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Home My WebLink About17568-z FORM NO. 2S TO~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017568 Z Permission is hereby granted to: ~.z~..~,,?:....~....,/,~, ....... ...... ~, ,,e~,~e, ,~ed ,, ..X~.~..~.Z~.....~.~.L.~.~~. .................................................. ~~~ ........................................................ Counh/ Tax Map No. 1000 Section ....... ,//'../. ........ Block ...... ../...~.,. ....... Lot No ....... ./....~... ......... pursuant to application dated ...... ./...~..../~./..~.. .............................. , 19...4~'~, and approved by the Building Inspector, Rev. 6/30/80 FOUNDATION { lst) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. STATE ENERGY CODE Ye FINAL ADDITIONA'L COMMENTS: L..,'TI'Lt ¥, I0.1 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y, 11971 TEL,: 765-1803 , isapproved a/c :. , , Tow~ OF SOUTHOLO ,,, Received .......... INSTRUCTIONS a. This '~ppli~ation must be completely filled in by typewriter or in ink and shbmitted to the Building Inspector, with 3 ts 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 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- tion. c. ~/he work covered by this application may not be commenced before issuance of Building Permit. d.~ Upon approval of this application, the Building Inspector wilt issued a Building Permit to the applicant. Such peTmit ail be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in pai't' for any purpose whatever until a Certificate of Occupancy all 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 dlding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or ..gulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. te applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to mit authorized inspectors on premises and in building for necessary inspections. · · Envi~.onme at; .E ~e.~r · Irm .................. (Signature of applicant, or name, if a corporation) 307~ Indian Neck Lane · ..Be¢oc~£o,. ~ .115.58 ....................... (Mailing address of applicant) ate whether applicant is owner, lessee, agent, architect, eugineer, general Contractor, electrician, plumber or builder. .............. 9.e.n.e.r.a.1.. C. 9.a.~.~..~9.~.q~. ........................................................... ~tme of owner of premises .... .M?....~. ?l?.s. :. ?.a.m. ~. 9. ~e..P~.r.l.a..n.d ....................................... (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. .................................... p¥.e.~ ~¢prm (Na~ne and title of corporate officer) Builder's License No...¢~. 6F~I ................ Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No .............. ; ....... Location of land on which proposed work will be done ..................................... y¥ ........... ~9 Little Peconic Bay Road Cutchogue ~ House Number Street Hamlet County Tax Map No. 1000 Section ...111 ............ Block ..... 1[[ ........... Lot ....... 17 ........... Subdivision N~uasau. ).oia.g ....................... Filed Map No. . . 37 ......... Lot ............... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ~ingls..fa~ly. d~,e 1].~_.ng ...................... ................ b. lntended use and occupancy ......... : ................ ' .....~.~ ff~. ,e · ;... .................. t~' f ' k( ' ppi' ) Additi 3, Na re,o wot check whl¢ll a :cable: New Building .......... on ...~ ...... Alteration .......... .... RemOval Demolition Other Work 4, Est:~ed Cost ,,, Fee .............. o bo paid on filing thi~ a cation) S ' ' ~"~ ~'" ~ : ' · Numb6r of dwelling units on each floor . If d~ nfimber of dwelhnglumts ........................... If garage, number of c~s .... ~ .................................................................. 6, If business, commercial or mixa,d occupancy, speciy nature and extent of each type of use ................... 7. Dimensions of existing stmlctur~s, if any: Front ..... ~3,) ....... Rear ..... ~.~ ..... Depth . ·, ~Z) ....... Height ............... Number of Stories ...... ~ ............................................... , Dimensions of same structure ~ith alterations or additions: Front ....... ~ ~ ....... Rear , ~ ~ ........ 5,8, ~ H~ight Number of Stories & ' ' ' Depth ................ ) .......................................... 8. Dimensions of entire new const~ction: Front ~7~ 6" ~ , ...... , ..... Kear ............. Depth ......... Height ............. ,.Nm er of Stories .................................................... O. Size of lot: Front ..... 99. k. ~ ........... Rear ..... 95~ D~-th Z62~ ' 3. Date of Purchase ·.. ~ Name of Fom~r Owner 1. Zone or use district in which premises are situated .... · Re.s~de.n$18Z .................................. 2 Does p posed ' ' ' ordi or regulati . ro construction wolate any zoning law, nance on: ..., ....................... L Name of Owner of premises~ ~. , .~:~a~ .d,~. Aaares~ .................... rhone mo ..... Nme of Architect .......................... Aaaress ................... rnone mo. .. Nmne of ContractorKuV~p.qaz m~ .~ a$.~,. Iaa. Address 30.7.5 .I~Lan. N~akP~e No. Peeon~e, Locate clearly and distinctly all 'operty lines. Give street and block todor or corner lot. PLOT DIAGRAM buildings, whether existing or proposed, and, indicate all set-back dimensicons from number or description according to dee~l, and show street names and indicate Whether See Attached 'ATE OF NEW<Y-O ~/ ............ '~--~r¢..(....'~: .C~.~. ,~..~..-~..('~.~. being duly sworn, deposes and says that he is the applicant (Name of individual sign ing contract) )ye named. i ' ent,,corporate officer, etc.) said owner or owners, and is dui authorize od~-ff~rform or have performed the said work and to make and file this )lication; that all statements cont~ ined in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set forth in the application filed therewith om to before me this tary Public .... County ~o. '~.?~Y~ / ~ ' /(Signature of applicant) Cemmlssion Expire., December 8, 18...~_? ,