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Home My WebLink About23518-Z IJ 1. FOUNDATION (1st) COMM£NT~ ' ~ FOUNDATION (2nd) 2. ROUGH FRAME & .FLUMBING INSULATION FERN. STATE ENERGY CODE FINAL ADDITIONA'L COM~:ENTS: FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Disapproved a/c ' .(n4,)rAIding Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS BOARD OF HEALTII ......... '--3 SETS OF PLANS ......... ~SURVEY ...... SEPTIC FORH . . CALL .................. FLAIL TO: a. This application must be completely filled in by typewriter 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 sti'eets ar areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- 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 i~sued 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 pa~t for any purpose whatever until a Certificate of Occupancy shall have 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 removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectOrs on premises and in building for necessary in. ns.~ 7 /] ~ ' ~ ' _ (Mailin= address of applicant) State whether applicant is owner, Jessee, agent, architect, engineer, general 'contractor, electrician, plumber or builder. N~meofownerofpremmes ...~.~.k.t'N..~. L;/'kO~.O...~'I ~t-l~r-h ~P"0~D~"~ If applicant is a corporation, signature of duly authoriied officer· ~EE~~BY: ~ )/~ N~I~ BUI~!NG DEPA~ENT AT (Name and title of corporate officer) Builder's License No .... O..L)Qf)'-..'~ .Y~'.... Plumber's License No .... ' Electrician's License No. Other Trade's License No ...................... 765-1802 9 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION TVVO REQUIRED FOR POURED CONCRETE 2. ROUGH * FRAMING & PLUMBING 3. INSULATION 4. FINAL -. CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION· SHALL MEET THE REQUIREMENTS OF THE N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE ]. Location ofland on which proposed work will be done. . . : ................. DESi?NOR. CONSTR .U~,Ti..i~ORRs. ...... - ................ ............. 5.5. !i ...... . ltouse Number Street Hamlet ,,~ - :.~,.~ county Tax Map No. 1000 Section .... :~ ........ Block ' ~ Lot / Subdivision ........ . ................... ......... '. Filed Map No ............... Lbt ,~. · · M: ........ (Na~ne) , 2: State existing use and occupancy of premises and intended Use and occupancy of proposed constructioni a. Existing use and occupancy .............. · ......... , ................... .. ....... ....: ............... '. ... .... , b' Intended usc and °ccupancy - · ".I. ~, · · · ,~, ·I.. . ,~0. FT..~.'.. TT.. -3. Nature of work (check which applicable): New Building ....... Repair Addit on . Alterati Removal .............. Demolition · . .... Other Work . .~ .... 4. Estimated Cost .................... '. ~...~ .~/~-0X> (Description) ......... Fee 5. ' (to be paid on filing this application) If dwelling, number of dwelling units ............... Number of · . ......... · If garage, number of cars ... . dwelbng units on each floor.. 6. If business, commercial or mixed occupancy, specify nature and extent of.each type of use ................... 7. Dimensions of existing structures, if any: Front ..........Rear ~H.eight ·.... ~-'. ......... Number of Stories ..... ' .... ' ............. Depth ............. ~trnenmons oI same structure with alterations or additions: Front ...................................... Depth ' ' ................ Rear ................ .................. Height ...... . .......... Number of Stories ............ ~ ......... 8. Dimensions of entire new construction: Front ........... Rear Depth Height ............... Number of Stories... ' ..... . ...... Size of lot: Front ....... · .................. · ·, ....... Rear ......... ' .................. · .... ............. Depth ....... ' .... Date of Purchase ....... Name of Former Owner .......... one or use district in which premises are situated ...................... ' .............. Does proposed construction violate ............. any zoning law, ordinance or regulation: ..................... ~%le°;fb;Tng~;doefdo/~,,',~'_' ...................... Wall excess fill be removed from premises: v ....... *~ ........... , ........ Address Phone No .. . Yes Name of Architect ......... Address .................. Phone No ......... ; ' ' . Name of Contractor .......................... Address ' '. Phone No' ' ' j ......... 15. Is th±s property within 300 feet of a tidal wetla~'d'*'''* ............ ' ............. · *'If yes,'Southold Town Truo~ ~ ...... ' Yes ........ No ......... .... PLOT DIAGRAM ' Locate clearly and distinctly all buildings, whether existing or proposed, and. indicate all set-back dimensions frc.n- property lines. Give street and block number or description according to deed, and show street names and indicate whethe: interior or corner lot. 10. 11. 12. 13. 14. STATE OF N~J.t-YORI(~,~.~- I [~ S S COUNTy OF .~-"'"54_.~ t~.h. - .... ..: ........... (Name of individual signing contract) above named. being duly sworn, deposes and says that he is the applicant He is the .. ................. (~ t.C) ~ ~ (Contractor, agent, corporate officer, etc.) ' '"" ....... of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the Work will be performed in the manner set forth in the application filed'therewith. Sworn to before me t~h.i~r, / /~ (~ ........... ~ ........ day of~..~ .~J/~ .~.'....., 19 ..~. ~ No'tary Pu'bl~~ County ' ' Notary Public, State of New York ~ No. 4879505 ' · ,~//' ' ' ' Qualified in Suffolk County ///'z-~.. ........ . . Commission Expires December 8, 19 [,&..t (Signature of applicant) l~O~' NO. · TOWN 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) N.° 23518 Z Dote June 18. ......................................................... 19...9..6.. Permission is hereby granted to: John Sabatlno 27756 Hain Rd. - Rte 25 Orient, N.Y. 11957 CONSTRUCT AN ACCESSORY SIIED IN '£H~ REAR YARD AS APPLIED FOR. THIS REFLACE$ BP ~2183~-Z 27756 llAIli RD.Irrg 25 ORIEI~r, N.Y. at premises located at ............................................................................................................................ County Tax Map No. I000 Section 18 Block 6 Lot No. 21.10 pursuant to application dated .......... ~u..a.e....!.O..? .............................. , 19..?..6..., and approved by the Building Inspector. /~/Building Insl~ctor Rev. 6/30/80