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Home My WebLink About23327-zFORM TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y, N~ 23327 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted tc~ .. ~ . ...... ~.~...a..~,..~.. ................................ ........... ~~ ....... ~ .......... CountyTax Map No. 1000 Section ........ lZ...~.. ..... Block ......... ~ ............ Lot No ..... L..~.. ................. pursuant to appllcatlon dated ............... ~..~.../......~... ..... 19.~ ....... and approved bythe Building Inspector. Rev. 6/30/80 FEE: ~. ~ BY: N~ GUI~ING OEI 76S-1~2 9 AM ~ 1. FOUNOA~N . ~R ~URED ( ~ ROUGH . 3. INSU~HON 4. FIN~ 6E ~MP~ FOR ~E R~UIR~E~ ~D~ N~ DESIGN ( YOUNG & YOUNG JOSEPH O. MUNZ TED · ~".~ MfiNT MEE THE N. ENERG FO 'l ONhOA ~' ON/lOX ~OUt43 N DU3N:J ~ 'N 3J I0 N~DIS~iQ .tON ¢Ol.[Ofltl/SNO3 ~.Y18 NOUDi'~t~ISN03 "nv ) UO'13J-qldl~'lOD 38 I~J.$NOO ' ']VNIJ NOU. Vq~ISNI DNOD 03UflOd J ' NOLLVONflO~I '1, )llO3d~NI t, 0.1 ~IV 8 ~08t'ggz 30 ONJ(TIJR8 AdLLON BUILDING DEPARTMENT.. TOWN IIALL SOU'FHOLD, N.Y. 11971 TEL.: 705-1802 Examined . . 9 Disapp~ oved a/c ................... ' BOAI~.I) OF IIE^I. TII ....... 3 SETS OF PLA?tS ....... SURVEY ................ CIIECK ................. SEPTIC F Oltll ........... CALl HAIl, TO: l)ate ................... 19. INSTRUCTIONS a. This application must be completely filled in by lypewriler or in ink and submitted to the Building lnspeelor, will sets of plans, accurate plot plan to scale, Fee according {o schedule. b. Pict plan showing location of lot and of buildings on premises, relationship to adjoining premises or public st're or a~eas, and giving a detailed description of layout of properly must be drawn on the diagram which is part of this apl cation. c. The wink covered by this application may not be commenced before issuance of Building Permit. d. Ill)On approval of this applkmlion, the Building Inspector will issued a Buikling Permit to the applicant. S mh penq shall be kept on fire p~emises available for inspedion throughout the work. e. No buikling shall be occupied or used in whole or in pad for any purpose whatever until a Certificate of Occupan shall have been granled by the Buihling Inspector. APPLICATION IS IIEREBY MADE to the Building Department for the issuance of a Buikling Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for. the construction of buildings additions or alterations, or for removal ~demo~tion, as ere ~ escr bt The applicant agrees ~o comply with all ap ~licable laws ordinances,~di/g cot e, ~o~ng c~le and ~egua o s d ............ ... ..... . (N. giling address of applicn,lt~ Slate wile{her al>plicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plunlber or builde If applicant is a corporation, sfgnature of dtdy authorized officer. (Name and title of corporate officer) Builder's License No .......................... Phunbe~'s 1.,icense No ......................... I£!ecldcian's License No ....................... Other Trade's IJcense No. l louse Number Sh'eet llamld (Name) : ........ 2. :lale exislhq~ use and occupancy of p~emises and inlended use and occupancy of proposed cons[~uclkm: 3. Ni~lurc of work (check which applicable): New Buihling .......... Addition Repair .............. Removal .............. Demolition ........ ,t. Eslimated Cost.~..(,4 ................................. Fee ........ (to .......... Alteration .... ..... Olher Work .~--.~l,/~. ~.~'/1~,~. (l)escriplion) paid on filing this applicaHon) 5. If dwelling, number of dwelling units ....... .~. Nmnl~er o£ dwelling t nits on each floor ................ If garage, nulllJ)er o[' cars ....... , ' 6. lJ'business, commercial or mixer occupancy, specify natureamlextentofeach ypeofuse 7. Dimensions of exisling sm~ctures, ir any: Front ............... Rear .............. Depth ............. I leighl ............... Nmn bm' or Stories .... ' . ~ Dimensioas of shine slruclm'e with alteralions or addilions: Front ...... ; .............................. )~ , ................ Rear ......... [ ~pth ................. leight ....... ' ......... '..Nu,nber~fStoHes ............. ~j~j~ 8. ) mensmns of entire new cpnstruction: Front ............... Rear . ..... ~ ......... Depth ....... l leigbt ................ Number of Stories , 9. s~ or ~o,: ~',-o,. ..... g~ ~ ....... ... '~'~; ~ ~25~0~ ( ......... ' ' '~' '/~;h;' '. ~ ~4~'. ~ ~; ~ ~ ~: '. ...... 10. Date of Purchase ............................. Na~o ofl~rn}er C)w~er . ...... ~: ....... I 1. Zone or use dJslrict in which )remJses are situated ..... ~.~1~ .~ . 12. Does proposed constructio~ v~ to any zonim~ law ordi-~--~.- ~ ...... ~,,,;~. ' 'J.~] ........................... 13, Will ot )e regr t er /~ .... · ' ~ ............................. ~ .... ' ..../ rM '; ' '7; ~' ',~ ....... wm excess ~tl[ bq re~lloyed frt)m p 'e nses Yes No Name of ?cbilect ........... / ............... Address ................ Phone No ......... -' . -' I I * 'Y . -n4. n .~uu reer or a Eldal wetland? xYes J~-. No ~i[ yes~ SouEbold Town Trustees PermJE may be ratlu[redY .... ' ........ P1.O'F DIAGRAM ~ Locate clearly and distinctly all buildblgs, whether existin~ or proposed, and.~ndicate all set-back dimenskms fi'om property lines. Give street and block number or description according Io deed, and shbw street names and indicate whet'her inlerJor or corner lot. S'I'ATE OF NEW YORK, X')I)NTY ~ .......................... being duiy sworn, deploses and says Ibal he is the applicanl ~~dLIM si~ning conh'acl) ,1' said owner or owners, ~nd is duly authorized lo perform or have performed lbo Sal~ work and to make and I'Jl~ lifts pplJcalion; lhaI all sIatcments contained /o~k will be performed in lhe rllamler sol forth in lira applJcalion l'ilml lhm'ewJlb. ' ' wo{ml to I)efore llle this _ ~78~ (~gnalllre ol applicant)