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Home My WebLink About19126-zTOWN O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE K:EPT ON THE PREMISES UNTIL FULL COMPLETION OF THE wORK: AUTHORIZED) Date 19.~..0.. / Permission is hereby granted to: /x'~/ ............................... at premises I~ated at .~......G..~...~.....~ ....................... County Tax Map No. 1000 Section .... /...~....~.'~.. ...... Block .......(~....~:'... ....... Lot No .....L...~. ............. pursuant to application doted ...... ....~. ~.~.I ....................... , 19.~....O.., and approved by the Building Inspector. Fee $,-'~,~/...'..~. Building Inspector Rev. 6/30/80 FORtd NO. t TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 705.1802 Approved....'5] ~ J.~.., 19 ~',0. Permit No. J.~ .1..~. ~ (Building Inspector) APPEIgATIO~ FOB BUILDING PEr,tilT INSTRUCTIONS BOARD OF HEALTH ....... o .... 3 SETS OF PLA~$ SEPTIC FORH ................ NOTIFY: CALL . .^,L T;; ..... ...... · a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildir~ I/L"Pector, with sets of plans, accurate plot plan to scale. Fcc according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining prcmi~e~ or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which i~ pa~ of this cation. c. The work covered by this application may not be commenced before issuance of Building PermiL · ' d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit sha!l be kept on the premises available for inspection throu~_hout the work. e. No building shall be occupied or used in whole or ~n part for any purpose whatever until a Certificat~ of Oocupancy 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 Yo~rk, and other applicable Lax~s. Ordinances or Regulations. for the construction of buildings, additions or alterations, or for ~:emoval or demolition, a~ h~min described. Thc applicant agrees to comply with al! applicable laws, ordinances, building code, housing code. and regtflanonx, and to admit authorized inspectors on premises and in building for necessary in.ns. ~.~d~° ~ , · . '.(Signature o£hpplicant, or ~a'r~e', (Mailing address of applicant) State whe'ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. B ddcr s Lmense No. Plumber's License No ......................... Electrician's License No ....................... Other T)~ade's License No ................ 2 ..... · Location o£1and on which proposed work will be done; llouse Num her r Hamlet . yTa pN ' Count x Ma o. 1000 Section ........ Blbck .............. , .... Lot.. /~/' ~ubdivision ,., Eilcd Map No ,; .............................. ~ ...... ' .............. Lot . . (Name) ............. State c" · . X~Shng nsc and occupancy of premises and tntendcd use and occupancy of proposed construction: · ~ ~ a. Existing Use and occupancy .1. Nature of work (~hcck which appiacable): New Building .......... Addhicn .......... ,'dlcrazlon ........... Repair R~mov~l Demolition ' ' ' pool. Tennis Court ......... Accessory Building ..... Fence OCher 14ork .... "z' ~: ...... ~' ................. Fee ........ , ..... . . . ... .. ...... ......... · · · . i (to bc paid on filing thisapplication) 5. Ifdwclhng, number of dwclhng units . . ; ...Number of dwelliug units on each floor ...... 6. If business, commercial or mixed occupancy, specify nature and extent of each c of usc .................. typ · . 7. Dimensions of existing structures :if any: Front Rear Depth Heieht Number of Stories Dimensions of same structure witfi alterations or additions: Front Rear Depth ' tle~ght Number of Stones 8. Dimensions of entire now~e.onstructmn" ' ' ' ; Front Rear Depth Height ' ~'~-, ~qumb,er~ ~ of Stories 9. Size of lot: Front ......... 'j R .... lO, Date of Pure ~' -~ :~ .................... e ............. 1 I. Zone or Use district in which premises arc situated · . ............ 12. Does proposed Construction violaie any zoning law ordinance or regu arSon .............................. 13. Will lot be regraded .; ........ i .................. ~Vill excess fill be removed from premises: Yes .... No. I t Name of Owner of premises ' Address Phone No ' Name of Architect i Phone No ........................... Address .................................... Name of Contractor ' No ,*'.. · Phone ' ........................... Address ................................. 15.Is this property locat!ed within 100 feet of a .tidal wetland/ *YES .... RO .... · If yes, Southold Town Truatees Permit may be r~quired. PLOT DIAGRAM Locate clea~ly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give Street and b!ock n~mbcr or description according to deed, and show street names and indicate whether interior or comer lot. APPROVED AS NOTED FEE' ~ ~" ~ ~- ~Y: NO'~:IFY BUILDING DEPARTMENT AT 7684802 9 AM TO 4 P~ FOR THE FOLLOWING INSPECTIONS, 1. FOUNDATION ~O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4~ FINAL CONSTRUCTION MUST B~ COMPLETE FOR C,O ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES, N~ RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS oO STATE OF NEW Y.~ RK, cOU,~T¥ OF...~ge. Vff4~: .~. ..... ........... f2. ./!~.e55. . .~. .am ~q/~ ............... (Name of individual signi=~g contract) above na~cd. being duly s~vom, deposes and says that he is the applicant (Signature Ofapplic=nt) k~e is the ' . i (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulylauthorizcd to perform or mvc performed the said Work and to m~e and file this applic.tion: that all statements contai?ed in this applicatioo are true to the best of his knowledge and belief; and that the work will be perforated in the manner ~et forth in thc applicatioa filed therewith. .,~ Sworn to before mc this , , ,~ o SUR VE Y OF ~ LOTS 17 & 18 SUBDI VISION OF PROPER T Y 0 WNED B Y NA THAN GOLDIN FILED NOV. E;2, 1932FILE NO. 1106 A T SOUTHOLD CERTIFIED TO' SECURITY TITLE & GUARANTY COMPANY TITLE NO. S 968666 FRANCES ADAMOWICZ SHERYL ADAMOWlCZ TOWN OF SOUTHOL D SUFFOLK COUNTY, N. Y. , ~,~~ 1000 135 02 16 Scale I - 30 Il'fl- June 1, 1988 ~~ ~ ~Rs, P.C. o~r. 11971 88 - 352