ff bus~ mss, commercml or roi.xed o.ccupancy, specify nature and exteut oLeach type o~ use .................... 7 Di nsionsofexisti~gstmctu if ny: F t R D pth lleight Numbdr of Stories Dimensions of sa ne structure wtth alterahons or addgmns, Front ................. Rear ................. Depth lleight ' Nmnber of Stories ' ' 8 Dinensi of nti stn 'rio Fr t R D pti . ~ ohs e reuewco, m n: on .............. : ear ............... e ~ ............... Height Numb~r of Stories Date of Purchase ..... + . .' ...... amc o onner Owner .. a~oa Zone or use district in which preniises are situated ...................................................... Does proposed construction vie aide any zoning law. ordinance or regulatmn: Will lot be regraded ....... ~ ~ ................. Will excess fill be removed from prmmses Yes ' . ~rr~r~em,[ Phone No Name of Architect ................... Address .................................... Name of Contractor Address ' Phone No tS. I,s kbts property w~thin 300 feet of a t~dal wetland7 *Yes ........ ~o.~ ..... *If yes, Soutbold T6wn Trustees Permit may be required. " PLOT DIAGR~ Locate clearly and distinctly all Buildings, whether qxlsting or proposed, and, indicate all set-back dimensions from property lines. Give street and block nhmber or description according to deed, and show street names and indicate whether interior or corner lot. 10. 11. 12. 13. ULLOWING INSPECTIONS: 1, FOUNDATION . ~O REQUIRED FOR POURED CONCRETE 2. ~0[~,~ * FRAMING & PLUMBING ' '~',~, ;' ..... 8~ COM~LET~ FOR C.O. ALL CONSTRUCTION SHALL MEET THE REOUIREMENTS OF THE N,~ STATE CONSTRUCTION & ENERGy CODES. NOT RESPONSIBLE FOR OESIG~ OR CONSTRUC~ON ERRORS STATE OF ~EW YORK. coum'Y OF ..... ,4 . ~.,q',,'/',='o,~.4~ ./'L/..4t .,%(.A:) ~(~. ,¢~. being duly sworn, deposes and says that he is tile applicant (Name of iudividual sigt)ing contrac0 above named. ~ .. lie is the .., ............... ~. ~. , ~: ~Costractor, agept, corl~orate officer, cie.) of smd mvner or owners and is dqly a?tlmrized ~o, pprform or ha~e ~?[~med tim said work and t~ n)~ke a ~d file this applicafion; tlmt all statemehts c0)~t;ahmd in this'al;plidat on'arff (rub t6>th6 best of Ids knowledge and belief; auc that the work will be pmfo~ned io the man 1]er set fort t in the applicafiou filed therewith. Sworo to before tne this/'~""'3 .............. N~A~YPUBUC, S~eo~ m.~. . ~.. ' (S~gnature et appncant) Term Expires May 31, ~ ~ ~ ~ GU~ FOR X~ $AN~RD:~NAUER, & ~E B. ~NAUER ~w~ AT MATTITUCK ' ~WN ~ ~UT~ SUFFO~ ~OUNTY, NEW ~K .... ,,, -'I~JYOUNG YOUNG STAKE ~D~ W,~NG, PR~FE~ION~L E~GIN~gR HOWARD ~YOUNG, ~ND SURVEYOR