The URL can be used to link to this page

Home My WebLink About23070-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N? 23070 Z BUILDING PERMIT [THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted ...~.1.....~. ~..~. ....... £.d...: ................................. ........ .~....:.~..: ......... l/~.l ................. t o..~.~ ........ ~ ........ ,~,~ ........./~ .......... ~.~.~ .......... ~.....~'.. .... · ..~.~..-.. ......... ./.~' ....... /...~,~..~ .......... ../..~ ....... ~ ........ ..~........,~... ..... .~..~J... ...~J~ ........... ,. .?~:,~. ............. ~.: ................................................................... ~_ .................. ~oun~a×~ap~o. ~000 S~on....~ ........... ~,oo~ ...... ~.~ ......... Lotto..,.Z,,~,,,, ............... pursuant to application dated .......... ,~,,,,~,,~,,~-- ........................... 1 ~..,~,,,~,,,,..,, and approved Building Inspector. F~ ~..~:..!~ ...... Rev. 6/30/80 F.× ;t t n ine.,.I .... /.'0/./.7. FOF~M NO. 1 TOWN OF SOUTIIOLD BUILDING DEPABTMENT. TOWN HALL SOtJD~OLD, N.Y, 11971 TEl..: 7GSq 802 197.'?"-. Pc r mit ^,,,,,o,.0,...<V./.?. ...... , No. I)isapploved a/c BO,",KD OF BEALTll ..... 3 SETS OF SURVEY CIIECK ................ SEI'T I.C F 0 il, Il .......... CALl ................ I'ttk I L TO: APPLICATION FOR IBUILDING PEtqMIT Dale ................... I' 1N S'I'ld. JCI'IONS a. This application must be complelely filled in by lypewHler or in ink and submitted to thc Building Inspector, v sets oF phtnS, accurate plot plan to scale. Fee according to schedule. b. Plot t)lall sJlowillg location or lot and of buildings on premises, ~elationship to adjoining luemises or lmblic s or a~eas, and giving a detailed descliplion of lagout of property must be dlawll oH the diagram which is part of this cation. c. The work covered by this aplHicatkm may not be commenced before issuance of Building Permit. d. Upon aI~ploval of this application, the Building lnspectm will Nsued a Buikling Pemdt to the applicant. Such shall be kepi on lhe p~emises available for inspecHon IhroughotH the work. e. No ImildiHgtshal] be occupied or used in whole or in part for any purpose whatever until a Certificate oF Occtq shall ha~'e been grmeed by the Building hlspector. APPLICATION IS iIEREBY MADE to the Building Depmtment for lhe issuance ora Building Pemdt pursuant Buikling Zone Ordinance or the Town of Southokl, Su('falk County, New Yo~k, and other applicable Lt~ws, Ordinant Regulations, For the ~ons~ruction of buiktings, additions or alterations, or rot removal or demolition, as herein desc~ The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and reguhHk>ns, admit authorized i?spe'ctms on premises anB. in building [or necessa~ inspey~. ~dtueofappic~ t, or. a e,j~acorpo ali,m) (Mailing address of applicant) Slate whether applicant Js ownsr, ]essee, agent, mchi[ect, engineer, general contractor, electrician, plumber o~ bui ..... .......................................................................... (as on [lie tax roll or lalest deed) If applictmt is a coH~oration, signatuze of duly authorized officer. (Name and title of coH~orate officer) Buihtel's license No .......................... Phunbel's License iqo ........................ EIectt 'c'a ~ s [.iceuse No ....................... Suhdivision Filed Map No ............... Ix>l ............ (Name) St;He existing use and occupnno/ t)t' ptmnises and intended use ami otto}panty of proposed constrnctitm: a. Exislhm use amt occupancy ...~e~A~e.../Y/~6 ........................................... b. httended 3. Nalulc of wo~k (check which applicable): New Building .......... Addilion .......... Alte~ati0n .......... Repair .............. P, emoval .............. Demolition .............. Other Wo~k~ ~ .... ~ . · ~ ~ (Descriptk)n) · 1, Estimated Cost.../~, ......................... Vee ..~ ............................ (to be paid tm filing this application) 5. [~ dwelling, mm~bet of dwelling units ............... Number of dwelling units on each floor ................ if garage, nuntbe[ oF cars ........................................................................ 6, If business, commerdnl or mixed occupancy, sp~it'y mmu¢ ami e~teut of each type o¢ use ..................... 7, l)hncnsions of existing structures, ff a~W: ~mut ............... Rear .............. D~pth ............... H¢i¢~t ............... Number of Stmies ........................................................ t)imenskms of s;m~¢ sh'uoture wifh alterations or additions; Front ................. Rear , ................. D~gdt ...................... Ilci~ht ................... : , . Numbe~ o[ Straits ...................... 8. Dimeilsim~s o¢ entire new cpnstructim~: front ............... Rear ............... Depth ............... Hci¢;t ............... Number o[ Stmies ........................................................ ~. Size of lot; Front ......... , ............ Rear ...................... Depth ...................... I0, Date of Purchase ~ .2~.¢~ ................. Name of Fonne~ Owner ~.~¢.~(~ ....... I ~. Zmm or usc distriot infwhichlffemiscs ar~ situated .............................. ~...~ .......... - ........ 12, Does proposed construction violate any zonin~ law, ordhmnce or regulation; ................................ t 3. Will lot be ~egraded ..... ~ ................... Wilt excess Rtl be removed fram premises: Yes bt. tq~mm eL' Owner of premises .~,~. ~(/~g~.. Address~/~ ~,.. Phone No. ~.~' Name o¢ Architect ........................... Address . . ~(~¢~ ....... Photm No. Name o~ Contn~ctor . ......................... Address ................... Phone No ................ Is khis propergy ~eithl. n 300 feel of a LZdal tqeLJand? *Yes ........ No · If yes, Sou[hold Town 'l'rusCees Permit may be tyequ[i;ed. PIDT DIAGRAM l.ocatc clearly and distinctly all buihlings, whether existing or proposed, aiM, indicate all set-back dimensions From propeily lines. Give street and block nmnber or description according to deed, and show street names and indicate whether intUlJor or corner lot. APP IOV£D AS NOTIW BUILDING OEPAHTMENT 765-1802 9 AM TO 4 PM FOR THE FOLLOWING 1. FODNDATION ~ ~O REQU~REO FOR ~UREO CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSU~TION 4, FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEE~ THE REQUIRE~NTS OF THE N,Y, STATE CONSTRUCTION & ENERG~ CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR~ e , . ,~ .........ttName o[ individmd signing contract) is the ............. ................................. (Contractor, agent, colporate officer, etc.) said owner or owners, and is duly authorized to perfoun ar have petFarnted the said work and to make ami file q3licatkm; that all statements contained h; this application ate true to ihe best of his knowledge and belief; and that the otk wilt be performed in the manner set forth io the application filed therewith. to before this ~m.y Publ, · ,. ¢ ..,~ ...... County ~ N0IA~ PUBLIC, State of