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Home My WebLink About19274-ZTOWN 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-~ ~27-~ Z Permission is hereby granted to: ,-. /'~/VI , /~ ...... u..~ ....... ~_..~.... ............................. .......... , ................................. .~6.5 ..ILa, Ci~T, S ..ROAD ................................ A .................................................... at premises located at .,.~...u..~.......,~...~.........~. ~.........~....:...~.....s.......~...~.....~.~.. Co, nV Tax Mop ,o. ,000 Sec,o, ..... J....o...~. ....... Block ...... ~..~ ........ Lo, No. ~...2.:.~......C ~ Fee $.t ~..%..~ ........................ ~.:.: ....... Building I~tor Rev. 6/30/80 FORt~ NO, '1 TOWN OF $OUTHOLD "" BUILDING DEPARTMENT TOWN HALL $OUTHOLO. N.Y. llO71. TEL.: 7G5.1802 Ex,mined ..... , I9 .. ,o ............ (~uildin= ]nspec[or) APPLICATION FOR BUILDING PERMIT BOARD OF HEALTa ........... ;3 SETS OF PL,I,'{$ ........... SURVEY .................... .;;;;,.... ............. NOTIFY~ HAIL INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Buildi~I~Ctor, with 3 sets of plans, accu~te plot plan to s~e. Fee acco~ing to schedule. b. Plot pl~ ~owing location of lot and of build~gs on premises, relationship to adjoining prcm~ or public ur areas, and giv~g a det~ied description of layout of property must be draxvn on the diag~m which ~ ~ of t~s appH- ~fion. o. The work Covered by t~s application may not b~ commenced befo~ issuance of, Budding Peril - ' d. Upon approval of this application, the Building Inspector will issued a Building Pc~it to th= app~L Such pe~it shall be kept on the Premises available for inspection throu~out the work. e. No build~g shall be occupied or used in whole or in part for any purpose whatever until a Cc~fl~ of Occup~cy shall have been g~ted by ~e Buildup Inspector. ' A ..... .~ON 15 HEREBY MADE to the BuildUp DcF~mant for the i~uance of a B~lding Pe~it~uant to the Building Zo~e Ordnance of the Town of SouthoId. ~uffolk County, New York, ~d other applicable ~. Ord~ces or RcguJati~s. for ~e const~ction of bufld~gs, additions or alterations, or for ~emovaJ or demolition. ~ ~ deathbed. The applicant agre~ to comply with all applica~e laws. ordinances, bufld~g code, housin~ code, and ~ons, and to admit authorized ~pecto~ on premises and ~ buildup for necessaW inspections. (S~nature o~ appheant, or name. if a ~I0 South St~. 6r~6nport. NY (MaiLing address of Stat~ whdther app~e~nt ~ owner, 1e~ee, agene, ~chieeet, engineer, g~neral eont~etor, electrician, plamber or builder. N~m~oeownerorwemises ~qS$~ ..................... .. ~ .~ .......... .... Fqrk. ~.o~i~g .Allianc(. Ina (as on th~ tax roll or latest deed) ffapp[ieant is a e~rati~a, signature of duly authorized officer. B~v~rly J. Halloek. President (Hame an~ title of co.orate officer) Buil~eFs Lieeme Ho ......................... Pl~m~er's Lkease No ................. O~her Tra~e~ ~ee~e No .................... · ~oeaHoa o~land on which proposed work will be 'Private Road off Elijah's L~n~ 365 ~S RO~ ~I~CK .' County Tax Map No~ 1000 5~cfion . ~ 0S ' ................. Bi~ck .... 04 P/0 7 ............. Lot Subdivision ...~l~hah Lan~ Estates ................ .................. Eilcd Map No. 6065 (Namc) .............. Lot ............... Statc existing nsc and occupancy of prcmiscs and intended use and occupancy of proposed cons$ru~tio~ ~xistin: usc and ~q ~g ' occupancy ............. b. Int~nd,d u~ and occupancy .... ~ .......... of work (check which spplicsble!:,~¢ ' 3. lqaturc ew Building ........ Repair .............. E~moval ...y .......... Demolition'' Ad~jcn .......... ,~tc~=tm, ...~ Tennis Court .... ...... . ..Swimmin, poor . . , ..... Accessory Suild~n~ .......... Fence 5. Ifdwclling. number of dwcllin- "s 0 (to bc pa~d on ~]ing this application} 6. Ifbusincss. commercial or mixed occupanCy, so~, -'u-- ''; ...................... =''', .............. 7. Dimensions of existing structures, if any- Fron~ ~ narc ~ nnu extent of each type of usc . "= ' ''' ' · ''' ......... ... Depth .~,...~ ........... ~",,,~ofs~o.~ .~ ........ ~. ~a~= ............ ' ......... Dimensions of,amc structure with attcrationx or additions: Front ........................ ~c~=ht ............... Numberof~tofie.' .............. Rear ............... Depth . ' ''' =. ~zeoflot. Front ' ~ ......... ............. 11. ZoneorUsedNtrictinw~:.~._ ''. ................ NamcofFo~erOwner TOm~ ai Ro,e~"~5 ........ .... . : ............ . N~e of Owner of premises ~ '~o~ ~'A'P>;';J~XWdl e~cc:= fill bc removed from premixe:- N/Ayc~ . ~ ~' ~ '' N~e ofCont~Ctor .gh~.%d g 3aa~ -0&8~n' ' ' ~ress ;,.,;.;..: ........... Phone No ............ II.Is this propert- - ' ................. Aa~rcssUP~.L~ p~,~.~ ,, ' .... -If y~s, Southold ~ .... z~,,~- luo feet or a tidal ~etland~ =YK5 . ~n~ '' Locate cle~ly ~d ~t~ctly ~1 band.g,, whether exi*ting or proposed, ~d, indicate ~1 ~et-back d~enxion~ from prop~y Hne~. Give street ~d block number or desehption acCord~g to deed, ~d sho~ street nme~ and ~di~ate whether interior or comer lot. · REMOVE SUBSTANDARD OVERHANG ~ROM GARAGE ;TATE OF NEW YORK, COUNTY OF. Beverly Jr Hallac~ ".'" ~=,~ -v-.-. .... : ............... =bore named. · APPROVED AS NOTEe FEE:_//)-"-'--- BY: ~ ~'~- 755-1802 9 AM TO 4 PM FOR THE FOLLO~¥1N G INSPECTIONS. 1. FOUNDATION ~O REQUIRED FOR POURED CONCRETE 2. ROLJ$H · FRAMING ~ PLUMBING 3 INSULATION 4. FINAL CONgTRUCTION MU~T gE COMPLETE FOR C.O ALL CONSTRUCTION SHALL ME~ TH~ REQUIREMENTS OF THE N.Y. STATE CONSTRUCTI~ ~ [NERVY CODES. N~ RES~NSIB~ FOR DESIGN OR CONS~U~ION ERRORS .... being duly s~vom, deposes and says that he is the applicant fi: is lite P-'t g~ide, n~. ' · ' (Con tractor .......... , agent, corporate officer, etc.} ............. ' ' :f said owner or owners, and is duJy authorized to pe,rform or have performed the said Work ond to mal~c and file this :Pplication: that all statements contained in Il:is aPPlication arc true to the best of his knowledge and belief; and that the york w~J be pcrtbmtcd Jn the m~ner set forth in the application filed therewith. ,,yom to ~; n~lli: . , · ..;;.. :--- . .. ' · .~.' ......... :': ' / .... ~" '~ f"~'~t~o..,r ~ / ~77/ . . / ~,~A.sw~, ' ~....//. ~./// .~ ~ - , . ," ..... .