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HomeMy WebLinkAbout21899-Z / FORM NO.3 / 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) N221899 Z Date ........ ..................................................... 19./..�.. Permission is hereby granted to: ................7e �r /'7,3© ............. .. ....................................................... ��, . . .......... � ....................... to .. .. � � �.,.. . ..0 sta ... %. ........ ��' � .... .... ..... .-&a ........ / . . �...,�. . ...I......................... .................................................................................................................................................................. .................................................................................................................................................................. .................................................................................................................................................................. i / at premises located at..... ` j�.7 ......;r�' I�...... � '............................................................. � � .....................W-/-./-.....1...................... County Tax Map No. 1000 Section ....... ........... Block..../.................. Lot No. .er�>. ......... pursuant to application dated ..... 19..��...f........ and approved by the Building Inspector. Fee ... C . .y .... .:�-:.................... uilding Inspector Rev. 6/30/80 =0Ui7DATI04 ( 1 s t) 'OUNDATION (2nd ) ce 0 SOUGH FRAME & I CU •PLUMBING v II to H • II � C'7 rNSULATIO,J 'PER N. Y. • , STATE ENERGY II CODE t FINAL I �f ADDITIONAL COMMENTS : x H ~A G`o x ••o H `LL BOARD OF HEALTH FORM NO. 1 3 SETS OF PLAYS . . . . . . . . . . 4u TOWN OF SOUTHOLD SURVEY . . . . _ _ . . . . .. . . . . . . . im 1 319 CHECK . . . . . . _ . . . . . . . . . . . . . BUILDING DEPARTMENT TOWN HALL SEPTIC FORK . . . . . . . . . . . . . . ° SOUTHOLD, N.Y. 11971 !�. - __ { •'...z jb..-_`_a._.. .___. qWN TEL. 7651802 . C� V� CALL IVJ . . . . . . Examined .� . . . . . . . . .. 199Y MAIL TO : . . . . . . . . . . . . . . . . . . Approved . c` 7. . . . . . . . .. 1919�ermit No. . . . Disapproved a/c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u' no, Inspector) APPLICATION FOR BUILDING PERMIT Date .. !+�. . . . . . ., 191.` . INSTRUCTIONS 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 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. 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 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. 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 de, housing code, and regulations, and to admit authorized inspectors on premises and in building for necess ry ins ction . Au . . . (Si ature f pplicant, or name, if a corporation) o.-'.box &ZI4. 4 0 . . . r. /11'-5 2 1. . . . . . . (Mailing address of applicant) State whether applicant is owner,.lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Name of owner of premises l(;� �` . . . rl !6. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . h as on the tax roll or latest deed) If applicant is a corporation, signature/of°duly authorized officer. T. .9A . . . . !'� .�. . . . . . . . . (Naml. and title of corporate officer) Builder's License No. . . . . . . . . . . . . . . . . . . . . . . . . . Plumber's License No. . . . .. . . . . . . . Electrician's License No. . 1pe- L'7- . • • N Other Trade's License No. . . . . . . . . . . . . . . . . . . . . . 1. Location of land on which proposed.work will be done. 7 . . . �I'. . �'"• • • • • • • • • • • • • • • • • • • • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . House Number Street Hamlet County Tax Map No. 1000 Section . . . . . . . . • . . • . Block . . . . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . . Subdivision . . . . . Filed Map No. . . . . . . . . . . . . . . Lot . . . . . . . . . . . . . . . (Name). . 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .�l%(%f� . .� .�'�.C/t.�. • . L '�� J.. . . . . . . . . . . . . . . . . . b. Intended use and occupancy . . . . . . . . .. . . . . . . . .. . .. . . . . ... . . . . . . . . . . . . . . . 3. Nature of work (check which applicable): New Building . . . . . . . . . . Addition . . . . . . . . Alteration Repair . . . . . . . . . . . . . . Removal . . . . . . . . ... . . . . Demolition . . . . .Pthey Work . - � Al scn tion) 4. Estimated Cost . . . c C 90 . . . . , , , , , , , , , , 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 . 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 . . . . . . . . . . . . . Size of lot: Front . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . Rear . . . . . . . . . . ._. . . . . . . . . . . Depth . . . . . . . . . . . . . . . 1 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 i 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. G2<� A P���(�����d iP.e'F R'flyC4�' tPC� 1 AT -. PAMI TO, 4, PM FOR THE • 6'""�.�i..S�4 4'tl6F i'LG.J LEA.?al F.'P'..0 C Elp':5.�; I. hOL�NDATblof.,l - 114fO REQUIRED FOR' POL,REO CONCRETE' S. INSULATION' 4. P1111A(- - OONST UCTIONN !0f€.1S f BE COMPLETE FOR C.0. 'ALL C0iVS T RUC rj0Rj SHALL VAEE T THE REQUIREMENTS OF THE N.Y. STATE C'OKISTRUCTION & ENEROY CODES, NOT RESPONSIBLE FOR DES9GN OR CONSTRUCTION'ERRORS STATE OF NEW YO ' COUNTY OF . . . . S.S being duly sworn, deposes and says that he is the applicant (Name of in idual signing contract ibove named. ) ieisthe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (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 pplication; that all statements contained in this application are true to the best of his knowledge and belief;and that the York will be performed,in the manner set forth in the application filed therewith. :worn to before me this . . . .day of. . . . . . . ., 19 gT Votary Public, . . . . . . , . , , County ANN NESTOR• NOTARY PUBLIC,STATE OF NEW.YORK . . . . . . . . . . . . N0.03-8121250 ooUALIFIED IN SUFFOLK COUNTY (Signature of applicant) COMf�ISSION EXPIRES AUGUST 31,19 o��g�FfO�,�Co 0 co Z Town Hall,53095 Main Road p • Fax (516)765:1823 P. 0. Box 1179 A Telephone (516)765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD January 19, 1996 Loretta Dimaggio 390 Rose Street Massapequa Park, NY 11762 Re: Building Permit #21899-Z Premises : 2795 Arrowhead Lane - RR3 Suff. Co. Tax Map #1000-98-2-22 During a review of our files it was noted that the above building permit has expired, and a Certificate of Occupancy has never been issued. According to the Code of the Town of Southold, Article XXVIII 100-284, it is unlawful to occupy or use a structure until a Certificate of Occupancy has been issued. Please contact this office as soon as possible so that we may clear up this matter. Thank you for your cooperation in this matter. Very truly yours, SOUTHOLD TOWN BUILDING DEPT. sO�� UNDERWRITERS CERTIFICATE REQUIRED _ N o r r ROVIOE ,66 Na LIST F/ D O[E/L ' I l +:". 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