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Home My WebLink About19681-Z leO~,~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PER/VtlT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°- 196 1 Z Permission is hereby granted to: County Tax /V~ap No. 1000 Section ....~,....~... ........ Block ..... ~... ...........Lot No...~....~..z.~, pursuant to application dated ...... ~"~'" .......... ~...~,.., 19..~....~, and approved by the Building Inspector, Rev. 6/30/80 BLDG. DEFT TOWN OF $OLITNOL FORM NO. 1 TOWN OF SouTHOLD BUILDING DEPAF~ TWIENT TOWN HALL ~OUTIq Q L.D.. ~'~- TEL.: 705- 1802 Examined,- ............ -- . 19,.. ,o./. Disapprovcd a/c ........................... BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURV£¥ ................... CllCC~ .................... SEPTIC FORN .............. C^~L .. 7A~..~¢.q? ...... HAIL TO: (Building Inspector) APPLICATION FOR BUILDING PERIMIT 91 INSTRUCTIONS a. Tkis application must bc completely filled in by typewrit'er or in ink 5nd submitted to thi Buildin~ rmxpe.etor, sets of pl-m~, .~'e,,rat~ plot plan to scal~. F~r a~.c~rding to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public strc: or areas, and giving a dele/led description of layout of property must be draxvn on the diagram whiehis pan of this apF cat~ort. C. The work covered by th. is application may not be commenced before issuance of BuLlding Permit. 'fl. Upon approval of this application, the Building Inspector will issued a Building Permit to the appJiea.,qt. ~uch pent shall be kept on the premises available for inspection throughout the work. c. No building shall b~ occupied or used in whole or in part for a.ny purpose whatever until a Certificate of shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Pe.,-m..it .='-'.'~aant to Building Zone Ordinance of the Town of £outhold, Suffolk County, New York, and other applicable Laws, Ordi.n0.nces Regulations, for the construction of buildings, additions or alterations, or for ~;emovat or demolition. :x hereto deicribe: rite applieznt agrees to comply with all applicable taws, ordinanceS, buS/ding code, h~l~in= code, an~ regulations, and ~dmit authorized i.nspector~ on premises and in building for neeeasary in~p.t:ctions, t./ ' .... ..... ............ (Signature o~ apphcant, or n;~ie, ifa cor~cranon) .. ~ q...0....~ .z~. ??.? :~.~..~..L... ! !? ?~. ........ ~Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build": Owner Name of owner of premises Herodotus Damlanos . (as on the tax roll or latcst deed) 7fapplicant is a corporation, signature of duly authorized officer. ........ i~,;=;,;J ;~J 'titii o~ co~;J&iJ ZrncJr~ ..... Builder'~ License No Plumber'g License No ......................... Electrician's License No Olher Tradc'~ License No Lot:ntion,, -, .~ .-,°f.,Jand on which proposed work ~vill be done; ,iou,e N..,~ ~;5;~ ............................. ' Heroic: ~oumy Tax Map No. 1000 Seclion ............ ~lock ............... Subdlvi~ion ................................... F. llgd Map No. (Name) Sllle ~xi$~ing u~e and occupancy o~ premises nad h~gendcd A. ~xtstlng usc mad occupancy.; .... , ...... .--.? Demol~t ~, 'lntemded use amd qceupmncy.; ............................ ,*.-. ..... -,..:-,. ] Repair . ............. R~moval .............. Demolition............-X .S~i."~l~c~t~l~.: . ,an,, ,=.=, .... cnee .... o ,y s,mated .' i.'.' .................... (la bc paid on filing this ao.0lication} $. If dwelling, numberofdwellingunits .. .......... ... Number ofdwclling units on eaCh floor ............... II'gara"e numbcr of cars .............. ' '' ' 6 If business commercial or mixed occupancy specify nature and extent of each. type of m;e ...... ~ · · · ' ' 40' 40' Depth ~" . 7. Dimcns'ons of extsting structures, if any Front ............... Rear ............... ' ..... '''' '' Hole_hr 2.0.' Number of Stories ~., 5 ......... Dimensions of same structure with altcrations or additions: Front Rear. · ............ . . . Depth }lcight Numbcr of Stones· - · ..-- 8. Dimensions of entire new constn~ction: Front ............... Rear ............... Depth Height Number of Stories ,; ' 9. Size of lot: F?ont ..................... . Rea." ............ .......... Depth ....... 10. barco(Purchase .............................NameofFormcrOwner .4qqn-~ng.a ..... 11. Zone or use district in which premises are situated ............. . . .. ....-- · · · · · 12. Does proposed construction violate any zoning law, ordinance or regulation?- ,~q. · ~ ....... .' · · :. %;~&j~¢; ~.~,:~-' '. Name of Owner of premlx~ He.r.o.do ......... Addre - 14 ......... ~ ........ Z.; ........ Phone No ............ Name of Architect Address . .. Phone No ............... Name of Contractor ................. : ....... Address ................... phone No ............... 15.~.~ r_ki~ prop~rl:5' Located within 1{10 feet of a tidal wetland-* ~flZ$ .... UO X ~If yes, Southold Town Trustees Fermit may he required. PLOT DIAG P~Abt L0¢ate clearly ~nd distinctly MI buildings, whether'existing or proposed, amd. indicate ~1 set-back dLm:n:ior.: f: 3roperty lines. Give ~tree£ ~d block number or description according to deed, and show street names and indicate w:::::. interior or comer lot. TATE OF NEW YORK, S.S 'OUNTY OF {'Name ~findividual signing contr being duly sworn, deposes and says that he is the aPplie::' e is rite ............................................ ' ....................... ; .................... (Contractor, agent, corporate officer, etc.) ' said owner or owner*, amd is duly authorized to perform or have performed the said work and to make and file th 'PHC=t/on: that all statements contained in this application are true to the best of his knowledge and belief; and tl~at I2 orr wdl be performed in the manner set forth in thc application filed therewith. yom to before mc this .... o~S . da of -.~.~..... ,) PUblic, .~;'~ .... ; ............ - · ~. 4707878. Suffolk County ~ ~ . Term E.T(pires Merch 30, l<l ~ ,/~