The URL can be used to link to this page

Home My WebLink About22735-zTOWN OF $OUTHOLD BUII.D~NG DEPAR'~MENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (TH{S PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 22735 Z CounlyTaxMapNo. 1000 Section ....... ~/,, ....... Block ....... Z ............... LotNo. ,~..,,,~,. ................ pursuant to application dated ......................... .,./.. ......................... 19. .. and approved bythe Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTIIOLD, N.Y. NOTICE OF DISAPPROVAL ...... ~f.~..~;.j ...... PLEASE TAKE NOTICE that your application dated County Tax Map No. 1000 Section .... ~7~... BIock ..... Z ........ Lot . .~. ~. ...... Subdivision ................. Filed Map No ................. Lot No .................. is returned herewith and disapproved o~ the following grounds · ............ ..... ,...> ......... ;...~~ .... ~...~...~~.~ ............. r .... T~.. ..................................... ....... RV 1/80 FIELD INSPECTION REPORT FOUNDATION (2NB) ~ ROUGIt FRAME & PLUI{~IN¢ INSULATION PER N. Y. STA~ E}m~ II CODE II 765-X802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ]ROUGH PLBG. [ ] FOUNDATION 2ND [ ] FRAMING [ ] I/N8ULATION [~'~' FINAL [ ] FIREPLACE & CHIMNEY REMARKS: ~,/,/4~ .~//2/./~~'~ ,,, ~,~'/~.~ - . ~ ~ ~ DATE FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL · SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ./.~//. ~ .., 19?f~f ................. : ......................... 3P?LICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 SETS OF PLA~S .......... SURVEY ................... CHECK .................... SEPTIC FORH .............. ....... HAIL TO; . . . . - Date .................. , 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 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, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ,~ ~ .... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of prethises .~..~..~..~.~':...ITT...~.. ?..%....~..C.~.~ .,~..~.'...~ .C).~...~..~..~..-(.T". ............ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No..l:~.O. ~.~. I ............ Plumber's License rio .......................... Electrician's Licens~ No .... < ...... ~ ~ i ........ ~ Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. .... .... .... p ..rh. ................................................. House Number Street Hamlet County TaxMap No. 1000 Section . .?'..q. ............ Block ..J[ .............. Lot....c~.3 ............ Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................... ~.,~:, ,:'~ j ::"7 2 .<h. . .......... . . .c.. .t .< '+" ': b. Intended use and occupancy ........... q~J ............... ., ;,~ 3 ~ ..... ' '~ ............. :, ' ....... 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration .......... Repair ........ Rembval ...... ; ....... Demolition .... Other Work .... ~?.~. ~....~ t~ i (Description) 4. Estimated Cost ~ ~P ,tg(~ Fee ! (to be paid on filing this application) $. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ If garage number of cars 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: .................... . ...... Front ~,,.~; .......... .-'. Rear ....... Depth ............... Height· Nuraber of Stories Dimensions of same structure w~th alterations or ad&tmns: Front ................. Rear .................. Depth ................... i ' ' Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction Front .............. Rear ............... Depth ............... Height ................ Number of Stories ........................................................ 9 Size of lot: Front : Rear Depth 10. Date of Purchase ........... , ....... ~ ........ Name of Former Owner ......... 11. Zone or use district in which pr6mises are situated ..................................................... 12. Does proposed construction rio!ate any zoning law, ordinance or regulation: ................................ 13. Will lot beregraded........................~ ..... Will excess fill be removed from premises: Yes No 14 Name of Owner of premises ~ Add No .... i ................. ress ................... Phone ................ Name of Architect . . ......... '.~-"-"--~----'"--'" ~-'~'~-- ' 'r'x'' '~;~' ~'~ 1' 'r~ ...... '.L~dress .... -'~ .... ,.~..,~ ....Phone No. ~ ........... Name of Contractor .kAo~lt~¥~I,~Sdwn~dress ~P~Ld/4~[~ ~.. Phone No. Q,~2F. ~.~..~. .... 15. Is th±s property ~/th±n $00 c~eet of V t±dal wetland? ~Yes ........ No ......... ~I£ yes, $outhold Town Trustees Perra±t may be requ±rsd. PLOT DIAGRAM Locate clearly and distinctly alli buildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block: mmber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEgatORS_. [[/S s (Name of individual signir~g contract) above named, i APP ROVED AS NOTED _. , 765-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTiONS: ~, ~Ut)ND~IlON ~ ~ORE~RED FOR POURED CONCRETE Heis the (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly~authonzed to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manner §et forth in the application filed therewith. Sworn to before m~ t.h!s ........... .~..5 :"'('-/x'.,,~/. .... day of ....... .~2f~...., 19 .C[ .~f Notary Public, ~'~. t~...~..~ County ., CLAIRE L GLEW i ~ '-"- _ No 4879505 I " .................. uualifle~l n Suffolk Coun~ Z"~ (Signature of applicant) Commission Expires DeoemberiS, 19 r 2. ROUGH ~ FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST ~E COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY being duly swo~I~g~p~l~d~._~l~t~,[~til~ th~tl0plicant ,..~o,v:.~ o~ UUNSTRUCTION ERRORS