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Home My WebLink About19584-z FO~ NO. ~ TOWN OF $OU'I3'IOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~- 19584 Z / Date.~....~...~/../..~.~./..~.~. ........ .............................. , 19...~....~9 ,~,~ ...... ~~..~..~..,...,..../..~..~.~:~ .............. ...................................................................................... County Tax Map No. lO00 Section ............ ~..~..... Block ........... ~ ..... Lot No ......~. ............. pumuant to application dat~ .......... ~ ...................................... , 19.~., ~nd approv~ by the Building Insp~tor. Fee $. ~'~.~. Rev. 6/30/80 FORM NO, 'J TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHQI_D,. N.Yo 1.1.°,71. TEL.: 755-1802 Disapproved a/c ..................... (Bucfi~ling [~:~ctor) ....... APPLICATION FOR BUILDING PERM IT BOARD OF HEALTH SEPTIC FORM NO?I p¥ ~ c^,.n . .q. 7. 7.: .LO./.O ........ MAIL TO: INSTRUCTIONS a. This application must be completely filled in by typewriter or iu ink find submitted to the Building I~laeCtor, with sets of plans, nect;rat~ plot plan to scale. Fcc according to scheduIe. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stree or areas, and giving a detailed description of layout of property must be drawn on the diagram which is parr of this app. 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 perm -shall be kept on the premises available for inspection throughout the work. , e. No building shall be occupied or used in whole shall have been granted by the Building Inspector. or in part for soy purpose whatever until a Certificate of Occupanc APPLICATION IS HEREBY MADE to the Building Department for the Budding Zone Ordinance of the Town of Soathold, Suffolk Count issuance of a Building Permit pursuant to th ~R,e. utan.o, ns, for the construction of buildings, additions or a t ?, New Yorls, and.~other applicable Last's, Ordinances o ~ ' eratzons, or for rem emolitio erein deschbec the apphcant agrees to comply with all applicalJie laws, ordinances, building cod oulations, and tr · ' ~~O.D. ?..0'..~_ Greenpor t, NY (Mailing address of applicant) 1 1 9 4 4 State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bail'let. .. . .Attorney and A~ent Name of ownerofpremises Bayberry Enterprises, Inc. (as on the tax roll or latest deed) ............. If applicant is a corporation, signature of duly authorized officer. ........... ti& ofcoh;gral; i/ aide'; d .................... Builder's License No. Plumber's License NO .............. Electrician's License No .................... Other Trade's License No ...................... Location of land on which proposed work will be done: · Cox' s Lane .... Cutchogue ' llou$c Number Street, ' ....................... . Hmnlct ............. ty p N .0p. · Coun Tax Ma o. I000 S~ction .............. Block .... 03 · -- L .°2 bdi · · Su vision ....... :... ..................................... Eilcd Map No. (Name) .............. Lot State existing ............... use and occupancy of premises and hltended use and occupancy of proposed construction: A. Existing use and occupancy .... Vacant Land , B. Intended use and occupancy.: ..... Vacant Land ............... ~;ah~W~ t~Pe~O.,a/kh~.~t**,~t~ ................. 3. Nature of work (check which applicable):. New Building ........ .. Addition . ......... /alteration ....... Repair.. ...... R~moval ............ ;. Demolition ...... SwL'mlng pool. .......... 4. Estimated Cost..~.[.~Q.Q.Q, '~, ..................... .. Fee .................................. · . . i (to h~ paid on filing !his applicat!on~ 5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor. .. lfgaraee number of cars " 6. It' business, commercial or mixLd occupancy, specify nature and extent of each type of use ........ 7. Dimensions of existing structures, il'any: Front ............... Rear .... Depth .. Height ............... Nu[nber of Stories .......................................... . Dimensions of same structure with alterations or additions: Front ................. Rear ..... Depth ' Height Number of Stories 8. Dimensions of.e~tire ne~v construction: Front ...... Rear .......... Depth ........ Height ........ Nu er of Stories .. ; ................ ' ...... 9. Sizeoflot:Eiont-....59~2...74 feet 4~[5 17. .'.'.f.e t. 5..59.-+ ~ ............... Depth . . et 10. Date urc '~. ...................... am o x e ........................ 1 I. Zen or use dmtrmt ~n wluch premises are situated .... L.I. ...................................... 12. Does proposed construction vi;late any zoning law, ordinance or regulation: ... i No i ii. ]]].' ......... 13. i No. ' ....... Will lot be regraded .................... {6.~ ...... Will excess fill be removed from premises: Yc.s .... Name of Architect ......... :i .................. Address ................... Phon~ No ............... Name of Contractor ....... ~ ......... i ........ Address ................... Phone No .... ; .......... 15.I.a ~_l~ig property [oe!ated within 300 feet of a tidal wetland? ~YES .... ~If yes, Southold ToOn Trustees Permit may be required. ' PLOT DIAGRAM Locate clearly md distinctly all buildings, whether existing or proposed, and. indicate all set-back dimen'Aon% :~: property lines. Give street and bloc ~ number or description accordLng to deed, and show street names and indicate interior or comer lot. ~See~~ ~~/attached. survey· ~ ~' .' Fence ,t9' enclose entire lot and to be maximum height allowable pursuant to So~thoid Town Zoning Ordina. nce. STATE OFNEW YORK, i S.S COUNTY OF... O.U.P..tJ'0L~..... I ..... 4 ,. tqW. I.N., [~.c.L.%Vg~.L.Z.N. i ................. · ·. (Name of individual signiug contract) above named. APP/~O~ED AS NOTED 765-1802 9 AM TO 4 PM FOR THE FOLLOW~NG ~NSPECT[ONS: 1. FOiJNDATION - 1YVO REQUIRED 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 N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS being duly sworn, deposes and says that he is the applies: .A.t.t.o.r.n..e¥ and Agent ' He is the. .... ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dply authorized to pe,rform or have performed thc said work and to make and file th application; that all statements contained in this application are true to thc best of his knmvledge and belief; and that work will be performed in the man,er set forth in the application ~led therewith. S~vom to before me this ! ~.~...~..day;f .... November ' · .. 9.79 Notary Public...,~., .......... ?..~U~;~p.i.k. ....... County