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Home My WebLink About17472-z FOB~ NO. ~ TO~N OF $OUTHOLD BUILDIIqG DEPARTMEHT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017472 Z Permission is hereby granted t,o: .... ..~..~..~..,..~.~......./.~.~..~ .... County Tax Map No. 1000 Section ............ .~,/.,, .... Block ........... ~,, ....... Lot No ......,.~,.. ,~,.. ........ pursuant to application doted ... Building Inspector, and approved by the Rev. 6/30/80 Job No. TWIN FORK FENCE CO. P.O. BOX 476 - NORTH ROAD (RT 45) MATTITUCK, NEW YORK (516) 298-4777 NAME Mr. Ander,~om ADDRESS 170 'T'or,'~Q'~nd Pelham, N.Y. 10803 D^TE 9/10/88 TELEPHONE JOB SITE: 370 North Parish Dr~vm; Sonthold: N.Y. Tnstm11 12 ~mnt. ions Two short sections of Lneumt Split Rmil to tapar to ~round level $504,00 D~posit 252,00 Bnlanem du~ on mompletimn ANY SPECIAl. ORDER FMMCTNC. DF. POSTT Tfl NOT PRFIINDARI.~ DEPOSIT TO HAVE JOB SCHEDUleD ground, or to ~rform any additiona~ work not ~ver~ by this contraS, a rea~nble charge is to ~ made to the Purchaser for such work or s~ial construction as an extra. Unless other- wi~ provi~d, the fence is to follow the existing ground lines, tf grading or filling of the ground is n~essary to the pro~r installation of the fence, this work to ~ done by the Pur- chaser. We are not res~nsible for any underground damage of wire, pi~s etc. Unless pro~ erly staked or marked by owner or contractor. ACCEPTED ~~~ (Owner of ProperS) OVCr,,lO0° FORM NO. 1 TOWN OF SOUTHO~D E[UILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined .. ?. ~,/~. ....... , 19~..~' Approved ...~...~....:.., 19~. Permit Ng~.,~.~. ~'.~../~ Disapproved a/c ..................................... ........................................... Inspector) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ........... SEPT,~c ro~,t ................ NOTIFY (914) 738-0114 CALL ..................... MAIL TO: Lois T. Anderson 170 Townsend Ave. Pelham, N.Y. 10803 TOWN OF SOUTHOLD INSTRUCTIONS a. This application must be completely filled in by typewriter orin 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 9f 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. ¢. 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 of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, a,d. ditions or alterations, or for/'emoval 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 o~and in building for necessary insl~ection~%~. ' _,..,~,8~m''" ~,~ _:/'.' ", ).4 i "" ........... ~ R~t ~ .-la ~ (Signature ct applicant, or name, if a corporanon) - ./ ~ ~75i¢~ 170 Townsend Ave. . [ 5:. ... z. .................... State whethef'applical~{~vner~i ;};;~a~e/tt, ~chitect, engineer, general contractor, electrician, plumber or builder. .................... p~.;;~t.~.'*~ 5;..t;°'''~ ' · ................................... . .................. Name of owner o f pre~j,s~,,,~v~??~,.'.~ >,.'.~n,~ .e~. ~p.n. ..................................................... If applicant is a cq,01mti'drl?~n~a~it~,[}¢dl~J~, hU.thOrized officer. .............. ~,~g'33. =~-,,,.~t~,*~ ~ ................. (Name a.u~l~t~ttb~JE~e~ or.~ ~"o ffic er) Builder's License No ........................... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................ 370 Nortk ~arish Dri,y~, Sou.t-hold.,. N.Y,..t19.7.1. ....................... House Number Street Hamlet County Tax Map No. I000 Sect. ion 71 Block i Lot. 34 Subdivision ..................................... Filed Map No ............... Lot ............... (NaIne) State existing use and occupancy of premises and intended use and occupancy of proposed constrnction: a. Existing use and Empty Lot occupancy ..................................................................... b. Intended Use and occupancy ..... ' ................... ..; ............................. 3. atu e of work (check which applicable) ion .......... Altera n ......... ep~ur .......... : ·.. Re{noval ..... . .......... Demolition ............ Other Work..x.... Construct 3 h~gh Locust Spl:kt Rail Fence ......... 4. Estimate'd Cost $504:..00 $25.00 (Description) , (to be paid on filing this application) 5 If di;~ellthg; number o£dwellin'g units · Number of dwelling units on each floor ' If garage number of cars ~ 6 If business commercial or mixed occupanc~ ......................................................... · ' specify nature and extent of each type of use · Dimensions of ex,sting stmctulres if any: Front Rear .................... Heiglit Numder of Stories ............................. Depth ............... Dimensi;~ ............ ' ....................................................... of same structur witli alterations or additions: Front ................. Rear .................. !~ ...tleight ............ N berofSt ri · :ruction: Front ............ Rear D ............ nbc of Sro i .................. epth ....... r res ........... * ....... ' ....... 9 · ' ' 33 10 Dh't~fPurchase-. '.~.9~ .9'7.~ ' ' ear ............... Depth · N 6fF O 11 ................ amc ormer wner .- ..................... ,~one ~[.m'~.~.g ~.S .B~I; tlr~tlt p~remises are situated .... .SAn. g.l.e. ?.arailY. Hgmes 12. uoes prop'o'sea con~trd0't[bn viblate any zonin- t~,, a' ' '; ; ......... ,~, ....................... W:I' ' ' ~- , , ~, - - . - --=-~-, or,~lnance or regulation . ~p ..... 13. ,t~otoeregraaea . .~xq.. ' . .. , ..... ' ................... " L~" ' -' ' :' '~ ......... wui excess fill be removed from premises Yes 14. e~ame of Owner of premises :ks..'+'..a. ncterson _,, ~70 To ......... : .... No Name of Architect ....... ' .............. Aaares~ ...... .w.~.~.uj).u. Aye.. Phone No { 9.1..4 L7.3.8.': 9.1.1.4. Add P lham Phone No ', .................. ress . . e , N.Y. Nam fC ................... e o ontractor ....... · ............. · ~ .................. Address ................... Phone No ............ ;... 15.Is this property loc~tted within 300 feet of a tidal wetland? ~YES .... NO .... ~If yes, $outhold Towln Trustees Permit may he required. ..· i PLOT DIAGRAM Locate clearly and distinctly alll buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and bio k number or description according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEWYORK,NeSL. COUNTY OF ................. Lois T. Andersoh ............................. ~ ..... being duly sworn, deposes and says that he is the applicant 'ndivldua] signi~ .............. (Name of g contract) above nam'ed. He is the I ' (Contractor, agent, corporate officer, etc.) of said owner or owners, and is dulyI authorized to perform or have performed the said work and to make and file this application; that all statements contaihed in th s application are true to the best ofliis knowledge and belief; and that tlie work will be performed in the mannerlset forth in the application filed therewith. Sworn to before me this ' FFIANOE$ W. REIOHERT l No. 60-4817547 j · · . . . . Qualified in Westchester County,~ Onrnrnlsslon Expire~ March 30, 191.7.o (Slgna~tlre of applicant)