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Home My WebLink About18845-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 18845 Z Permission is hereby granted to~ " ~;2/ ~'~ ' -- /' / ~un~ Tox Mop No. 1000 Section ~/ Bilk ~ Lot No ............ ~... pursuant to application doted .... ~ .................................., ]9.7...~,~= Building Inspector. and approved by the Rev. 6/30/80 From ~he desk ROBERT L. STO'FT, JR. FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL ~o~.. ~ ~/_~-~. ~. _/..~ ~,......~ ~,~ ..... PLEASE TAKE NOTICE that your application dated ...,~ ~ .................. 19 ~ ~. for pe~it to ~~.~ ..... ~ ................................. at County Tax Map No. I000 Section ...... ~f ..... Block ..... ~ ....... Lot .... ~ ~ ..... Subdivision ................. Filed Map No ................. Lot No .................. .~....~,~ .... /.~,~. ~.0.o. ~. ..¢). .~/.d-z~..~. . /.~. .o.-:. ~.~/. i~, .... RV 1/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL BOARD OF HEALTH ........... 3 SETS OF PLANS ........... SURVEY .................... CHECK ..................... SEPTIC FORM ............... BLDG. 0E?r. ,,pproved ............ , l~,~ men, it No./.~. Disapproved a/c ................................... z.. SOUTHOLD, N.Y. 11971 _ ~OT . TEL.: 765-1802 ................. [ INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, witl ~ets 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 sire or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of ti'ds ap! 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 pen 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 m3y purpose whatever until a Certificate of Occupa~ 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 ~ Building Zone Ordinance of the Town of Southotd, Suffolk County, New Y/o'r¥, and other app~ Laws, O.f~ces Regulations, for the construction of buildings, ad~ditions or alterations, or/forfi-emoval or dem,~lJyion} as her~fescrib~ The applicant agrees to comply with all applicable laws, ordinances, buil~inlfcl;~te, iI, ou~q~o n~ons, and admit authorized inspectors on pre,mises and in building for necessary inspect/ ~ //~r ~ ,,~ / · t~ t~.'~'?~., ' . /-' ', , ,~ (I~,~iting~ldressofapplicant) /y,l~ ~1~ ~"~ ~'~' ':2 :.-' .' '. ~ ~ ['q [~ :~5~3~ /" ' State whether applicant' is ownkr, lessee, agent, a~chitect enoineer oeneraI contractor, electrician, plumber or build, .. O...~..~ ~! ?: .':... i.: .......... ~ ...................... ,..,. ...... ~,... ~, ........... Name of owner.? f.premise~ ~..(--~'...~...~. ~..~.~r.T... f. :...~.~.5....~.~._~../ .... ~.~.:..~...~... .. .77../. .... *' ' ' (as on the tax roll or latest deed) If applicant is a"¢OI, poration, si~na'ture of duly authorized officer. t ~ i':~ "' ' ........... ~'. v%:'~R .~,..,'.-L ...................... (Nam'e ~nd'~Itl~ o,f co.orate officer) Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No .... ..~-~..0...~. ..... .~..~?.7-~/-/~gt'4' ~t~/~rc~' CO ' I louse Num~!~l~ Street. Hamlet Subdivision ..................................... Eiled Map No ............... Lot .............. (Name) 2. State existing use and occupancy of premises o, nd intended use and oc, cupancy of proposed constrnction: a. E. is,'n use and occupancy.. ................................................. . b. Intended use and occupancy ...................................... ,I Nature of wp ' (check which applicable) ' ~v Building "~ '~' Add' ion ~ · Alterati n E ' ' ' ~ -- "' /' ,- / mmma 4. surnamed Cost ....... ~dd.~ ......................... Fee .................................. (to be paid on filing this application) $. I£dwelling, number of dwelling unixt}r, .......... Number of dwelling units on each floor ...... If garage, number of cars ...... . .~ ........................................... V,;/, ............ 6. If business, commercial or mixed occupancy, specify, n~4ure and extent of each type of use . .~ ............ 7. Dimensions of~'~)ting structures, if any: Front.,..~./~ ........ Rear .... ~ ........ Depth. ~.~ ....... Height ..... /...'.'.~. ....... Number of Stories ..... ,,X'~.'. ........................................... Dimensions o~ll~ru[dtEh'e with alterations or additions: Front ................. Rear .............. Depth ...................... tleight ...................... Number of Stories .................. 8. Dimensions,of entire new construction: Front ............... Rear ............... Depth ............ Height ............... Number of Stories .............. ; ...................................... 9. Size of lot: Front ...................... Rear ...................... Depth ................... I0. Date of Purchase ............................. Name of Former Owner .......................... 1 I. 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 ............................ Will excess fill be removed from premises: Yes 14. Name of Owner of premises ................ .... Address ................... Phone No ............. Name of Architect ........................... Address ................... Phone No ............. Name of Contractor ................. i ........ Address ................... Phone No ............ 15.Is this property located within300 feet of a tidal wetland? ~YES .... NO .... · If yes, Sonthold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buL!dings, whether existing or proposed, and, indicate all set-back dhnensions fr property I/nos. Give street and block number or description according to deed, and show street names and indicate whet interior or comer lot. 765-1802 9 AM TO 4 PM FOR THE FOLLOWING iNSPECTIONS: 1. FOUNDATION FOR POUREO CONCRE'n~ 2~ ROUGH - FRAMING & PLUMBING 3, INSULATION FINAL CONSTRUCTION MU~'T BE COMPLETE FOR C,O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. N~OI RESPONSIBLE FOR t2,FS!GN OR CONSTRUCTION ERRORS STATE OF NEW YORK, S.S COUNTY OF ................. ................................................. being duly sworn, deposes and says that he is the applies (Name of individual signing contract) above named. He is the ....................................................................................... (Contractor, agent, corporate officer, etc,) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file tl application; that att statements contained in this application are true to the best of his knowledge and belief; and that t Work will be performed in the manner set forth in thc application filed therewith. Sworn to before mc this Notary Public .... ~..Y_,j~... , .D.: ...q~,~.t,..~..~.' ......County . 'y'g '' .... ~t ....... ~ ............ tt[[[~I ~. 0EV0E (S?gnature of applic~r N~TARY eUSUC, S~te of New Y~k No. 4707878, Suff~!k Term Expires M&fch