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Home My WebLink About23847-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) ......... ..................... Permission is hereby grant~7.,~,e: ./ _~, /~ ~- ....... ::::~.:-:2:..~ ..... ; ......... .~ ................. ................. .,'~..,~.....~.,. ........................... ....... ~~~~z~ ,o~~ ~ ............ ~ ~ :"~'""."'~ '~ :'~ ~ ~ ............... ~..~.J z~..;~ ........ ~..~..~:.~..~..~.~ ....... ~,,r,~,,, ,~,ed ~, .............. Z~.~ ...... ~...~~ ................................................. ........................................................... ~., ~~ .................................... County Tax Map No 1000 Sect on ...~..Z B ............................................-~'-"~'.- LOt I~10 ......................... pursuant to application doted ........... ~.....~.... ................. , 19...~....~., and approved by the Building Inspector. ~:....~ Fee $ ............. Rev. 6~30/80 DEC 5 [o~6 FORH NO. ] 'rOaN OF SOUTIIOLD BU [I,I)ING I)EPAR'I~IENT TOWN IIALI. SOUTIIOI,D, N.Y. I ]97 } TEl,: 765- 1~02 oi sale)roved a/c .................................. INSTRDCTIONS BOAED OF IIEAI,TII ............... 3 SETS OF PLANS ............... SURVEY ........................ CIIECK ~ ...................... SEPTIC FORH ................... Date ................ ,19 .... a. lids application mast be c~npletely filled in by typewriter or in ink and sulxnltted to the Building Inspector with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan sl~q~ing leeaticu of lot and of Imildings on pr~nises, relationship to adjoining premises or pahlic streets or areas, and giving, a detailed deseripticu of laycut of property mast be drm~u cu the diagran which is part of this application. c. 1he ~ork covered I~ this application nay not be comeneed before issuance of Building Permit. d. Upon approval of this application, tim Btfilding Inspector will issue a Building Permit to the applic~ant. Such permit Mmll he kept on tim premises available for inspection througtmt tim turk. e. Ilo building stroll be occupied or used in ~d~ole or in part for any purpose sdmtever until a C~rtificate of Occopency ~all have been granted-Dy the Building Inspector. AI~PI,1CA'IqCIq IS I~I~']BY ~A!]E to ~']m Buildiog Department for tim isstmnce of a lkdlding Pemit t~rsatant to the Ik~ildi~g Zcme Ordigm~ce of the Toga of Southold, Suffolk O0unty, ~ York, and other applicable Lm~s, Ordinances or Regulaticus, for tim construction of buildit~gs, additions or alterations, or for re. oval or demolition, as berein described. ~llm aDplicant agrees to comply with all applicable la~s, ordinances, laiilding code, ho~slng cede, and regulatinas, and tu al. it a~tlvoriz~¢l inspectors on prani.qes and in building for nacessary inspecticam. (Signature of applicant, or ~tam~, if a corporation) (l¢ail ing address of applicant) SLate ~hether applicant is mr, lessee, agent, architect, engineer, general contract~F~91ectrician, phmher or builder. .?...k~ Y ~..~3~ ~q. C.~.~ l~nme of o~mer of premises . 2. ). ~ .......................................... (as o~ the tax roll or latest~deed) 1 f applicant is a t,orporaticu, signature of ~h~ly m~thoriz~ed officer. (l~qme as~l ti!lc of corporate officer) Builders License No .......................... Phlmhers License No .......................... Electricians License No ...................... Other 'h-miens License No ..................... I. Ifr~atian of land on ~hid~ proposed ~ork will be done .............................................................. ..... .................... ..... .( Ihjse Numher Street II~nlet ~tyTa~.No. ,~ ~_ti~ '""~'l ......... ~"~ .... ~ ....... ~ .:Z ............ Sul×livisicu ...................................... Filed la. ap No ......... lot ............... (Nane) State existing use and eccupancy of pr~nises and intended t[s~. and occupancy ,of proFosed constroctina: a. ~:~is,:ing ~ _, ~cu~ ...~.~. ~.%e....¢. ~.~.,.~..4..v~....t.[ .~.~c ...................... l)in~llSi~m of s~ll~ 8L[~:ture ~itll alt:e~atJ(~ls or ~Nlitions: Front ............... l~ar ............... I~plll .................... I~i~d: .................... ~li~r of 8l'orie~ ............... 8. I)i.~n~i~ls of entire ~ c~sl~:lirnl: Fruit ................ l~ar ............... ~plh .............. l~ilO~t ......................... ~d~r o~ 5torie~ ..................... 9. Siz~ of lot: F~(nlt .................... I~ar .................... l~pth .................... I I . 7x~ or tls~ distT'icC in ~Hd~ pT~i~s are ~tnmt~l .............................................................. 13. ~ill lot I~ regr~l .................... ~ill egcess fill I~ ro~m~l I~. ~s o~ {~r ag pmni~s ........................... &hlress .............................. tlgn~ ~ ............. ~e oF ArdHt~:t .................................... &glress .............................. 1t~ ~ ..... [ ....... 15_ Is Ihis pml~*t:y within ~1 f~t of a timbal s~tla~l? * YILS .......... ~) .......... I)I,OT I) I^I;IIAH Itx:ale clearly and dlsrhx:tly all Ix]ildings, ~hether existing or pro~s~l, a~l it~licate all set-I~:k di~nslons Fs¢~n prol~rty Ibis. Gi~ sl:r~t aal I}l~k IIIIIE[ or {~scriptlta~ according I:o ~hl, al~ ~ street' lilies ar~l i~licale ?~{5-1802 9 AM TO 4 P~ FOR ~ COUNDAT~ON ~ ' BPJO ¢~ POU~ED CONCRETE ,': Fh~P,& CO?~ST~U~ION ~UST [~ COMPL~E FOR C.O. ALL CONSTRUC~ON SHALL MEET Ti~E REQUIREME~ OF THE N.~ STATE CONSTRU~ION & ENERGY CODES. N~ RESPONSIB~ FOR DESIGN OR CONSTRU~ION ERRORS or s~HII (x~]r ()r {~rs, taxi is duly ;~Hhorlzol to Ix~rfo~m or h;lve lei lot.ed the ~id ~}rk m.I to n[Ike taxi file Ihis nlqdicntiun; thai. ~sll stal~nt~ c{~tal*~l in Ihls gq~lication are I:n~ to Ihe I~st of his k~x~l~ll[e Ihal Ihe ~)~k will I~ I~rFom~l in Ihe n~nn~r ~t [orlh il~ the alqd i(:al:i(al fil~ tl~r~ith. N~ARY ~BLIC. State No. 4725089, Suffolk Term Expires May 31, ~9~