The URL can be used to link to this page

Home My WebLink About21745-zFOI~M NO.3 TOWN OF $OUTHOLO BUILD]NG D£PARTMEN~ TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date ............................................................ 21745 Z Permission is hereby granted to: ~z.~.....~....~.~ .~.~. ............... ,~:,,.~,.,~z~ ........................................... CountvTax Map No. 1000 Section .....,./, ,~,,,,,'~,,, ....... Block ....... ~ .............. Lot No ........ .,~..~..../,. .......... pursuant to application dated ...... ./...~/./..~.. ............................. ~ ....... 19...~...~ .... Building inspector. Fees ....... ~....~.../~,~ and approved by the Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1197~1 , · / TEL.: 765-1802 Examined . ./?/~ ?. , 19 ~ ' ' ' ~pproved.. /.x/4~. ~.~.' ...... 19~f Permit~N6 . (B~ldin~spector) APPLICATION FOR BUILDING'PERMIT B~,~O' Or SURVEY CIIECK CALL HA I L Date ....... : .......... , 19 . . . , . a. This application must be completely filled in by typewriter or in ink and subinltted 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'eets or areas, and giving a detailed descriptioh of layout of property mu~t be drawn on the diagram which is part of this appli- cation· c. ' The woi'k covered by this application may not be commenced before issuance of Building Permit. . d. Upon approval of this application, the Building Insp4ctor will igsued a Building Permit to the applicant. Such permit shaU 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 Occupan'cy 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 South61d, 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 describbd. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. (Mailing address of applicant)/t/y//~3~ State whether applicant is owner,' lessee, 'agent, architect, engineer, generai contractor, electrician, plumber or builder. N~m¢ of owner of premises ........................ ~..~. ~.. ... . ( d) ............ . ' as on the tax rol or latest dee It' appLi~nt is a corporation, signature of duly anthori~ed officer.' · , . Bu ~der s L,cense No.' ....... ~. . Plumber's Li¢onse No ....... '...;. ' ' Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work will be'done... ~ ............ · Itouse Number Street Hamlet ..... ' z Coullty Tax Map No. 1000 Section .... ' ....... Block i .... ' Lot., .' ........... Subdivision..; ..... . ............. , ................ '. Filed Map No. Lot (Name) ' ' '" ......................... Stat~ existing use and occupancy of premises and intended use and occupancy of proposed constructioni a. £xisting use and occ,pancy ...'..~...7~J..~../~.. bi dd ~d ~ '3. Nature of work (check which alpplicable):. New Building .......... ~.ddition .......... Alteration ......... Repair .............. Removal .............. . Demolition ..... : ......... Other Work...~-~/~,~.... ' (D riptio ) 42 ~ Estimated Cost Fee .I (to be paid on filing this application) S If d~(~elling number of dwelling units " Number of dwelling units on each floor If garage number of cars 6. If business, co.mmercial or mi.xed occupancy, specify naturre and extent of.each type of use 7. Dimensions o! existing structures, if any: Fronf .... /-~.(q ~ ....... Rear . . .~/..(e .~ ....... Depth .-~D../ ..... Height Number' of Storms' Dimensions of shine structure ~ith alterations or ad~litions: Front ,--,5'~:.O.*.~. ......... Rear . ..~'~a.~?· ..... Depth ' Height :. , Number of Stories ' 8. Dimensions ofenbre n~w construction: Front ........ : ..... ; Rear ............... Depth .............. Height . ~ ............. Number of Stories 11 Zone or use district in which p~emises situafed 12 Does proposed consm~ction' vi61ate any zoning law 'dinance 'egulation: ~.O.' 13. W, ill lot be regraded ...... )~4¢~i..~......~..z..~./ :.. Will excess fill be removed from prenlises)- ---~- Yes 15!o Name of Arch,tect . ... ...... ; .... ,~4 ~ . Phon o .... . Name of Contractor . ........... /t¥'.~'-~ ..... .............. Address ............. ' ...... Phone No ............ ;. 15. Is chis property withi~ 300 feet of a tidal wetland? *Yes ........ No...~J~. ..... *If yes, Soutlmld ITown Trustees Permit may be required· i ' PLOT DIAGRAM Locate clearly and distinctly ail buildings, Whether existing or Proposed, and. indicate all set-back dimensions from property lines.' Give street and blocI~ number or descriptiofi according to deed, and show street names and indicate whether interior 'i B~' COMPLETE FON ALL C(}NS"fRUCTIOht 5HALL MEET THE '~I~OUIflEgENTS.'OF THE . STATE CO~BT~UCTIO~ · E~E~GY CODES. NOT RESPONSIBLE FOR DES~G~ OR CONSTRUCTION ERRORS STATE OF NEW_YORK. i' COUNTY o~:..~.~¢.¢~ ..... · ............... '.'~.~ fi : ......... ' ........ being duly sworn deposes and says that he is the applicant (Name of individual sigfiing contract) above named. /.~.~ ~ ~r ~ ~~¢7.... ......... ~ . SHe is the ... ' ' ........ c, ...... ~fi; n ;~ ~ ;o~, ~.t, '~¢p o ;~t~ ~}~ ~, ~ t;~. ............. ' .............. of said owner or owners, ~d 'is du~y authorized to perfom or have perfo~ed the said work and to make and file this ~pI cat on t at all statements con~amed m th s apphcatmn are true t~ 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 I % .... .............. o ~l~lon E~lres June.tO, r~ow of' 0 formerly ° 5 9 bS' S.8~7 O0 ~' £rnest ~ Horold W~ Isberg SUFFOLK COUNTY TAX MAP DIST. lO00 SECT, 140 BLK 3 LOT 4,1 SURVEY FOR I0898 MAIN ROAD, INC AT i~TT/TUCK TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK DATE : APR 2,1991 SCALE: I": 30' NO, : 91 - Z58 G UAI~ AN.%E.E D TO CHICAGO T'ITL YOUNG a YOUNG ALOEN W. YOUNG,PROFESSIONAL ENGINEER AND LANO SURVEYOR N,~S, LICENSE N0.12845 HOWARD W. YOUNG, LAND SURVEYOR N.Y.S. LICENSE NO 4589.5 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK