The URL can be used to link to this page

Home My WebLink About19369-zTOWN OF SOUTHOLD gUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PEP, MIT (THIS PEP, MIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Coun~ To. Mop No. ~000 S.c.on ...... 7..~ ........ B,~k ....... ~ .......... Lot No...~.~.:.~.... pursuant to application dated ........ ..~)./.~. ..................................... , 19.,~.....~.., and approved by the Building Inspector, Rev. 6/30/80 Invoice// Da te Fence Master 874-2449 .... J_! 57.__ BOX 220, Speonk, N.Y. 11972 Wood Type '.Pype..~__~, }l~t~h~, Height_ Pos~s '2 EnOs_ Ends LSnes __ Lines / Wire Gauge Coil Wire Barbwire Ga2e Description Job D'escripiion FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ..¢ .......... Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH . SURVEY .... ~,~. . c.EcK ...-~.. ~.& ........... SEPTIC FORM ................ NOTIFY} CALL ...... ;.. MAIL · %~ ~,.. ' Date ................... 19... ' INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Ihspector, with ~ ' 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 street: or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. The work covered h~, 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 shall 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 shall 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 Building 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 ail applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors ..... on premises and in building for necessary inspe tions. · . (Signature ut ~p~c~ ~a'~, if'a'c'o~t~o'r~t~o'n) '' (Mailing address of applicant) State wh~ther applicant is owner, lessee, a~ent, architect, engineer, general contractor, electrician, plumber or builder. (as on tlq~ tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .......''(~la~e" .~Jci .............................title of corporate officer) ~uilder's License No ...... ;.¢..~.~....a'./.,. ....... PI tuber s L~cense No ......................... Electrician's License No ....................... Other Trade's License No ...................... h Location of land on which ~p~sed work will be done~ .... · ................. .... llouse Number Street, Hamlet vd' ' .7. .34: f. ty p N S ' BI0 Coun TaxMa o. 1000 ection .................. ck ..-....-....... Lot.. . . Subdivision ..................................... Riled Map No ............... Lot .......... (Name) ..... State e .' · - xlstlng .se and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy Intended use and occupancy ......... . ' o .......... S~immi'' 'ng pool .~,~. ~,.,, Repair ........ ~ ..... R~moval ............. Demoliti n ......... ~ ' ': · · Tennis Court ~ ....... Adcessory Building .......... Fence ~,O~r~J-Ofid. Othe~*Woek:~ J)~;}~.. J~i....- 4. Estimate'dCost...~.~.Q:.ff~. .... , ............ Fee . · ................ ,..' ' i (to be paid on filing this application) 5 Ifdwell b fd 11' ~it N b fd Iii its ch · lng, hum er o xve ng u s ............... um er o we ng un on ca our ....... , ...... ... If garag?., number of cars .............. ; .............................................. 6. If business, commercial or mixed 9ccupancy, s ecify nature and extent ofeach type of use ........... Front Rear Depth 7. Dimensions of existing structures,!if any: .., ......................................... Height Num b~r o f Stories. ..... ........................ · Dimensions of same structure xvit~ alterations or additions: Front Rear . Depth i Height Number of Stories · · 8. Dimensions of entire new construction: Front . ........... . .. Rear ............... Depth ............. Height ,Numbler of Stories .......... · · 9 Size of lot: Front ~ Rear Depth ........... 10. Date of Purchase ............ ! ................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated .................................................... 12 Does proposed construction violate any zoning law ordinance or regulation: ..... 13. Will lot be regraded .... .........i ........ . ...... Will excess fill be removed from premises: . Yes .... No. ' ....".... Add P1 N 14. Name of Owner of premises ......... . tess ............... . . . . tone o ................ ' Address Phone No Name of Architect ............................................................... Name of Contractor ' Address Phone No 15.Is this property located within 300 feet of a tidal wetland? *YES .... NO .... mIf yes, Southold TownlTrustees 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 :lumber or description according to deed, and show street names and indicate whether interior or comer lot. FEE' BY. 765-'1802 9 AM 1'0 4 PM FOR THt: FOLLOW'NG t_N~P.ECT~g:REQUIRED 1. FouNDATION FOR POURED cONCRETE 2. RouGH ' FRAMING 8, PLUMBING 3. iNSULATION 4. FINAL ' CONSTRUCTION MUST SE cOMPLETE FOR C,O. ALL CONSTRUCTION sHALL MEET THE REQUIREMENTS OF TIlE N.Y, STATE coNSTRUCTION & ENERGY S NOT RESPONSIBLE FOR cODE . . ERRORS DE.qlGN OR cONS [RUCTION STATE OF NEW YORK, ;S.S COUNTY OF .................. ............................ i .................... being duly sworn, deposes and says that he is the applicant (Name of individual sig~iug contract) above named. ~ is the ..................... i ..................... : .......................................... : "' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is du!y authorized to pe,rform or have performed the said work and to make and file this application; that all state~nents cont;ained in this application are true to the best of his knoxvledge and belief; and that the Work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .......... .,fl...~. ...... ~.~fiday ol...~ ....... 19'~. NOIRRY PUBLIC, State of:NeW Yodl ' . ~. 47onn, s,,~ ,~r~%,/ mm Expires March 30, ~ . ' ~ture of applic i