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Home My WebLink About22256-zFORM NO.3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No 22256 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: LINDA SCltEER P.O. BOX 198 to CONSTRUCT A FENCE TO CODE AS APPLIED FOR. at premises located at ....... .2. ~.9..9.' .8.I...~.....S.~..P~..~.,.....1~..?.?..I...1~...C..K. ................................................................ Count/Tax Map No. ] 000 Section .......... !.!.4, .......... Block ........... .8. ............. Lot No ............. .2. .............. pursuant to apD[Icat[on dated ............ ...JJ~....Y....2..5. ~ .............................. 19....9..4. ......... and approved by the Building Inspector, Rev. 6/30/80 LC. [-~[: FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 ,j TEL;: 765-1802 Approved ......... ermit No.' . Disapproved a/c ................................. '.... / ' ~ ............ ~.,~.'~0~. ~,, ~i0.~.,~J~. ...... ~... ~ ..... ~ 7~5-1802 9 AtVl 70 4 PM FOR~LICA~ION FOR BUILDING PER~IT FOLLOWING ~SPECTIONS; 1.FOUNDATION '~NO REQUIRED FOR POURED CONCRETE f 2. ROUGH - FRAMING & PLUMg]NG INSTRUCTIONS 3. iNSULATION BOARD OF REALTH ......... 3 SETS OF FLA~S .......... SURVEY ................... CtIECK .................... SEPTIC FORM .............. . c^,.L .re.. HAIL TO: a. T4d~:t~i~licatio~f~t~t~'B~$~l~kl~illed in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plan~f~.~16t~nCt{}~cale. Fee according to schedule. b. P~plC~[i~.T~[~ht~l~i~lo~l of buildings on premises, relationship to adjoining premises or public streets or areas,-~ l~lg~} c~:cr~:~on~o~ layout of property must be drawn on the diagram which is part of this appli- cation. STATE CONSTRUCTION ~ ENERGY c. T~i~l~k c~{;~e~R~[ti~l~tFtca~_~may not be commenced before issuance of Building Permit. d. t~i~iY~O~Po"~T~t~9~ ~uildi~g Inspector will issned a Building ~ermit to the appilcant. Such permit shall be kept on the premises available for inspection throug~iout 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, bui~ng code, housi~ code, and regulations, and to - (Sign~ure of ap~/i._dant, or name, ifa corporation) (Mailing address of applicant) ~ O ~ q~5 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician plumber or builder. Name of owner of premises ................ ' ...................... (as on the tax roll or latest deed) If applicant is a corporation, signattii'e ,of duly authorized officer, (Name and title ,of cgrporate office[) Builder's License No .......................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No.. ~.l ~).q.d{q'.,v .{~.~.. .... D~c~O Location of land on which proposed work will be done ............... / ..... '~ ............. House Number Street Hamlet County Tax Map No. 1000 Sectio, ....... ~[~. ...... Block .... ~ ............ Lot ~ 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 ........ ~.e,.%,.\r,~e-f3'~. x,o~.~ ........................................... b. Intended use and occupancy ....... ' ...... '; 3. Nature of work (check which applicable): New Building .......... Addition ...... r · {' .',Alteration .... Repair .............. Removal .............. Demolition .......... Other Work....~-. ~-,W~Gq~... ~ (Description) 4. Estimated Cost ....... T~(-~P ....................... Fee .. (to be p3!d on filing this application) s. If dwelling, number o f dwelling u:,nits .......... Number of dwelling units on. each floor ............... · If garage, number of cars ...... i · .~ ....... . ' ' 6. If business, commercial or mixed !;Jcu'pancy, speciJ~ .................................... "' .......... nature and extent of each type of use .... >[J/~ ............ 7. Dimensions of existing structuresi if any. Front Rear Depth Height ............... Numb!er of Stories ..... ~.~ ........ ~ .......................... · .......... Dimensions of same stmcfure with alterations or additions: Front ....,'/?r.rO.~_ ....... Rear . %.~ .......... Depth ...... ."5'.&.eTvx.~. ....... i- Height .... .-&~O0q~.~ .......... Number of Stories...%9..oqqq.. ............. 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... i He ght .............. , Number of Stories . .. 7~ .............. 9. Size of lot' Front /O~ ! ~e,~r l^^ ..... &"~,' .... 27'~' '3~ ....... ......... · ! .................... ,uauJ ............ ~epm ...r..,-r~o.,~,.~ ............ 10. Date of Purchase ......... J.l~?~ .............. Name of Former Owner ...~O.~lr'l:5~. .............. ... 1 1. Zone or use district in which premllises are situated ..................................................... 12. Does proposed construction violat~ any zoning/aw, ordinance or regulation: ..... j~.Q ................... 13. Will lot be regretter ........... i/O.O ............. Will excess ill/be removed from premises: Yes~ 14. Name of Owne~ of premises ~xwct_023.,..~.<.rL-~7... Address ~%? 7~ ~. ~J/~O~l~tle~lPhone No.'?..~. Name of Ardhit~ct .. ~,.. iD .~.O.~l~. ..... ;~ ~... Address .................... Phone No ................ Name of Contractor . ~; ..~.1.~.~%.?.~i~. Address'~.'~l~3.~ .9~Oc.~.~O..~]~g. Pho~n0. No.~'~-.b~.~ ~/.... 15. Is this property within 300 feet of a t~dal wetland? *Yes ........ No,/~ ..... · If yes, Southold To~n Trustees Permit may be required. PLOT DIAG RA/vl Locate clearly and distinctly all bttildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block nuh~ber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~. S - " cou Y oF ..... ........ . (Name of individual signing cogtract) above named. being duly s~5,orn, deposes and says that he is the applicant &He is the ! (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly auth~orized to perform or have performed the said work and to make and file this application; that all statements contained i~ this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ///~) !. .................. /.,&Jay ................ , // ~..~[~!_~.~lt~,~t~0~N,l~. ~'~'7 ~ ~Si-nature of a licant'