The URL can be used to link to this page

Home My WebLink About20375-z l~OB~ NO. ~ TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPu~IT MUST BE KEPT ON THE PRF_AAISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 20375 Z Permission is hereby granted to: .... ~.~. .... ~: ................... , .......... .~.....I ............ ,o ................. County Tax Map No. 1000 Section ..... ..~...~....~ ....... Block, .....C~...~... ........ Lot No.....~...~'....~.~.. ........ pursuant to application dated ......~. ~..~....~ ................... ,19~..~..., and approved by the Building Inspector. Rev. 6/30/80 FORM NO. 1 *, TOWN OF SOUTHOLD J/?J '~' 7 BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11071 · TEL.: 765 1802 \pproved ..~., 19q. ~.. Permit No. ¢~...0..i~..~... ~ Disapproved a/c ..................................... ............... iFding Inspe · · 'm-( · · · Bu ctor) APPLICATION FOR BU1LDING PERM IT BOARD OF HEALTII ......... 3 SETS OF PLANS ......... SURVEY ................... ClIECK CALL ................... FLAIL TO: INSTRUCTIONS a. This application must be completely fillcd in by typewriter or in ink and submitted to tim 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- ~tfon. ¢. The work covered by this application may not be Cbmmenced before issuance of Building, d. Upon approval of this app ication the D-:~,~:_~ ...... , ~ ' ~ Permit· ~u,,u,,~ m~pec~or %vnl issuecl a ~udding Permit to the applicant. Such permit mil be kept on the premises available for inspection throughout the work. e. No building shall be occunied or used in whole or in part for any purpose whatever until a Certificate of Occupancy :all have been granted by the Buiiding Inspector. APPLICATION IS HEREBY MADE to the Bui din~ Department for the issuance of a Building Permit pursuant to the ailding Zone Ordnance of the Town of Sou]hold, Su~ffolk County, New York, and other applicable Laws, Ordinances or egulations, for the constraction of buildings, additions or alterations, or for removal or demolition, as herein described. ,)e .applicant agrees to comply with ail applicable laws, ordinances, building code hous ~, · 'm~t authorized m specters on premises and in buildmg for necessary inspections.' ~~nEulations, and to ............... Susah. Egai3 ....... dj · -~.. (Signature et applicant, or name, ifXalcorporation) 200 Founders Path, Southold, ay 119.71 (M'ailing address of applicant) ate whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner ante of owner of premises ......... Sa, hie .as app.] i cant (as on the t;[x roil or latest deed) ............. applicant is a corporation, signature of duly authorized officer. Location of land on wi]ich proposed work w/II be clone..-... O0 Fo~n~da,r,~;, P, ath~:,-,, ~, t,~ ALL ~,~,Lo,~J{.,~tOIV 'g~A~,.~, "M~E~ .... Southold, House Number Street COt~IH~OT RESPONSIBLE FOR ................... 0 Z o aGU co smu R"o s · CotmW Tax Map No. 1000 Section '~G4 , OO Diock ............... Lot .... (~. ,.~.~ ....... Subdivision ............ ¢ "' ' '¢C,' ', ..... Fikd Map (Nan c~" .............. Lot . ' 5t2~c cxjs[in~ usc 2~d occup2¢~cy o¢ prc~s(?~ and i~ dSd use and occup2ncy OCproposcd construction: E ' ' BeE~d~nce ' ' 1, xlmng use and occupancy ...., , Residence , ~. Intended use and occupancy ........ ~ ........... .......... . 3. N~"ure o£work (check whichlapplicable): New Budding .......... Addition Repair .............. Removal .... · ......... ?dictation ...... ........... Dcmobtion .............. Other 'Work ...F.~{~o, . 4. Estimated Cost ........... 250 in mate. r!a.l.s' .... Fee . . . (Description) If dwell/n- nh- h,,._~., , , .. (to be paid on fi ins this application) · l[,gar"~ge, numberofcars ....... ' · · Numberofdwcibngu,msoneacbfioor.. 6. l~°usmcss, commercialormXedocr,,',,'~.,~_' /,'.j ..................... ; ...... ...... ;'... ''" 7. Dimensionso'-~<'t e ' . -- u,-,~-y, speclw nature anti extent of each type of use . . , ~ ~ ''' tlei~ht lStmg stmctu,res, finny: Front ......... · .... .. ............... Number of Stories ...' · · ~ .... Rear .............. Depdl .............. Dimensions of same structur,~ with .......... alterations or additions: Fro it '. ' . R Depth ..... . .. ' ................ .......... 8. . .lIeg~t . ' ............ ear ........... ... Dimensions of entire new consirt ction' Vr ............... Number of Stories ................. ' ' ' He's it ,. . · ont ............... Rear, ............... Depth ' ' ' ............ pmm~,er of Stories .......... . ............. 9. Size of lot: Fi'ont .......... ': ' '. · . Rear .. . I0. DateofPurctmse .... 12/8'9 ....... ~,~ '''Z' '' . D t ............. 11. Zoneorusedstricti~M.'~,:'''", ...... ; ......... r~ameofbormer v er 12. Does proposed Construction violate any zoning law, red' Baker .... lot be regraded ....... ~... No. rdinan, ce or regul~ i ~'.,o. 13. Will 0 tion: .............. '' 14. Name .. Wdl excess fiji bo remo;,od from premis,3~: ' ' of Ownerof prom,scs' .~?-,mq, ,~..5 .o,~. ~./t.c.a..3 ~ ' ' ' ' ' ' ' ' ' ' Address ~.o..~. ooo~c~.J~b_,h.. Phone No.,5'/.6..".7.~,.~-: ..K57.,q~,.'~.' ' '"' Name of Arctdtebt ...... ~qrle ' .................. Address ......... ..................... Address .... ' ......... Phone No ................ tS, Name of Contractor. "N°n°3~O' feet: of a fa±da.1, wet:land? ~Yes ........ No ...... .X.X. ' '' l's eh±s propert:y w±t:htn ............... Phone No ............. ~Tt yes, Sout:hold Town~ Trusl:ees Permit: may bo required. · ... PLOT DIAGKAM Locate clearly and distinctly all buiIdings, wt~ether existing or proposed, and, indicate all set-back dimensions £rom property lines. Give street and block humber or description according to deed, and show stre¢l ~am .es ~d indic~te whether interior or comer lot. ux'-rv or: ...... /. .... , o,,e named[ ,heel individual co,,trac, '"'~ ";il', ....,e constructed 8" p,~parcy i~ ,e. It will measure .~,'~[' i'~ hoi~ht and 17'8" in length. It will be con ..... '" 'u.t,.d" of cedar both wood and lattice. See drawing a~d location information. ~['~-q~Lv(oe .......... being duly sworn, deposes and says that he is the app leant the ~ (Contractor agent corporate officer ........................... ' , , etc.) said owner or owners, and is duly authorized to perform or have perforated tile sakl Work ,~nd to make and file this q/cation: that all statements contained in tiffs application are true to tile best of ' wdl be performed in tile manner set forth in the application filed therewith, bls knm~ledge and belief; and to before me this :that the ary Public, .~~'~ ' ~oti~ P~lio,'State 0f New Yo~ · N0, 2~26087 ' . ....... uommis~on ~plres June 30, ~/~q~ (Signature of~pllcant]