The URL can be used to link to this page

Home My WebLink About19016-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULl COMPI_ETION OF: THE WORK AUTHORIZED) N9 I ?01 ~ Z Permission Js hereby granted to: .... ~~. ..~.. ~t~ . ~ ......... :~......;..~..~..?.~. ........... .. ~.~ ,r. ~..~~, ~ .i.~ ........... Counw mox ~op No. ~000 S~ct~on .... J....a..k ........ Bb,:k ......... .? .......... Lot No....~k~..a,..."/ ...... ~,~o~t *o opp,cotion ~ot~ ............... ~.....~....7 ................. ~..~..0.., ond opp~o~ Building Inspector. Building Insl~ctor Rev. 6/30/80 3. Nature of work (check which applicable): New Building ..... ' ......Addition .......... Alteration ........ Reps.ir .............. REmoval .............. Demobtidn .............. Other Work ~-'~,,h oz.~ .... "~ . (Description) 4. Estimat~dCost ....... ~"~' '~ ........ '-'. Fee ~ (to be paid on filing this application) Number of dwelling ' 5. If dxvelling, number of dwelling units ............... units on each floor. If garage, number of cars ......................... · .......... 6. If business. COmmercial or mixed occupancy, specify nature and extent of each type of use 7. Dimensions of existing structures, if any: Front .................... · - ............. Rear ............... Depth .. . Height ............... Number of StoNes ........... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... HeiSt ...................... Number of Stofi Dimensions of entire new construction: Front ............... Rear ............... De .. Height ............... Number of Stores ....... , pth 9 F(O~' ' ............................................... . Sizeoflot: .......... Rear ..... De ............... pth 10. DateofPurchise .......... ' .................................. ................... Name of Foyer 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 ...................... Wall excess fill be removed from premises Yes 14. premise kg m ,, .~ M .... ;' ~z.. ........... Address . ~l[~h~o M, ' ' ' ~If yes, Southold To~u Trustees Permit: may be required. ' ' ... PLOT DIAG~M Locate cle~ly ~d distNctty ~I bu~d~gs, whether existing or proposed, ~d. indicate ~I set-back d~ensions fron prope~y ~nes. Give street ~d block number or deschption accordNg to deed, ~d show street nines and ~dicate whethe intehor or comer lot. STATE OF NEW YORK, COUNTY OF ................. S.S APl?ROVED AS NOTED DATE: Sp il/' 0 # I 4. Nm~ BUILDING DEPARTMENT'AT 765-1802 9 AM TO 4 PM FOR THE FO~OWING INSPECTIONS: 1. ~OUNDATION ~O REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING ~ PLUMBING 3. INSU~TION 4. FINAL CONSTRUCTION MUST ~E COMPLETE FOR ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y~ ...................................... .STA. T.E CONSTE{UCTIQN & ENERGY (Name of indMdual signing contract)CbDE~'. NOT °~f{~;'lghffS~k~°ses and says that he is the applicant above named. DESIGN OR CONSTRUCTION ERRORS lie is the ................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ............... 7. ....... day or.. .............. 19Z< ........... ~ ....... .iwW... County ~ RY PUBUC, State o! New YO~ T ~.~70787~ ~k~. ~ (Signature of applicant) FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CRECK ...................... SEPTIC FORM ........ ' ........ Examined ....... , 19~.~ DiSapproved a/c ............... i ...................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS NOTIFY CALL MAIL TO: a. This application must be compteiely filied in'by typewriter 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 appH- ¢. The work covered y this application may not be commenced before issuance of Building Permit. id. Upon approval of this application, the Building Inspector will issued a Building Permit to the aEplicant. Such permit shall be kept on the premises availabl~ for inspection throughout the work. e. No building shall be occupied or used in whole or in art for a.ny purpose whatever until a"C~f'tificate of Occupancy sh~ll 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 Ordinancd of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Re-ulations, for the construction of bui/dings, additions or alterations, or for ~:emoval.or demolition as herein d scrib d The apphcant agrees to comply w~th all applicab"ie laws, ordinances, building code,'-housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections.~ . (Signature oI3applicant, or name~if a corporauon) (Mailing address of applicant) State whether applicant is owner, lessee,, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... .':n. ~ ................... 'i . ~ ; .... (as on the'taz'roll or latest deed) Il'applicant is a corporation, signatur~ of duly authorized officer.. .... (Name and title ofcorpor~te officer) ' ·: Builder's License No .... .~.(P. Elcctr cf License No ...... , ..........,. ~ .....'.; ~ , , let ra License o ........ ; ........... · 1. iLocation ofland on wbich propo~ed work will be done. ..............' ' House Number ' Street, Hamlet County Tax Map No. I000 Sectioln .............. Ock ............... Lot . .c~,; .... :Subdivision ; Eilcd Map No Lot , (Name) 2, :State existing use and occupancy Of premises and intended use and occupancy of proposed construction: I :a Existing use and occupancy .. ;.~['~..~-$.1.~'~'~,~ 1..-~ .~.~ . , ,b. lntendeduseandoccupancy .~[).. ~ "!