HomeMy WebLinkAbout23208-zFORM NO.3
TO1NN OF SOUTHOLD
BUILDING DEPARTMENI'
TOWN HA~L
SOUTHOLD, N.Y.
N? 23208 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date JA~. 3, 19...9..6. .....
Permi~lonis hereby granted to:
.... ~..~:~. ...........................................................
.... ~.~.~?..~.,~ ..............................................
~ttituck, N.Y. 11952
~....~.~!9~.~K..~..~...S~.~..~,./~It,~CCZSSO~.~S..A~.~ ..................
at premises located at ......... .S...2..5...~.E. ~....G..O.. ,M~....p.~.., ............. ~,.T~.1[.q~.C~,..~,~ .........................................
CountyTax Map No. 1000 Section ......... ],,I.} .......... Block ....... ].~. ............... LotNo ...... .QS ..................
pursuant to application dated ...... ...J~...,.[...1.?.., ................................... 19....9x~. ....... and approved bythe
(REPLACES BP i[21568Z)
Building Inspector,
Fees ........ ~.~gg .......
Rev. 6/30/80
FORM NO.$
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
No
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date ................... 2./...~..~.. ............................
21568 Z
/
Permission Is hereby granted to:
...... %~~.....~.~'_~¢ .........................
....... ~.~. ....... ~.....~.~....~.: .......
............... ~ .,CZT...~....~,~.... ./.,¢.f..-~7. .~... .......
.... /%..S. ........ .8~ ........ ~...c..~.~.._s...,[.¢..~/ ........ .~..-T.. ....... ~../¢~<./..¢/J.....~,~¢~ ....................
at premises located at O"-"2 ~'- ..~..~.,~......~,.2..E.~... -/---)~', . .............
.............................................. z~...m......~..~.~..... ~/.:.,. .......... .././.Y.~ ............................
CountfTaxMap No. 1000 Section,,,,.,?l, .~., ........ Block/,~,,,z~',.~,. ........... Lot No ..... ..~..~ .............
pursuant to application dated ............. ~./.. ,/...~... .............................. 19,....~.,~......, and approved bythe
Building Inspector.
Fee $. ,J...~.'..~ .........
Rev, 6/30/80
wOUNDATION ( ] st)
~UNDATION {2nd)
~UGH FRAHE &
·PLUMBING
~SULATION PER N.
STATE E~ERGY
CODE
FI:;AL
~DDITIONA'L COMMENTS.'
Town Hall, 53095 Main Road
P. O. Box 1179
Southold, New York 11971
Fax (516) 765-1823
Telephone (516) 765-1802
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
December 14, 1995
Mr. Thomas Flurry Jr.
525 Deep Hole Drive
Mattituck, NY 11952
Re: Building Permit #21568-Z
Premises: 525 Deep Hole Drive, Mattituck
Suff. Co. Tax Map #1000-115-13-5
During a review of our files it was noted that the above
building permit has expired, and a Certificate of Occupancy has
never been issued.
According to the Code of the Town of Southold, Article
XXVIII 100-284, it is unlawful to occupy or use a structure
until a Certificate of Occupancy has been issued.
Please contact this office as soon as possible so that we
may clear up this matter.
Thank you for your cooperation in this matter.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
765-1802
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[ ] F,REPLACE & CHIMNEY ~
DATE
FORM NO, 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N,Y. 11971
TEL.: 765-180:~
BOARD OF HEALTH .......
3 SETS OF PLANS .......
SURVEY ................
CI1ECK .................
SEPTIC FORH ...........
CALL ' · . ·
HAlL TO:
Approved ..... 19~.-~. Permit No.........../'~'~ '
Disapproved. a/c ' .'.
· . ' ' ,' .....
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
!
a. This application must be completely filled ha by typewriter or in ink and submitted to the Building Inspector, witl
, sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of bfiildings on premises, relationship to adjoining premises or public sti'e[
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this apl
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 will issued a Building Permit to the apphcant. Such pern
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 purpose whatever until a Certificate' of Occupan
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bu/Iding Permit pumuant 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 or demolition, as herein describe_
The applicant agrees to comply with ail applicable laws, ordinances, building code, housing ,o~de,~.nd regulations, and
admit authorized inspectors on premises and in building for necessa,~i~ections. /D
· ........ ...:
-- (Signature of applicant, bt.name, if/'fl~r, poration)
g'i~;lalling address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, generaJ contractor, electrician, plumber or builde
.o..~..0..e..~. ......... ~ ........ ' .................... '...o~: ....... . .................... . . ......
Name of owner o f premises-~.. ~ ¢~...~J..~.~.... ' .~ .... ..........
(as on ~$ #0TE~
If applicant is a corporation] signature of duly authorized officer.
U / ,peuov AS
(Name and title of corporate officer) ~A{'E: B.P,# 4 PM FOR 'HIE
Bui d r Lic nse No .............. /.'I..NOTI. F.Y. BUILDING DE TWOREQUIREO
, ~ /'J~L 765.1802 9 AM TO t~ PM FOR
P]Qmber s L~cense No ....... ~...t .w.../.fl.. F. OLLQVVING INSPECTIONS: CRETE
& PLUMI~ING
ROUGH -
t'l/ I ~t} I FOUNDATION , TWO REQUIRI%
Electrician's License No. [.V., //fi- FOR POURED CONCRETE ,,, ~UL~ ~ur~
.................... FINAL - ( MUST
-/ t ,. 2. ROUGH - FRAMING & PLUMBII~
............../V .~. a. ,.su~o. ~e ME~r
' k CONSTRUCTION
4,"F'ffqAL - CONSTRUCTION MU~I~EE COMPLETE FOR THE N.Y,
Other Trade's License No
· . . COMPLETE FOR C,O.
I. Location of land on w,hich prol~osed work wdl~hq~E~,,rm~,, ~a*r,- L. ~r'NBRGY.
<"Q.~_'I3~F,~ ./.L, IF--~ THE REQUIREMENTS OF' ;OR
'-d.'Y. :.. %2~. YYc.[IJ..1.J.~..M .............. STATE · CONSTRUCTION. &- ERRORS
itouse Nmnber f
· S(;I}B~Es. NOT RESPONSIBLE FO~amlet
· ' t ~'~/~~¢'~°" CONSTRqC~CM~~~
County Tax Map No. 1000 Section ~. ,,~., ..... ~ ..... Block ~?. Lot ..................
Subdivision ........ . .............................. Filed Map No ............... Lot ..............
(Name) .
2: Stat~ existiug use and occupancy~ses and intended use and occupancy of proposed construction':
a Existing use and'occupancy '~P~P ~'~''~7' '
· '"L .... rS ZT-i4_ ....... ...........
b. 'n,ended use and occupancy .................... ...... ............
· 3.Nature of work (check which applica le): New Buildi dition . .' ........ Alteration ......
Repair ........ Removal .............. Demolition .... ; ......... Other Work
f O O ~ ' - (Descriptim
4. Estimated Cost ... l~ ..... -..: ...... ' .................. Fee ................
5. If dwelling, number of dwelling units .~/.//~r- (,o be paid on filing thi~pt~ation)
.............. Number of dwelling units on each floor.. ~ ( Y .......
If garage, namber of c~ .............................................................. ~ ..... .
S. 'If business, commercial or mixed occupancy,specify natgr~and extent of.each type~f use ......
7. Dimensions o[ ~i~i~g structures, if any: Front...~./~ ..... Rear ... ~ .... Depth ..... ~..
Height .... ~./.~.... Number ofStohes.. ~./~ ............ ' .a ..................... ~ .....
. Dimensions or ~hm~cture with altera~%ns ~adgi~dns: Front ... ~{/f~ .... .. Rear .,./~fff~ ....
Depth .... '~. ~.~ .......... HeiSt ...... ~: ........... Number ~f Stones .... ~'~' ~ ' I ....
~. Dimension~f~n~r~hew construction: Front.../ ...... ~...; Rear .. ~0 .......... Depth . .~;~ .....
Height .~ ' ~ ~umber of Stohes ~ ~ -
9. Sizeoflot:t~ront ...]P.Q .............. ge~ .... [iX 4 qii..iiii[['b ;i [L[ ~.i[ii[ii;
10. Date of Purchase ........ ~./~ ............. Name of Foyer Owner ~/~ ......
1 1. Zone or use district in which premises are situated ..................................................
12. Does proposed construction viola¢~ny zoning law, ordinance or regulation: .............................
13. W~I lot be regraded ...... ~ .... -~r.. ~-....~ill exc~ll~ removod ~ premises: __
14. N~e ofOwnerofpremise~/~..~Addre~ ~-~a~ Phone No ~~/O/·
Nme of Archatect ..... ~(/.~ ............... Address ................... Phone No ..............
N~e of Contractor .... ~ ............... Address ............ . ...... Phone No ............ '.
15. Is this property ~ith~n 300 feet of a tidal wetland~ eYes..~'~... No ..~ ..
~If yes, Soughold Town Trustees Pe~it may be required.
PLOT DIAG~
Locate cleaHy ~d dist~ctly ~] build~gs, whether existing or proposed, ~d~indicate ~I set-back d~ensions fr.
prope~y ~nes. Give street ~d block number or desc~p~on accord~g to deed, and show street nme~ and indicate wheti
£
....... USE IS UNLAWFUL
W!!TF; OUT CERTIFICATE
'0F OCCUPANCY
STAT~ OP N~W ¥O~¢,~ / ~ . S
co. Y -- ·
....... 39. w.. ............ · .........
(Namt or individual si~nin~ contract)
above named,
/0 ' --- "';>
sworn, deposes and says that he is the applic:
He is the.i ..~ ............. ..;.,.' ..... it. ............................ · ............
· (Cohtra~tOr, agenl~ cor'porate officer, etc.)
of said owner or owners, and is duly authq.r~d to pervorm or havg performed the said work and to make and file
application; that all statements contained :in ~t}is appli~atj0n are true to the best of his knowledge and belief; and that
work will be performed in the manner set forth in the application filed therewith.
Sworn to before me~ ~, /7
.., .........
Notary Public~/,-~.'..~'~--..~..~. · County
Notary PubliC,No. 4879505State of New Yo~ ~ J',. .' ,' ...........
Qualified in Suffolk Coullty ~[/~
Commission Expires December 8, 192..\ '