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Home My WebLink About22257-zFORM NO.3 TOWN OF $OUTHOLD BUILDING DEPARTMENT 1OWN ~ SOUTHOLD, N.Y. N_° 22257 Z BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission Is hereby granted to: NORTH FORK. F~NCE & SUPPLY - AC - G~RDIELLO, ALFP~D P.O. BOX ~76 ............ ..~.. ~.T.z. ~..u..c.~ ,.....m(.. ....... !.!~..s..~ ................................... to CONS~.R.U.C.T.. A..~.c.~., .T.O...c..°,..D.~...~..s....A.~.D....~q~: ............................ GIARD~ELLO, ALFRED at premises located at ....... I~..~ALIBUZ. P. LA(3~,..MAT:I'I~I. CK ................................................................ CountyTax Map No. 1000 Section ......... !..4.~ .......... Block ........... pursuant to application dated ............... ~.. ~.5.., ........................... 19....~..~ ........ and approved by the Building Inspector, Fee $ .~., ...~..~..~ Rev. 6/30/80 BLDG, DEPT TOWN OF $OUTHO[ D NORTH FORK FENCE & SUPPLY CO. Wholesale & Retail ~ 7470 North Rd. P.O, Box 476 MATTITUCK, NY ~~952 ,/ SOUTHOLD, N,Y. 11971 ~~7 ii TEL.: 765-1802 Examined ~-..~..~'., 19 ' Disapproved a/c ' .. . (Budding Inspector) APPLICATION FOR BUILDING' PERM IT B~ARD OF HEALTH URV£Y ....... SEPTIC PORH INsTRU6TIONS Date . ..:.~.: ......... 19 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 sti'eet, or areas, and giving a detailed description of layout of property must be dra~vn on the diagram which is part of this appli- cation. c. ' The work covered by this application may n{~t be commenced befo~ · · ::' ce of Building Permit. d. Upon approval of this application, the Building Inspector will issued a ~ ing 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 pumuant to the Building Zone Ordinance of the Town of Southold, Suffoik 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 descr/bed. The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and r gulations, and to admit authorized inspectors on premises and in building for neges~ary iqspectiot!s_, · . (Signature of ap:l;c'a;t, ;~- ~;~'e~3~ia't[o'n') .... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. N~ne of owner of premises ..... ~ ' ' (as on the tax roll or latest deed) If appli,e'¢n.t is a c~orpora¢pn, signature/Of duly authorized officer. Builder's License No .......................... Plumber's License No ................. : Electrician's License No ....................... Other Trade's Lieense No. c~/ ~.rS~. -- j~..~.. '' Location of land on which proposed work will be done ............. ouse Number Street Hamlet Subdivision ........ . ............................. Filed Map No. (Name) .............. Lot ............... State existing use and occupancy of premises and m tended use and occupancy of proposed construction: a. Existing Use and occupancy ... %>(t ~'fi '}~... (O.~%,'O.6~C b Intended Use and occupancy .?.~.C I' 7:c~'q~': ¢-~g SI .3. ature ofwork (check wh~c apPlicable, N w "u "' ' ' ' ~ ' · ! . ~: e ~ lib,rig .... . . ' ' Repmr .............. Removal ,. . .... Add~tzon ......... Alteration ........ · . . .... ... ..... : ~emo,,t,on .... : ....... .,C~.;V/£~.'~.~ ~' O7'/4~ ": . OtberWork 4. Estimated Cost .......... ~ ...... ' ,.~...~. (Description) 5. If dwelling, number o . i ~fi.~./~ (to be paid on fiHfig thismpplication) fdwellmg units ............. u,t~we ing units on each lloor · If garage, number of cars .. '1 .~-/~ Number ..... 6. I£ business, commercial or mbf ...... ' ......... ed occupancy, specify nat re and exte 7. Dnnensions of existin- stmct"-^~ '-' ,- . ~,Su~r nt of.each type. of use ...... H Y .... ~-q. ..... Re y ar ........... Depth. ~ ~ght .... ~ ..... Nt tuber of Stories ....... · ....... Depth ........ ~/~ ...... '... Height ...... Dimensi ~ "" ......... .. · Number of Sto~es ... ~ .... '.. :.: ........ ohs of entire new con t~ction: Front .... . , ' ......... : Rear .... ~ .... Depth Height ............... Nut, her of Stories ................. ' ................ X 9. Size of lot: Front · ',~ ............. Re r .. · ........... ~10. Date of Purcbase ..... 7 ............... De~th .... , .....~.., ..... .... , .......... ' ........ Name of Fommr Owner ~ ~/~ ~/~//~ ~" 11. ~one or U~e district in which piemises are situated .......... 12. ~oes proposed construction viAD* ....... · , ' .. ' ........ ' ........ ................... ~ ~,~ ~-y ~u~l~g law~ orama~ce or regulation o ...... 13. Will lot be reeradea .. I;r~ . - ' : ..~ ............... 14. Nme of Owner o~re~'ises~fi~'F~Y;'...,.)~dl excs~~ fi~L~e rqm~yed fro~premises:" '~;i "'~- .... ~{ ~o. ~et:~f.,.. Nme of Architect ......... } .............. ". · ·. Address .............. ~me of Contractor ~0~ ~.n~-.~_.~¢ a~ .... o, zo~g~ >[ [ L;kj~ne No ............. &~ thins propert w~thmn 130 at of n ~-, --~-,- ~ · ......... ~i~one No. ~/ W777 . · ~If yes ~.~h~ '~ 0 f~ ....... ~ ~=c&anut *Yes ........ w~ ~ ............ ~ , ....... ~ ~!own 'A'rustees Permzt may be required. ' ............ .... PLOT DIAG~ Locate clearly ~d distinctly ~1 bulldogs, ~heth~r existing or proposed, ~d ;, '.,: ate ~1 set-back d~ensions from prope~y Hnes. Give street ~d block[number or descfiption'~ccord~g to deed, and sr..:- .<',. ~t nines and indicate whether ~tefior or corner lot. ' . . . '~ .. · ,, :~ ;TATE OF NEW ~O,g~K, _ 'S 'i)~ h[''''l\'t ["'~' ' ~)`{'-) ^~ ' :ou~y oF...~ k~ , . . ' ' ~' ' ..... being duly s, Or ,d es ~d says that he is the applicant (Name of individual signin~ contract) gels the ' " (Contr=tor ....... ...... ;'tc3 .............. ' .............. , agent, corporate o'ffice[, . a:d owner or owners, and is duly authorized to perform or bare performed the said work and to'make and file this 'plication; that all statements contained Ln this application are true to the best of his knowledge and belief; and that the )rk will be erform · , P cd mthe, j~nner se/~forth in the applicat on filed therewith. ' ,om to before n,e this // / : . ..., ..... .z.,~ . .//~ %,~. . ~. . . . : .q~.~, : ...... , · "7/ ........ :.._:_:.::__:~.. ~ounty t £ A '