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Home My WebLink About21315-z FOB~ NO. ~ TOWN OF $OUTHOLD ~UILDIHG DEPARTMENT TOWN HALL $OUTHOLD, N. Y. N~2~o, BUILDING PERMIT (THIS PER~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) ~131~ Z Dote ..~ ........................................... , ,9~...?. Permission is hereby graqt, e~ to: ................... ~, p~e~e~ ~t~ ~, ...~&~ ............ ~~ ...................................................... .................................................... ......................................................................... co~ T~, ~ ~o. ~000 S~,~o, ......... Z~... e~k ......... ~ .... ~ot ,~..~ ............... p~nuont to opplicction det~ ...... ~ ................................... , 19~.., and oppmv~ by the Building Inspector. Fee ~ Rem 6/30/80 APR 21993 BLDG. DEP'L ~ ..Examined ........ 19 .~7,.~. ^pproved ......... 19 ~eermit No. ~../..~../..'~./ Disapproved a/c ' FORM NO. '1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 . ..(Bufl~,lnspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ......... 3 SETS OF' PLANS .......... ~SURVEY ................... CHECK .... ; . .. NOTIFY: CALL . .. . ....... HAIL TO: INSTRUCTIONS a, This application must be completely filled in by typewriter or in 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 sti'eets 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 i~sued 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, c~nsf~'~tmn· of-buildings, additions or alterations, or for removal or derholition, as herein described. The applicant agrees t,o comply with all applicable laws, ordinances, building code,J~ousing code, and regulations, and to admit autli°ri~ed'ff~spe~t°~s °n p~e~ses and i~ building f°r necessarv inspecti~/+: _ ~ / ~ ~ .:/~.~ '~ ,Q . , / ---- I ' (S~nature of applicant, or name, if a Eorporation? State whether applicant is owner, lessee, agent, architect, epgineer, ganerM 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 L~cense No ......................... Electrician s Lmense No ....................... Other Trade's License No ...................... · ...... .......... '.: ......... House Number Street Cou'nty Tax Map No. I'000 Section ... ~).-~ .......... Block ...... d~. t~,~...' Lot...'.. ~../~ ......... Subdivision ........ . ............................ '. Filed Map No ............... Lot ............... (Name) State existing use and occupCncy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ....... 9. ID. 12. 13. 14. · ;5. Nature of work (check which applicable): New Building ' Addition Alteration ' Repair .............. Remov, al, .............. Demolition .,..~..........' Other Work ¢'.~.q< .L.t .~!t. . ~..~.~,~ · ' .~.oC...D~) I ' ' ' (Description) 4. Estimated Cost . (to be paid on filing this application) 5. If dwelling, number of dwelling uti.its ..... i ......... Number of dwelling units on each floor ................ If garage, number of cars i 6. If business, commercial or mi,xed o~cupancy, specify nature and extent of,each type of use ...................... 7. Dimensions of existing structures, ifany: Fronf ............... Rear .............. Depth ........... Height ............... Numbe~ of Stories .. :.. ~ ........ ' · . .............. Dimensions of shme structure with hlterations or additions: Front ................. Rear .............. ~D.epth ,. ...................... ,Height ....... ,~' 7' ......... ,.. Number of Stories .......... '. :. , .... '" ~Jlmenslons of entire new construction. Front .,;~O . ,o .... ,-~n*' ,., .. --.,,~l .... ~ .,,u, ZIt ,, i ............. ,:,~ur ...~*' .......... ~epm .q~. ......... ,,el~,,,t .. rz ........... ~umber of Stories ................ ~.... Size of 10t Front ..... ' Re,~ .......... ' ....;,' ' L' ............ .............. ~eprn ............ Date of Purchase . ~ .... x~ ....... " · ............. i ......... . &~ame oI eormer uwner .......................... Zone or use district in which premise,s are situated ............................................ i.. Does proposed construction violate a~y zoning law, ordinax~ce or regulation: ./¥~0 ....................... Will lot be regraded .,.. ?..0 ........ i ....... ~ ....... Will exce~a fill be removed from premises: Yes Name of Owner of premises .~/e$'.o4:. ~).. ~.g..8..~.. Address . ~?.(4j.~/...~ .... Phone No.. ?'.J. tgrx. ~?.~-~.. - Name of Architect ' Address Phone No Name of Contractor ............ ~ .. Address .. 'v ................ Phone No. 15.' I.$ this property within 300 f et of a tidal wetland. *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. I PLOT DIAGRAM Locate clearly and distinctly all bulldogs, 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 indleat~ interior or'corner lot. . AEF OV E:D AS NOTED. N OJ!F B'U LO PART r AT 76§ 1802 9 AM TO t~ PM FOR THE FOLLOWING INSPECTIONS: mUN AT O RmUmEO FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUC¥10N ERRORS STATE OF NEIg-Y, OR.~.j~ // S.S cou y. '2 . , , · ..'..-(.~..O.~.C.~.. ~ .~... ~. ~ being duly sworn, deposes =d says that he iS the applicant (Name of individual signing contract) ,, above named. '" .......................... ' ~Contractor' ' ' ............................. " ' .............. ,. agent, corporate officer, etc.) of said owner or ownexs, ~d is duly author~ed t~ perfom or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are ~rue to the best of his knowledge and belief; and that the work will be. perfo~ed in the manner set forth in th~ application filed therewith. Sworn to before me this . . Gu~llfled ~ 8u~olk eou~ , ' (Si nature of ic %% HEALTH DEPARTMENT-DATA FOR APPROVAL TO CONSTRUCT NOTE: I=MONUMENT O=PIPE STAKE BRAflOtS & SON~ [NC. 1046 SURVEY FOR THEODORE O. BEEBE, JR. AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK SEPT, DATE MAY SCALE' I"=.%0' NO. 85 - 59:5 GUARANTEED TOt YOUNG a YOUNG ALDEN W.YOUNG,PROFESSIONAL ENGINEER ANO LAND SURVEYOR N.Y.S. UCENSE NO, 12845 HOWARD 9/. YOUNG~ LAND SURVEYOR N.Y.S. LICENSE N0,4§895 400 OSTRANDER AVENUE RIVERHEAD, NEW YORK