The URL can be used to link to this page

Home My WebLink About21639-ZFORM NO.3 TOWN OF SOUTHOLD BUlt. DING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. N~ 21639 BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE Vv~RK AUTHORIZED) Permission Is hereby granted to: ................... ............ CountyTax Map No. 1000 Section ....... ~..~....."~-....,, Block ............. ~ ...... Lot No ...... ~ ........... pursuant to application dated ..,.~.~. ......................................... 19...~'.. ..... Building Inspector. Fe~ $.../Z ................ and approved by Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 1'11171 TEL.: 765-18013 BbARD OF HEALTH 3 SETS OF PL,,%N-,q SURVEY ................. CIIECK .................. SEPTIC F 0 R.~! ............ CALL Date Se tomber 2, ..,199..3. INSTRUCTIONS a. Tiffs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 2 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of l~uildings on premises, relationship to adjoining premises or public sti'eeb or areas, and giving a detailed description of layout of prgpert!( mu~t 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 i~sued 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 Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. -- (Signature of applicant, or name, if a corporation) P 0 Box 2.133,- Aquebogue,N.Y. 11931 (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, generai contractor, electrician, plumber or builder. OWNER · Joseph S Grattan owner of premises ' Name of ......... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer.' (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ............... . .......... Electrician's License No ....................... Other Tra tes License No ...................... Location of land on which proposed work will be done .................................................. e et Lane, chogu , New Yor . . House Number Street Hamlet Cotmty Tax ?,{ap No. 1000 Section -102 . Block 2 ' Lot... 25 .. ' Filed Map No ............... Lot ............... Subdivision ........ . ............................. (Name) . State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy two (21 .c.~ g~J~ge measurih~ 18" 3", .x.,18' b. Intended use and occupancy De.nlo'],i~h ~t[n~ - .No occupancy Nature of work (check which applicable): New Building .......... Addition .......... Alteration ......... ....... Removal ...... 2 ....... Demolitign ...XX. ~,... ~/. ,,vj~ther Work .............. 4. Estimated Cost ..................................... e ..................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............... . Number of dwelling units on each floor ................ · If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use .......... ,,. ,, ........ 7. Dimensions of existing structures if any' Front 1.8.- $ Rear 18-3 Depth i Height ............... Number of Stories ..... ~QOg..(.3. ) .......................................... Dimensions of shine structure, with alterations or additions: Front ................. Rear .................. Depth ....................... Height ........... · ........ ;.. Number of Stories ........... 2. ,; ........ 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... .Height ... ~ ........... Number of Stories ........... .'~0 ............................... ; ........... 10. Date of Purchase .................... - ......... Name of Former Owner . .B.c..r.t.h.a,..K,u.r.c.z..e.w.s.~3. 1 1. 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 ....... : .................... Will 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 ................ 15.' I~ this property within 300 feet of a tidal wetland? *Yes ........ No · 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 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. · ' It is the desire of the undersigned tO demolish a dilapidated two 2) car garage on the.aforementioned property. 3 ~NSutATION 5~5: CGN~PLETE FO~ C.O, ALL CONSTRUCTION ~HALL THE REQUIREMENTS STATE CON~UCT]~ ~' ENERG~ COOES. N~ RES~NSIB~ FOR D~gtGN OR ~S~u~ON ERRORS iTATE OF NEW YORK.. L ,. ,. ........... ~. ....... ............. · ......... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. isthc ...,,, ........... ' ......................................................... (Contractor, agent, corporate officer, crc.) said owner or owners, ~d is duly authorized to perfom or have perfomed the said work and to m~c and file this ~plication; that all statements contained ~ this application are true to the best of his knowledge and belief; and that the ork w~l be perfo~ed in the m~ner set forth in the application filed therewith. .yom to before me this ........... ..... · .... · ........ .......... ~'~[~~ - ' f / / / (Signature ofapplic~t) ~mmi~ Expires March ~. 19~ '