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Home My WebLink About18394-z roast xa 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) N°- x.8394 Z Date 19.1..1.. Permission is hereby granted ro ..~Fr~.. .~~~k4.~........ .....~....1~......ti~~r. ~~f~...... G / ~J c,~ at premises located at ......~Lt..~~.+...~G.-~nC~.../~......~ Caunty Tox Map No. 1000 Section Block ........T......... Lot No..lP.... y~ ~y p pursuant to application dated ...............LJ./4~............................, 19..f?./.., and approved by the Bui lding~I7nsp~ector. Fee $.••de`.~. av Bui ng 1 or Rev. 6/30/80 x.. , _~i`' _ tV ta, i ~ ~ ` A~• _ .i ~U ~-i ~ wl~ C u_ g ~ ~ u o o i~t' ~ to ~ _ ~~l d y' o ~ s ~ ~ 1 i :a x a•~'£t~ 3 '~:~~~<.~,'~o f ~rav-i r~n~.w~ a.t Cs'~n -,.w_..L__----~ M1 i ~ r- 3 '-a I h- . ~ ti ~ ~ ~SZ i~ ~ ` ; i V'~ :d VI tf _ / ~ ~ I U; ~ ' ~h n r-~ ' \l _ H ~ nn f L• ~ '~~11 ~ ~Q ~ Q1 ~ ~ ~ -1J _ ~r~ 1_ ~ M i Ins ~A \I ~ ( Z ' C) ! < ~ ~ - ~ ~ ~ u~' ~J tj y _ ~ i I ~ h~ I A L' G r w - cv • i~ l ' C 1 ,Sr k~~~ ~ M A. u ~ ~ BOARD OF HEALTH A~ ~ FORM NO.1 3 SETS OF PL.1N5 . SURVEY TOWN OFSOUTHOLD CHECK BLDG.DEP7 BUILDING DEPARTMENT SEPTIC FORI.1 . TOWN OF50UTHOLD TOWN HALL SOUTHOLD, N.Y. 11D71 NOTIFY e / TEL.:7G5-1802 CALL f~ Examined .O/~-t7........., 19 .~,t MAIL T0: ~C R I - l ~ 20 p.~ ~q / Hof \pproved . ,l,~i........., 19u[ .Permit Nol.~~.~~. ~ . i Disapproved/a/c . uildi o Ins ecto ) APPLICATION FOR BUILDING PERMIT - Date ...~~'!~f..~..-~~.., 15.9 INSTRUCTIONS a. Tltis application must be completely filled in by typewriter or in ink and submitted to the Buildin; Inspector, with 3 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 streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 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 Buildin; Zone Ordinance of the Town of Southold, Suffo]k County, New York, and other applicable Laws, Ordinances or Rc,ulations, for C{~~bcJnStiruc"lion: o(',buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees [o .comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspe~tois oh-pre'"miser and in building for necessary inspections (Signature ai applicant, or name, if a corporauon) y~' . , ~ ~"Y~~/A ~82oLr'ft/e j?ec;~;t?a(,~ C~f~6,djy~ (1~Y. ?l.eC3i ' - - (Mailing address of applicant) State whethei applicant is owner, lessee,-agent, architect, engineer, general contractor, electrician, plumber or builder. c t ttw4 t'' Name of ott,nrvtr ~~{lpresrl'jses„,+:~o,~z.~`;~`• lovS... ~ . GIB/!; e~i•r~ h•~ ~~,c,s . yB;add ,g ` ~ (as on the tax roll or latest deed) If applicant`'i's~'a co~r~~t~5"hrQri',sig~,~Lure of;d.uly,authorized offcer. (N'amc and tit]e/o,,f corporate officer) Builder's License No. C/.~. ~"a?~!. - Plumber's Liccnsc No . . Electrician's Liccnsc No . . OlltcrTradc's License No . 1- Location of land on which proposed work will be done. ' f louse Number Street. • ' • • ' ' ' ' ' - ' - Hamlet CJ County TaxAlapNo.l000Section Block Lot..~~.. Subdivision Filed Alap No. Lot . (N;une) State ceisting use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy 5 i a~~,n•e•C~• • , , , • b. Intended use and occupancy~0. s~'•1i•~• •~•,•02• { ~•~~~n• •~~..be,~,Y~Ctev' f?c?[rs:r •f?ar;~'•or~/7~ ~i I , _ 7 3. Nature oCwork (check which (',applicable): New Uuilding ,Addition • Repair Removal ~t ation' J , Demolition .......'......#L~[f`(V''otk~:ri'.'~i;~?-~'~-,r.~l`43•r~ 4. Estimated Cost ~ (Description) Fee...........,............,............. 5. If dwelling, number of dwelliri (to be paid on filing this application) g units , , , , , , , , , , , , , , , Number of dtvellittg units on each floor , . If garacc, num bcr of cars , ! . , , , , , , , , 6. If business, cornmcrcial or miu•'ed occupancy, specify nature and extent of each type of use , 7. Dimensions oC existing structu'tes, if any: Front . ' • • • • • • • • • • ~ Hei.ht Number of Stories . Rear Depth Dimensions oC same structure Fvith alterations or additions: Front • ~ ~ • • • • • ' ' ' ' ' Depth . Height . Rear Nu " NuntbcrofStories 8. H`mi Tsions of entire new consFntction: Front . . Rear . ' " Depth 9. Size of lot: Front tuber of Stories • ~ ~ • ~ ' ' m 10. Date of Purchase . 7f/„$~l ~ 7 • • • , Rear Depth . 1 1. Zone or use district in which • ' ' • ' ' ' ' ' ' • • • • Name of Former Owner SC.C~i! C~py{'i, ~s ~asf , , , . • • premises are situated . , , , , a ose construction vio ~ p P ,raded , , • , . , . late any zoning law, ordinance or regulation: • • • • • • • • • . • • • • ~ • 13. 1Vi11 lot be re" l4. Name of Owner of premises , I• • • • • • ~ • • • • • ' ' ' ' ' ' Nill excess fill be removed from premises: Yes Nc Name of Architect • ' ' ' ' ' ' ' ' ' ' • • • • • Address ...................Phone No. . Name of Contrac[or.•••••~ ••••••"""'•••Address Phone No..•••.••..••••. IS.Is this ro ert loc•• "•••.Address.. ,phoneNo.. P P y ate,d within~00 feet of a tidal wetland? *YES....NO.~. *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly al~ buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block~number or description according to deed, and show street names and indicate whether interior ar corner lot. I~ i ~I PP DYED NS N D DATE: loo ~7 S.P, # ~ 3S' NOTIFYFY U~ DE AT 766-1802 9 AM TO 4 PM THE • FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE ~ • 2. ROUGH -FRAMING dr PLUMBING i 3. INSULATION Q. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. j ALL CONSTRUCt10N SHALL MEET i THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION 8 ERGY CQbES. NO'T RE$PQN$19C'~ FOR p@SIGN OR CONSTRUCTION ERRORS j i STATE OF XE~V YOR1:, COUtiTY OF , , ' S:S (Name of individual si" g contract) ~ ' ' ' ' ' • being duly sworn, deposes and says that he is the applicant above na ,ninl med. 'Ic is the , ' (Contractor, agent, corporate officer, etc.) ~ ~ ' ' ~f said owner or owners, and is duly ;juthorized to perform or have performed the said work and to make and file this PPlication; that all statements containy:d in this apphcgtion arc true to the best of his knowledge and belief; and that the °qrl; will be pcrforntcd in the mannersyt forth in the application filed therewith. 'tvom to boforc me this j , 'otary Public, R' , County HELEN K. DE VOE I'' ..........G~?Yi:'~: , ~ y . NOTARY PUBLIC, State of N9w Yak (Signature of applicant) No. b767878, SuNolk County Tartu Ezpires March 30,19;._.