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Home My WebLink About18923-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18923 N~ Z Date ..... ~')/-'~ ~ ' ~ * c~ · ,~...~e~... .............................. , 19.~...e Permission is hereby granted to: · .~.~...~ ~ . .~..~&~..~.:..v..:....~.,...~.~-...~. ,o at premises located at ...... .~......~-~....~.gd,.....~... ............ ~.g~i~.~ .............................. County Tox Map No. 1000 Section ....... ~....O.....'/. ...... Block ....... .~..~ ........ Lot No....~,..~., ............. pursuont to opplication dot~:t .......... .~..~. ............ , 19..~.~., ~nd oppro¥c~l by th~ Building Inspector· Fee a.....,.~,k. .............. Building Inspector Rev. 6/30/80 RPPI~OgEO AS ~O'[EO DATE' NOTIFY B[,IILDING OF~PARTMENT AT 765-1802 9 AM TO ~1. PM FO~ THE FOLLOWING 1. FOUNDATION TWO REOUIREI~ 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 ~'o~ ? BUILDING DEPARTMEHT FEE SCHEDULE AMENDMENTS EFFECTIVE 2125/89 SINGLE FAHILY D~ELLING ]) New dwellinss & additions & alterations, decks, to existing dwellings-$50. O0 plus ~15¢ for each Sq. Ft. of floor area in excess of 850 Sq. Ft. additions and alterations for each ~ilding. 2) Accessory buildings, additions, fences, stoves and alterations to existing accessory buildings-S25.00 plus . 15¢ for each Sq. Ft. of floor area in excess of 500 Sq. Ft. FARM BUILDINGS ]) Farm buildings and buildings: $50.00 to existing farm HULTIPLE Hotel, motel, multiple dwellings and business, industrial and all other buildings: ]) New buildings and additionsand alterations to existing buildings: $100.00 plus .20¢ for each Sq. Ft. of floor area in excess of ]000 Sq. Ft. 2) Accessory buildings and additions and alterations to existing accessory buildings: $25.00 plus . 15¢ for each Sq. Ft. of floor area in excess of 500 Sq. Ft. FOUNDATION Foundations constructed under TENNIS COURT $ 25.00 POOL & FENCE $]50.00 existing buildings ~75.00 DEMOLITION Demolition and/or removal and/or relocation minimum and .05¢ for each Sq. Ft. in excess area of any building: $10.00 of 300 Sq. Ft. of floor SIGNS Ail signs, except signs permitted by § ]00-3[C(9)(a), shall for each Sq. Ft. of sign area, with a minimum fee of $25.00. ~ERTIFICATE OF OCCUPANCY [) be $ I .00 Business buildings and/or business uses and additions and alterations thereto-S50.00 2) New dwellings and additions and alterations thereto-S25.00 3) Accessory buildings and additions and alterations thereto-S25.00 4) Pre-existing dwellings-$]O0.OO ~ 5)" Vacant land-$20.OO 6) Updated-$50.OO 7) Copy $5.00 Over 5 years $10.00 8) Temporary: Residential $ 15.00 Commercial $[5.00 ** Cellars, decks, attached garages and any habitable area be included in the calculation of floor area shall FORM NO. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ~OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined · ..'~. ..... 19 ?..D Approved'7~..~"~C......-~...., 190.O. Permit No..J..~. ?. Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH 3 sETs OF~,__PL,~S .. C,ECr ..~.~. ................. SE?r~C ~OR~ ................ NOTIFY~ CALL ~^~L ;;:~' .... ~) ........... .. ........ ·..~. ~: .~J ¢ ....... Date ' · ........... 19... INSTRUCTIONS a. Tl~s 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 premise~ or pubLic streets or areas, and o' · cation. ~,~vm~, a detailed description 6f layout of property must be drawn on the diagram which is part of this appli- ¢. 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 appLieant~ 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 ~:emoval or demolition, as herein described. Thc applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ...... ...... - . (Si=nature o! ~lpptican~'~; nad e', ifa ¢~;~&.~o.)' ' ' (Mailing address of applicant) State wh~ther applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . c~ .~ .~.~ Name of owner ofpremises ...... ...................... ~'e'; ~ ;; ................ on t a roll latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title'of co Builder's License No ............. ~y.~..cL~ C_~. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No 1. Location of land on which proposed work will be done; .... '~ .... ' ........... Hamlet ~ House Number Street, .... ' ' '~ ............ . .... ~o,,~ ~,~ ~,~, ~o~ ,0~o ~,o. ....... ~.. ' ~o~~ ....~o~...~., ....... .~... ~ ~q~ ~. ~ ...... . ........... Subdivision ..................................... Eiled Map No. (Name) .............. Lot . . ~.- State existing use and occupancy of premises and intended nsc and Occupancy of proposed construction: a. Existing use and occupancy ............................. ~ ........... , .... ~t~!~ ...... b. Intended use and occupancy .......... . ......... ~m~C~:sc *~t~g~i~:4~aaa .......... 3. Nature of work (check which applicable): New Building ...... ,... Addition .......... Alteration ........... Repair ........ . ..... R~mov.41 ....... 1~ ...... Demolition .., ........ :.p..Swimming pool. ............ Tennis Cgurt ........ Accessory uil. dlng .......... Fehce ......'~/ Other h/ork ........... .. 4. Estimated Cost .... ~.. ~.~..~ .?.~. ' ..................... Fee. .................................... i (to be paid on filing this application) 5. If dwelling, nmnber of dwelling uaits ............... Number of dwelling units on each floor ................ If garage_ .numberofcars """i ..................................................... ' ; ......... 6. If business, commercial or mixed occupancy, specify nature and extent o£ each type of use ...... .............. 7. Dimensions of existing structures,!if any: Front.., ...... ; ..... Rear ............... Depth ..... , ......... Heieht ............. Num bbr o f Stories ................................... Dimensions of same structure ' ~ ' Front Rear with alterations or additions: ........... Depth ................. ; Height Number of Stories .............. 8 .... Front Rear Depth · Dlmensonsofentlrenew construqtmn: .......... , ......................... ... . .. Height Number of Stories · ' 9 Size of lot: Front · Rear Depth 10. Date of Purchase ........................... Name of Former Owner .......................... 11. Zone or use district in which prenlises are situated .......................................... 12. Does proposed Construction violate any zoning law, ordinance or regulation: ......................... . . . . . 13. Will lot be regraded .: ........ : .................. Will excess fill be removed from premises: . Yes .... No 14 Name of Owner of premises ' Address Phone No Name of Architect Address Phone No Name of Contractor ' Address Phone No ,,' ' 15.Is this property located within lO0 feet of a tidal wetland? ~YES .... NO .... ~If yes, Southold Town [Trustees 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 nfimber or description according to deed, and show street names and indicate whether interior or corner lot. STARS EW_YO , ' ' g S COUNTY QF.~.~.~...~..~..~..~..~.. i' ......... ............... . (Name of individual signi~ig contract) above named. being doly sxvorn, deposes and says that lie is the applicant (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 m~e and file this application; that all statementi contained in this application are tree to the best of his knowledge and belief; and that the Work will be performed in the m~ncr ~et forth in the application filed therewith. Sworn to before me this ,,' ~a~[~ ~h ~,~lgnature of applic~