The URL can be used to link to this page

Home My WebLink About19529-ZTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERNIIT MUST BE KEPT ON THE PRENIISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) co..w To× Map No. ,000 Sec,o. ......... ~.i.m ...... ~lo~k ........ ./... ......... Lot No ......... ~ ............ / pursuant to application dated ..... ./'/..../~/..~.. Building Inspector. 19~...~.., and approved by the Rev. 6/30/80 FORM NO. t TOWN OF SOUTHOLD , , BUILDING DEPARTMENT TOWN HALL $OUTHOL.Q. Lq.X. A./' f~. TEL.: 7G5-1802 Exandncd ......... , 19 Approved..?/.~../. .,19f~.PcrmitNo............ / BOARD OF HEALTH ........... 3 SETS OF PLANS ... ci,E~ .:....t15.5. .... "::' SEPTIC FORH ............... NOT ! FY ] CALL .................... MAIL TO: DisappfoC'ed a/c .............................. '~ ......... APpRO~D~N~ED ........ ~ ....... ~>.. ~ ~ BLDG. DEFT N~I~ B~LD~G DEPA~T AT / ' ~ [~ TOWN OF SOUTHOLD ~ · 76_-1802 9,AM ~ 4 PM FOR ~EAPPLICATION FOR BUILDING PERMIT 1FOiJNOATION ~O REQUIRED FOR POURED CONCRETE 2~O'.J6F~ - FRAMING & PLUMBING %~j~ apph~9~~ely filled m by Wpewnter or mmk and submlttcd to the Buddm~ sets or ~~t~fi'to k'~t~: F~ a~xn. to schedule. b ~i&kT~v~e~on~[~t and of building5 on premmes relationship to adjoining premises or pubUc $tree~ or ~.~ ~)~~r,M~, of layout or property most be drawn on the dmgram wh,ch is pan of t*, appl ~;~ i~o~~p~tio, may not be commenced before issuance of BuUdMg Permit. d, ~ ~~~-the Building Inspector will issued a Bu Id/rig Pe~it to the appHc=t. Such peri shall be kept ~,n the p~$ ~Eg~or inspection throu~out the work. e. No: ~ d~g ~ ~ Sr ~ed in whole or in part for aoy purpose whatever until a Cea/ficate of Occup~cl APP~IO~]~ ~ ~O the Build~g Dep~ment for the ,ssu=ce of a B~ldmg Pe~tt pu~uant to th~ Bmldmo ZD~l~a~/~own of Southold, S ffolk County, New York, ~d other apphcable ~egulatLon~p~e~Y~~gs, add,hons or alterat,ons, or for removal or demohtmn, as hereto desc.bed The ap~id~[~'E'~'~y w~tfi"~li 'a~plicab~e laws, ordinances, bu~d~g code, ho~sin~ code, and regulations, '~d tc admit a~h~~0~,e~ ~ build~g for necessa~ inspections. ~ , r, . BE COMPLETE FOR C,O, . ..... ~~. /~.-. ALL CONSTRUCTION SHALL ME~ . (Signature o~applic~t, or name, i(a corpor~tio~) ' STATE qONSTRU~ON & ENERGY ........ -CODES. N~ RESPONS~B~ ~R (Mailing address ofapplic~t) DESIGN OR C~STRU~ON ERRORS State whether applicant is owner, lessee, agent, ~chitect, engineer, general contractor, electrician, plumber or builder. . p.~.w..c~.. ~ 1,l .. ,~am, or ow,er of premises E .~q..~..f~...C~..e.q..~...O..~k...~NT~. fi7.~% ......... 5 .... ~ .... (as on the tax roll or latest deed) If applicant isa corporation, signature ofduly authorized officer..~~../ ..~/ Plumber's License No ......................... Electrician's License No ....................... Other %;ade's License No .................... 1. Location of land on which proposed work will be done; ' House Number Street Hamlet &.O 'Bio County Tax Map No. 1000 Section ............ ck Lot.... . .. ' Subdivision ~ ;, ................................... Eilcd Map No ............... Lot ............... (Name) 2. State existing use and occupancy of premises and intended nsc and occupancy of proposed construction: 2 . ' ........................... ..... ;75 .. ,. ~.,.,,.~ u,, ~,~ o~.,~,,y ..... ~Z/..).. ................... ' ...... ~ ork (check whsch' apphcable}:' Ne Building Addition : . ... Alteration '. 3. Nature ofxv xv ........................ · ........ Demohtlon ,~ ........... ~, r ... ....... Repair .............. R~movai ...... · '' Swi:m'ain, '"oo I. Tennis Cdurt .. ....... Accessory Building .......... Fence ....... Other Work: ........... 4. Estimated Cost. . .~.~./..~(~. ...... · ................... Fee .... ~..~,.~.~... ........................ ' ~ ~Q be paid on filing this applicationl $. If dwelling, number of dxvelling units... ~.l/~. ........ Nnmber of dwelling units on each floor ........ : 6 If business commercial or mixed occupancy, specify natnre and extent of each type of use . · .~'~!2;:~ .~.... 7. -Dimensions of existing structures, if any: Front... ~Q.~ ........ Rear :~ .o.' ....... Depth .. ~.o:.. Heieht J.~.~ N f St ri .~q .~.. - . ........ umber o o cs ........................ · Dimensions.ofsanre'sr'rfi. cture with alterations or additions: Front................. Rear.. .......... .. . Depth .............. ........ tleight ...................... Number of Stories ............. 8. Dimensions of entire ne~v construction: Front. ./J/fi,. Rear .......... ,. .... '~epth'.].. He -.Itt a~A. I' .~1'1~.. Number of Stories .............. : .......................... ~. a ........ -9. Size oflot.I~o~Ft ........ [~ ........... Rea ...... I..q~ .............. Depth..2...?.~) ........... 10. Date of Purchase ..~'~.vx....~.l).c[.~.~ ......... NameofFormerOwner~,),(~.~."~..'~7.~..-~..~}~-.¢q.~.:.. 11. Zone or use district in which ptc~aises are situat~'d ' '.l-i;.~.lq~ <~c3~5¥k-,'&[ '' .~.. " 12. Does proposed construction violate any zoning law, ordinance or tegulation: ....,A/O .... ............ . ......... . 13. Will lot be regraded ....y~/.O.~. · .................. Will excess fill be removed from premls~'.. ,, 14. Name of Owner of prem~,e.s.'~'~--)~'~C-%.~...~,. J .... Address ..~..'~_.~."~...-~..~hone No.C~(l~'?--~-O. .~.1 ..... Name of Architect ... !~Y?.~ .................... Address ................... Phone No ........... ..... Name of Contractor . .r~,/.JN ........... : ........ Address ................... Phone No .......... cad- - , IS._Ls th.i~ property located ulthln 300 feet of a tidal wetland? *YES .... NO.r.. · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM . Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back diraensions from property lines. Give street and block number or description according to deed, and show streei names and indicate whether interior or comer lot. /k,//~, -- ~-~L <j~v-~ye~/ RPPROYE~A~HOTED .. NOT~F~ ~NG DEP~TMENT AT Z(~5-i~02 9 AM TO 4 PM FOR THE i'OL L~W}N~i INSPECTI~NS: ~ FOUNDATION '~0 REQUIRED FOF~ POURED CONCRETE 2 ROUGH - FRAMING & PLUMBING 3 i~SU~TION 4. FINAL CONSTRUCTION MUST , BE COMPLETE FOR C.O. ALL CONGTRU~ON GHA~ ME~ THE REQUIREMEN~ OF THE N.Y. STATE CON$TRU~ION & ENERGY S T A (l~_.Ell~ ~'. N !~. ~_,{~I~,~LI~ FqP~ C 0 LDE8~ I~ ~It-{~INS~mOC:t'IOKT:R B 0 RS' , .L being duly sxvom, deposes ~d says that he is thc applican (Name of individual signing contract} above named. ~ is the ~ - (Contractor, agent, corp~rate officer, etc.) or said owner o~ owners. ~d is duly authorized to pe.rform or have perfo~ed the said wor~ and to m~e and file thi application: (hat all statements contained in this application are true to the best of his knowledge and belief;and that th ~vork w~l be perl-om~cd in the m~ner set forth in the application filed therewith. Sworn to before me this ~m~fl Ex~ F >,z ~., -, ~ Ill ~z~ ~ z i ,F '%,..