The URL can be used to link to this page

Home My WebLink About20359-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Yo BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COJ~APLETION OF THE WORK AUTHORIZED) 20359 Z Permission is hereby granted to: ~..~...~.~..~..~...~:~...h. ~-. ..... ~.~.~.....~.:.....~.~...~ ................. ...~, ~~.:....~.:.~.:.....,..:.~.~. ~. ........... to~....~......~...~ ......... ~.~L.~....~.~....~:......~ ......... .... .~..~../.. ~ ~ ~ LL~ C~ ~, ~*~ ' ' at' premises located at ~ ............... ~...~.,..--..:= ........................ r. gJ..~ ............... pursuant to application dated ~.~.(~:~........~.~ ............. , 19.."1...(.., and approved by the Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD ¢ BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765.1802 h'xauuned . ,X.o,.,~..~...., 19 9..~ IV Per,nit No. 1.% Disapproved a/c ................................... .......... ' ............... ..... (BJildlng Inspector) APPLICATION FOR BUILDING PERMIT BO,\KD OF HEALI'II 3 SETS OF PLANS SURVEY ................... CIlECK CALL . HA I L TO: ? ' INSTRUCTIONS a. Tkis application must be completely filled in by typewriter or in ink and submitted to tile Building Inspector, with 3 :ts 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 streets r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ~tion. ¢. The work covered by this application may not be Cbmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Budding Permit to the applicant. Such permit :all 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 .all 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 ~ilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~e applicant agrees to comply with all app cab e laws. ordinances, building code, housing code. and regulations, and to · mit au tho rized insp ec tops on premises and in building for necessa ry inspe c~ ~.~._~ " (Signature of applicant, or nam~ f a(.(.g,j~rporatior~ , (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, enzineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) a pplica n~.~si.g~nj.)tu rgd..~.j~ au thorized officer (Name and title of co,rt:r6'rate office ' ' ) ffic~ff ...... Builder's License No ........ : ................. Plumbcr's License No .... . .... ,. ................ Elcctrieian's License No ....................... 0 mr Trade's L ccnsc No ................. ~/qT/M? afl ~_,j ' ' Location of land on which proposed work will be (tone..' ..... .. - llouse Number Street Hamlqt Con,'ty Tax Map No. 1000 Section ...... 1.o..7 ....... mock ...... ....... Lot .... ..~..,. I ' SubdM,don ,' ...................................... Filed Map No. (Name) .............. Lot ................ S~ate existing nsc and occupancy of premises and intended use and occupancy of proposed construction: 3. Nature of Work (check which apPlicablA): New I:tuddin~ . ..C . ...... ' /~s,/,~, - · Addition .......... Altcratmn Rep~r ........ Removal . . ....... Dcmohtion .............. Other Work ............. 4Estimated Cost ' ' (Dcscnptmn) .................................... ................................ (to be paid on flung this application) S. If dwelling, number ofdwelli9g units ......... Number oFdweUing units on each floor ........... . lFgarage, numberofcars ..., ......... ' ..... 6. If business. COmmercial or mixed occupancy, Spcclty nature anti extent of each type of use .... ~ ..... ' ' ' ' 7. Dimensions ofexistitgstmct~res fan Front '"' '.... ' ......................... ' .... He g ~t . Y: * · .... ~ , , · D- , " '' ~ .......... ~mberofStories .... ' .... Rear .............. Depth ...~. ....... -lens o ~s ol same staicture :with alterations or additions: Front .................................. Depth .......... .. . 8. Dimensions of ' · · ~ · · · IIe:ght .... ' ........ Rear entire new cgns'tmcdon: Front .. ' ' ' · ......... Number of Stories .... ' ............ e' .. - · ..... Nt tuber of Stones . . . , 10. ~ze otlot: Front .......... ~ ....... · ......... , ............ .. DateofPurchase , ,. Rear .... ' '&'- ,' ................... I 1. Zone or use district in which p~em scs are s~tuated ...... ' weptn ....... ............................ Name of Foyer Owner ....... ' ................... 12. Does proposed Construction vi61ate any zoning law, ordinance or regulation: ..................... 13. Will lot be regraded ..... f p ........ ; .................... Will excess fill be removed from premises: Ye Nc 14. N~e of Owner o remises , N~e of Architect .. , ' ............ Add Phone No ........ N~ of C ....... ~ ................. Address ........ · ...... ontractor ........ is propert ~00 f ross .... . . · Is th f Y Y within eet of 'da~ wetland? *Yes .... No ......... [ 5. ' ................ Add ........... Phone No ............... · I es, Southold ~ow- ~ ~ a t~ .............. PhoneNo ...... .. .. ~ - ~cusnees Permzt may be required. '''' ~ PLOT DIAG~M Locate clearly and distinctly ~I~: bullrings, whether existing or proposed, ~d, indicate ~1 set-back d~ensions from prope~y ~nes. Give street ~d block mmber or description accordNg to deed, and show street nines and indicate whether interior or comer lot. FEE ,.~z ........... BY' --- NO'r{FY BtI~I..DING DEPARTMENT AT FOR POURED CONCRETe7 2. fiOUGlt FRAMING & PLUMBING 4, FINAL COi~ISTRUCTION MUST DESIGN OEt CONSTRUCTION ERRORS ?,".TE OF_~NEW YORK, __ , _..- . ...... .... ' ..... ' boil,,' · . is tho .......... , ' U k'-' ........................................... ... . ;. . ~ (Co tractor, agent cot)orate' said owner or owr ers. and is'du' .; . , :y aul~or:zed to perform or have ~erfor~ed tie snd work ~nd , icafion;lhnt ~1~ statements contained Jn ttis a I' ' to ',: xt~l be *crformcd i tha m- . PP ~cat;on are true to Ibc best oflu~ I~e and file this ~ncrset lorth m the apphcation filed therewith knowledge and behef;and that the .................. day of.. . ·.., 19 , · . .... :Y - Commi~o on Fxnire~ hln¢ ~ ~n q ~ - to:~at~ applicant)