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Home My WebLink About950-z FOF. M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 950 Z Dote ........................ .;.~,~rz.......6. ........... i .~o... .... Permission is hereby granted to: ~t~,...c..o.~.,.~.r..~?..~:~.:....~....~.d...L?..~ .......... ... ~..~.e... ~..t..e.. ~.?.~ ................................................... ............ lkmko~ae,,,....~,.~..,. .................................. to. ~. ~t~.. :~...~?..t~..t..z.~...~.~.e..Z..Z..t. ~. ............................................................................................... at premises located at ..~.~..].3.~...~M~....~......~...~...e.~ ........ ~ ..................................................................... .................................. ~. ....... ..s.~.,.~..~...,. ..... ~.:....?.... ............................................. pursuant to application dated ......................... ~.e.~?..~.~....~.. ................. 1~.?....., and approved by the Building Inspector Fee S],O.,.~.O....,J~;1,~.-che~ Building Inspect;;' '"'"'I ' FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL To IAd o.. ~ .on ~.~r~.c~;LO~.....~.,....-~..t.t.n. ~A .1..b..e.~..~er guson .Roee.vaZe..A.ve ................................................. · Ronko~o~e,~... L,~..,.... ~ ~ .......................... PLEASE TAKE NOTICE that your application dated ................... 11/...21 ....................... 19..~c~.. for permit to construct ..~..w.~.~..~.~..n.g ........................ at the premises located et ...................................................................... Street Sour, hal.ct ~ N,Yo Mop ...~. I~..~.g.o..d...~,.q..r.~..s ........... Block .....s..e..O..t.~.o..n......~. .................... Lot ...]'..~. ...................................... is returned herewith and disepproved on the following grounds ..... ,T~.t~'~.~lo::!Le~,t.'~..~:Lde..~.~.d..or~ .... ....... t~o~"~,he~-ly..e~.de. ·. ~r~t. · .no..ff. ee..e~e~&sed., .... ............................................................................. Building Inspector FOEM NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFICE $OUTHOLD, N. Y, APPLICATION FOR BUILDII~IG PERMIT INSTRUCTIONS a. This application must be completel,,y 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 be.fore 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 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, 6~ name, if o corporation) ..... ....... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~ .... N me of of ........ ...... ................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate, officer) ,~;,¢:.t.-/- / 1. Location of land on which proposed work will be done. Map No..:1~: ...... ~..~..~KI.. ............. f%Lot , Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ......... ~.~.~x<-8,,~ .................................................................................................. b. Intended use and occupancy .......... ~'~.~z~'f~4.:~-~ .................................................................................... 3. Nature of work (check which applicable): New Building .................... Addition .................. ~..Alteratton .................... Repair ........................................ ~ Removal ~"~ Demohhon' ' .................... ' *'""'"- Other Work (Describe) .................... 4. Estimated Cost .......... ........................... Fee ....,~,.../.....6....~ ................................................................ (to be paid filing this application) on 5. If dwelling, number of dwelling units ....... ...J. ....... : ....... 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 for additions: Front .................. '.... .......... Rear ................................ Depth ................................ Height ................................ ..~" Ndmber of Stories.t,~ .......~ ........... ~ .......... 8. Dimensions of entire new construction: Front ....~...~....--.. ............Rear ...... r?..!:......'~..........'Depth .... '.~ .............. Height ...... 1....%.~'.. ............ Number of Stories ................................ · .... ~. S,ze Of lot: Front ..~/.~,,'~ ......... ~,,, Rear ...../,.,?~ ................ Depth ............ ~ ....... 10. Dote of Purchase ... ~..:../.Z...'....,~,__ .............. Name oF Former Owner ~ .......... 11. Zone or use district ~n which premises are situated ..................................................................................................... i2. D, oes' proposed construction violate any zoning Jaw, oj'd nonce or regulation? .... .,~.~....~ ............. ~.~. ........... Name of ^reh teet NO, .................... Nome of Contractor ~(~ ......... ~..~...~.~l~ddre~s ...../..~~. Phone NO ..................... PLOT DIAGRAM Locate clearly ah~ .distinctly all rbgi,ldings whether existing or proposed and indicate oil set-back dimensions from property lines. Giye street and block numbers or description according to deed and show street names and indicate whether interior or corner lot. STATE OF NEW YORK ) $. S. COUNTY, OF .......................... ), ~.'i(~," ,,,~~ ............ ;..beihg doIy' sworn, deposes ond'~says that he is the applicant (Name of ind~wdual sig~lTnb appTication-T abow~ named· He is the ........ ~;~ .............................................. ;V: ............. f ....................................... ~ontractor, agent, corporate ~ttlcer, etc.) of saJ~' owner or"owners, and is duly authorized to perform or have performed the said work and to make.and file this application; that all st~ements contained Jn this application, are true to the best of his knowleSge and belief; and that the work will b~eqformed in the manner set forth in the application filed therewith. Sworn to~efore me thi{///j //~ ' Notary'P.b',c ..~.~;~.~~ou~ (S,gnature of ap~c~h~ DRN. I~IC~4.°O~.'~O~Vd I00.00 LOT /.,.-~ MAP O~== .~Co ! TOVv'IV O~c ._~OUTHOLD / SUF?OL/C .~OA LEI ": o~,O' L eon¢rcf V. CA4¢ry va~e/ .~urv. Oc/ ~ svRwrrv fOR: £/dO Cona/r~/c//o/~ Cor~ I B. J. BOLENDER, JR. LAND SURVEYOR, LIC. 33112 CELLAR SHEET NO. I CTI.. LOC,~T~O~t / I t SHEET c¥i ON V L I I I Sl"l,_ ~:T NO. A N