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Home My WebLink About22667-zFORM NO.$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 22G67 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZEDI Permission Is hereby granted to'., pursuant ,o application doted ......... ~,~,...~... ~....,..~..;../'.. ....... 19.....9 ..~..., and approved by the Building inspector, hoe ~,,,.~, ................... Rev. 6/30/80 Note! A II posts alld decorative caps shown in this entite catalog ate fi;r illustration only. You may choose a zy ~tyle post or cap that suits your need~. ( Pos~, caps, and pa e s all sold sr7~arately, j #711 NEBRASKA #706 KENTUCKY # 718 VERMONT 0719 NEW HAMPSHIRE #705 TENNESSEE # 726 MINNESOTA #724 MISSOURI TAPERED I'ANEL S. 4 HARBOR LANE ?.26 48.63' 7.,~. N. ~5° 53'10 "W. LAND Prepared in accordance with the '~minimum standards for title surveys as establi~b0d by the LI.A.L.S, and approved and adopted for 6uch use by The New York ,State Land ~itle Association. OF FOGARTY I;55. OO'. oo N. ~4° 18'50"W. LAND BLDG, DEPT, 1'OWN OF SOUTHOLD TEL,: 765-1802 Exanlined .... ...~/Zf~,. ...... , 19 ..5~ ' ' Approved.'. .... ...... ,192.;YPe/-mit Disapproved a/c ............................. . BOARD FORM NO. I 3 SETS TOWN OF SOUTHOLD SURVEY BU!LD1NO DEPARTM [-NT: ClIECK TOWN HALL S E P'T'I C SOUTHOLD, N.Y. 1197~ (Bsrfl'~ 'I~pJJtor) ........ APPLICATION FOR BUILDING'PERMIT INSTRU6TIONS OF HEALTH ........ O?~,~'P L A h' ~q ........ FOR}I ............ HAIL TO: * a. ' This apl~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sits of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of Buildings on premises, relationship to adjoining premises or public sti'eet or areas, and giving a detailed descriptioh of layout of property muJt be drawn on the diagram which is part of this appL cation. · c. ' The work covered by th.is 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 perm/ 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 Occupanc- shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Departmer~t for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southbld, .Suffolk County, New York, an:d other applicable Laws, Ordinances o 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, building code, hoffsing code, and regulations, and t( admit authorized inspectors on premises and in building for necessary inspections. /,4 . ·. .~--"- -- ' ..... .... ~ .......... -" '-'~,'~- ......... ;" ;'~.t · · · · . (S~g~tur9 of app'licanr,'or B~ffie','if"a corpori/ib~! (Mmhng address'oW ~tpphcan0 State whether applicant ~s owner, lessee, 'agent, architect, engineer, ....... general contractor' M~t'r,i~!31q,~Dlu/nb~'~;orlbu'ilder Name of owner ofprer~ises '.~.///~q~ ~../'~'gt,-~ ~o~,T~--~t- (as on the tax roil or latest deed).' If applicant is a corporation, signature of alu ly authoriied officer.' ~' ' ' . '(Name a~d title of corporate officer) Budder s Ltcense No ........................ Plumber's License No ........................ Electrician's License No aJ,¢ " Other Trade's License No .................... I. Location of land on which proposed work will be done ................................ House Number Street Hamlet cou ,,y fa× Map No. f000 Section .... B ock . .47..6 ....... ' · Zot.. . 25.: .... Subdivision ·, · ~ Fil ........ . .......................... '. ed Map No. Lot .............. (Name) ............... 2: Stat~ ex/sting use and occupancy of prePnises and intended use and occupancy of proposed construction: Ex sting Use and'0ccupancy " · ",' ,, -' · ......... . ..... 3 N of k (ch k h' h!ppi' bi ) N B ildi ' ,~,dditi Alt tion · . ature wor ec w.lC ,a ICa e : ew u ng ........ , on .......... era .... ; .... Repair .............. Removal ............ Demolition ..... ; Other Work .~.~.."~g¢..~.'-. ' .... (Description) 4. Estimated Cost .......... .--w. ' Fee (to be paid on filing this application) 5. If dwelling, number of dwelli~g units'. .............. Number 0f dwelling units on each floor .............. If garage number o f cars ~ '. 6. If busxness, commercial or roi.xed occupancy, specify nature and extent of.each type of use.. i~/i 7. Dimensions of existing structulres,if any: Front Rear Depth Height ............... ~qmber of Stories ....................................................... Dimensions of shine structur~ with alterations or additions: Front .......... Rear ....... ep[h ................... i '" Hexght ........... . ........ ?.. ~ Number of Stories .......... '. 2 .~ ...... 8. Dimensions of entire new construction Front . · · ~ ........ ~ Rear ........... Depth ....... j. . ' .Height ...~ ........... Number of Stories...' ................ i . : .. .... 9, Sxzeoflot, Front ......... ~ ............. Rear .......... ;.'... ~-, ~ m~ut~,auu ....... '.. ~ .......... ' ........ '. Name of Former Owner .......................... 11. Zone or use district in which p~'emises are situated .... . .......... ' ............................... i ~..' .... .12. Does proposed construction viglate any zoning law, ord~nar~ce or regulation: ..... ..... ........... ] .............. 13. Will 16t be regr~ided ........................... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises Address ' Phone No Name of Architect Address Phone No Name of Contractor ....... ~ .................. Address .......... ;... Phone No.. '- 15.' I.s this property withinl. 300 feet of a tidal 'wetland? ~Yes ........ No ......... · .If yes,'SoutholdiT, ow9 Trusgees Permit may. be required. '". ! PLOT. DIAGRAM. . : Locate clearly and distinctly ~I buildings, ~heth~r existing or proposed, and. indicate all set-hack dimensions from property lines. Give street and bloc~ number or description according to deed, and show street names and indicate Whether interior or corner lot. ~IB'~IF~, BUILDING DEPAR'I%/IENT .AT 7664802 B AM TO ~ PM FOR THE FOR POURED CONCR~ ~ ~ 2. ROUGH * FRAMING & PLUM,BI~G -- BE COMPLETE FOR C.O. AIr CONSTRUCTION 8HALL M~ET THE REOUIREMENTS OF THE ,N.Y. ,~TATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FO_R '.SmN OR CO STRUCnON ERRORS (Name of individual slgnlpg contract) above named. . :Ie is the ~ (Contractor agent 'porate Officer otc ) ' )f said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and file this ~pplication; that all statements contained in this'application are t'rue to the best of his knowledge and belief; and that the ~ork will' be pe~'fprmed in the mannerlset forth in ,the application flied therewith. ' iwom to before me this ., 0uslified in Suffolk C0un~y, 1~ ' ' (S gnature of applicant) ~mmissmn Expi,es December 8,