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Home My WebLink About22263-zFORM NO.$ TOWN OF BOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. N£ 22263 Z BUILDING PERMIT ITHIS PERMff MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED] Date .................... AH.G~..s.%...I. 6.., ..................... 19...9..4. ..... Permission Is hereby granted to: JOHN & ItgLEN BEIII)INKA 1330 FACTORY AI~I~. MATTITUCK, NY 11952 to ......c.9.~ .s.~.c.~.,~., ~.c.~..~.°....c. PP~.. A.s...~.z.~P., ~, ,°.~: ..................................................................... at premises located at ....... !.3,3.0.. ~A.C.~,OR~..AI/~ :..., ,t~,, ~,1:1.,, ,C'~,. .......................................................... CounhtTax Map No. 1000 Section ......... ~.2. .......... Block ............... ! .......... Lot No ........ .7. ................... pursuant to application dated ................... ~,~,,,,2,,7,,,, ....................... 19,,._.?..4. ...... and approved bythe Building Inspector, Fee $..~...~.......~. Rev. 6/30/80 Appr°ved '~'~.~,~)i/., 19 · . . Permit No.'~...~..~-. ~: ~...~.~ Disapproved a/c ...... ] ......... ~ ..................... FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 7G5-1802 APPLICATION FOR BUILDING' PERM IT g~)ARD OF H£ALTH 3 SETS OF PLA~S SURVEY CHECK NOT ~ I:¥; CALL .......... · . HAIL TO: INSTRU6TIONS '. Date . .~..~.b~.. a. Tkis application must be completely filled in by typewriter or in ink and submitted to the Building Ingpector, with .7 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 muit be drawn on the diagram which is part of this appli '. ' The work covered by this application may not be commenced before issuance of Building Permit. . / .'lpon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permil. sh~t' ' '.ept 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 s,hall 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 C6unty} New York, and other apphcable 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, ordinancesl building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ~Signa[ur~ of__applicant, or ifame, if a corporation) ' ' ' · . ...... ........... .... . (Mailing acYdress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generaJ 'contractor, electrician, plumber or builder. Name of owner of premises .. . .~..~...~1.~...~,.~ ................ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.' \ b. Intended use and occupancy .... ~...'7.. (Name and title of corporate officer) ; B alder s Lmense No ........ .~./~ ............ Plumber's License No ....... '.'1/..'~-.... .......... Electrician's License No ............. Other Trade's License No ..... ~./..e~. ........... Location of land on which proposed work will be done ................. : a...9 ............................ ber k/ ....... :*~ .............................. ~. .......... ltouse Num Street Hamlet Cotmty Tax Map No. 1000 Section :,..,/:~.~.,.o..O ........ Block .... O/t p.O. ........ Lot ..... qtg7:O.~ .O ..... Subdivision ................ (iqame) Filed Map No ............... Lot ............... State existing use anti occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... ~ ..... ' - ............ ~ ~t ........ p r .............. K~moval ............. Demolition ' Addition,i:. 11' ' ! ' '> ' 'AheraMgn .' ....... · i . .... , ............. ; Other Work ~.. 4. Estimated Cost . .-.. O, -- · ' ' a o (Description) .... .... - ............... Fee "-'- ............... .... If dwelling, number o/'dwellit,]g units ..... (~q.~.g,~,l this a I t . If garage, number of cars .... .~. ' o,~,-.,. ........... 6. If business, commercial or mixed occu-~-cl.' ~' '.,1' ' ' :' '.'' ', ............ ' ........................ · . . ., p.- y, ~,~:cny na£ure and extent of.each type of use .. : .... ~.. ~. i .... 7. Dimensionsolex,stmgstructqres, ifany:Front..,,g, oo.:y.t Rear ...~.,.~,..t... Depth ...j..~..&../. Height ............... Ntt ...... .. . ..... Dimensions of same structure ,with alterations or additions: Fron ' i.. ii ~ ............... tuber o£ Stories .... ~.--~ ........ ' 'ti~, ' ~ ' ' ..... pth ..... ~ ............ Hcight ... · Rear .. 8. ~;mensions of entire new conltruction: Front ................ :.. Number oSStories. ~e'p't~..' J"'i ..... ~ ..... ; Rear ........ ; .... ;. .. Height , r.. 0. · ........... Nutm bar of Stones ............. 9. olzemlot: Front ...... ~,.~. ........... ;. Rear ...... ~ ~ t" ', ................... 10. Date of Purchase q,~ /~,.,t-o L ' ............ Depth ~[~./,.~.~.. I1. Zone or use district in ~l~i;;~ ~remises are situated . x'~ame of lmrmer Owner .. r,4.4~4-~...~ .... 12. Does proposed construction vi61ate any zoning law, ordinance or regulation. 'tq .o .... d .............. ,)'i .... 13.Will lot be regraded ....... ;I. · ~,.~ .............. Will excess fill be remov d rom e 14. NameofOwnerofnremise~O'oN~%,c.,qe-t.,.~a.., ,-,., f pr mists: e ..... i' ' ¢.o,,~.~/~t,,~.~/- '... Address t.-~qq .~'~¢7v4 .,~y..4t.a.~. · . Phone No ............ ;.. Name of Architect ...... I. , - .Address ...... .-TX'.. .... Phone No. Name of Contractor . . _~ · 'r~ ~,__._ - .' :'. '1 .................. ,~aaress ....... . .,~,-- ,, ~-- · 15.' ~.o ~..x~ propercy wztnzn ;300 feet of a tidal wetland9 *.. · ......... r. une~ ~o ......... · .If yes, Southold Town Trustees Permit mav be're2,~,'es'j ...... N°'''~''O .... ' ....... "-. i PLOT DIAGRAM Locate clearly and distinctly alI buildings, ~heth~r existing or Proposed and. indic - · property lines. Give street and blockmumber ~- .~-~--'--' ~ .... , . . ate all set back dwnensions from interior or corner lot ! u, u*aus~puon according [o aced, dna snow street names and indicate wh~ther 765~1802 9,AM TO 4 PM--FOR. THE 'i. ¢OUNDAT~ON TWO REQUIRED s('~*~ POURED CONCRETE 2, ~2OUG J L FRAMING & PLUMBING 4, Ft~A, CO~¥STRUCT~O~ MUST :BF COMP.,,~ ~E FOR ALL " ,? ~' , cONo/'aUCr ON SHALl. 'TI-~E REQUIREMENTS OF THE N,Z S~ATE ' CONoTRUCT~ON & ENERGY CODES. NGT RESPONSIBLE FOR [:SIG~ OR CONSTRUCTION ERRORS . ;TATE OF NEW ¥OR.K, ° I~ :oui, rr',, o?. ? b (Name of individual signin~ contract) ova named. .. '. i ' (Contractor, agent corpm:aie Offider. etc ' . m: ~; that all · . I . ' -"7 ............ - .......... -,~ nmi *~ - ~,~ .. .... statements contalnpd m tbJs aDDliCalloD .~r~ fro., ~ ~1.~ t. ........ '- ~r< wm ue parroted in the manner set Torth in, th~a--,:2-.7'~ ~,-~ }~ ,,,~,?~ o:ms <nowiedge and belief and that tle ..'om to befdre m~ thi'~ v~,,cauon meu tnere~m~. ' ~OM~I~ Evnlmn N~ ~, I~ ,' being duly sworn.,..depo~e{ and says that'' ' the a'~'~pplicant 4