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Home My WebLink About21445-z FO~'M' NO. fJ TOWN OF SOUTHOLD BUILDIHG DEPARTMENT TOWN HALL SOUTHOLD, No Y. No.N? BUILDING PERMIT (THIS PEIb~AIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~1~ Z ~)ote .... .~ ........................................ , ~.~...~ Permission is hereby gronted~to:/ //) .~ ~ ~ ...... . - .............. ~ /.~,// ~.-' -.-~,-- ~ '~..~.~?~/ ~. / , ................................ · .-:':'-~,-~~~::z~ ..... "-: ................................................... County Tax Mop No. 1000 Section ...... ~....~.. ......... Block ..... ~ ........... Lot No ...... .~.......~... ......... pursuant to application dated ......~'-../....~..: ......................... ............ , 19.~...~..., and approved by the Building Inspector. ~~/.,~7,..~ , i Fee $ .................. ~> ,gY~ Y Robert Bohn Contracting P.O. Box 55 Peconic, NY 11958 (516) 765-1119 Rep. Bob Bohn FENCE License No. 7541-HI Customer Name Address ,Rep. JasonLeona~ All material is guaranteed to be specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of: ~onars($ ,/~'0~°~ ). with peyments to be raade as foUows: ~ 9~051~'~ ~ ¢~,rO ,~k~.;alteration or deviation from above specifications mvotwng extra o ts, will be executed only upon written o er~, and wdl become ":~:i~tra charge over and above the estimate. 11 agreements contin- gel~t ~pen strikes, accidents or d~lays beyond our control. Owner to i,~an'y fire, tornado and other necessary insurance upon above work, ~orkmen's Compensation and Public Liability Insurance on above v~ork taken out by ~ .~.0~ . Date 5//d~P~ Date Note - This, proposal may be withdrawn by us if not accepted within ~C~ days. Signature Signa~ , ~CE~~E 7ROPOSAL -,% MAY 2 J NO. TOWN OF SOUTHOLD BUll. DING DEPARTMENT TOWN HAIl $OUTHO/D, N.Y. 1197~1 Examined ...... ,19 Approved ...... 19 .~. Pemlit Disapproved. a/c ..................................... INSTRUCTIONS sb, n OF E^urH ......... 3 SETS OF ~LANS ......... SURVEY .................. CI1ECK .......... Date .............. a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, wlth 3 · :ets 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 st~'eets ~r areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this appli- :ation. . c.' Tl!e ~work covered by this application may not be commenced before issuance of Building Permit. d:' Upon approval of this application, the Building Inspector will i~sued a Building Permit to the applicant. Sugh permit ,hall 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 .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 ]uilding Zone Ordinance of the Town of Southbld, Suffolk County, New York, and other applicable Laws, Ordinances or [egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. :'he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to .dmit authorized inspectors on premises and in building for necessary inspections. (Signature of applicant, or name, if a corporation) (Mailing address of applicant) 3tare whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) f applicant is a corporation, signature of duly authoriied officer.' (Name and title of corporate officer) : Builder's License No .......................... Plumber s Lmense No ............... . .......... Electrician's License No ....................... Other Trade's License No. ¥, 4- 14 o Location of land on which proposed work will be done .............. House Number . - Stree~ ' ' :' '"' Hamlet' ' ..... :: ............. Couhty Tax Map No. 1000 S~ction ~' , o O Block O q. O O ' Lot. ~ O o Subdivision...-- ~ ~ ' Filed Map No. Lot (Name) Stat~ existing use and occupancy of premises and intended use and occupancy of proposed constructionk a. Existing use and occupancy .... ~. ~ ~.- '7 ".~ ':. ~.; b... ~..Intended~ ., .~. . .use. ~nd.. occupancy. ~..'. 0 ~ )C ~ ~,~ ~,~s:~ !~,.. ' ' .' ........... ~ .... ............ .'--': : ,'~ '~ · 3. Nature of work (check which applicable): New Buildin~g.. ~ .~. ...... Addition .......... Alteration ....... }.. Repair .............. Remove .............. - D'6m~lition . . . . . Other Work.. 4. Estimated Cost.. ~. f, -']oO ~ ·" · ~ (Description) Fee (to oe paid on filing this application) ' 5. If dwelling, number of dwelling units--. .... T ......... Number of dwelling units on each floor.. '7 ............ · If garage, number of cars ...................... ' · 6. If business, commercial or m~x~d occupancy, specify nature and extent of each type of u~e 7 Di ios ofexisti truct es if F t f'~-~ ~ ~ Rear 'I~ ................... · mens n ngs ur any' ron o.~uR - Hight N I;e of~io les .... : ........................ epth . .. Dim ionsofshm ith It atio dditi F ....................... ens e structure w a er ns or aons: ront ............ Rear ................ Depth ' Hight ........ 8 Dim 'i; .................. e ....... . ........ ;.. Number of Stories ........... ~ .... of enti ti F ...... · ens ns re new coIlstruc on: ront .............. : Rear ............... Depth .. .Height ............... Number of Stories .................... ' ............ 9 Si f I F ' Rea .... ' ................................ · zoo or: ront ........ r ................. Depth 10 Ddt of Pu ch ........................... · e r ase .................... · ......... Name of Former Owner ................ 11. · ............ Zone or use district in which premises are situated. $; .-~4-. $-~'y. '~'3 ,. ~r° +- .~-.~'~.- ' Does proposed construction violate any zoning law ~ ;l'a}l~'ffo'r'- ~ .'" 13. Will lot be regraded · W ........ ' ...... :'"~' ....... ......... ~ ................ ,u exce~ nn ne removeu ~rom premises: ~ No 14. Name of Owner of premises I;~'~.b....r.i.t!~..S...d,> .~.,.c~.. Address N. ~. P..~.%~.' .kip. y.t~.. ~ Phone No..7.kd.":. ? 3 3 .~ '.. ' Name of Architbct .................. ' Address ................... Phone No ............ ,:... Name of Contractor .......................... Address ................... Phonf~o ............... .5. I~ this property within 300 feet of a tidal wetland? *Yes ......... No..~. ..... · If yes,~ Southold Town Trustees Permit may be required. ... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ~nterior or corner lot. 'ATE OF NEW YORK, S.S 3UNTY OF . 3. ~ }~..~. '~r. '. '.~. ~ '. '..'.~. '. '.~. '..~:~, ' .~.. ............... being duly sworn, deposes and says that he is ,the applicant (Name of individual signing contract) ove named. is the....... ............................. . .................................... . (Contractor, agent, corporate officer, etc.) said owner or ownem, and is duly authorized to perform or have performed the said work and to make and file this ~lication; that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set forth in the application filed therewith. om to before me this o~-/ 'da'of .................... y ..... e ou~fi~ ~ 8ull0lg ~n ~ ~ ~ (Signature of applic~t). ommlssioa Ex;~ Nov, 2,