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HomeMy WebLinkAbout22262-zFORM NO.3 '(OWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. No_ BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ....................... .~.U.G~.S.~...!.6..~ .................. 19..9..4. ...... 22262 Z Permission Is hereby granted to: JOHN & HELEN BERDINKA 1330 FACTORY AVE. HATTITUCK, NY 11952 to ....... .C, .O,~ ,S,T .R..U.. g~. ,.A.., ~.E,..N..C..E., .TO... g.o..~, ,E,,, ,A,. ,S., ,,.A~....I~.. ~p.. ~.O...R.: ................................................................... at premises Jooated ct ....... !.2..6..~...~.A..~...~[..~.~...A...V~.....~...~t~..`.~`...T.~..T-~...C..K.~ .......................................................... CountyTax Map No. 1000 Section ......... !.4..2. ........... Block .............. .1 ........... LotNo .............. .8, ............. pursuant to application dated ......................... ~,.~....2,.7.~ ................. 19,.....9..~ ....... and approved bythe Building Inspector. Fee 8~ .... Building Inspebtor Rev. 6/30/80 "~ BUILDING DEPARTMENT ~1~1 !2 7!m ,,~j, TOWN HALL i ~ ..... iR:, j SOUTHOLD, N.Y. 11971 Disapproved, a/c ..................................... ~ APPLICATION FOR BUILDING PERMIT S TS Or ........ ................. CII[:CK CALL HA ~ L TO ' INSTRU6TIONS" a. This application must be completely filled in by typewriter or in ink and submitted to the Building InSpector, with 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 rr'a~t be drawn on the diagram which is part of this appli cation. · c. The work covered by this application may not be comm .:~,~ }:~fore issuance of Building Permit. . d. Upon approval of this application, the Building Inspector ,~ ::. '-~ed a Building Permit to the applicant. Such permit. s~aall be kept on the premises available for inspection throughout the ' c. 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 Coufity, New Yorl~, 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, build'lng code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary,/~nsp, ectioas./]~ ~. ,, ~. pP , or name, if a corporation) · (Mailing ~ffdress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai 'contractor, electrician, plumber or builder. Name of owner of premises ................. .~--,~. .. - (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 Plumber's License No ' Electrician's License No ............. Other Trade's License No ~ Localion ofland on which proposed work will be done ....... I~;O . - .......... , ........ ~ , ~ .... ltouse Number Street Hamlet County Tax Map No. 1000 Section ...... /..~/.~ ....... Block ...... ./ ....... .'... Lot ...... ,~. ........... Subdivision ..................................... Filed Map No. . Lot (Name) ............................ State ex/sting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing Use and occupancy ..................... ~ ' , ' ~~ .,~.9 ..... % .... ........ .... , . ... ...... .3. Natureofwork (check whichlapplic .... , .... ' ' , 7 ,,f~77 ' , ' , ame). New uuiming ........ Additio ! ............ ~.,cmon[lon .... ; ........ ?thcr Work ~... (Description) 4. Estimated Cost. . o'o -- ' 5. Ifdwelhng, numberofdwe gunits .... d .. Numbcrofdw~lli,~~~thisapplicat on'~ If garage, number of cars 4. .~. ' r ......... If business, commerc: ' ' ~ - 7. ' ' ,a~ or mF~ea occupancy, specify nature and exte Dunens~ons of existinn stmcturt.~ i¢ ~ -~"~ u' , nt of.each type of use ..... -, .. ~m~ensl°ns?£shmestructure,witl~alterationsoradditions:Front 33 3 i l 8. Dimensions of entire new con'~truction. Front ....../:,'/,~.. ..... Rear ...... , ......... Depth .... ~ ...... .......... r~u:maer or Stories.. .... -- - ~ . 9. Sizeoflot: Front ... ~(o!! . ~one or Use district In which P~emiscs aFe situated ...... .. 12. ' Will lotLbe regraded ....... ~ o .......... Will excess fill ' - - -. ........................ Phone No ............ ... Name of Contractor ...... ! ... 15.' I,s this property w:kt:hin ,300 ~,- ,-¢ - ,--'-,-, ' ....... ' ........... Phone No ...... Loc ..-. i PLOT DIAGRAM . . . ate clearly and distinctly ali buildings, Whether existing or proposed and, in ' . .property lines. Give street and blockmumber or desc-'-*: ....... -':-.- ] . , . , dmate all set back dimensions it .p.un ,n.~.ummo to eeeo ana snow street names and indicate wheth,.. interior or corner lot. ~ . AP ROt/EB AS NOTED 7~:5-'i~02 9 AM TO 4 PM F~ T~ FOLLOVV~NG ~NSPECTIONS: FOLINDkT~ON '~O REOUI~ED FO[~ poURED CONCBETE RouGH - FRAMING & PLUMBING S. IN.q, UL.ATK)N -" J 4. FINAl- ' coNSTRUCTiON MUST I BE cOMPLETE FOR C.O. ;. ALL cONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, , STATE CONSTRUCTION & ENERGY, cODES, NOT REspONSIBLE FOR ;TATE OF NEW,YORK, S IS DESIGN OR CONSTRUCTION ERRORS, e JS the . . ~ ~ ~ .......... , - J, (Cont,r~ctor, agent, corporate officer, etC~) .................. . ~. ..an, - - ~ ~ ,~.,,u. ar= true to thc uest ozlns knowledge and belief; and that thc org w~l be pcrfo~ed in Hie manner sot ~orth in tim a ' ' , ,; , · 'om to before me this I pphcat~on filed therewith. ...... '"' '. : ........ ~~~ ', , -,. , · ..... , ...................... (Signature of applic~t) mm zo>F2 zOzZrm~O~ ~o~ Z ©