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Home My WebLink About20931-z FORM NO. B TO~N OF $OUT~OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST DE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N _N? 20g lZ Permission is hereby granted to: ..... · ~.. ............. ~ ...... ..~.~.~......~.. .................... :~. ........ at premises located at ........................................ ~. ................ ~.. ........... ~.. ........................................ pursuant' to application dated ....................~....~.../. .......................... , 19...~...~.., and approved by the Building Inspector. ~'~ldtng Inspector Re~ 6/30/80 N 50'09'17" 15.69' N .~0' ~ 9'26" 5.43' 3.53' / LOT 217 / . LOT'218 .... ''~, 89'58'2¢ E 60.00' ........................ LOT 2Y8 PlO LOT 2~4 80.52' p~O LOT 214 N/O/FMcSHERRY 2' ACTUAL " DEED ,1 NUMBERS AND THE LocATION OF ISLAND PATH {EFER TO "AMENDED k~AP A OF NASSAU pOINT" [-'ILE No. 156, PILED AUG. 16, 1922. ~LAND$ IF ANY ARE NOT sHOWN. FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL,: 765-1805 Approved ., 19?.37Permit No ............ Disapproved a/c ..................................... .- ~Bui~ffing Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTtI 3 SETS OF PLA~,/S .......... SURVEY ................... CIIECK . CALL ................... HAIL TO: Date .... ~.v .... 1 ...... a. This application must be completely filled in by Wpewriter 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 streets 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 ;hall be kept on the premises available for inspection throughout the w4rk. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy 5hall 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 3uilding 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, build~ng code, and regulations, and to ldmit authorized inspectors on premises and in building for necessary insl~..--.~.~.~ .( ~__20 ~~ (Signature of applicant, or name, if a corporation) ?.! .e ...... ............. ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on ta× roll or late t f applicant is a corporation, signature of duly auth, onzed officer. NOT FY 8U LDING DEPART~ENT'AT 765-1802 9 AM TO 4, PM FOR THE .............................................. FOLLOWING INSPECTIONS; · (Name and title of corporate officer) 1, FOUNDATION - TWO REQUIREO ~OR POUREO CONCRETE Bu'lder s License No.. ?...¢-.~.. ~L~,~-~_ ........... 2. ROUGH - FRAMING & PLUMBING 3. INSULATION Plumber's License No ......................... 4. FINAL CONSTRUCTION MUST 8[: COMPLETE [:OR Electric. ian's License No ....................... ALL CONSTRUCTION SHALL MEI~ THE REQUIREMENTS OF THE N.Y. Other Trade's License No ...................... STATE CONSTRUCTION & ENERGY COi-~E$, NOT RESPONSIBLE FOR Location~ of land on which proposed work will be' done .... O~',~'i('~l'a OR CONSTRUCTION ERRORS o .......................................... ' ' ' .................................................... ~,,~, .~, ...... ,~o, .%,,-,~ ..... House Nmnber Street Hamlet County Tax Map No. 1000 Section ~ I / .... Block Lq ~(o ~1 ................................ Lot .... ; .............. Subdivision ..................................... Filed Map No ............... Lot ............... (Name) State existing use and occupancy of premises and intended use ant/ occupancy of proposed construction: a. Existing Use and occupancy co,~e ~.~.*..,~.',/~ '~ o,--,~ e_ ' b. Intended use and .5~..q? c e occupancy . . . 3. Nature of work (check which abplicable'p Now · ~ -' .......... - ......... Addition .......... Alteration .......... Repair .............. Remioval .............. Demolition .............. Other Work . .~.~... 4. Estimated Cost ~.D.,~..~ ,~..,~) (Description). (to be paid on filing this application) 5. If dwelling, number of dwelling!units ............... Number of dwelling units on each floor ...... · Ifgarage, numberofcars .. ~ .......... 6 If business commercial or mixed occupancy specify ................................................... 7' Dimension's of existing structur4s , nature and extent of each type of use .................... · if any: Front Rear Depth Height Number of Stories ............................................ of same structure with alterations or Front .. i .............. Rear .... Dimensions additions: Depth .................... i.. Height ...................... Number of Stories ....... ' .... :!'ii':'" 8. Dimensions of entire new construction: Front.. ' ' ' ' ' .... ............ Rear ............... Depth ......... ~eight ............... Num[ber of Stori 9. S:zeoflot: Fr6nt ...................... Rear .................... Depth .................... I0. Date of Purchase ........... Name of Former Owner .......................... 1 I. Zone or use district in which premises are situated ............................................ ' ...... 12. Does proposed construction vie e any zonin aw, ordinance or regulation: ......... 13. Will lot be regraded ..... i ...... Will excess fill be removed from premises: Yes No 14. NameofOwnerofpremises · ? ............ Address ............... PhoneNo ................ Name of Architect ...... . ....¢ ................ Address ................... Phone No ................ Name of Contractor ......... ; ................ Address ............... ;... Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Tbwn 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 n'umber or description according to deed, and show street names and indicate whether interior or corner lot. TATE OF NEW V~IRK~--r~ t OUN;r , s.s, ......... ~' ~'~ ~q ' :~ .... ¢~ :-.~.~q ............ being duly sworn, deposes and says that he is the applicant (Name of individual signing ~ontract) ~ove named. is the ~ ~ ~ ?~ ' , (Contractor agent corporate officer etc ) said owner or owners, ~d is duly adthorized to perform or have performed the said work and to m~e ~d file this plication; that all statements containe~ ~ this app cation are true to the best of his knowledge and belief; and that the 3rk will be performed in the manner set, forth in the application filed therewith· ~om to before me this ................... day of .~ .%~ ............ , 19~ Nota Public;State~[?wYo~k , (Signature of a licant) ~ , pp No. 52-8125850, Suborn Co~% - ' Tnrm ~ixoirPs (Jc~eb~r 31, 19~