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Home My WebLink About19590-ZTOV/N 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) Ne' 19590 Z Permission is hereby granted to: A · .... L.'~....~.~,..,.L~.~..~ ........................................ .... ~~.~......~.,..~ ....... u..~.,~..~ ..... ,o ....~.~..~.....~....~.....~..&...~.~....~..-- - ot premises ,c~oted at ,~....~....~.~ ........ ~.~....~ ........ .?~.....~..:...~- .~.....~..~ County Tax Mop No. 1000 Section ......... ..~.~ ....... Block ....... ..~,...-[. ....... Lot No...,~..:..1 .............. Building Inspector. , Building Inspector Rev. 6/30/80 FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING" w INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: '~ Di. sapp?ved ale ..................................... .- .- ........ (Building Inspector) APPLICATION FOR BUILDING PERNIIT TOWN OF SOUTHOLO BU] LD]N'~] DEPARTMENT TOWN HALL ~OUTHC1LI~ N._Y. "Ll, q71,. TEL.: 7D5.1802 BOARD OF HEALTM ........ .,. 3 SETS OF PLANS .......... SURVEY ................... ClIECK .................... SEPTIC FORM .............. CALL .................... MAIL TO: ..... Date .. J ........ I.~.C INSTRUCTIONS a. This application must be completely filled in by t'ypewriter or in ink and submitted to the Building l~,?e.t'mr, sets of plan% acmurat= ~lot plan to scale. F:e~ =ccord'ing to schedule. b. Plot plm'~ showing location of lot and of buildings on premises, relalionship to adjoining premises or public stree or areas, and giving a detailed description of' layout of property must b: drawn on the diagram which is pa~ of this app 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 issued a Building Permit to the applicant. Such l~errn shall be kept on the premises available ['or inspection throu-_hout the work. c. No building sfi.all be occupied or used in whole oran part for any purpose whatever until a Certificate of Occupant shall fi.ave been granted by tb.s Building Inspector. ' APPLICATION IS HEREBY MADE to the Building Department far the issuance of a Building Permit puzxuant to th Building Zone Ordinance of th~ Town af Southold, Suffolk County, New York. and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for ~emoval or demolition, as herein describec The applicant agrees to comply with all applicable laws, ordinances, building cod¢,_housing coda, and regulations, and admit authorized inspectors an premises amd in building for necessary in~p~ctior~. - 7/(Signature" "-'--~--o~ applicant, or name, if a cO~'l~o'rldSn') ' '' If applicant is a corporation, s~gnature o£duly ~uthorized o[.Dcer. (Name and title of corporate' oflqccr) . , . .~./.o?.7:.~.' l~ttdder s L~cens~ No ..... / ......... Plumber's License No ......................... Electrician's License No ....................... Oilier Trade's License No ...................... Location of land on wliich proposed worl~ %vill be done; . s ...... ' ' llous~Number "~ ~ ~tre~t, ' :' Hamlet '" Coun[yraxMapNo. 1000S,ctio, ~'. ' Block ~ '~ ~. ' ...... . ................. Lei .... ~ ...... .:.. SubdNjsJon ..................................... F.i~ud M:p No. . ............. ~ot ..., ........... (Name) Slate existing ucc and occupancy of prcmiscs and intended usc =nd occupancy of proposed construction: I. Existing usc and occupancy ~& ~ ' -/ ./~'. =. ~ .............................. .... ... .3. Nature o£ work (check which applicable): New Building --,,-- Addition ,.' . ...... t~tcr;ltio~} ;i ~ Rep'~ir.. ............. R~moval .............. Demolition .............. S~n~ ~1. '..' ........ Tennis Court ......... Accessory B~ilding .......... Fence ..... ~r ~; .......... . 4 E~fimated Cost · - ' ~ he paid on ~Iing thi~ application) 5. If dwelling, nmnbcr o f dwelling units ' Nnmbcr o f dwelling units on each floor ................ or = ..................................... .............. 7. Dimensions of existing structures, if any: Front..',. ..... Rear . . Depth ..... Heieht .......... Number of Sto~es .................................................. Dimensions of same stmctu~ with alterations or additions: Front ................. Rear .................. Depth ...................... }Iei~t ...................... Number of Stories ...................... 8. Dimensfons of entire new construction: Front ............... Rear ............... Depth ............... Height ................ Number of Stofie~ .............. ; ......................................... 9. Sikeoflet: Fiont ...................... Rear ...................... Depth ...................... 10. Date of Purchase ............................. Name of Fo~er O~mer ............................ 11. Zone or'use district in which premises are situated .... ; ................................................ 12. Does proposed constmctionviolate any zoning law, ordinance or regulation: ............................... 13. W~I lot be regraded .... ~'~'~ --~ -- z~ ; ................... Will exce~s~__~__._.. ~fill be~e~oved from pr~: . Ye; .... :,c No N~e of Architect ..... ~/~. ................. Addre~ .. ,. ........ .--, ....... Phone No. L.;g~ .~,- ~-~ .... lg-,~m Lkim property Located uithin 3~0 feet of a tidal wetland? ~yES.~NO .... ~If yes, fiouthold Town Trumtees Permit may be required. PLOT DIAG~bl Locate ele~ly ~d dis~ctly ~1 bu~d~gs, whether existing or proposed, ~d. indieate M1 set-back d~en:ien~ i: - prop~Y Hnes. Give street ~d block number or desc~ption accord~g to deed, ~d show street n~es ~d ~dieate wh:::. · L. 3. ~NSULATION 4. FINAL CONSTRUCTION BE COfCPLETE FOR ALL CONSTRUCTION S~ALL THE REQUIREMENTS OF THE N Y. STATE CONSTRUCTION ~ ENERGY COOES. N~ RESPONSIBLE FOR DESIGN OR CONSTrUCTiON ERRORS STATE OF NEW YORK, S.S COUNTY OF ................. ~ ....................................... being dnly sworn, deposes and says that he is the applica:: (Name of individual signing contrxct) above named. I-k: is the '. ......... · .......... z ............................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to pe,rform or have performed the said work and to make and filc th: application: that all statements contained in this application are true to the best of his knowledge and belief; and that Work will be performed in thc manner set forth in thc application filed therewith. Sworn to before me this ............ ..~. ......... day of...: ."~...o~ ............. 19'¢.d. .'o,ary':ubl,;. Coun, HELEN K DE VOE . NOTARY PUBLIC, State o~ P~ew Yo~k No. 47D7~, Suffolk County,=, Tm'm .Ezpires Ma;rch ~0,19 -Id