HomeMy WebLinkAbout27499-ZFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
P~R~IT NO~ 271499 Z
Date AUGUST 31, 2001
Permission
is hereby ~ranted to:
!
~ TI~OTHY_MUELLE%
~ 51% WES~ 2~TE S~ 2ND FLR
| NEW YORK,NY 10011
for :
CONVERSION OF SCREENER
PORCH TO UNHEATED SUNPORCH AS APPLIED FOR
at premises located at 285
County T~-x Map No. 473889 Section 033
pursuant to application dated APRIL
Building InspecTor.
MIDDLETON RD GREENPORT
Block 0005 Lot No. 020
18, 2001 and approved by the
Fee $ 75.00
Rev. 2/19/98
ORIGINAL
Disapprcroed
FORM NO. l
TOWN OF SOUTHOLD
BU ~LDING DEPARTMENT
~OWN HALl,
SOUTHOLD, N.Y. ] ]97 ]
TEL: 765--I 802
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS -
a. This applicatio~ m~
3 sets of plans, accurate
b. Plot plan .s~,rg 1¢
streets or areas, and g~vlng
this appllcat fun.
d. Upan approval of thJ
permit shall be lmpt on the I
e. No building shall
~t be ~mupletely filled in by typewriter or in ink and .submitted to the Building ~nspector
~ plan to scal~. Fee according Ko schedule.
mtio~ of lot~and of b~ildings.~ pi~ses; relaticaship to adjoining pranises or public
~ detailed description of lay0cWc of property ~st be drawn on .the diagram ~hlch is part o
~ais application may not be ccrmmnced before issuance of Building Permit.
s application, the Building Imspector wiil issue a Ikdlding Permit to the applicant.
remises available for inspection throoglx~at the work.
occupied or used in ~aole or in part for any purpose ~aatever antil a Certificate of
6ted by the Building Inspector.
.' ~.ICATIf~ IS t~Y ~ to the Building l~t~nt for the isstmrme of a Building Permit pursuant to the
Bui'lding Zrme .Ord/~nc_ e o£ ~ Toan of 8onthold, ,,S~.,folk County, l~w ¥,o~1~; and other applicable L,~rs? Ordinances' or
Regulatic~s, for' the constn~qtiou of.txlildlngs, additio~ or alterations, or for remm~ or demolition, as herein
descrl _1~,'.', The apphcast :' . ' agrees, to c~mlply wlth all applicable 1--, ordinascea, lxdlding c~l,:e, housing c0de, and::.: ! .i:~~'"'~-~ ~----~- L....~ [! ~ '
(Signature of appllcast, or uaue, if a corporation)
..?,, .~z~.. j.~.~.; .s..o!~.o. ~ .~. ,.~., X... !t..~]! ........
(Mmiling address of applicmut)
State whether applicant is ~
...... ~c~4.T..../..r?~..~,
Name of ol~ner of ~ses ...
If applicast is a corporatio~
(Na~e and title of ~orporat~
Builders License No ....
Plu~ers License No ....
Electricians Liomse No.
Other Trade's License
Location of land on ~hi~
...... :Z. .............
Banse N~uber
County Tax [tap NO. I000
mr, lessee, agent, architect, engineer, general contractor, electrician, pluuber or Nail
.TC.t.~...qT..~...~. ..... .~.~ :c. ;..w~...~.:... ..................................................
(as on the tax roll or latest deed)
signature of duly authorized officer.
officer)
...~..~..~..~. ............
, proposed work will be done .............................................................
~.~ ~p..~.T.o..~.... g..o.~...~. ......... ~ .......... . .~. ~?.?.~.¥. .............................
Street lt~ulet
Section ....~..~.. ........ Block ...(P..~. ......... LOt ....~..~.. .........
............. ~o~-a~ o~
Subdivision '.bO..A.~....~.~... ~.b..~..~.t...~.. Filed Map No ................ Lot .................
State .existing use and oCcupancy of pr~nises and intended u~e and occupancy of proposed comstr~tio~:
a. 'Existing use and occupancy .~. !~.C~....?emi.or....f~..~. j...~..... F....S~. ~...~ .......................
.,-OS; .8 ~6 ~.~x~
{0.
Il.
13,
15.
I~[~ir ............ ~al ............. l~liti~ ............ Od~r l~rk ~ .~..~ ~ ......
~ (~ri pti~)
Est h~t~ ~st ......................... f~
(to ~ ~id on filing tliis a~li~ti~)
If ~l'li~, m~l~r of ~lling onits ............ l~r of ~lling ~mits ~ ead~ fl~r ................
If garage, g~m~r of ~r8
If I~si~mss, ~rcial or mi~ ~, s~i~ ~ture ~ ~tent of ead~
Uh,~nsi~s or ~isti~ statures, ir ~ny: ~t..~ ........... ~ar .~.'. ......... ~tl, ..~'. ..........
I~i~t ...... ~ ................. ~r of Stories ...I ...................
Dinmnsi~ of ~m stature with alterati~ or ~i~ions: Front .... .q~.. ~ar .,.~ .........
' ".....~ ...... ~ ..... l~ij~t '~ r ..............
,Mpt ..................... ~i~r of Stories ~
Di,~si~m of entire ~ ~sc~tion: l~t ~.~ ....... [~ar ~f~ .... ~pth
I~i~t . .~(~ ............ ~r of Stories .~ ........
s~ or ~ot: ~ ...~ ............ ~ ..~..~ ........... m~,, ..z6~'. ............
Ihte of ~rd~a~ ~..~ ..... ~ of Fn~r ~r .... ~...~~ ................
~ or ~ district in ~i~ pr~ni~s a~ s~t~ ..............................................................
~s pro~ ~mt~ti~ violate ~y ~ing 1~, o~i~me or re,latin: .~. ..................
Will lot ~ ~r~ .~ .............. ~ill ~e~ fill ~ r~ ~ M~i~s:
~ or ~ o~ ~.~MY. ~.~ ........ ~ .............................. ~ m .............
~ ~ -o ~ '- ~ ' Po ~)~7~.,. ~'~.. n~ ~.7~:/~..
~ o~ c¢,~o~ ~..6~k...(~.~~ ~.¢~ ............................... ~ ~ ............
Is this ~rt~ ~idd. ~ let o~ a ti&t ~[lCt * ~ .......... B ..~ ....
PI.fir DIAGRAH
l~cate dearly and distinctly all L~ildings, ~etlmr existing or proposed, and indicate all set-bnck dir~ensions
property lines. Give street ~ block r~t~er or description according to deed, and sl~ street na~s aa] indicate
M~etber in~erior or corner lot.
,S'1'^'11'.' OF Fi'.M
SS
(.Z JUN IY (X" .......................
..... ~.. ............................. ~i,,~ d.~y ~,m,
~ e{ i~lividtml signJufl c(~Lract)
~,, ¢,. ....... ~ .................................................................................
(~Cractor, agent, cor~raEe officer, etc.)
said (~r or ~rs. n~l is duly ~thori~d ~o I~rro~m or I~e t~rfnn~d tl~ aid ~[ a~l to ~.~e a~l file Ihis
application; Llml: all s[ata~n~s ea~tai~d in this ~l~l. ie~[ial are tn~
tha~ the ~)rk ~itl 1~ ~rfon~l in tl~ n~.~r ~t fortli in the ~l~tie~tlon [Hd tint. ifiL