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HomeMy WebLinkAbout21183-Z~OUNDATIO.~I (1st) fOU~;DATIO:! (2nd) ~OUGH FRAHE & -PLUMBING ½. ~SULATIO:! PER N. STATE E~;ERGY CODE FI:;AL ADDITIOIIA'L CO!*.I-~E~ITS: IPO~Bf NO. · TOWN OF SOUTI4OLD BUILDING DEPARTMENT TOWN HALL SOUTI'IOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) .......... ............................. t p m',e, ,ocoted at.~.~.~/~....~/~ ..................................... County Tox Mop No. 1000 Section ........ ...~...../.. ...... Block ....... ../...~.. ....... Lot No...:-,.~.. .............. dated ............ ./../...~.. ............................. . 19.~.~., and approved by the pursuant to application Building Inspector. Fee $.....~..~..x.~ Inspector Rev. 6/30/80 NEW YORK STA~E DEPARTMENT OF ENVIRONMENTAL CeNSERVATION Regu£~tto~ y A f fe~s Bldg. 40, SUNY--Room Stony g~ook, NY I!794 1516) 751-7900 RE: l .~cv.~a.: ~ beo~ ~de of :;o~ ~,~opo.~.,t to: Co~-~c~ /O New Vo~ ~ate DcFa~c~t of Envd,tor~o~l Conservation has ~eund proje~ to Oa.eat&r than gOO' from inve)~e~,d, ed td~da~ tcet&m~. t~n 100 i) ~e~gth ~o~a~ted p.~ror .to Se. pte~" 1977... gr~cr Land~,a.'td of 10' contotat elevation above mean sea leved on a g~,ad.e£, ned'aaal alope. . Lan~v~ of topog~p~c~ ~e~l of bluff, ~ff or d~e dn exc~6 of I0 ~ in ~ev~on above m~n ~ea lev~. Th~¢~c~.e, no peamit und6r ~%.tle~e 25 (Tidal Wc. t2and~ of .the Envd~wnmen.tal Conse.~vatdon Law is re.quiaed sdn¢.e the proposal ds beyond State manda, ted ddotion puas~rant .to thds at, t:. ? '(/' . S~ALE ! JAN - 8 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved.../.~./...' .' .' .'~. ........ X 9 .~.~.. permit No. ,~.//.~. ~...~ Disapproved a/c ..................................... . .,,(Buil~ Inspector). APPLICATION FOR BUILDING PERMIT NOTIFY: CALL ................... HAIL TO: . .3 ....... INSTRUCTIONS a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation. ¢. 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 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 hav~. 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.~r,.emoval or demolition, F'a-~rein~'-es~ribed. The applicant agrees to comply with all appllcable laws, ordinances, b.~0~t~rg co~e, ho3~sings:ode, at~d reg.dlat~ns,Jand to admit authorized inspectors on premises and in building for necess~[ ...LS.. ~~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (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 ......................... : Electric, Jan's License No "- Other Trade's License No ...................... Location of land on which proposed work will be'done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ~..~fl(. Block' ( ~ Lot ~ Snbdivision ..................................... Filed Map No ............... Lot ' (Name) State existing use and occupancy of premises and intended Use and occupancy of proposed construction: a. Existing use and occupancy. . .... ~/.~ ~." b. Intended use and occupancy. ~ FORM NO. 1 '.;. JAN - 8 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ........ ,19 · Approved..~, .'~. ........ 19 .~.~.. permit No. ~.//.~. ~...~ Disapproved a/c ..................................... Inspector) APPLICATIOM FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTtI SURVEY . . . SEPTIC FORH .............. t: UT I F'!; CALL HAIL TO: · ......... a. This application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to.scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appLi- cation. ¢. 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 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. APP'I-ICATION IS HEREBY MADE to the Building Department for the issuance of a Bu3ding 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 demolitioru"~'l~rein,&~scfibed. The applicant agrees to comply with all applicable laws, ordinances, ~ c'~te, ho,~sineecode, a~d reedlat~ns.)and to admit authorized inspectors on premises and in building for neces.sa_~_ _n~/~ ~~ (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner o f premises / 0' .~...C.//~',/ff C ~. e.J/'~ 0 /.a/~/,5- (as on the tax roll or latest deed) If applicant is a corporation, signature ofduly authorized officer. (Name and title of corporate officer) Builder's License No ............ · Plumber's License No .......................... Electric, ian's License No ................. '. 7 .... Other Trade's License No ...................... Location of land on which proposed work will be'done ....................... g>o L ........................... A,e House Number Street Hamlet County Tax Map No. lO00 Section ~. .: ..fl.. /. Block' { ~ Lot ~ Subdivision ..................................... Filed Map No. ' (Name) .............. Lot State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ./-L .~../~...~...': b. Intended use and occupancy /~..~. Ad ~-- ..,. .~&C~'L. 3. Nature of workt (~eck which applicable): New Building .......... Addition ........... Mteratmn Repair ..... ,.-. ....... Removal .............. Demolition .............. Other Work .v~-~-' ~-~-~.-'eSD" 4. Estimated Cost .~.'.~...O..O..O. ' (Description) ''' - ............. Fee (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 ........... '~J- ....... 7. Di~ensions of existing structures, if any: Front.../.~. ......... Rear . ../.~..-~ . De tb . . ' ' Height .... 1.~ ......... ~umber of Stories .../' ...... P .0'7, ........... Dtmensmns of/saorne structur,, with alterations or additions. Front [ F- ......... l~Jlr ....../' '.o' .......... Depth ~..'7 H ..... 'Y ' · ...................... .%1... ............ ~,r~,[ ...... ~ '~ .............. Number of Stories ..... I.. 8. Dimensions of entire new construction: Front .......... Rear Dc th He "hr · ' .............. P ...... ................ Numaber of Stones ... ' ..... 9. S ze of lot Front ~.. c/. Rear ....... "~' 3'~ .................... '~ ">"~ ......... a '''/'~ .................... ~-.:7. .......... De th ....t?.:>.. 10. zD [;OofrPut~re ~;};ict in rich premises are situated ,l. o %se. r Fo=er Owner .. ................. 12. Does proposed construction violate any zoning law, ordinance or regulation. ,.';~ ~ .............. 13. ~%leOto~;~ve~de: ''"''' ~'~"~S~'"~"fi7~ ........ Will excess fiIl be removed from premises: Yes 14. o~ premmes .c.,..-....cH. .......... Address ~.~.' No..g.? ?.. Name of Architect .............. ,; ........ Address Name of Contractor ~ t-{-/~.."L ·Address ................... Phone No ................ ....................................... ,2.z~" · ' Phone No ................ 15. Is this property within 300 feet of a tidal wetland? *Yes ........ No ......... · If yes, Southold Town Trustees Permit may be required. · ". PLOT DIAG RAM 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. ~o-o f~./_~.' c~ 5'~,~,~"~/ .~7 -77-~ 0 q-fo m/ ;TATg OF NE3.U--YO~. {/,/ S S · /OUNTy QF...t'-~.~.L?... · ..... ~.~Ov. V. [.~..~....~...L ¢l..%F_..~.vT.. :.~. C.. being duly sworn, deposes and says that tie is the applicant (Name of indMdual signing contract) 5ore named. eisthe ..................... r~..O~.x'.../~. ~ (Contractor, agent, corporate officer, etc.) said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this 'plication; that all statements contained in this application are true to the best of his knowledge and belief; and that the ork will be performed in the manner set forth in the application filed therewith. ,'om to before me this d o .~ ( , · .. oun , )tary Publi · · CLAII1E k GLEW "