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HomeMy WebLinkAbout10300-Z FORM NO. z TOWN OF SOUTHOLD BUILDING DEPARTMENT ,TOWN CLERK'S OFFICE SOUTHOLD, N. Y. \/0 I BUILDING PERMIT f, (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NOO 10300 Z Date ...... Z I....... a................ .. 197.,x' Permission is hereby granted to: .f,. .ee1.1........cz'�:r�✓ 1 .ir:r.&` .'.�.'�.'` ......... V��....`at d�.� �'J£'�.......!`A e�1 T. ..................... to ...0 �c'„1.0</ .,'! .1..... ... ! .. �. +-- ../ .... ,r�.. �: . ...... ...... ��r. 5 .!,<''✓`...... ...................................... ...................... ........................................... at premises located at t ... ~ ..... .'... x° ........ d t' °5.!�. =...../ '. ................................................................................ ................................................................................ ................................................................................................................................................................ pursuant to application dated ............S .{ .....-'-'5 ................. 197, , and approved by the Building Inspector. Fee $...� :..." .... B ding Inspector FORM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE -' SOUTHOLD, N. Y. Examined .....`:.7 ./.�®................... 19 .`. Application No.� .�OQ............. Approved .....6............. ........_.. 1.9/..�.., Permit No. .. Disapproveda/c .................................................. ......................... .............. ...................... ... ... ... (Bu' di Inspector)' APPLICATION FOR BUILDING PERMIT Date ........ ....1.979......... 19 ............ INSTRUCTIONS a. This application must be completely filled in by' typewriter or in ink and submitted in triplicate 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 d detailed description of layout of property must be drawn on the diagram which is part of this application. 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 issue 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 code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ............................................ (Signature of applicant, or name, if a corporation) .. Route...27.A.. Iattituck� N.Y. 11952 (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........................C.011.traQt.0x'.................................................................................................................................................. Name of owner of premises .. .1panal.da..Jan-a................................................................................................................. If applicant is a corporate, signature of duly authorized officer. S. Perricone ........................................................................................ (Name and title of corporate officer) Builder's License No. .................................................... Plumber's License No. ................................................ Electrician's License No. ......................................... ' Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.• aQ `t... .......... Lot No.-?�..�.�................. Beebe Drive Cu tcho e N.Y. 11935 Street and Number ..................F'��...a............................................................... ...................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ................one family_ dwelling.......••...•.•....,.......•....... b. Intended use and occia anc o71.G-taTIL71` d�re .lx� � � �� G� 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .............. . • Repair .................. Removal .................. Demolitior.................... Other Workfp-nae&poo.i..inztal.l---ation (Description) 4. Estimated Cost ......... h1 200.00...............................Fee ......$.1.5...00....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................ Ifgarage, 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 ..................................................................................................................... 9. Size of lot: Front ...........100.4..................................... Rear .... 00............................... Depth ....200.t.................... J 10'. Date of Purchase ........................................................Name of Former Owner ........................................................ 4- 11. Zone or use district in which premises are situated .......••.•••••••••.••••••••••••••••••••••••••••••••••••••••••••••••••••••........................••• f 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 .....Donald Lan an AddressBeebe- Dr.Cutch Phone�,No.7.�4-60 Nameof Architect .............................................................. Address ................................ .Phone No. ...................... Narne of Contractor ............................................................ Address ................................ Phone No. ...................... PLOT DIAGRAM Lodate 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. Ic STATE OF NEWSY?g I S.S S COUNTYOF ................................ S.®...Per.ri.cone ................... ..................................bei g duly sworn, deposes and says that he is the applicont . . ....... .... ......... y (Name of individual signing-contract') above named. Heis the ..........................contra,ctor............................................................................................................................. (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 than the'work will be performed in the manner set forth in the application filed therewith. Sworn to before me this �1 . ... day of .................... � ............. 197. .. Notary Public. .............................151 6..�,� . County /a;u . .. .. ... ..... !�-`.... .............. ... . ... .. ... .. . . ` (Siof applicant) ELITABEM AN*"WI118 NOTARY PUBLIC. SWV a Ifew York No. 52.8125850, Suffolk Cou v ae&J731f-603Y >Z,o 114 -,1 O FORM`NO: I �I`� � ,� �iirrc�J ✓r/ 'OWN OF SOUTHOLD BUILDING DEPARTMENT � TOWN CLERKS OFFICE O SOUTHOLD, N. Y. Examined ....... ...................'"19 plication No.`� �,� ............3\ �� • � ga-.0 .. Approved ` .....�...../�J7 ../0........ 19 ... Permrt No. ... Disapproved a/c .. ........................................................................... (Bu' dl Inspector) APPLICATION FOR BUILDING PERMIT Date ........ixily...5-�-- -979............ 19............ INSTRUCTIONS a. This application must be completely filled 'in by.typewriter or in ink and submitted in triplicate 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 application.l 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 issue 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,lnspector,,- 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 buildings for necessary inspections. (Signature of applicant, or name, if a corporation) r� ....Rou: a..?7JL.Bat-Utv. TNU X.....1.:1952................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .........................eoneontnactw?­................................................................................................................................................. Nameof owner of premises .... ............................................................................................................. If applicant is a corporate, signature of duly authorized officer. i9 ................5.0-2e'r G.0PAQ............................................ (Name and title of corporate officer) Builder's License No. .................................................... Plumber's License No. ................................................ ' a Electrician's License No. ............................................ Other Trade's License No. .............................................. v ?7 --07 - 0ZV 1. Location of land on which proposed work will be done. Map No.: ......... Lot No. ............... e Street and Number .....Bee ba..Dxi-T.e.9. .cut.cho.clue ............................................................. Municipality o 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occuponcY ................ . .......... r b. Intended use and occupancy ,......... ,.©3�ea—faml11y.-4dw-e7..1-11. .. �.J/ .�JL 0&ckl• .�144<14....... 3. Nature of work (check which applicable): New Building• .................. Addition .................. Alteration .............. . . Repair . Removal ........ Demolition:................... Other Work f9p .0c • p f3Ol ••? ,9 11© �: 31 p (Description) 4. Estimated Cost ..........8P 1200..00...............................Fee ......4!5.00...................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................ Ifgarage, 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 ...................I................ Rear ............................ Depth ...........•............. Height .................... Number of Stories ......................................................................:............................................... 9. Size of lot: Front ...........1001..................................... Rear ..... .............................. Depth ...200.°.................... 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: ........ .....:.........................................i 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .....Pon. ld..L.anEa ................ Addressik9b e..1 ,,-Q�1Ph—Phone NoTll 6474..... Nameof Architect .............................................................. Address ................................ Phone No. ...................... Nome of Contractor ............................................................ Address ................................ Phone No. ...................... 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. 7N i Vill STATE OF NEWSuxOO�.1� 'i S.S COUNTY OF .................................1 S Perricone _ y........................................being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. Heis the ......0,.M4rack.as.................................................................................................................... (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 than the work will'beperformed in the manner set forth in the application filed therewith. Sworn to before me this , � .... day of ..T�J0 19.7.�j. NotaryPublic. ................................i. �.��. County // ... ........ . ..- ......................................................... (Signof applicant) a ELIZABETH Am NOW � RPUBLIC,580, guffulk ty�k No. 52 8 fert" Wites Mgtch 90, 19_ LSS F V A�F- �S —7�O A D Af 17 0 VR lea 0 'J 0 t,/ -ri V y,��q 9/30/70 9 7-5 Z r 9 7o � . � ��� 360 z /79 � A-�Z"