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Home My WebLink About33-zFOR~I NO. P. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~UJLDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROV£D PLANS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: Date .......................................................... 19 ........ J'~tly 13 ~ 57 Nain Ro~ Southold ~ N,Y, build an addition to exis.~nf~ d~.~elling ............... U~;;~'~;'"~;;;~';~/~¢¢;'"3~¢~;~67f'~¢';~;~W '~E:;"'~ 'f 7'i'5'5~?'~ ......................... ot premises Iocoted ot ............................................................................................................................. pursuant to application dated ................................................................ 19 ........ , and approved by the Jt~e 21, 57 Building Inspector. 5-00 Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ..... ~,~,.. ~ ~'~ ................................................ ..... ~,~t.h ~3,r,]. ~ ...... ~.,~, ................................. PLEASE q'A~E NOTICE thor your opplicotion doted ............................. ,~.~,~,~..~.$ ........ 19..~.. for permit to construct ~..~,cl:]~;,~.¢~Z ............... at the premises located at ~/..~z~'~£?...~l~].~...]~?~ve ....... (... ~:f~.~ ~...~':~.~ ~::-..) .............................. Street Map ........................................ Block ............................................ Lot ............................................ is returned herewith and disapproved on the following grounds ~t~t,~,f~£],~t~%...~?£~.~.t...~:.~.,.q,,~3~ ..... ...... i~/.. ~ .v.~.~...~.~?... ~ ~:t :~. ~.~.¢~ .~ ................................................................................................................. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No~...~....~"~i .......... Examined ........ .,~. = .~.......~...~l..... 19..~.-'~...~/ Approved ....... ~..~/... ......L~......, 9..~.?..Permit No....~ ........ sappro~ved, a/c ....... ...... ......... ........... ..... /.., .';7Tt. _~....'~. ........... }'J~'~'i'l ~l'i'l~ g I n sp' ' ' f' ' '% ' 'k;~'~)';i ................ ~ ............. APPLICATION FOR BUILDING PERMIT gate .............. ,~ .... INSTRUCTIONS a. This application must be completely filled [n by typewriter or in ink and submitted in duplicate to the Building J nspector. 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 location. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this oppJicatlon, the Buiidlng inspector wiiJ issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of 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 and regulations. (Signature of applicant, or name, iF ........... ...... t' ,, (Address of applicant~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of prem~ses'""x{~r~'~':~"¢~'"~%~'~'~*'~$*¢¢~'v':~;'':' ' , ...~ ........................................................................ ~ If applicant is a corporate, signature of d~outhorized officer. (Nome and title of corporate officer) I. Location of land on which proposed work will be done. Map N .~w.,~., '~,,. c< ........... street N,mb ....... ¢ .................................................. State existing use and occupancy o~f?remieses and intended use and occupancy of proposed construction: a, Existing use and occuoancv "'~t~,'~ ~J ~¢' ~ J.~ ¢.~ A,J · ~ b. Intended use and occupancy .................... .~..~. .................................................... . ............ 3. Nature of work (check which applicable): New Building .................... Addition ........ /~.. ........ Alteration.....~ ......... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4, Estimated Cost ............................................................ wee .......................................................................................... (to be paid on filing this application) FEES: 5. If dwelling, number of dwelling units ............... ~ .......... Number of dwelling units on each floor ............................ IF garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature and extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ........ ~....~. ............. Rear ....... .~.....~.. .......... Depth ..... .~......'I~Z. .............. Height ...... ~....~....~. ........... Number of Stories ......... l ................................................................................................... Dimensions oF same structure with alterations or additions: Front ........... ~.~ ............. R~[~....~..~ .................... Depth ~ ~ Height / ~ Number of Stories /~ ~ * · . 8. Dimens,ons of entire new construct,on: Front ........... / ............... Rear ........ Z ................. ~th .d....~...>~....~ ...... Height ....... Z..~ ............. Number of Stones ....~ ................. . ~.~..~' ' 10. Zone or use district in which premises ore ,tuoted o, ........................................... . ........ . ]2. Name of Owner p .. dress ........ ~ .............................Phane NO..T:". ....... ' ......... N~me of Architect ...................................................... ~ Address ............................................ Phane 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 numbers or description according to deed, and show street names and indicate whether interior or corner lot. S~-At'E OF NE~V YORK, -- ) COUNTY 01~~.,,)~ S S.' . ~~....~h...~ ......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .................... ~.~.~¢~..f~ ............................................................................ (Contractor, ~gent, 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. ~--~ ~ ~ (Singature of applicant) FOK~ NO.I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........... ~...~. ...... 19 ....... Approved ......... ~z.~.. ........ : ......... 19... No.. ................... ~Disapproved a/c ........ ....... ............ .............. ............... (Building Inspector) A.PUCATION BU L ING RMrr ............... .......... Date INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. 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 location. 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 o Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any p.urpose 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 o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinarices 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 and regulations. (Signature of applicant, or name, if o corporation) ............. .................... ~ (Address of applicant)~' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. coPporate,r ' - :-'~ "~' '.' -": ' '- '."~':i-" -'signature °f d~Yauth°rized °f ricer' ..... ~'; ''~ ...................................................................... If applicant isa ........ ................................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No .~'.. ~ · k .......... ~ ............... Street and Number '-~'~q,4 ½ '.~..~...~.~..) ~\.~...../.~. ~//~'~ 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: o. Existing use and occupancy ..... ...~'~'...~..~...~../.~..(_.~. ......................... b. Intended use and occupancy ...................................... 3. Nature of work (check which applicable): New Bud&ng .................... Add,hen .................... Alteration .................. % Repc, ir .................... Removal ............. :,......Demolition .................... Other Work (Des~rj;e~...~..j~l,...~.,~, 4. Estimated Cost ...............................................Fee ;~"t~ O (to be paid on filing thi; ap~iic'c~¥i~'t~)' ................ FEES: 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ........................................................................................................................................ 6. If business, commerical or mixed occupancy, specify nature,, and extent of each t~/pe of use ................... :; ........... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ DeiCh 2- ~ Height ....../.. .................... Number of Stories ........ ./. .................................................................................................... Dimensions of same structure with a terat ons 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 ...... .~....~..f.~.. ......... Rear ...~'. ........... Depth .. ../.'. ~..d~.. ................ 10. Zone or use district in which premises are situated ............... /.'[....~ ............................................... 1 1. Does proposed construction violate any zoning law, ordinance or regulation? .................................................... 12. Name of Owner of prem~s ..... ....... ~,~dd ress .~.~.,., ~.&:~, ~..~ ............... Phone NO ..................... Name of Architect...,,,~ ................. ~ ........ .,~ ........ ;.. ........ Address ............................................ Phone NO. ' of r'..~*.~*~.C'~'~'~ I.~ ~,'~; //¢":~o(,l,j.~Wc .... ..._.~ .... ' ................... Name ...... ~ .............................................. :: ........ ~aaress .....;,.~ ........ : .,~. ,,'. ,,...~.. ~[,~ ...... t'none N O. ~ ¢,.... ,~;"., .?.~. ~... 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 numbers or description according to deed, and show street names and indicate whether interior or corner Io~:: :--.,--~-. STATE OF NEW YORK,-- ) s s.. COUNTY .~..~',~,,,,~,~...~.....~ .................................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ....... (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 tobeforemethis ~ J/'~/~"~'"~ ~ .....~..7......~.. ........ dey of ......... ~ ............ 19. ~'~...7.... ~'"/~~ ~ ~' (Singature of applicant) Notary Public,. ~.. ~.. ~.,,County