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Home My WebLink About18018-Z FORM NM 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. 0 1 1 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES U TIL FULL COMPLETION OF THE WORK AUTHORIZED) N2 18018 Z Date .........—4- i . ..................... 19D. -k Permission is hereby granted to: LA %.............I . ..... .............................. .............. .. .... ........ ................................. ......... ... .... ........ ................ to .. ........ ...... . ..... eO&. , ...........CL...... q-0--A ...............I.......................... .......................... ............................................................................... at premises located at ....& -A ....... .....1w.............. -A............................. .......................................... .............I..................... ..I............................................................................. ....................................... ........................................................................................................................ County Tax Map No 1000 Section .......0.9.2_... Block ......Q.1%.....``..'. Lot No. —4.7�L............. Pursuant to appli tion dated ...... ...................... and approved by the Building Inspec r. vv Fee $.... I— . . ........... .............................. .................................. Building Inspector Rev. 6/30/80 BOARD OF HEALTH 3 SETS OF PL.1N5 FORM NO.1 SURVEY TOWN OFSOUTHOLD CFFECK BUILDING DEPARTMENT SEPTIC FORPt TOWN HALL SOUTHOLD, N. Y. 11rJ71 NOTIFY TEL.:7G5-1802 CALL Examined .."?'-~u'+l. , 19~p MAIL T0: , Approved 1v)A , .b. ~ 19.1. Permit No. ~ g ~ ~ a ~ r -»,--,--k°', Disapproved a/c APR - 7 i~89 . TOWNUFSOUTHOLD (Buildino nspector) APPLICATION FOR BUILDING PERMIT Date 15... INSTRUCTIONS a. Tltis 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 [he applicant. Such pet~rtit shall be kept on the premises available fot 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 Buildino Inspector. APPLICATION IS HEREBY MADE to the Buildin; 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 Reculations, 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 necessary inspections. (Signature of applicant, or name, if a corporanon) Box. 3¢.( ....6'.r~9N~:~ A/.,l~.l~~ss~.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. h. .n _ r Name of o•.vner of premises .~.T~~ ~ STeP>t! o;j.f'l. f . (as on the tar roll or latest deed) IC applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No . . Plumber's License No . . Electrician's License No . . Outer Trade's License No . . 1. Location of land on which proposed work will be done. . House Number Street Hamlet County Tax 11ap No. 1000 Section ......;1.7 Block Lot . Subdivision Filed 1\tap No. Lot . (Name) State existing use and occupancy of premises and intended use a/nd occupancy of proposed construction: a. Existing use and occupancy O~ .C.4t.~? .r..4`5~ b. Intended use and occupancy 3. Nature of work (check which applicable): New Building Addition ~Uteration Repair Removal Demolition ~ Other 1VOrk . 7 (Dtscrip on) d. Estimated Cos[ Fee ~~'~1~'.U.Q~'• J. (to be paid on filing this applicatio 5. If dwelling, nwnber of dwelling units Number of dwelling units on each floor . If gara;e. number of cars . 6. if business, commercial or mixed occupancy, specify nature and extent of each type of use ..(jftR N• • 7. Dimensions of existing structures, if any: Front . Rear Depth . Hei;ltt ...............NumberofStorics........................................................ Dimensions of same structure with alterations or additions: Front Rear . Depth Ilcight Number of Stories . Dimensio~is.of entire new construction: Froni Rear Depth . Height Number of Stories . 9. Size of lot: Front Rear....................... Depth 10. Date of Purchase .............................Name of C'ormcr Owner . 11. Zone or use district in which premises ate situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . l3. Will lot be regraded ............................Will excess till be removed from premises: Yes No 14. Name of Owner of premises ....................Address ...................Phone No............... . Name of Architect ...........................Address ...................Phone No............... . Name of Contractor ..........................Address ...................Phone No............:.. . IS.Is this property located with in~00 feet of a tidal weClaud? *YES....NO.... *If pes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or comer lot. q„_ APPROVED AS NO.'TED~~ -C- J a•tr~pt~ FEE: S • ' BY: ~ _~JItY NOTIFY BtJILOINp DEPARTMENT AT }y _ 765.1$02 9 AM TO 4 PM FOR THE n r4 ~ FOLLt)6'I11NG tNSPEfTIONS. 1. FOUNDATION - TWO REQUIRED (]d fOR POURED CONCRETE ~`co 2. ROUGH -FRAMING & PLUMBING + `LtbryY~JJ 3. INSULATION ` 4. FINAL - CONSTRUCTION MUST ~_C~t'p6`~.. 8E COMPLETE FOR C.O. ALL CQNSTRUC710N SHALL MEET THE REQUIREMENTS OF THE N.Y, STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS STATE OF \E1V YORE, S.S COUNTY OF . • • • • • • • • . • • being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) about named. ffeisthe (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best oC his knowledge and belief; and that the work will be performed in Ilse manner set fortis in the application Glcd therewith. ~wom to before me this ~ q ....day of.....%-?:......., 19~f• rotary Public, ..1~~:. ~'~=~~:v County ~ G~. rte. . - . HELEN K DEVUE (Signarure of applicant) ~No. 4470 BS78 Su o1k~CauMYo Term Expires Merch 30,19_-L~