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Home My WebLink About20345-zTOWN 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) 20545 Z Permission is hereby granted to: . , ~-~ ,~ ............. ~~.....~ .......................... ~.~. . ~~.~:~.,~.. ~ ~.~C ..... .... ~~, .............. .., ...~.. ~. ..... ~o.~.~....~~ ....... ......~.~ ..................................................... at premises I~ated at ..~.~.~/~ ........ ~....~ ............ ~ ................................. ~ ...... · ~Z ............... ~ ................................................ .: ................................................................. ................ .................................................................... co~ ,~ ~p ~o. ~o0o s~o~ ...... ~.~ ....... m~k ..... ~.1 ......... [o~ Uo....~..~ .............. Building Inspector. "~'"'"'"'""'"BuYl'ding Inspector Rev, 6/30/80 rotlM NO. 1 TOWN OF SOUTItOLD [IUILDING DEPARTMENT TOWN HALL SOUTIIOLD, N.Y. 11971 TEL.: 765-1802 Bo^nv o~' 9~^t. ttt ............ OF PL~ ............ S1J R"] E¥ ..................... SEPTIC FORH ................ NOTIFY ,,-.?~ HA~L TO: Disapproved a/c ............................ . ~ . . ~/...~ ................................ ...... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled iii by typewriter or iu ink and submitted to the Building Inspector, with 3 sets of plans, accnrate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of bnildb~gs on premises, rdationsfiip to adjoining premises or public streets or areas, mid giving a detailed descriptiou of I~yout of property nmst be drawn on the diagrain which is pad of this appli- cation. e. The work covered by t~s application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wilt issued a Buildhtg Pemit to the applicant. Such permit shall be kept on the premises available for inspection tbrougbont the work. e. No bnilding shall be occupied or used in whole or in part for any pnrpose whatever until a Certificate o~ Occup~cy shall have been granted by the BulldOg Inspector. APPLICATION IS ttEREBY MADE to the Building Dep~tment for tlle issuance of a Btfilding Pemit pu~uant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, ~d o/her applicable Laws, Ordin~ces or Regulations, for the construction of buildings, additions or alterations, or for femoral or demolition, as hereN described. The applicaM agrees to comply with all applicagJe Jaws, ordinahees, building code; housin~ code, and regutatigns, and to ad~it authorized inspectom on premises cud iu buildiug for necessa~lnspections. (S~g~latt~e ot apphcant, or uame, if a corporation) .. '"' ih;id;~ ;~;~;; ;~.~i~;~;) .......... :' State whether applicant is owner, lessee, agent, architect, engineer c electrician, plmnber or builder. (as ~ the tax roll or latest deed) I[ appliglnt is a corporation, signature of ~uly attthorized officer. Builder's License No.. [. ...................... l'lomber's Liceuse No ......................... Electriciau's License No ....................... Other Trad,?s U~e,,s~ No../~%C.F-..,:/. ,~ ....... Locatio, ofla.d on which proposed work will be done ................ : .................. c.~ ~/3- /,&L 9'g' ~'r~~ ,, ~,,,-' '. ' ' ~ //~ ............. ...................................................... ~ .......... ( ti..~ ( ............. Ilouse Number Street llamlet /0 V~ ~,i oo-o08,-oo~ County Tax Mai) No. lOOOSection.................00 Subdivision ..................................... Filed Map No ............... Lot ............... (Name) Stare existing use and occopancy of premises and intcmlcd nsc and occnpancy or proposed construction: Existing Use and occnpancy ......................................................... ~ .......... b. Intended Use and occupancy 1 , 3. Nature of ~y_ork (check which apli)licabh,): New Building ..... ' ..... Addition .......... Alteration ......... Repair .~... Rem, wal .............. Demolition .............. Other Work ..... t~ ~ (Description) .l. Est n ate'd Cos ~ O .~ ............ ~ ......................... Fee ...................................... (1o be paid on fil off tlus ap ~heatmn) 5. If dwellln~, ntu d~er ofthvelHng mits ............... Nnmber of thvelling traits on each floor ................ If garage number of cars ' 6. If businegs, colnmercial or ~lixel{ occupnncy, specify llJttt[C dlld extent et each type of use .............. , ..... 7. Dnnens~o~?~fyx~stm~strnch~re~.ffany: front ..... ~o r l~,,,m /'la ' ~,.',,,r . llelght . ~. ~ . .~.' .... Nt tuber of Stories ..... ' ................. ' ........... ~ .............. "' Dimeosions of same structure xvi]tl~ alterations or additions: Front Rear Depth ] lleight Number of Stories . mensim n re exvcons ~c on: t ............... ear ............. ,cpm ........ 4.. lleieht ~..'~y.. ~ ..... Number of Stories ................................................ - 9 Size of lot: Front ' Rear Depth I0 Date of Purchase , of Fenner Owner I 1. Zone or nse district in which prehdses are situated .... 12. Does proposed construction vtolote any zonmg law, etd ~ a~ce or regt lat on: .. ~cff .................. 13. Will lot be tegraded ...... 4ffff.,~..?. ~ ....... , ..... Will excessflll be ~emoved front premises: Yes , N~e o Contractor ......... ~ ................ Address ................... Phone No ........ i... 15.~. th~. property located within 3OO f~et oi ~ tldat wetland? ig9 .... ~If yes, Southold To~n{ Trustees Permit may be requlr~d. ' PLOT DIAO~M Locate clearly and disti,ctly ~1: ' ' · · ibudchngs, xvhether existing or proposed, and. md~cate all set-back dimensions from property lines. Give street and block ?tuber or description according to deed, and show street names and Indicate whether interior or corner lot. FOR POUFd::D C()KIf;~TE I 4.FINAl,, CO~STRUCTtON MUS'fi SE. COMPt..ET~ Vo!'t C,O ALL (.OI&~TRULttON SHALL THE REQUIREMENTS OF THE NZ.' ,:~ ATE CO~iSTRUCTION (~ ENERGY~ ST,\TE OF NEW YOP, K, COUNTY OF .......... ....... S?S' (Name of individual s'g~Hlig contract) above nan{ed. being duly sxvom, deposes and says that he is the applicant lie is the ....................... i ....................................................... ~ .......... : (Contractor, agent, corporate officer, etc.) of s.id ow.er or mvnets, and is dulylanthorized to perform or have performed the said work and to m~e and file this apl:lic2fion; that :,Il statements contai:;icd in this application arc true to tim best of his knowledge ami belier; and that thc work will be performed in tho nu mcr scl fotlh ill the applicatIo, filed Sworn lo before Ine this '"' No. ~522~, Suffolk ~un~_ Term ~lres June 12,