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FORK NO. 9
TOWN OF SOUTHOLD PE( j`(')+ No Lon -e -
BUILDING DEPARTMENT (�
TOWN HALL L1 !
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL'
COMPLETION OF THE WORK AUTHORIZED)
W 20 159 Z Date .. -,V................ .................... 192/
Permission is hereby grante to:
........ . ... ....... .........
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.... ..... .-� � `+�.... ...... .. ... .�
to .:�. ... .. . . . ..... ................
.. .................................
............................................................::;!w
..................................................................
atpremises located at ....... .... ...... .......................................................................
............................................ �¢ :`�/ •..............................................................................
.................................................................................................................................................................
County Tax Map No. 1000 Section ...... ........ Block ........;�........ Lot No. .......:1. ......
pursuant to application dated ..........`T-/..3................................. 19�/., and approved by the
Building Inspector. /
Fee
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....... ......•Buiidiai :,nspector. .:�-°k...............
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Rev. 6/30/80
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BOARD OF HEALTH . . . . . . . . .
L— =J 1 ••' �� 1� FORM NO. 1 3 SETS g ,OF. PL.1:1S . . • . . . . . . • .' TOWN OF SOUTHOLD SURVEY SEP 131991 BUILDING DEPARTMENT CHECK . .
TOWN HALL SEPTIC roRrt . . . . . . . , , , ,
t�. 43G'T, a SOUTHOLD, N.Y. 11971
_ TOWN OF SOUTH' � TE L.: 765-1802
�y �p CALL . . . . . .
Examined .! .?T . . . . . . 19 . . . . . . . . . . .
„ MAIL TO :
Approved . .,. ..(.!� . . . . . I& Permit No: ��f�.�� - . . . . . . . . . . . . . . . . . . .
. . . . . . _ . . . . . .
Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
;7
uildin nspector)
APPLICATION FOR BUILDING PERMIT Date . . '. .� . . . . . . . .. 1991/
INSTRUCTIONS
a. 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
)r areas; and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
..ation.
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
hall 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
Zegulations, for the construction of buildings, additions or alterations, or for removal or demolition; as herein described.
lie applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to
Amit authorized inspectors on premises and in building for necessary inspections.
. . . . ... . . . . . . .
(Signature of applicant, or name, if a corporation)
(Mailing address of applicant) k) 6 .3
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
vame of owner of premises .N. .�Cl l�i'!� J �,!�.�C<S. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
A (as on the tax roll or latest deed)
f applicant is a corporation, signature`of'duly authorized officer.
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(Name and title of corporate officer)
Builder's License No. . . . l LI?,,�. . . . . . . . . .
Plumber's License No. . . . . . . . ... . . . . . . .. . . . . . . . .
Electrician'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#*O . �1. ':97 Block . . . . . . . . . . . . . . . . Lot . . . . �. . . . . . . . .
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 . . .t,74,V.. . . .A
b. Intended use and occupancy . . . . on . . . . . 5/7.
. . . • • , , , , , , , ,�
3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . : . . Alteratio
Repair . . . . . . . . . . . . . . Removal . . . . . , , , , , , Demolition . . . . . . . . . . .:. . Other Work . . . . . .
_ (Description)
4. Estimated Cost . . 00
. .... . . . . 4 .. . . . . . . . . . . . Fee S . . . . . . . . . . . . . . . . . . . . . . . . .
. . . :
(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 • ._• • • . •
7. Dimensions of existing structures, if any: Front . . . . . . . . Rear Depth . . • . •
Height . . . . . . . . . . . . . . . Number of Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dimensions of same structure with alterations or additions: Front Rear
Depth . . . . . . . . . . . . . . . . . . . . . . Height . Number of Stories . . . . . . . . . . . . . . . . . . .
8. Dimensions of entire new construction: Front . . . . . . . . . , Rear Depth
Height . . . . . . . . . . . Number of Stories . . . . .
. . . . . . . .I . . . . . . . . . . . . . . . . . . . .
9. Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . Rear . . . . . . . . . . . . . . . . .Depth . . . . . . . . . . . . . . . . . . . . . . .
10. Date of Purchase . . . . Name of Former Owner
11. Zone or use district in which premises are situated . ' ' ' ' '
12. Does proposed 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 property 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 number or description according to deed, and show street names and indicate whether
interior or corner lot.
As
DATE: 2
FE P4kB.P # D
�.
nl0 IF Y By:
-- 765-1 Fi0 ING DEPART
A1V1 TO 4 PM AT
1. FOi LL�B JINC [NSPECTIONS: OR THE
1. C7 I lI�AT1014 - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH _ FRAMING & PLUMBING
3. INSULATION
. FINAL _ CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL, CONSTRUCTION
THE REQUIREMENTS OF SHALL MEET
STATE CONSTRUCTION THE N.Y
CODES, NOT RESPONSIB ENERGY
FOR
DESIGN OR CONSTRUCTION Lt ERRORS
TATE OF NEW RK,
OUNTY OF . . �.' .r�( S.S
Jam. �,f �, ,
�°'� rri( Ll �•S• • • • . . . . being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
rove named. "
eisthe . . . . . . . . . . . . . . . . . . . . . . .C .- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(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
)rk will be performed in the manner set forth in the application filed therewith.
porn to before me this
. . . . . . . day of. . . . . . . . .,'19 J I
Mary Pub , , Cot
ty
CLAIRE L GLEW . . . .
Notary Public,State of New York ` L�
No.487950b . . . . . . . . . . . . . . . .
Qualified in Suffolk County G�l� (Signature of applicant)
Cosomission Expires December 8,19 L
INSPECTORS
Victor Lessard
Principal Building Inspector �O��SVFfO(�COG
Curtis Horton = 'L� SCOTT L.HARRIS,Supervisor
Senior Building Inspector y = Southold Town Hall
Thomas Fisher P.O.Box 1179,53095 Main Road
Building Inspector O •
y Fish y p! Southold, New York 11971
Building Inspector Fax(516) 765-1823
Vincent R.Wieczorek Telephone (516) 765-1800
Ordinance Inspector
Robert Fisher
Assistant Fire Inspector OFFICE OF BUILDING INSPECTOR
Telephone (516) 765-1802 TOWN OF SOUTHOLD
ORDER TO REMEDY- VIOLATION
Date: September 6, 1991
TO: Nick & Martha Markadakis
256-52 Alamedd Ave.
Douglaston, K.Y. 10362
PLEASE TAKE NOTICE there exists a violation of:
Zoning Ordinance - CHAP. 100
Other Applicable Laws, Ordinances or Regulations
at premises hereinafter described in that:
AN ACCESSORY STORAGE SHED HAS BEEN CONSTRUCTED
WITHOUT A BUILDING PERMIT.
In violation of ARTICLE XXVIII CHAP. 100-281
YOU ARE THEREFORE DIRECTED AND ORDERED TO comply with the
law and remedy the conditions above mentioned IMMEDIATELY
The premises to which this ORDER TO REMEDY. VIOLATION refers
are situated at: 455 LEON ROAD, SOUTHOLD, COUNTY OF
SUFFOLK, NEW YORK
SUFFOLK COUNTY TAX MAP #1000-51-06-41
Failure to remedy the conditions. aforesaid and to comply with the
applicable provisions of law may constitute an offense punishable
by fine or imprisonment or both.
L `U
ctcx L VINr_ENT R. WIECZOREK
ORDINANCE INSPECTOR
31Q(- Kx, l . U�Y.ZJ c V
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