The URL can be used to link to this page

Home My WebLink About17690-Z lPO~'M* WO. ,e TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PEIUwAIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ ~17690 Z County '['ox Map No. lO00 Section ..... /.Z~,-~ ........ Block ......... ~.../ ...... Lot No ........ ..~....~....~..... pursuant to application doted .../.~.//.....~.... ................................ , I9~.....~.., and approved by the Building Inspector. ~ee $...,Z..~ Rev. 6/30/80 FORM NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL · °oOUTHOLD, N.Y. 11971 ~. TEL.: 765-1803 Examined../~../.~. · ....... ,19~..~ Received ........... ,19... Disapproved a/c ..................................... .~/:., _ ~ j _ .J UJI ~11]I APPL,O^T,ON ~O~ ~U,LD,NG PERM,T J ~ INSTRUCTIONS OF ~OUT~OLD a. This application must be co~ ~pletely filled in by typewriter or in ink and submitted to ~,he Bui!ding Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. , . ¢~ ,~.<~ '. ~ b. Plot plan showing locatmn of lot and of buildings on prem~s~,~latie~hlp~e~ad~fi~ng premises or public street~ or areas, and giving a detailed description of layout of property must be d~ra~Off~'~i~m i~vhich is part of this appli~ c. The work covered by this application may not be comlnenced bef6fe~l~t~hce6f Bulld~ing Permit. d. Upon approval of thru apphcat,on, the Braiding Inspector will ~s*Uefl a Buffdmg Permit to the applicant. Such permit shall be kept on the premises available for inspection fl~roughout the wo~. e. No building shall be occupied or used in whole or in part for'an3~'purpose whatever until ~ 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, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances buildin, g cpde housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary iaspections. (Signatur~ofiapplicant, or name, if a corporation) P.O. Box 565, Aquebogue, NY 11931 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ARCHITECT - WARREN & SUSAN CANNON Name of owner of premises .......................................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. N/A , (Name and title of corPorate officer) Builder's License No .... ...................... Plumber's License No .... ,...N/fi. ............... Electrician's License No.. N/A Other Trade's License No. N/A 1-. ~.ocation oriand on which proposed work will be done....(.?.0..~..~.o..~.~.~..o..r..S.o.~..~.~. ?.e.~e. ! ............ -', :- . .... ' 4.5¢'~..~..~?.~.~..e. ?.o.~..~.~../. .......... ~.~.V).~.~.o~ ........... ~ ?z_,~,-: ~.,~ ?.¥ .r: .......... / ..... · ......... House Number Street Hamlet County Tax Map Np. 1000 Section 112 Block 0 1 Lot 0 14 Sul~division .. .................................... 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 Private Residence b. Intended use and occupancy .................................................................... 3. Nature'if work (check which applicables. :,¢ Building Addition .......... Alteration .......... Repair .............. Removal .............. DemQlition . .X..X .......... Other Work ................ (Description') 4. Estimated Cost ....$.2.,.5..0.0 ............................ Fee ....................................... · (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .O.N.E. ...... Number of d~velling units on each floor ................ If garage, number of cars .... . .......... .N..O. N· .E ......................... '. ........................... 6. If business, commercial or mixed occupancy, specil'y~nature and extent of each type of use ...'..i.i.i.N/.A. .......... 7. Dimensions of existing structures, if any: Front .... 6.0. ......... Rear ...6.0. ......... Depth... K01 ........ Height ....%0. ......... Number of Stories ....O.N.E. .......................... 6, Dimensions of same structure ~;ith alterations or additions: Front N/A ......... l~/~ ............ ................. Rear .................. Depth ...................... Height ....... '4 ? A ........... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Dept,h ., ............. Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...2.0..0 ................ Rear ....... 2..0.0 ............ Depth ....... 9.2.~. ............ 10. Date of Purchase ...... ?, .B~. .................. ~gmg of F0rm~r.Owner , .~e..a~. ............... ...... · . a nesmaenv la±-~grlcu±vura± 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .N/.$ ........................ 13. Will lot be regraded ........ I~,/~, ................ Will excess fill be removed from premises: ~ ~ No 14. NameofOwnerof~remisesW.arden & Susan CannorAddra~~ Southold, NY (*) ~h~,,,l~I~ 765-~?~- Name of Architect 'Do~al.d. 4" ']J~; 'Al .'i :,~ :'" Addr;;; ~,c[c[~c~,c[~; 'I~ .... [ [ ~;~; ~;' 7'~.-'~.~'q' [ ...... Name of Contractor' '~-er[e~[c[ '~r[t[ I~'~[~' ' ' a~r~ '~'~;l~.c[; '~q-~ '(~*) Ph,~,,~ W~'f~7-'e~ .... *Calves Neck Road **Roanoke Avenue PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from ~roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ntefior or corner lot. 785-~802 9 AM TO 4 Pt'Vt FOR T:qE FOLLOWING INSPECTIONS; I. FOUNDATION . TWO REQUIRED FOR POURED CONCRETE~ 2. ROUGH - FRAMING & PLuMBiNG 3. INSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. AU. CONSTRICTION SHALL MEET THE I~'QUMEMF. NT~ OF THE N,¥. DESIGN O~ CON81~ ERRO~R: APPROVED AS NOTED OA~,/~ ' ..-,,- ..,. # ~-v- UUIL.DING DEPAR~ ;TATE OF NEW :OUNTYOF .... q ..... ....... S.S ........ DONALD A, DENIS being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore na~neo. ARCHITECT le is the ......................................................................................... (Contractor, agent, corporate officer, etc.) f~s~d owner or owners, and is duly authorized to perform or have performed the said work and to make and file this pplieation; that all statements contained in this application are true to the best of his knowledge and belief; and that'the ,ork will be performed in the manner set forth in the application filed therewith. worn to before me this ; ..... day of ........ rotary Public, I ..........................~~.~.~O~f)~o~County i'" /~ ~ ~ stun ~s~ ~ s~,vo~ ' '~.12 ' '~"~.' ' ': .... ~ ........ No, 4923702-~ulklkCe9~Z DONALD ~i DENIS ~ (Signature olappilcarlt) Tem~ ~ ~14,1~ ~_..~ (Architect)