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Home My WebLink About18214-Z irosas xo. 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) N ° ~ $ 21 4 Z Date 19..1. Permission is hereby grant to: . - . . r ~ : . . . ire to ~ ...............~...~,r~r-~. ~.........~.~~...~z County Tax Map No. 1000 Section .......-~r~......... Block '3....... Lot No......r~....O....<.. pursuant to application dated 19........, and approved by the ~~c, 6 /x-/89 Building Inspector. o~ ~ O~ Fee S.•r`•`~`~-l~ ~ Ma `~7i o ~l ding for Rev. 6/30/80 BOARD OF HEALTH ' 3 SETS OF PL.1NS FORM NO. 1 SURVEY TOWN OF SOUTHOLD CHECK FED BUILDING DEPARTMENT SEPTIC FORPt , d~25~`b TOWN HALL SOUTHOLD, N.Y. 11971 NOTIFY . TEL.:765-1802 CALL Examined .~/6/.v........., 19(1.: p MAIL T0: • Approved 19 ~ Pcrmi[ No..~Y. ~ ~ T . ~ i2 ~ M i" ~ 1 LS _ r Disapproved a/c • • - _ ' LJIJ ~•219es ~ q•" . ! , ~F, ~ BLDG. DEPT. • • • ' ' ' ' ' ' TOMM OF SOUTHOLD Bull g Inspector) APPLICATION FOR BUILDING PERMIT Date ....5/23/89........ 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 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 Ordinances wn of Southold, Suffolk County, New York d other applicable Laws, Ordinances or Reculations, f~~ ~io~~~f buildings, additions or alterations, or fo em val or demolihbn, as herein described. The applicant afire ~A comply with#1Aapplicable laws, ordinances, build odes, housing code, and regulations, and to admit ae:t}teri2tl~t~pectors on premises in building for necessary inspec ~INN110iM'1ldf AAAQ ick•I o•~, BNi)IT7R9 V,. (Sign re a t n }fir , if a corporation) PO BOX~J PORT JEFFERSON STAT NY 11776 'a QdAlKri hO? • • • • • . (Mailing address ofapplicant). - • • • • • • • • • • h-~-F a ~11MMAfli - N~UA:~ ' State w et er applicant is o~kAl; ness~e, cogent, architect, engineer, general contractor, electrician, plumber or builder. RQ~9t~9i'Y,u • ~ . T'1~M ~JNN N(~'f~1}AT2NG)'J t.> Name of~n~fprt~~U$HDAMIANOS ~ mM ~ .i (as on the tax roll or latest deed) If applic~~~1~~~~~~flLPIBC~'d~Ta"of duly authorized officer. (Name and title of corporate officer) Builder's License No. . Plumber's License No . ........................~p~`'~O ~~d~^'r • Electrician's License No . OtlterTrade's License No . 1. Location of land on which proposed work will be done. , ~3 29~ ~„ajy • ~e t{ouse Number Street, " • • • • • • • • • Hamlet County Tax Map No. 1000 Section 59 3 Blpck Lot.?$:?.............. Subdivision Filed Riap No. (Name) Lot............... State existing use and occupancy of prQemises and intended use and occupancy of proposed construction: a. Existinguscandoccupancy...~(.J~WD~aLt~.~....~~4``.~-LlalC•, f}ac(~ !}C_G/~SSoL2~(•.gLt~Q[(x~, b. Intended use and occupancy ~ ~ ~1~4Q.k ~ 5 , 3. Natute of work (check which applicable): New Building 'fin rUteration . Repair Removal Demolition Other Work . (Description) 4. Estimated Cost Fee..................................... (to be paid on ]fling this application) 5. If dwelling, number of dwelling units Number of dwelling units on each t7oor . Ifgaragc,numbcrofcars 6. If business, commercial or mired occupancy, specify nature and extent of each type of use . • • . 7. Dimensions ofcxisting structures, it any: Front . • Rcar Depth . Hdight ........:......NumberofStorics........................................................ Dimensions of same structure with alterations or additions: Front Rear , Dcpth.....,,.,•~.. Height ......................Numberof5tones...................... Dimensions of entire w construction: Front Rear De th p Height .Number of Stories . 9. Size of lo[: Front Rear • Depth 10. Date of Purchase .............................Name oC Former Owner 11. Zone or use district in which premises are situated . 12. Does proposed construction violate any zoning law, ordinance or regulation : . 13. Will lot be regraded ............................1Vill excess fill 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 vithin~00 feet of a tidal wetland? *YES....NO.... *If yes, Southold Tovn Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing of 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 corner lot ~ " ~ A At ~IE6 DATE: r ' ~ FEE: Sbe 0~~ NtnIFY~~ 786.1802 0 AM 10 4 F4M1 F011 1~ FOLLOWING INSPECTIONS: 1. FOUNDATION T1AIp ~~~D tj ~ FOR POURED OOI11C11lfE S ~ li- ~ 2. ROUtiN - P71AMN1ti a (F{„~DAENI~ 3. INSULATION 4. FINAL - CONSTRtICTgN NNNT BE COMPLETE FOR C.O. ALL CONSTRUCTgN ElMLL M~'1' THE REQINRE~AlNi'a a T?I~ N•Y STATE CONS7INJC'RON ~ CODES. NCF RiMp DESIGN OR CONSTINIC11pN ~Npl{ STATE OF \EN RIC, ~ S.S COUNTYpF .v._• . I. , • • • • `•~'h4~~T`".'s• • .~P.'??7f~11k~~............ being duly sworn, deposes and says that he is the applicant (Name of indi idual signing contract) lIeisthe (Contractor, agent, corporate officer, etc.) ~f said owner or owners, and is duly authorized to perform or have performed the said work and to mane and file this -pplication; that all statements contained in this application are true [o the best of his knowledge and belief; and that the work will be performed in dte manner se[ forth in [he application filed therewith. lwom to before me this rotary P bli County CILL E7....... . Notar Public, State of New Vork No. 4669631 Qualified in Suffolk County (Signature Of applicant) Commission Expires Mar, 30, 19~~