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Home My WebLink About1251-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIC£ SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1251' Z Dote .......................................................... 19 ........ Permission is hereby granted to: ....~o~yd...O,~.ari~ .................................................. ........ ¢~otmd.. JC.£e~:..Av.e ...................................... pursuant to application doted .............................. ]~O'~'~BS~'"'"~ ........19..~0, and Building Inspector ~.00 paid Fee $..~..~... ................... S ou-~-qo!~t.~......N ~,.~ ~. .......................... to .......... .B~,t.-Z(~-.a-n--.ad~.~.~4com..en...an...e-x& e~z.i, ng...clwe.l.l..&~g ................... : ........................... .............................................. .(.v .em&ane. e-. Ol*~nte~. ) ........................................... : ........................... at premises located at ......~/~...~,.a,~,~(l..~Ci,~lcF.,~Te ............................................... ,..:.: ........................ ..................................................... .8 ~u~ho-t~'l .¢ ..--. NY ~ ~ ............................................ '...; ....................... aj)¢'roved by the ................................................ ',..:¢ ............ :>f ...... 1.. Building Inspect ,~ir FOR~ NO. I T(~VN OF SOUTHOLD SUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........~.......~........, 19...~....O. Approved .................................... , 19 ........ Permit No. ~--I ~-~' I Disapproved a/c .... ~.~.......~..'..~.... ~...~........('3 -- 'VI u .................. ...... ............................ APPLICATION FOR BUILDING PERMIT Da' November 5 1 60 re ........................................................ , y ........ INSTRUCTIONS a. This application mus~ be completely filled in by typewriter or in ink ;:nd 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 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 o 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, os herein described. The applicant agrees to comp y with a I applicable laws, ordinances and regulations. ..... L!o. z4.....Cl rk .............................................................. (Signature of applicant, or name, Jfo corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ...................................................... O3d~ e/'.. ............................................................................ Name of owner of premises......~,~,o.~..c],..,..~.]~ .................................................................................................................. If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) l. Location of land on which proposed work will be done. Map No: ......... ZX3.~ ......................... Lot No:31;X3C~ .......... Street and Number ...~.~...~.Q~d...V.l~w..~.~.et ........ S.OllthDl(~ .......................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ........ ..~.W...e.~,]..~,~ ...................................................................................................... b. Intended use and occupancy ' with addition 3. Nature of work (check which applicable): New Building .................... Addition....,X~ ........ Alteration .................... Repair .................... Removal .................... Demolition.....~i ............. Other Work (Describe) .................... 4. Estimated Cost .........$.~.t.OO.O .................................... 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 .......... -R..b¢. ................. Height ............................ Number of Stories .......... O.D,~ ............................................................................................ Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth ................................ Height ................................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ..~..~ .....................Rear .....~ ...................... Depth ........... ,R.~ ............ Height ............................ Number of Stories ......... OD,~ ................ 10. Date of Purchase .......... ~Lc)..~.~. .................................... Name of Former Owner ........ ~I~ ...................................... 1 1. Zone or use district in which premises are s~tuated ......... ~.....~.~.$..~ ........................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... ~.~ ....................................... .................................................... Address .......................................... Phone NO ..................... Name of Architect " " Name of Contractor .................................................... Address .......................................... Phone NO ..................... PLOT DIAGRAM Locate clearly distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give .t and block numbers or description according to deed, and show street r~mes and indicate whether interior or e,r lot. , / /0 or ~- V STATE OF NEW YORK ) S.S. COUNTY OF ...................................... T,],~.~..C1 ~k ............... , ....... : ........ being duly. sworn~ ~eposes .and says that he is the applicant (Name of individual signing application) above named. He is the ........................ ~9.~F~3,e.~..,~],~l,],.~,ez'. ................................................................................................. (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 to before me" II~rv ~bl~c, ~ ~ #aw York this Ho. 52-0344963. Suffel~ ~..,,,~ ~_~ .................. day of ~plicant)