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Home My WebLink About15323-Z IPOB,M NO~ 0 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PER~,~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 15323 Z Permission is hereby granted to: ................................................. ...... County Tax Map No. 1000 Section ....~...~...~'1. ........... Block .... .(~)...~ ....... Lot No.....C~....~. .............. ~-~ '~ ~...~.~.....~...~. ............ , 19.~..~., and approved by the pursuant to application dated Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Approved~..~'~?~../'~....~.~/., 19~ (t. Permit No.) ~..~ ~ ~. ~ Disapproved a/c .................................. D /? (Building Inspector) APPLICATION FOR BUILDING PERMIT Received ........... ,19. /./.7 ' Date ..................19 INSTRUCTIONS b,~lyl~er or in ink and submitted to the Building Inspector, with a. This application must be completely filled in sets of plans, accurate plot plan to scale. Fee acc, a~iff.lD s~fi[~, t% b. Plot plan showing location of lot,~an~~s ~a~relat. io~ship to adjoining premises or public stree or areas, and giving a detailed desclll~'~q~o~'[ ~i~}nu~[~}{~ on the diagram which is part of this app c. The work covered by this app efore issuance of Building Permit. d. Upon approval of this applicatll?~l~,~ns~l~I5~ ~issued a Building Permit to the applicant. Such perrr ~ be kept on the premises available e. No building shall be occupied ~& ~'w~(]~lr~l~r any purpose whatever until a Certificate of Occupam ~.~?I~PLICATION IS HEREBY MADEt~J~e Building Department for the issuance of a Building Permit pursuant to tt ~ Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws Ordinances ~i}.i~t~ons, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe, ~.?~11~ al~iicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in building for necessary inspe/gtq'~hs. ~(Signatu~e of applicant, or name, if a corporation) (raail±ng addre~of applicant:) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde If applicant is a corporation, signature of duly authorized officer. Dc rE: F,,,P ,) ~''''~ RV- C, L, (Name and title of corporate officer) Builder's License No ...... ~/.~. ............ Plumber's License No ..... . .~/~ .~. ............ Electrician's License No .... ./~./;~. · ........... Other Trade's License No .... . .'~:'//(.'~- ........... r~OTIF¥ BUILDING DEPARTMENT AT 7t-5,1802 9 AM TO S ~ ~R THE FOLLOWING IN~PEC~ONR: FOuNDAtION ~tO ~,-QUIRED FOR ~3ORED ~ONC~' ' ~ 2 ROUG~ ~R~MINU ~ ~tJMBING 3 INStJI_A rli'lt~ ALL CONS'~RU~;FION SUALL MEET ST,~TE CoNsrRucI'ION & ENERGY Location of land on which proposed work will be done ................ COOES, 'NOT',~E:~)NSI~EE FOR' ....... .............. .g' 2 T'2 Y. House Number Street Hamlet County Tax Map No. tO00 Section .... /.0. ~-~ ......... Block .... 3 ............ Lot .... 7 ........... Subdivision ..................................... 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 ...... I..?--.~. .O*t.~. .L~-. .q- ....... (. 3~. {g-'g).C..C~- .......................... b. Intended use and occupancy ........ ~.T: O. ~ .~.G-.~.....~t,_..~ ~.-..~..~.'~:C.'0.~.5. T~..£ 7/~.Nl ........ 3.. i ature of work (check which applicable): New Building .......... Addition .......... Alteration .......... · R'~e~air .............. Removal .............. Demolition ........ Other Work ............ ~ ~ ~, d'! ~? (Description) 4. Estimated Cost ............. ,,. ....................... Fee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units....'3~./../.qS. ...... Number of dwelling units on each floor ................ If garage, number of cars ...... . ./V?..,Q. ............................................................ 6. If business, commercial or mixed occupancy specify nature and extent of eachlw, e of use 7. D~mensmns of ex~s~nng structures, ~fany: Front ..... ~ ....... Rear .... ? ........ Depth . .~ ...... Height ~ ..... Number of Stories ....... ~ ' ' Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ...................... Height ....... F~ ............. Number of Stories 8. Dimensions of entire new construction: Front ,/...~?~. · Rear 9. ~?( i ~e'p'ti~' i ~.' ~ Height ,q~ffS~a4(...~4~.. Suxnber of Stories v 2' '.''' t ..... 9. Size of lot: Front...'.././. ~. :, 6 ~..~. . ...... ' ~'e 'a; i l i '/. i~. '.~. i. i '?. '~. i ........ b'e'pi[~ ....'/' ~-~'~ 3 ' ~) ~ ......... 0. Date of Purchase . .:.~...~. :Y./9..~..~ ........... Name of Former Owner ............................. 1. Zone or use district in which premises are situated. .~7¢/.C&.~, 77~ ~-.L .~.ff.(~ i;.~/.~)..CC..~. .C..C.T ............. 2. Does proposed construction violate any zoning law, ordinance or regulation: .... .Ag....~. ....................... 3. Will lot be regraded ....... ~/--~.~,4 ........ ..,...: .:. Will excess fill be removed from premises: Yes 4. Name of Owner of premises [¢.,~,~,4~-.~.~d..X~.?..KAddress,'~'i~.~/_,fxi),qq/C' Name of Architect ..................... Address /...~. :z?'-~,(,~ Phone No~- 36,~- ~?.o.o. Name of Contractor .......................... Address ................... Phone No ................ 5. Is this property located within 1.00 feet: of a tidal wetland? * Yes ..... Iqo .,ce?... · ]~f yes, Sour:hold 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 roperty lines. Give street and block number or description according to deed, and show street names and indicate whether ,terior or comer lot. 'ATE OF NEVZ Y,O~R~ )UNTY OF .~3~c'(~z~z~/C- S.S ...... i ~ .~.i '.t~..~'.~. '. '.~. ~. ~ ff. ~ ~ ....... being duly sworn, deposes ~d says tha} he is the applic~t (Name of individual signing contract) ove named. ~ is the (~ ~ ~ -~ (Contractor, agent, corporate officer, etc.) said owner or ownem, ~d is duly authorized to perfom or have perfomed the said work ~d to m~e ~d file ~is plication; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the ~rk will be performed in the manner set forth in the application filed therewith. 'om to before me this ...... .......... ..... , 19~. ,,~ ,tary Public, . ...... ~&~'~. ].~ i ............... County ~1~~. (Signature of applicant)