HomeMy WebLinkAbout18584-Z FOEM N0. f
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)
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County Tox Map No. 1000 Section ....~.~P Block ....47.?.- Lot No...Q1SF0„~,.
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pursuant to application doted ..Qlz7~'v-~-•.•__• ~.9 19..`.1., and approved by the
[iuilding Inspector.
Fee
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wilding Inspectar
Rev. d/30/80
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BOARD OF HEALTH
3 SETS OF PLANS
FORM NO. 1 SURVEY .
TOWV OF SOUTHOLD CHECK - • • •
BUILDING DEPARTMENT SEPTIC FOR21
TOWN HALL NOTIFY
. SOUTHOLD, N. Y. 11971 CALL
TEL.:765~1802 MAIL T0:
Examined O .\~..~;~!~:..a-°. , 19
Approved 4.0~,~?•}, ,Z~.., 19 Permit No. / B J 8 Zi..
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
Date ,,,October 19,. lg89,
INSTRUCTIONS
a. Ttus application must be completely filled in by typewriter or in ink and submitted to the Building Irspector, with 3
setsrof 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 hate been granted by the Building Inspector.
APPLICATION IS HEREBY ItifADE to the Building Department for the issuance of a Building Permit pursuant to the
3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regtilations, for the construction of buildings, additions or alterations, or for removpl, or demolition, as herein described.
The applicant acrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
sdmit authorized inspectors on premises and in building for necessary inspections.
CUTCHCO CORP.
(Signature of applicant, or name, if a corporation)
P• :O: _ Box ,605,,. ,Southold,, New, York, 11971
(Isfailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
Owner
Name of owner of premises . ,CUTCHCO CORD .
(as on the tax roll or latest deed)
If applicant
is a cor~p`oration, signature of duly authorized officer.
Rbbe~`f' ;~Tch' 7~~itl'ent .
'~ilame ari~dtitle ofrcorporate officer)
ALL COt7TRACTOR'S MUST BE SUFFOLK COUNTY LICENSED
Builder's License No . .
Plumber's License No .
Electrician's License No . .
Otlte: Trade's License No .
1. Location oC land on which proposed work will be done . .
1275 Youngs Avenue, &,1g7Q,Trayelers Street.,,,,,,,,,Southold,.,,,,,,,,.,
House Number Street Hamlet
County Tax Dlap No. 1000 Section ,060; 00 , , , , Black , , , , , , ,02..00 Lot , 00? :000 & 003:000
Subdivision Filed 1]ap No. Lo[...............
~(Namcj
State existing use and occupancy of premises and intended use and occupancy oC proposed construction:
a. Existing use and occupancy . , , ,Auto Dealership Building _ -
b. Intended use and occupancy . , ,Demolish Auto Dealershi Building . -
3. Nature of work (check which applicable): I~`e~v Building . , , , Addition Alteration .
Repair Removal Demolition X........... Other 11'ork _
q. );stimated Cost .15,,000: 00 (Description).
Fee.13,6;15..........................
(to be paid on Gling this application)
5.
Ifg e,numbcrofcars
6. IC busine ommercial or mixed occupancy, specify nature and extent of each type of use , .
7, Dimensions of a ing structures, if any: Front Rear . • , Depth .
Hci~ttt , , , . • Number of Stones . • •
Dimensions of same structu •it}t alterations or additions: Front Rear
Depth igttt Number oFStorics
Drmensions of entire new construction: nt Rear Depth
Height Nurttber of Stories . ~ ~ • • ~ ~ ~ ~ ~ • • •
9. Size oClot: Front Rca Depth
0. Date of Purchase • • • • • •
••••••••••••••••••••••......,Na fFormerOwner
1. Zone or use district in which premises are situated _
2. Does proposed construction violate any zoning law, ordinance or re~ula '
:
3. 1Yi11 lot be regraded . . 5Vi11 excess fll be re ed from premises: Yes No
4. A'ame o(Owner of premises ....................Address Phone 1\0................
Name of Architect ...........................Address a No............ .
Name of Contractor .Address . .Phone
5 ;t.. .
*If yes, Southold Town Trustees Permit may be reggu>red. ~
. PLOT DIAG1tAM
Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions from
roperiy lines. Give street and block number or description according to deed, and show street names and indicate whether
iterior or cornet lot.
See Survey
. ,
APPROVED AS NOT''EooD~~ c~,,Q,Q ~n.Qt.~ ^~9 c.J'x•h.a, r~c.c~
GATE: G f B.P. # L9~9~`•' •
FEE:/ s31r,.• ! S 8Y: Y. 8, L• . u
NUTIFY BUILDING DEPARTMENT AT 1111
765-1f302 9 AM Tp 0. PM FOR THE
Ff7U. O'.ti'f^!r: !r4SPE~T1^, ~i5.
t. FOI;tJDATit)N ~wJCk:EQU!EG' .
FOR k'OUTtED COhJC_RETE
'L. nO:1GH FR~xni;NC, P, PLUfv!BING ntl ~~~w ~ ~ ~
3. !NSl)L A?ION ~CX ~ IA
4-rlPi:,L - CGCISTRUCTIQN hAUST ~-..T""_""""'`-n n ~ n
BE t;l1D„?LETE EOfi C t7t. c4,..,C(J~..~yll
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N Y.
STATE CONSTRUCTION & ENERGY
COPES. Nr)T RESPONSI8LE FOB
UES!GN OR CONSTRUCTION ERRORS
:'ATE OF \E1f 1'ORIi, S.S
~G\7Y OF .$UFF.4LR....... ,
_ ROBERT J. TANGEL bcin. } pp
(~atnc oC indi~•idual signing contract) ~ dul • sworn, deposes and says that he is the a titan[
ovc named.
is the ......?resident, • • • • •
(Contractor, agent, corporate officer, etc.) • ~ ~ ~ ~ ~ • •
said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
~lieation: that all statements contained in this application are true to the best oC }tis knowledge and belief; and that the
irk will be performed in the manner set forth in the application filed therewith.
orn to before me this
~
d.-, ....day of .......October..... . 19 . $9
tart'PubAl~!'c, y......,,,, S/uffolk C~~~,t`71HC0 (r0~ ~i~ v
NtStar Public QONNAM.CHI~UI~obert J~.~'TarigeT, '>ires:~
OONPJA M CH1R1K NGTABY PUBLIC, State of New vorl (Signature of applicant)
NOTARY s..;;~:e at NeM Yrelt Plo. 485[459, Suffolk Coun*
Nc. 7~: yuffolk County, Term Expires August IB.:S 9a
Term taWe~ Auqugt 18, 19La