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Home My WebLink About20142-ZTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTNOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne- 20142 Z Permissian is hereby granted to_: .~ ~/~/ ~...~~ ......... ~ ............... ...... ~../~.....~.....~z ................... County Tax Map No. 1000 Section ........ ~...~..~... Block ........ ~.. ......... Lot No...../...~...~....~..-,~,. Building Inspector. Rev. 6/30/80 FOUNDATION (1st) FOUNDATION 2. ROUGH FRAME & INSULATION (2nd) -PLUMBING PER N. Y. STATE ENERGY CODE FI;;AL ADDITIOHA'L COMMENTS: BLDG. DEPT. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 BOARD OF HEALTH ......... 3 SETS OF PLANS .......... SURVEY ................... CIIECK .................... SEPTIC FORH .............. E/ TOV~N OF SOUTHOLD Examined ~. ~_~ ........... 19~/ .... ...... I Disapproved ale ..................................... "~ r~ c~ ~ ~:; ~ :' i · ' ~'~'~' ~fi ~':",{ ~ ' ~:~.~ ...... ~.x..~.~.., ' , ~ APPhlCATfON FOR BUILDIN~ PERMIT INSTRUCTIONS CALL ................... HAIL TO: .¸1 This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ;ets. 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 77 areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- zation. 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 permit ghail 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 ;hall 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 3uilding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or 2eguiations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. Fhe applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to ~dmit authorized inspectors on premises and in building for necessary inspections. (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 of premises ......... .~-~..; . .a~.....~.....(~...~..0~. ~ ............................. (as on the t.a~x roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No .......................... Pinmber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... O~,CUPANCY OR USE IS UNI.AWFUL WITHOUT CERTIFICATE 1. Location of land on which proposed work will be done... ...................................... ' ......... ...... '~.,. ~. ........... o. ~.: ,~..... D~.. ................. . .-:~. ~ .~..~ I louse NumberStreet / Hamlet ............. County Tax Map No. 1000 Section ..... .'~..-~ .~T ........Block ........ .~. ........ Lot..(..'~..'~ .~.-. ........ · ~ v (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 ...... .~. O~-~. ~.. Repair .............. Removal .............. Demolition ..... ~ ~]] [ .~'..~. '~~ 4. estimates ~'ost .. ./.,.f. ?.(.j, o~/ .. ..; ','~, ~ ¥.].c ................... eec ........................ ;'~":" I .......... (to be paid on fihng4.h]s appficatJon) 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 ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth... Height ............... Number of Stories .......... ... ' ........... Dimensions of 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 ................ ' ' ' ' 9. Size of lot: Front .......... Rear 10. Date of Purchase .................... ......... Name of Former Owner ~L~: 1 I. Zone or use district in which premises are situated. ............................. 12. D°es pr°posed construction violate any zoning law, ordinance or regulation: ... 13. Will lot be regraded ............... ,' .............. ..... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect .................... . ....... Address ................... Phone No ................. Name of Contractor .......................... Address ................... Phone No ............... 15. Is this p~operty within 300 feet of a tidal wetland? *Yes ........ No ......... *If yes, Southold 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 property lines. Give street and block nutfiber or description according to deed, and show street names and indicate whether interior or corner lot. APP, ROVED AS NOTED DATE: ~-~B.R # BY:, 765-1802 9 AU ~ 4 ~~ FOLLOWING INSPE~IONS: 1. FOUNDATION - ~0 REQUIRED FOR ~OURED CONCR~ 2. ROUGH - FRAUIN6 ~ P~MBING 3. INSU~ON 4. FINAL CONS~U~ON UUST BE COUP~ FOR C.O. ALt CONS~U~ON S~E MEE THE REOUIR~E~ OF ~E N.~ STATE CONSTRU~ON i [NERGY CC, DES. N~ RES~NSIB~ FOR DESIGN OR C~U~ON ERRORS APPROVED AS ~OTED Il)ATE:B.R # , rr~ ___BY: _ FOR POURED CONCRETE 2 ROUGH - ~RAMING & PLUMBING 3. INSU~TION FINAL CONSTRUCTION MUST BE COMPL~E FOR C.O, ALL CONSTRU~ION SHA~ ME~ THE REQUIR~EN~ OF THE N.Y, STA~ CONS~ON & ~ERGY CODES. N~ RES~NSIB~ FOR DESIGN OR ~U~ON ~RORS ;TATE OF ~EW~YOI~I~, / :OUNTY OF;~4-.-.~ .~... .... S.S ................................................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) bore named. le is the ............. ~ ............................................................ (Contractor, agent, corporate officer, etc.) f 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. worn to before me this ~i~'; ' ': ............ daY° '"' ' '" '(~'' 19 '~' '/ :... .......... Qualified i. Suffotk Co~m~/ (Signature of applicant) Commission Expires Jan. 20, I LISA DRIVE SU~Y F~ D.B.M. COMPANY ~u~K COUNTY D~A~T~ENT ~ H~ ~ LOT NO. 3, "HIGHPOINT ~ AT SOUTHOLD, SECTION ONE" AT ~UTHOLD OJTE: SEPT. 6, ~89 F~ ~V~ ~ ~S~ON ~Y ~WN ~ SOUTHOLD SCACg~ ~": 4O' SUFFOLK COUNTY, NEW ~K HE~ DEPARTMENT-OATA F~ A~R~ TO C~STRUCT , ANO ~ HIS ~LF ~ T~ TITL[ C~Y, GO~N- SUBDIVISION MAP NOT FILED AS OF SEPT 6,1989 ~OEN W.~NG, P~FE~IONAL ENGINEER AND ~NO SURVEYOR HOW&RO W. YOUNG, L&NO