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FORM NO.3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
BUILDING PERMIT
THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
A9 19./9
Date ZE
1... .
Na 21686 Z
Permission Is hereby granted to:
...............l.T...,................................
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to w,,~T..£ e4 C-l-......,...,.........,1`~~ G9
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at premises located at r4!.?.............. ......................~.............t!...................................
. .
County Tax Map No. 1000 Section ...~!e?........... Block -3......... Lot No.
pursuant to application dated 19,7 and approved by the
Building Inspector.
Fee '1'....
~...~1. .
Building Inspector
Rev. 6/30/80
~~4~OgpfFO(K~OGy
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Town Hall, 53095 Main Road Go Z Fax (516) 765-1823
P. O. Box 1179 , • Telephone (516) 765-1802
Southold, New York 11971 P p!
X01 ~ ~a
OFFICE OF THE BUILDING INSPECTOR
TOWN OF SOUTHOLD
March 22, 1995
Mr. Bert Lalli
1405 Narrow River Road
Orient, New York 11957
Re: Building Permit # 21686-Z
Premises: 1405 Narrow River Road, Orient, N.Y.
Suff. Co. Tax Map #1000-27-03-6.3
Dear Mr. Lalli:
During a review of our files it was noted that the above
building permit has expired, and construction was never started.
According to the Code of the Town of Southold, A building
permit expires in 18 months from date of issue, but work must
begin within a 12 month period or the building permit becomes
void. We have voided out this permit.
If you have any questions regarding this matter, please do
not hesitate to contact this office.
Very truly yours,
SOUTHOLD TOWN BUILDING DEPT.
Thom s J. is er
Sr. Building Inspector
TJF:gar
BOARD OF HEALTH
~E'~',~FORM NO.1 3 SETS OF PLANS
TOWN OF SOUTHOLD SURVEY
BUILDING DEPARTMENT CHECK
9t ?
SLP 2 ®TOWN HALL SEPTIC FORK . .
SOUTHOLD, N.Y. 11971 71
TEL.. 765-1802 NOTIFY
2 .1.?
Exami TO4U~et'si- 19 3 CALL
Q/• • , MAIL TO:
Approved .........7./. ~0..., 199. Permit No. j7l&AP. .
Disapproved a/c
(B ij ng Insctor)
APPLICATION FOR BUILDING PERMIT
Date 19
INSTRUCTIONS
a. This application must be completely filled in by typewriter Orin 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 stieets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building 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 pursuant to the
Building Zone Ordinance of the Town of Southold, 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 described.
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..
A
! . o . .`°"~'~f. .
(Signature of applicant, or name, if a corporation)
s
6!J®S.~c,
(Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general 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. ../VQ/U F . . . . . .
Other Trade's License No .
1. Location of land on which proposed work will be done. .
t .....l~`~ . C'~l~.......................
House Number ` Street Hamlet
County Tax Map No. 1000 Section 0 2. Block U Lot qd 03...... .
Subdivision Filed Map No. Lot
(Name)
2: State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ^ :a- 5 ,
b. Intended use and occupancy . , , , , , , , . .
.
I
3. Nature of work (check which applicable): New Building Addition Alteration
Repair Removal Demolition Other Work!GJ~F.P.G
(Description)
4. Estimated Cost /A A&Z) Fee .
5. If dwelling, number of dwelling (to be paid on filing this application)
s
g. units Number of dwelling units on each floor
If garage, number of cars
6. If business, commercial or mixed occupancy, specify nature and extent of•each type of use . .
Height ...ensrons..of. . ...existin structures,
S.. . . es> if any: Front Rear Depth .
Number of Stories . .
. . . . . .
Dimensions of same structure with alterations or additions: Front • , • • • • . • • . •
Depth... Rear..................
Height en of entire Height . Number of Stories . , .
. . . . . Nu Front : Rear Depth
8. Dimensions of entire new ew construction: ber ber of Stories , , , , , , , , , , • , • • • • • • •
9. Size of lot: Front . Rear Depth
10. Date of Purchase
6 Name ofFormer Owner
1. Zone or use district in which premises are situated . . .
12. Does proposed construction violate any zoning law, ordinance or regulation : . .
13. Will lot be regraded
i • • • • • • • • • • • • .......Will excess fill be removed from premises: Yes No
14. Name of Owner of remises 1 . , L•441 • • , , , Address Phone No..............
lrf. AU /N • • • • • • Address 77.11v: 7 411 Phone No.~U.'.72,7; Zri„y,$,
Name Nameoof Contractor br tntractor S ..ougol.l Oce'44tl,_ Address Phone No.............. .
15. Is this property within 300 feet of a tidal wetland? *Yes........ No.........
*If yes, d 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
property lines. Give street and block number or description according to deed, and show street names and indicate whether
interior or corner lot.
rZ'AkJ
STATE OF NET_YOl~
COUNT~YjOF....(?~. SS
• • • • • • • • • • being duly sworn, deposes and says that he is the applicant
(Name of individual si nmg contract)
above named.
He is the .
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application; that all statements contained in this application are true to 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 t KS
-day of. l 193 n N
County
g OV (Signature of applicant)
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WITrI IONG. yE1,~L Rla. hTl U 1 i 1TL FLU& 3 FEED
'AddG{~fl- Pxt.T~! ~4k ad=G. s ~ S~ NOTIFY BUI Na fSgNe fjpA'~ton trtrx x3 S"'{n ,y~j1_'r NOTIFY BUILDING DEPARTMENT AT !"tp ~ ~IG T CERTIFICATE
W1114 TAPOF OF Ec NEy I • L1 _ 765-1802 15 765-1802 9 AM TO A PM FOR THE o t.;f^ Drdwa ~N q'44~ n
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I~ t, + New FoM VLA6vfv'.n EXI~1f'WI iC~WSTOt~R t1MN Fiu(00T, fJTN. LIB WWITH VOI.d.-44, FOR pOl
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~ T iN (sPOx'('ON (1~1(• PDTN- VAt/ A FINAL HE COME A FINAL CONSTRUCTION MUST RE COMPLETE FOR C:O. Boole'
_ wr ALL CONS" ALL CONSTRUCTION SHALL MEET SLP 2 0 PKR PT~n
TFIE REOUI THE REQUIREMENTS OF THE N.Y, f I eM1t DtINY(,I t F,f
F"(2A-leN eLA 4 n FIRST FLadrpl -P 7Ai E COP 7AT E CONSTRUCTION & ENERGY B,
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