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Home My WebLink About18014-z roast xo. s TOWN 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) c` N°- ~BU~~ Z Dote 19a Permission is hereby grant d to: ~ ~ / 93.2 ro . .la..~......1~........ci~ .......4y~~,~.F~...T"°.G........,~ at premises located at .....~...9.~a.~......~ . County Tax Map No. 1000 Section ....~.1~1 Block ................T..... Lot No ~.1. c~ . pursuant to application dated 19R..~, and approved by the Building Inspector. D~ Fee 5.,.r..~.......... L~' I f for Rev 6/30!80 BOAFD OF HEALTH (R~ 3 SETS OF PL.1NS hJ L< rl FORM No.l SURVEY . TOWN OF SOUTHOLD CkIECK Ij(~ ~ ? i ~;~1 QUILDING DEPARTMENT SEPTIC FOEtPi TOWN HALL F ' SOUTHOLD, N Y. 17971 NOTIFY d TEL.. 705-1802 CALL r,D ~J ' MAIL TD: Examined . 19~ - . Approved , 19 ~~Permit No/.(!.~~r ~ Disapproved a/c ~ ~ ~ ~ ~ U J • • • • • BLDG D'cPT. (B~ng Inspector) TOWN OF SOUTHOLD APPLICATION FOR BUILDING PERMIT Date . IS . . INSTRUCTIONS a. Tlus application must be completely filled m by typewnter or m ink and submitted to the Budding Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddmgs on premises, relationship to adloming premtses ar public stree br areas, and giving a detmled description of layout of property must be drawn on the diagram which is part of this app cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of Lhis application, the Building Inspector will issued a Building Permit to the applicant. Such perm shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupan~ shall have been granted by The Building Inspector. APPLICATION IS HEREBY bIADE to the Budding Department for the issuance of a Building Permit pursuant to ti Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnbe~ Tlie app]cant agrees to comply with all applicable laws, ordinances, building code, housin; code, and regulations, and admit authonzed inspectors on premises and in building for necessary in~spe,_ctipons~. (2~,~, _ (Signature or a/pp'~licant, or name, if a corporation) 9 ( C ~ L-""ar V l~ro ~>r D2 c N'rA T7T Tl c rL • (Ivladmg address of applicant) 1 l `1 S L• State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde ....4y~ w ~'n- Name of o•.vner of premises ~s ~ 'F r`" n n d ~ ~ . L :..I--~ L G ~ .h~ ~a • . (as on the tax roll or latest deedlPP VED AS NOTED If applicant is a corporation, signature of duly authorized officer DATE•~• ' ~ B.P. # ~ • • • • • FEE BY: u NOTIFY BUILDING OEPA NT AT (Name and title of corporate officer) 765-f802 9 AM lU 4 PM FOR THE FOLLOWING INSPECTIONS. Bwlder's License No ~''1R~ 1. FOUNDATION • TWO REQUIRED FOR POURED CONCRETE Plumber's License No . 2. ROUGH -FRAMING II( PLUMBING 8. INSUk.ATIUN Electrician's License No . Q FINAL - CONSTRUCTION MUST BE COMPLETE FOR G O Other Trade's License No . ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N Y I Location of land on which proposed work will bu done . .................STATE. ,CQHSTRUC7IQN. b..~I~~F'tCjY, , , CODES NOT RESPONSIBLE FOR Z ti fr i........i~. ~n . (.-4".`.~`..... p,2. ~ ~ 16rt OlrQV81ST~U4"ItQN kRRO,rts . . house Number Street Hamlet County Tax h1.ip No f 000 Section Block - , • , , • , , Lot ~ . Subdivision Filed 1\tap No. , Lot . (Name) State rvts4ng use and occupancy of premises and intended use ,Ind occupancy of proposed constriction: a. Existing use and occupancy I' n~h ~T• • • • c??, •t~•UM.CC(L~. b. Intended use and occupancy . • • • • • • • • 4•i~~ 3. Nature of work (check w htch applicable). New Butldmg AdJ[hon Altecatwn . Repair Removal Demol[tron Other 1York •F~T!e~ 5 E 51eez-retf ~ (DcscnpUOn 4. Esttmated Cost ~.1.3........'"`A Fee . Cf H S-J /;L LItO rs~/ OW NEIL, (to be pard on filing flits applrcatton) 5. If da•ellmg, number of dwell[ng units { . Number of dwelling units on cacti floor If garacc, number of cars . b. If business. commercial ar m[~ed occupancy, specify nature and e:ctent of each type of use . 7. Dimens[ons of cx[st[no structures, tf any. Front . Rear Depth . Hcfgl[t Number of Stones D[mens[ons of same structure with alterat[ons or addthons Front Rear . Depth ......................IIc[ght....... Number of Stones 8. Dfinen~f.¢nnew consttvchon Front . • • , , • , , • Rear Depth . Hctgltt ..............Nu[nberofStones........................ 9. S[ze of lot. Front /s z , s ~ • • . • • • • , • , Rear ~.f.9 Depth ..:i`.r'' ` _ 10. Date of Purchase . .....................Name of former Owner . 1 1. Zone or use dtstnct m wh[ch premises are situated . 12. Does proposed construction vtolate any zoning law, ordinance or regulatton• N. ° . 13. YVill lot be regraded , . ~ ° • • , . 1Vd1 excess fill be removed from premises: Yes Ll 14. Name of Owner of premises L ^ Add~es~``~'F' P.~. Phone No. ??~.::51.~~? . . Name of Arch[tect • • Address ..'.":'4..":.',`.'; : ..Phony. No . Name of Contractor - :...............Address .Phone No......... . 15.Is this property located within 300 feet of a tidal wetland? *YES....NO.,~ *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distutctly all buddmgs, whether ex[stmg or proposed, and, indicate all set-back dunensions fro property tines. Give street and block number or descnption according to decd, and show street names and indicate wheth intenor or comer lot. ~y~ fUf~~i-4(lril)~. ~ ,~~`r 4/1 L/ ~n 3 ~ N '~C Ya ~y~ /TYJ'!?' ~i ~O IZ1~.C~ y2uP Lhl. LIN4 L=k151i.v t 1 ~ .7 \ a- ° i~ to !a ~ i SnAt~ f /.-i t~fi--Lt_ b P S p L e T R''9 ! L'- ! ' SALl7 RAzL t7ucrn,G (-'`~-yvC`>uG -rWOCz- SCZ(~CNS •---v~ \ / / A-od 1^rVk LS / SL'Z77Lw~ o f ~"'1~ .j pc.r R.i\L_ i¦ Z RAILS ~ ( V F i ? f_J Iti L3 H `'I=wG \wG ~ ~~.r N fLN ~Y7J uCu' G ILS,.,~ N s'S C ~ 11 1 , - * a r` ~ STATE OF \E1V'1'OT2K, j " ~ COUtiT.Y OF . S S a • . be[ngdufyswom,dcposcsandsaysthatheistheappfica (Na[rIc of mdrvidual sfgn[ng contract) about named -,1 - (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 tP apphcauon, that all statements contained m this apphcaUOn arc true to the best of tits knowledge and belief; and that t,' 'work wdl be performed m the manner set forth m the apphcauon Glcd thcrcw[th. sworn to before me the ..lP.........day of. 19~.`~. ~o[ary Publcc, fj~.L.~/•A-~....... CountY ~-~t: . NEtEN K DE YOE NOTARY PUOUC, State o! New York (Signature of appl[car No 447818, SuRatA Coaoty q Term Exmres March 30,19._1