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Home My WebLink About18826-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO- 188~6 Z .... at premises located at ........... ~ .......... ~....~?~'Z~ ....................................................... County Tax Map No. 1000 Section ......... ~.,..~.. ..... Block ........... ~,.. Lot No ........ ~., ............. pursuant to application doted ......................................................... 19 ......... and approved by the Building Inspector. Fee S...~~ Rev. 6/30/80 · OU~ID~TIO.~ FOU:~DA TI 0~'~ 2. [2nd) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE E~'IERGY CODE FiLiAL ADDITIONAL COMMENTS: R4//c/u/ /v ¢' F'teo/'4 ,~",,'¢',~ t FORM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 Examined ., 19 .~~. Approved ., 1~. Permit No./~.. . Disapproved a/c ..................................... .............................. APPLICATION ~OR BUILDING PE~IT INSTRUCTIONS BOARD OF HEALTH ........... 3 SETS OF PLANS ........... SURV,E,Y ........ ........... sEP'ric ............... NOTIFY .'.._~..... ............ · / ,, BLOG 0~" D~c ................... ~. a. Tl~is application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, 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 strec or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of tttis app cation. c. 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 perm shall be kept on tile 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 Occupan, shall have been granted by the Building Inspector. · A~. P. LICATION. IS HEREBY MADE to the Bt~ilding Department for the issuaqc, e ~o£~a:Bui. ld?,g,l~qrmit pursu~znt to tl Buildm, Zone Ordinance of the Town of Southold, Suffolk County, New York, agd other applicable I-OwL Ordinances Regulations, for the construction of buildings, ad. ditions or alterations, or {or, rempval or:'demoli~lon, 'as herein describe, The applicant agrees to comply with all applicable laws, ordinances, building d~cie, hous .rig cod%,'and regulations, and t (Signature o~ ap or name, zf a corporanon ! (M'ailing address of lipp!icant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor,, elect(lc!an, pi.umber or buildei ............... ,'la ~r4'~ :'C: .'~, ,V"h' :-" Nam, of owner orpremises ~~..~.~...'... ~. ~:;'4] .~. ~Q.'z..'~';...i.!:'..:: (as on the tax roil Ir applicant is a corporation, signature of duly authorized officer· ~ ': ' , >.e-.4. %9-4 ~(q' .... BuiIders License No. ~,~.-....g./.. ;'~- ............ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... I. Location of land on which proposed work wiIl be done. ' ' . ............................ · ........ ..... ............. ....................... llouse Number Street, Hamlet County Tax Map No. 1000 Section . ~ ''~ Block ~ Lot Subdivision ..................................... Filud Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......................................... ~: .......... ~.. ............ b. Intended. Use and occupancy · · . ....................................... 3. Nature of work (check which applicable): New Building .. ~..'. .... Addition .......... Alteration ...... Repair .............. R6moval .............. Demolitioh .............. Other Work ........... / .~/ .:~. ~ ~, .... , (Dcscriptio 4. Estimatdd Cost ...... ' . Fee ............... (to be paid on filing this application) .5. If dwelling, number of dwelling units ............... Number of dwelling units on each floor ............ If garage, number of cars .................................................................... 15, 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 ........... Heigttt ............... Number of Stories .................................................... Dimensions of same struct.l,[{.e with alterations or additions: Front ................. Rear .............. Depth :'~'~~~ ~i ..... }{eizht ......... Numberer Stories ........... ~.,,. 8. Dimensions of~btire i~e"~I/construction: Front...~../ ...... Rear...~;Ii~{~ ........ Depth . Height .,.~.o%~f~..,DNu~berofStories ..... ;:~ :~.~, .~'./~-.:~ ..................... ? ........ 9. SizeoCil~lffiFirc~.,;:./.'-.~.<5../ ........ Rear'" ~_' .~ '7 Deoth 1 I. Zone or use district iff%T0]itch premises are situated., .~... ,~.~. .......................... ' .... 12. Does proposed constru~'~ion violate any zoning law, ordinance or regulation: ........ ,/~.z~/.~;'~. ~. .......... 13. Will lot be regraded ......... .~.~'..~. .............. Will excess fill be removed fro~ premises; , Yes 14. Name of Owner of premises zf./~.,~f~Pg~. ~. ,M//)~. Address .P,.O,,./?~..)(/y~..~O.~.7..~Phone NorXY.2,J~ Name of Architect ........................... Address ................... Phone No ............ Name of Contractor ................. : ........ Address ................... Phone No .......... 15.Is this property located within~O0 feet of a tidal wetland? *YES .... NO.[X *If yes, Southold Town Trustees Permit may be required. PLOT DIAGILAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dknensions property lines. Give streeg and block number or description according to deed, an~[ show street names and indicate who interior or corner lot. d~ ~" ~ ~,C/q Al ~ A;"'A APP/R.0VED AS I OTED FEE' BY? NOTIFY Itl]ILDR~G OEPARTM~NT A] 76.6-1802 9 AM 10 4 PM FOR THE FOLLOWING INS,PECTIONS; 1. FOUNDATION':'- TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MU~T BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N,Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPON~tSLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF NEW ~K~,-~-~, ] ~/ COUNTY OF ....'~-~..'.'.'.'.'.'.'.'.'x~..~..%:~.L ~ S.S (Name of individual signing contract) above named. Ile is the ................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly authorized to perform or have perfo~ed the said work and to m~e and fin application; that all statements contained in this application are true to thc best of his knowledge and belief; and tha wmk w~l be perfomaed in the m~ner set forth in the application ~lcd therewith. Sworn to before me this 2: ........ ........ a~ Public, . ~. .. County ~RE L G~ · · ~. -~ N~ ~bltc, S~ d N~Y~ (Signature of appli No. remission ~xp~ros oe~m~r 8 ~/ ~ 70.0 70.0 I~-0 . 0 Gca/e ?