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Home My WebLink About18829-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. NO_ BUILDING PERMIT ~rHl$ PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18829 Z Dm....~ ........................................... i .~..~. County Tox Map No. 1000 Section ....... ./.~ ...... Block ............. ~ ..... Lot No ........... ...~:......~..,.. pursuant to application dated ........ ~,,~,,,~.,~., ................................ , 19..,~,.~.., and approved by the Building Inspector. F.e Rev. 6/30/80 · · , ' ~ ~ ~' TOWN OF $OUTHOLD '.,...~'~ , ~ BUILDING DEPARTMENT BUILDING PE~IT No_ ITel? PER/rUT MUST BE KEPT ON THE Pi~EMISF_5 UNTIL FULL C~PLETION OF THE 'WORK AUTHORIZED) 1'8829 ' Z Date"- ............................................ , Permission is hereby granted to: /' / __ ' . ~~...~:~...~....~......:../..~ ,z..~.~.....~..::~ ..................................... . . ,'.~'../.~...~...:...; ......... ,...,..~. ot premises ,ocoted at ...../.....~..~...~... ....... ...~..C~. ......... ~ ..................................................... .. pursuant :'to application dated ................................. , 19~.~.., and approved by the - Ruilding Inspector, FOU:~DATION (1st) FOU:~DATIO:! 2. [2nd) ROUGH FRAME & -PLUMBING INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: v e~ .,/ TOWN OF ~OU't'~IOLD 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 ........ O~%~ .... · CHECK '~ Examined . ?-/- ./. ......... 19 .~.~. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT CALL .................... MAIL TO: Date ................... 19. INSTRUCTIONS a. Tl~s application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, sets of plans, accurate plot plan to scale. Fee according to schedule. b. PIct plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre or areas, and giving a detailed description of layout of property must be dra~vu on the diagram which is pan of this ap~ cation. c. The work covered by this application may not be comm~ced before issuance of, B~ildin~g Permit. d. Upon approval of this application, the Building Inspector will,sued a BuiRiing B~i{ t6~e gpp~icant. Such pen shall be kept on the premises available for inspection throughout the work. c. No building shah be occupied or used in '~hol¢ or in peri for a-.n~ p--"fftpose whatever until a Certificate of Occupm skall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, ad~ditions or alterations, or for ~:emoval or demolition, as herein describ~ The applicant agrees to comply with all applicable laws, ordina4ces, building code, housing code, and regulations, and admit auzhorized inspectors ou premises and in building for necessary inspections. ,,-x ~, (S~gnature ct apphcant, or name, ~f a corporanon) (Mailing address of applicant State wh~ther app ca~nt is owner), lesse~, agent architect engineer generahcentmctc~, :el~ctzician., plumb? or_. build (as on the tax roil or latest deed) If applicant is a~.o~o'rntion, ~ignature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ~d,o-w. za/ Plumber s Ietgense ~ro- .. - ~.. :. ~,.. .............. Elcctrician's:~ce~NdW,,i~:~ ~'* ?' Other Trade's License No I. Location of land on which proposed work will be done: USE IS UNLAWFUL \ ilHOOl CERTiFiCATE OF OCCUPANCY tlouse Number Street Hatnlct County Ta.~ Map ~o. lo0o S~ction /q.~. ......... Ulock ~ Lot Z3 ' Subdivision ..................................... Eiled Map No ............... Lot .............. (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy........-~~-'--. ................... · ................. .. 3. Nature of work (check which applicable): New Building .......... Addition ...... Alteration ......... Repair .............. Rbmoval .............. Demolition ........... ... Tennis Court ......... Accessory Building .......... Fe~,ce 4. Estimated Cost ............................. ee ..................................... , (to bc paid on filing t ~s.applicat~on) 5. It dwelling, number of dwclling units Number of dwelling units on each floor ............... ......... ............................................. 6. If business, commercial o~ mixed occupancy, specify ~aturc and extant of a~ch typo of usa .................... 7 Dimensions of existing st~Ctures irony: Front Rc~r Depth ............ Heieht .............. Number of Stories ............................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................ Depth ...................... Heist ...................... Number of Stories .................. 8. Dimensions of entire new construction: Front ........... Rear .............. Depth .......... Height Number of Stories ' 9. Size of lot: Front ..~ ..,. .............. Reu- . ................... Depth ................... 1 I. Zone or us~ district in which premises are situated ...... ~..~ ........................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~ ....................... 13. W~I lot be regraded .;. ~ ...................... Will excess ~l be F~moved from premisesL 14. N~e of Owner of premises~/~.~. Address ~~ ~.~. Phone Nme of Architect ........................... Addre~ ................... Phone No ............... Nme of Contractor ........... ' ..... Address ................... Phone No ..... ~ ...... :. IS.Is this property located within 100 feet of a tidal wetlaad? *YES .... NO.~. *If yes, Southold Town Trustees Permit may be required. PLOT DIAG ~M Locate cl~ly ~d dist~ctty ~1 bu~d~Es, wh~ther existin~ or proposed, ~d, indicat~ ~1 set-back d~nsions fro prope~y Eries. Give street ~d bl~ck numberer descfiptio%accord~g to deed, ~d show street nines and ~dicate whcth interior orcoeer lot. ,~ ~ ~ 1. FOUNDATION - ~0 FOR POURED CONCRETE 2 ~OHGH - ~AMtNG & PLUMBING 3. tNSOLAIION 4. FiNAl. CONSTRU~ION MUST 8E COMPLETE FOR C.O. ALL CONSTRUCTION SHA~ THE REQUIREMENTS OF THE STATE CONSTRUCTION & ENERGY CODES. N~ RES~NSI8~ FOR DESIGN OR C~RU~ON ERRORS STATE OF NEW YOR~, COUNTY OF ................. .......................................... (Name of individual si~ain~ contract) above named. A PPJ~OY,,ED 7~5 tR02 9 AM ~ 4 PM ~a ~E FOLLOVViNG iNSPECTIONS: l r FOUnDATiON . ~REQUIRED FOR POURED CONCR~ 2. ROUGH - FR,AMfNG & ~MBING 3. 4. FINAL CONSTRUCTION MU~ BE COMPLETE FOR C,O. ALL ~N~CTION SHALL ME~ THE REQU/R~EN~ OF THE N.~ ~ATE ~NS~ON & ~ERGY CODES. lie is the ........................................... : .......................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pcyform or have performed tile said work and to make and file application; that all statements contained in this application are true to the best of his knowledge and belief; and thai Work will be oeribrmed in the manner scl forth in thc application filed therewith. Sworn to before mc this ............. ....... ..... "?"-'" .......... ' ~ ~BLIC, State o~ NOw 't~ (Signature of appli, . No. 4707878, Su~Fk Cowflty~,-/