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Home My WebLink About17341-z FOE.~ NO. ,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) NM 0173~! Z Date ,...~..../...?~.. 'Z..-- ......................................... , Permission is hereby gra_~.nted/to: .,~ ,4 _ ~, /~ ! L~,,~- a , ....... ~~~..~..~ .......... .......... ~...~ ....... ~ ....... ~~~..~ ............. to ............................................... ~~¢~ ........................................................................ co~ **~ ~o~ ~o. ~o00 so~.o~ ....... ~.~..~. ~k ................. 2 ~o~ ~o .......... ~.'. ......... pursuant to opplic~tion d~t~d ............. ~ .............................. , 19.~ ~nd ~pprov~ by the Building Inspector. F.. ,...~~ Rev. 6/30/80 PROPERTY OF: STANLEY & JANICE FLISS JR, 565 OLD MAIN RD. MATTITUCK N.Y. 11952 191,~1 CO. TAX H~ ;NOTED NOTIFY 766-1802 9 AM TO 4 PM ~:OLLOWING INSPECTIONS: 1. FOUNDATION ~ TWO REQUIRED FOR POURED cONCRETE 2. ROUGH ' FRAMING & PLUMBING 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE cONSTRUCTION & ENERGY cODES, NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS Examined..~.[. Disapproved a/c ..................................... APPLICATION FOR BUILDING PERMIT 'FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 Received ........... ,19... Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building 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 Building Zone Ordinance of the Town df Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessa7 inspec .~~....~~.. (Signat/{rp of applicant, or name, ifa corporation) · .5.6.5. ?.d.,.. a..t.t ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Nanle of owner of premises .S.t..a.n.l.e.y...J....~..J.a.n.~.c. 9..lq..F..1 .i.s.s.. ,J..r.. ..................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No.. J. 2,9.8.5.-. ~I I ............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. 565 Old ,Mai, n Rd. Ma.~.t~it.u~k House Mum bet Street Hamlet County Tax Map No. 1000 Section .... 1.2..2 ........... Block .... 7. ............. Lot....2 ............... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy Dwelling and Wood Shop. ................. b. Intended use and occupancy ...... S.a..m.e..w.i..th. decorative fence. . ............ Nature ofwork (check winch apphcable): New Building ... 'Addifio'n'...,.'.' ..... Alteration .... ' Work ~:~qg~ Repair i Removal Demolition ' Other (Descrip 42' high accroi'ss front yard. (See Plot Plan) :: 4. Estimated Cost ... ~[.,.~.QO,.0.Q ....................... Fee ....... i Ate b0 91~1 on filing this applicatio~ 5. If dwelling, number of dwelling units ............ Number of dwelling, un'its, 'oh, each floor,.,..., ..... If garage number of ca~s ' 6. if business, commercml or m~xed occupancy, specify nature and extent of each type of use ............... ' pth 7. Dimensions of existingistmctures, if any: Front ............... Rear .............. De ......... Height ............ .... Number of Stories .................................................. ' Rear Dimensions of same strUcture with alterations or additions: Front ............................. ' Height Number of Stories Depth ' .... Rear Depth D~menmons of entire new construction Front ....................................... He,.'ght ............. ; . Numb~r ef Stones ........................ i ...... i .... Sizeoflot: Front ' !':;~;" " - ~0~.5°' Dp,~th 16~ &26.8. 'ZOU ............... t~ear..47~-...,~ ........ , v~- ............ Dat~ of Purchase ... } .l:tiay..%.6,..1,9~ .......... Name of Former Owner Mtt~t.y. ~lta .~:ockJ-... Zone or use district in ;which premises are situated...lSJ~ .......................................... Does proposed construction violate any zoning law, ordinance or regulation: .['J. 9 ....................... Will lot be regraded . !..N9 ....................... Will excess fill be removed from premises: Yes Ntune of Owner of premisesS, t.. 13. F.1. ~, $ ~..337, .... Address ,5fi,5..O~.cl. MgJ-B. gO.-... Phone No. 298.-879 Name of Architect ..; ......................... Address ................... Phone No ........ :. Name of Contractor .. ......................... Address ................... Phone No ........ ? · PLOT DIAGRAM Locate clearly and dis~inctly all buildings, whether existing or proposed, and, indicate all set-back dbnensio property lines. Give street and block number or description according to deed, and show street names and indicate interior or corner lot. 11. 12. 13. 14. STATE OF NEW YORK, ! , S.S COUNTY OF · · being duly sworn deposes and says that he is the (Name of ind3vidual signing contract) above named.,' He is the ' ' (Contractor agent corporate officer, etc.) of said owner or ownersi and is duly authorized to perform or have performed the said work and to make an- application;that all statements contained in this application are true to the best of his knowledge and belief; an work will be performed ig the manner set forth in the application filed therewith. Sworn to before me this i Notary Public, ...... ~:..~.-g. Odr~ .... Count , I~0TARY PUBLIC, State of N~w Y0~ (ri , (Signature of .8~ 4707878, SuffolkCounlyp,~ lean ~cpt~ Match $0, ~fl_ o ~