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Home My WebLink About22983-zFO~M NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMP,EtiON OF THE WO,K AU'rHO,,ZEDI 22983: Z Date ............ ~f.,~..../.. ................... Permission Is hereby granted.to: . ~, __ '. 1~~..~,..~ ./.~:~ .................. .../..¢,~.....~.,~..,~........~..,....~ ~ ................... ..-,~.~~:-..~,.... ~.~..~..~.... to .....~_~.....~'.z......,~.....,,~ ~...,,,~.~,.. ..... ..,~.~~...,~~...._~_.~..:.~~,~~~~.. ,~_z~ : ...... ...... ......... ........ CounlyTax Map No, 1000 Section ............ ,~.~.. ..... Block ......... ~ ............. LotNo...,./~,,,,,~. ................ pursuant to application dated .................../'~,,,,,~.~ ...... 19..~and approv~ by~e Building In~tor. .... Rev. 6/30/80 ~ ]'OF1M NO, 1 TOWN OF SOUIttOLD ][!JG'2 ! ~ BUILDING DEPARTMENT~ TOWN HALL SOU DIOLD, N.Y. 11971 I)isapprovod a/c ........................ ,A ..... ~ .... INSTI~UC'I'IONS B0~RU OF IIEALTII ......... 3 SE~$ OF PLA~f5 ......... SURVEY .................. CIIECK S£FTIC FOtttt ............. Date . ~//.7. ............. 19 ~'.~. a. This application must be completely filled in by typewriter or itt ink and attbmitted to the Building Inspector, with sets Of p[allS, accmale plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot alld of buiklings on premises, relationship to ndjoining premises or public sheet: or areas, and giving a detailed description of layout of prope;ly mu~t be drawn on the diagram which is part of this nppli cation. c. The wink covered by this application ma~ not be commenced be[ore issuance of Building Permit. d. Upon appmval of this application, the Building Inspector willi~sued a Building Permit to the appIicant. Suchpermil ;hall be kept on the p~emises available ror inspection Ihroughoul the work. ~ e. No buikling shall be occupied or tlsed in whole m in prat for any propose whatever until a Certificate of Occupanc~ shall have been granted by the Building t,spector, APPLICATION IS IIEREBY MADE to the Building Department For the issuance or a Building Permit pursuant to the Building Zone O~dlnance of the Town of South~ld, Suffolk Corinth, New York, and other applicable Laws, Ordinances Regulations, for the constnmtion of buiklings, additions or alle~ations, or for removal or demolition, as herein described The applicant agrees 1o comply with all applicnhle laws, ordinances, building code, housing code, and regulations, and tc admit auH~orized inspectms on p~emises and in building for necessary ins.ec{io,~.. ' ; (Si=nattu~of applicant, o/name, if a cot[ otalion) ....... (Mailing~ddress of tiq4icnnt) State whether applicant is owner, lessee, agent, architect, eugineer, geueraI couttactor, electrician, plumber o~ builder. Ir applicant is a corpora6on, sigrmttue of duly authorized officer. (Name and title ofcorpo;ate officer) ~,i~de,'s Uc~,,~e No ....... x'7.. ~ ~.g.. Z'-[,..L-/.. I It t bet s License No ......................... FAectdcian's License No ....................... Other q'tadc's License No ...................... Location of laud on which proposed work ',viii be done ................................................. ....... z o a' ~,. . 4 a.~.~. .~. ~ :~ /¥. .L. ~,~. .<. ....... .~. . ~: .~. ./4. . . .&?o. .~.~. o ~-. ..... : ............ Ilot~se Number Street thnnlet County 'rax Map No. lO00 Seclion .... ' .'7]. .......... Block ..... O]. ' Lot ...... /.' .7. ........ Filed Map No. Lot Sttbdivisiort ........ .......................................................... (Name) ' "' 3. Nat[ne o[ work (check Which applicable): New Building .......... Addition .......... Alteration.. P, epair Re Demolition Other . . ........ ... : ......... Work.. [(Description) ~stinlated Cost ~. : , ...................................... Fee ................ ~:..' ................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... Number o[ dwelling units on each floor ................ . If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, speci[y nature ami extent of each type o[ use ..................... 7. Dimeosionso[existingstmctures, ifany: Front ............... Rear ............. : Depth ............... I leight ............... Number o[ Stories ........................................................ Dimensions of shine strncture wiLh alterations or additions: Front ................. Rear .................. l)eptb ...................... lleight ........... ' ........ ;.. Number of Stories ...................... 8. Dimensions o~ e~tire new construction: Front .............. : Rear ............... Depth ............... Ile[gbt ............... NumBer o~ Stories ........................................................ Size or lot: Front ......... ~ ............ Rear ...................... Depth Date of Purchase ............................. Name of Fol~ner Owner ............................. Zone or use district in which premises are situated ..................................................... I)oes proposed construclion violate any zoni~g law, ordinance or zegulation: ..... ~O ........................ Will lot be legraded ....... '.~ ................. Will excess fill be removed froln~memises: Yes Nalll¢ of (~olllraclor . . . . .~.~'{~.0~ ........... Address ................... z Phone No ................ Is tl~ls properuy within 300 feet o[ a tidal wetland? *~es..~ ..... No ......... *If yes, Sout[lold Tow[l Trustees Pertait taay be required. PLOT DIAG I~M Locate cluarly and distinctly all buik}ings, whether existing or proposed, and. indicate all set-back dimensions property lines. Give street and [>lock nnmber or description according to deed, and show street names and indicate interim or comer lot. A~PPROYEO AS NOTED 765-1802 9 AM TO 4 ~ FOR THE FOLLOWING INSPECTIONS: 4 FINAL CC':? fT': :,: ; m.~,xl ~ CQMPt. EIE FOF; ALL CONSTRUCtiON SHALL THE REQUIRE~ENTS O~ TNE STATE CONSTRUCTfO~ & E~JE~GY CODES, N~ RESPONSIBLE FOR DESIGN OR CONSTRuCT~Ota :'FATE OF NE\¥ YORK, SS (ui'qlh of. ................. (Name of imlividua~signing contract) ;e is the ........................................................................... ' .............. (Contzactor, agent, corporate of[icer, etc,) f smd owner or owners, and is duly authorized to perform or have performed the saki work and to make and [ile this ?plication; [hal all slateltlellts colltained ill tllis appJicatioll are true to tile best of bis kllO~vledge and belief; and th;It the 'or k will be performed in the manner sc[ forth in the application filod therewith. worn to before me this Nm~ Public, State of N~ Yo~ ~ (Signature of applicant) No. 49513~ . Qualifi~ in Suffolk Coun~ ~ Commission E~ires May 22, 19