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Home My WebLink About19068-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: ...... ..... ~..~...,.~......,.~~..J.!..~ ...................... · ..~. ~...h ...... ~...~.~..~ ............ ,o ~.~.~......~...~...~. J..~...'~ ....... i._~.Z ................................................ at premises located at ....... ~.e~..~....'c.~..~....../..°...D..~.~.....~..~...~..(......!.:.l,..~.. ..... County Tax Mop No. 1000 Section ..... 1.~....~.... ........ Block ........~..! .......... Lot No......-~....~. ............. pursuant tO application dated ...... ..~...~....-~..~ .................... , 19.~...~.., and approved by the Building inspector. Ir~dding In.fl:~ctor '~ Rev. 6/30/80 SPEEDY SIGN~A~RAHA.USA [S16)696-2636 APPROVED BY Speedy Sign. A. Rama, USA SIGNS. BANNERS. LETI'ERtNQ 1070 Midd!e Country Road SELDEN, NEW YORK 11784 PHONE (516) 696-2636 FAX (516) 696-2637 12' SCALE FACTOR: 0.7S INCHES = I FOOT FORtvl NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTItOLD. N.Y. 11971 TEL.: 7135.1802 E,~a,nincd ...-~.~'~'~. { ..... ig~.u. ^ppro,.ed .... ?.a.*s~.L..., i9 ?.0. Pc=it No./. 5'.0. ¢.'~ Disapproved ale ..................................... ......... ' ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTIt ............ 3 SETS OF PLANs ............ SURVEY SEPTIC FORH ................ NOTIFY: CALL . . ..... '¥'''''; .... MAY 2 2 Date..~yl ~';'~J.~j~. ] L .A~... a. This application must be completely filled 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 i~ part of this appli- cation. ~. 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 permit -¢&alI be kept on the premises available for inspection thruu~out the work. ¢. No buildLhg 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. ' 1 " APPLICATION IS HEREBY MADE to the Building Department the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk Count ;w Yor;5, and other,..a~Rlicable Laws. Ordinances or Regulations, for the construction of buildings, additions or alterati :, or for removal offdemfilitic/n, ax herein described. Theapplleanta~reestoeomplywithallappiical:fieiaws, ordinance ~ ~ode/hou(~e, tn-d regulations, and to admit author/zed inspectom on premises and in building for necessar ~ ~ ~ J,')/2~O//J,,O~.c'D,'v- mature olappncant, or name, ifa corporation) d'PtOOq ...1.4. ,o~. PrJ V¢o. Ceo~ere~cb,..u~. Ypr. k..U ZL0..'. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...... /3. Lessee Nam ncr of premises . .. ,g.l.a.~..C,a.r..~i.n,a.l.e...'P, 0. Box. 22.. Matt~tuck, .~e~/.yqr. l~ Ifa or fduly thorized officer. . · '- b -"-~.: :"-:--:d~ · :- .... .'-.,~,,. 1...'... ~/1~., ..... '- (C~ame aad title of corpora'~e-bffice~') ' Builder's License No ..................... Plumber's License No .................... Electrician's License No ....................... Other Trade's License No ...................... a. Existing use and occupancy b. Intended use and occupancy Location of land on whic~t.proposed work will be done; ' Store~ Mattituck Plaza Rou~e '' , 25: Mattituck New York 11952 " · N be St .................... ouse um r reet~ Hamlet County Tax Map No lO00 Section .......... Bl¢ck ................ Lot,..~°F:.. /" Subdivision ~ , ..................................... Eiled Map No. ..' ' Lot (Name) ' O. ';' ........... ' .... State existing use and occupancy of premises and intended use and occupancy of proposed c,onstr~qtion: , -- Nature of work (check which fpp!feeble): New Building .......... Addition .......... Altcratlon ........... Repair .............. R~rnoval .............. Demolition . .. ............ Swim=lng poor ............ Tennis Court: ......... ACCeSSOry Bu£1dlng .......... Fence ....... OCher Work..~.I.G~ ....... Estimated Cost 7~. i ~. ~..~.42,~ ~c~q~ee ' i (to be paid on filing this applicat,ion) [fd~ ailing number of dwelling uhits ' Number of dwelling units on each floor If garage number of cars 6. If business, commercial or mixed Occupancy, specify natnre and extent of each type of use ....... : ....... 7. Dimensions of existing structures, if any: Front ............... Rear ............... Depth .... , .... Height ............... Number of Stories .................................................. Dimensions of same structure with alterations or additions: Front ................. Rear ............ Depth ..................... :. Height ...................... Number of Stones ................ S. Dimensions of entire new construition: Front Rear Depth Height .Number of Stories ' 9. Size of lot: Frofit ............ i .......... Rear ...................... Depth .................... 10. Date of Purc,~ase .............................. Name of Former Owner ........................... 1 I. Zone or use district in which premises are situated .... ; .............................................. 12. Does proposed construrtion violal:e any zoning law, ordinance or regulation: .../'/'O .......................... 13. Will lot be regraded .: ........ i .................. Will excess fill be removed from premises: . Yes .... N,, 14. Name of Owner of premises .... i ............ ' ....Address ................... Phone No ........ ; ...... Name'of Architect ........... ................ Address ................... Phone No ............... Name of Contractor .......... ....... 2 ........ Address ................... Phone No ..... ;v. ..... i.. 15.18 this property locatled within i 00 feet of a tidal wetland? ~YES .... NO.~.. ~lf yes, Southold TownlTruatees Permit may be required. PLOT DIAGRAM Locate clearly :md distinctly all auildings, whether existing or proposed, and, indicate all set-back dimensions from' property lines. Give Street and block number or description according to deed, and show street names and indicate whether interior or comer lot, , APPROVED AS DATE: FEE: NOTIFY BUILDING DEPAR ........ T AT 765.1802 9 A~ TO 4 P~ FOLLOWING INSPECTIONS 1, ~OUNDATION ~O ~ FOR POURED CONCRET[ 2. ROUGH - FRAMING & P, 3. tNSULATION 4. FINAL CONSTRUCTI{ ,T 8E COMPLETE FOR ALL CONSTRUCTION SHAt.. ~T THE REQUIREMENTS OF 3 STATE CONSTRUCTION & [ CODES. N~ RESPONSIBL ~ r ~ DESIGN OR CONSTRUCTION E~' STATE OF NEi.Y. YORK .... S · . (Name ofi,i~lividual signii~g contract) abogc nameS. : He is the ' : (Contractor. agent, corporate officer, etc.) of sam owner or owners, and is duly a.u, thorized to pe,rform or have perfop'n,~d the said work and to make and file this aoplication: that ail statements contained in this applic;ltion are true to tl~ be~t of his knowledge and belief; and t ~at the Work will be perforated in tile re:tuner' set forth in thc application filed thekcwit~. %vomtobeforemcthis j ' · 7~ .~' .Diary Public, Stateof NewYo~,k k - ' l/ i-natur hcant) tduaJlfled in Suffolk ~urlty ~ · Commission Expire! ~y 9, I~ J ' ' . 1L' I 15 i8