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Home My WebLink About18559-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEPJ~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 18559 Z County Tax Map No 1000 Sect,on ........... /?~.... Block ....... ~ ........ Lot No ......... ~. ....... ........... 19.(~..., and approved by the pursuant to application date¢J .......... ~...~...~.~-m.~ / Building Inspector. Rev. 6/30/80 or formerly t~obert Kolog/ forr~erly NormOn Probe 15,000 s f 200 57 ~.~ /'IOW 0£ , Horold ~ inspecto~ by thls ~:paL~m~x,% and fo~ to be s~tisfa~tory. O+-- ~ zq Chief of General EngineerinR SURVEY FOR EDWAt?D PtPOBE 8 LYDIA Pt~OBE AT SOUTHOLD TOWN OF SOUTHOLD SUFFOLK COUNTY, NEW YORK MA~C~ DEC ~ DArE ~UG I SCALE / No 83- ~ FORM NO. 1 TOW~ OF SOUTHOLD BUILD, lNG DEPARTMENT TOWN HALL BOARD OF HEALTH ...... 3 SETS OF PLANS o-~¢~- .... SURVEY ..... ~.o CHECK .......... SEPTIC FORM ............. : NOTIFY , TEL,: 765 1802 Examined/.0h ......... , I9~?. ~ T0: ,,~,o,..~ .:./.¥~. ........ ~ :~'.:/ /: ~..~ ~'~ , ~ ~ r~ 19~. Pe=,t No../:. ..... .................................... .. ......... AP.P. RO~ED AS. NOTED ............... · ..... (./_~ BLDG. DEPT. DATE: ..... ~.P.# ..... '~ --~-~/~ '/~-T'"--/7~-~ FEE , BY: ( midi ,*./Inspector) "OT{FY E~UILDING DEPAI~"T~EI'dT AT (~ 76~-1802 9 AM TO 4 P~ FOR TNI~PPLICATION E'OFI BUILDING PERMIT 1 FOUNDATION TWO REQUIRED Date . . 7 .. FOR POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING INSTRUCTIONS 3 INSULATION a4 ]i~[pphcag~NSllRSKl~laO~ls[y filled m by typewnter or mmk =nd subm=tted to t~c Bmklm_g [n~pcctoz, sets o£ p~lP.~.,~Kt#!t'gq~gflOR~l.a~ to scale. Fee according to schedule. bA~I~;:ilIh~Tfltll3ti'al~[c~ dilEE~' =nd o£ braidings on premmcs, =cIat~onsil[p to =d.iommg p~ermscs o= public ~ =e~AEa~t~i~{~llR~MEl~l~l~lFcifl~l~EipNc~ of layout of p~operty must bc drawn on thc dmgram wh]cil ]s pert o£ tl~s app cat[O~oTATE CONS'tr~Uc'trlON & ENERGY , c.Ct-~ESwol~l~rov~ESl~l~plrt~l~ion may not be commenced bet'o=e ~ssuance o£ Bmldmg cl~li~ ~p~I~UtEI~IO~FEiiIBI~ the Budding Inspector wall issued a Dmldmg ?ermzt to tile applicant. Such perm shall be kept on thc premises avatlaMc £o~ mspcchon throughout the work. c. No budding shah be occupied or used in who]c or m part £o~ any purpose whatever until a Certificate of Occupan, sh=[! have been g~=nted by the Building [nspcc~on AP?LTCA'['[O~ IS HEREBY MADE to thc Bm[drag Department £or tile [ssumace o£ = Bm[ding ?erm[t p~rs==nt to tl Bmldin§ Zone Ordinance of tilc Town of Southold, Suf£olic County, New York, and other =pphcable La~vs, Ordinances R. cgulat[ons, for tile cortstructton ot7 buddings, acldmons or =/ter=gons, or £ot removal or ctemoh~ton, ~s ile~cm describe, Tile apphc3nt agrees to compJy w~th all apphcablc Jaws, o~dmanccs,~dm~g code, ilous~ =~---"~de, an~ reguiahons, and , (S~gnatttr¢ of =pphcant, or name, if = corpo=nt[on) 2X. ~..~..Se ./4.~...~... ~.....~... ........... ~o.~ ' ~ (Mmhn~ addre~ ~f apphcant) State whether apphcant m owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber bmlde ....................... ~O.~.~..~¢-... .......... : ....... ~ .... .................... (as on the tax roil or latest deed) I£ apphcant m a corporauon, signature o£duly authorized of£~cer (Name and Utle of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED ]3udde~"s L[cense No ........................ Plumber's L~cense No ...................... Electrician's License No.. ..... ~,~.~ ...... ~,~..~:~::~: ............... : .............. :. House NumberStreet Hamlet County Tax Map No 1000 Section ....... ~ ......... Block ................. Lot.., Subd~mon Fded Map No · Lot (Name) State e':mmg use and occupancy of premises and intended use and occupancy of pro, posed construchon: a. E~stmg use and occupancy .4. .......... t.//.A ~ ....,.' .. ;~.,. . . b. lntended use and occupancy ............................................ · · -. - . ..........,. . .. . 3. Nature of work {check which apphcable)- New Building .......... Addinon .......... Aherano~ ......... Repa.w .............. Removal .............. Demohtion ............. · ~>--6 (Descnpiion) ...... 5. Ifdwclhng, number of dwclhngumts ....... .--w~,.... Number of d elhng mrs on each floor .............. If garage, number of cars ...................................................................... 6. If business, commercml or rap, ed occupancy, specify nature and extent of each type o£ use 7..Dzmenszons o£ e×~stmg structures, ff any Front ............... Rear .............. Depth .............. ~[1~ ............... Number of Stones ~"~--p~nslons of same structure w~th alteratmns or addmons: Front ................. Rear ................. ~th ~ffilll-~ '~, -~-~-fi~ .... :~, ....Hmght ...................... Number of Stones ..................... 8. hlae. ns~o~ enhre hev(~[~strucnon' Front .............. Rear ............ '.-.. DeI~th '. .............. tem~,~ .... ~.-.,, ~ . N~mber of Stones ......................................... 9. ~ze o,~ [~t~9t~. ~,,~tl,.., .[ ............ Rear' .................... ' De th-- .................. Dal'er~ffi%rc'hase ........................... Name of Former Owner~ ............................... '. 1.Zone or use d~stnct in which premises are situated .............................................. 2. Does proposed construction violate any zolllng law. ordinance or regulation: . .'-.~.'. ........................ 3. Will Iot be regraded ......................... Wdl excess fill be remoye, d,f,r,o¢, premises Yes No 4. Name of Owner of premises ................... Address ................. P.h.one ~No ................ Name of Architect .......................... Address ............. .. .....Phone-No ................ Name of Contractor .......................... Address ................... Phone No ................ .5. Is this property located wzthzn 300 feec of a t3.da~ wetland? *Yes ..... ~ No ..... *If yes, Southold Town Trustees Permit may be required. PLO~ DIAGRAM Locate clea~ly ~nd dlstmctly ~1 buddings, whether ex~stmg or proposed, and m~z,ca~e ~l set~back~dm~ens~ons from )rope~y hoes G~ve street and block number or descnptmn according to deed, and showy, st~)? ,~rnes and mdmate whether ntenor Or comer lot. ~ t ,'~ ,r 7.r / TATE OF NEW~RK~ .f /~S" (Name of mdn'~dual szgmng contract) >ovc named. (Contractor, agent, corporate officer, etc.) said owner or owners, ~d ~s duly authorized to perfo~ or have perfo~ed the smd work and to m~e and file ~s ,~bcatmn: that all statements contmned m tins apphcatmn are true to the best oflus knowledge and behef, and that the ork will be perfomed m the m~ner set forth m the apphcanon filed therewith. ~o~ to before me thtg Ou~hfled m Su~tk CounW