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Home My WebLink About22211-z FORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORITEDI No 22211 Z Date ........ .5. ,u, ,t, y. . . .2. .6. ~ ...................................... 19 ........... 94 Permission Is hereby granted to: Security Fence systems a/c Maryann Farley Box 555 Southold, N.Y. 11971 to ......... ~9~.~,T~T..~.. ~.~...!~.., ,I~, .!~.. ,A. ~..,, ,A~, ,~!~.. ~, ,R.; .......................................................... HARYANN FARLEY otn,^~'~-'^^~*^-~+ 1450 LONGVIEN' LANR SOUTHOLD~ N.Y. Counh/Tax Map No. 1000 Section ......... .8..8. ............ 4 43 Block .......................... Lot No ............................. pursuant to application dated July 6, 1994 19 ................ and approved by Building Inspector. lngnspeo or Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUt LDi-NG DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 · / ' TEL.; 765-1802 Approved.....~./~'.~ ...... , gf~. eennit No. . ~.-. .~. .~2-. .,/./ ~ Disapproved a/&. .................................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK i ~ SEPTIC FORM ................ NOTIFY CALL ..................... MAIL TO: , a. Tiffs 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 wl~ich 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 tliis 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 i~ part-fo[ a~3y purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the,~p.ilding Department for th~ issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ahd other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for ~:emoval or demolition, as herein des~cribed. The applicant agrees to comply with all appticab]'e laws,:ordinances, building code, housing code, and regulations; and to admit authorized inspectors on premises and/n buil~l~g_~cessary inspections.' ' ~ ...... .-~ ~"eo-v-~3 ~" ~'-v'~ t I . (S,=natur~apphcant, orname,~acorporatmn) " .... : '~ (Mailing address of applicant) State whether applicant is owner, lessee, a?ent, architect, engineer, g~neral contractor, electrician, plumber or builder. Name of owner of premises ...... ¢"~X .~-~,x ...... ............................. ..._) (as on the tax roll or larex~ deed) Il' applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... 1. ~7& .2,~. iD. )..}:4.'~... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work :rill be done .............. ' o... L, ' ,o.l.J }louse Number Street, Hamlet .............. County Tax Map No. 1000 Section ...... ~5". Z'. ...... Block....(~..~ .......... Lot... ~.~ .......... Subdivision ..................................... Eiled Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing b'lntendeduseandoccuCancy..V.}.~.fi.~.~-~-..~.~.~...~.~, , ..'~ ~,~'~, .~J~ j/ $' NatureofworkCcheckwhi~,~pplicable):NewBuilding ..... '..'.. Addtion.'.:..~...:,~,. Altera,ti . .. 4. Estimatffd Cost ~ ~ ~ ~ D~sc~ption) .......... .......... '(to'b6~am on ming tins application) S Ifdwelling nUmber of d~vellin~ units Number of dwelling ' ' ............ units on each floor... Ifgarage, numberofcars . , ........... .............................................. ' · specify nature and extent of each type of use ~ ....... 7 Dimensions of existing structures if any: Front Rear ................ Height Nu~er of Stories ' ", ........................... Doptfl .............. Dimensi~ ............ ' ..................................... , ............... Depth of same structure With alterations or additions: Front ................. Rear ................ ................... ;... HeiSt ..................... Number of Stories .................... Dimensions of entire new construction: Front ' Redr Height Number of Stories ............................. Depth ............. 9. Size of lot: Front .......... ~ ............ Rear ...................... Depth ........ ' I0. Date o~Purchase ........ ~ .................. Name of Fenner Owner ............... ' ........... 11 Z d' i ti wtil t mi sit . oneoruse atrc n ~c~pe sesare uatec .................................... 12. D op d tie i61 ................ oes pr ese Construe n v ate any zoning law, ordinance or regulation: ...~.~. ..................... 13 Willlot be regraded ~ ~ ' ' ' .... ~ ................... Will excess 14. N~e of Owner of premises .'~v.[~ ~ .... ' ....Address~.~m~.~, I N~e of Arch teet ~ ~ ' ' ~ ~ 7~ ~ ...... ~.~,,~ s~v. . .~.~ ~.~ ~ ~, Y a~ ~ouEhold To~ TruaEaes Permit may be re~u~red. ... ] PLOT DIAG~M Locate cle~ly ~d dist~ctly ~ bu~d~gs, whether existing or proposed, ~d, indicate ~1 set-back d~.ensions fr~o~ prope~y ~nes. Give street ~d bloc~ number or description accord~g to deed, ~d show street n~es and ~d~cat~ whethe: interior or Co.er lot. ,t ', PPRpVED AS NOTIFY BUILDJNG DEPA~ENT AT · S. STATE OF NEW YORK I ,,~,. bore named. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3, INSULATION 4, FIN~,L CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQIJIREMENTS OF THE STATE CONSTRUCTION '& ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he is tile applicant I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is i , duly authorized to pe,rform or have performed tile said Xvork 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 ~ mannerl set forth in the application filed therewith. Sworn to bcfore~.~his ·. ~.O -- ' .day of, HELENE D. HO Notary Publlo, State o No. 495136, Qualified In Su~fol~ Commission Expires Ma iNew York (Signature of applicant) Cou. 22, 19 , r;..c.&~m ' ~ ~.:, ,-~- -: .......... 5. If dwelling, number of dxvclling units .... Ntlmber of dwellillt° be pa ..... ' g thts application) If garage, number of cars ......... j ........ g units on each floor ...... , ' . .... 6. I£ business. COmmercial or mixed occupancy, specify nature and extent ore ' ' 7. Di,mensions of existing structures, if any: Front . . ,-, ach type ot use .......... Hmght ............... Number of Stories ........... tqear ............... Depth .... ~ ........ Dimensions of same structure with alterations or additions: Front ·.. Depth ..... Height ................. Rear .... 8. ' ................ . ..... NumberofSto es ........ .... Dimensions of entire new construction Front ' , · · He~t ,,, _ · ............ Rear. D ........... rqumt~er of Stor/es .............. : .............. epth ........ Size oflot: Front ....... ~ .............. Rear .. 10. Date of Purchase ............................ , ................... Depth ..................... 11. Zone or use district in which premises are situated .... Name of Former Owner ........................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~.~..~. ............ ' ......... 13. Will lot be regraded . I,O <~ . Will exces .... , - 14. Name of Owner of pre~n'i~Js' )~. ' ' 't ......... . ...... . s nu a,,e remo. y.vea ~rom pr.emises Yes Name o*' ,'--'-'- - ·. ~c-a~.. ,~, .......... Addrcssl:.o..~.~.q.,.. 1 .,'x~,.~,.."r',-~n.}ex .. .,~lc. tcct . . '"'J ~ *'/ '' '~' .... ~'tone~o .t'.~,;:5-.,7~,'~)e.~. N .... : · · . ................ Address ,,:.. ' ' ame of Contractor?.~,. . . ' ................. Phone No .... · '~'-'~"~- '~-[",~-~.$: ~.d ............ 15.Is thJ_s property lo~"~ed w:~-~-''--'r~r~'h'%A~ dressB'~-~6~"~i~c"w~JdPhoneNo. · I£ yes, $outhold trow- '-- ~,--*-~uu feet or a 'tidal wetland? ~¥Ig8 .... · , ~Us/ees termit may be required. ... PLOT DIAGRAM Locate clearly and distinctly all buildLngs, whether existing or proposed, and, indicate all set-back dimensions fron property lines. Give street and block number or description according to deed, and show street names and indicate whethe. interior or corner lot. I ........ ,: ..... ~a,~.~ h~- ~ ............. ~ ~_ STATE OF NEW YORK, ......... , ....... . . I.:) '", · · ' ............. being duly SWorn, deposes and says that he is the applicant - (Name ofind~vzdua s gui ~g contract) above named. agent corporate officer etc ) ..... (Contractor, , , . of said owner or owners, and is duly authorized to perform or have performed the said Work and to make and file this application; that all state~nents contained in this application are tr,.. t~ **;~ ,.~.. ~,-, ,