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Home My WebLink About1399-z FORM NO. 2 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.o 1399' Z Date ......................... 1~'.....12 ................ 19~... Permission is hereby granted to: F~shers · .l~$h~r ,~...t~ta, d ............................................. to 'Bu~'td'"an--add~ti.a~...o,..~.~n~onTer~.n~-~t~t~..b~.~-d!~ ............................. '" ('ePee l.a'l...e~c ept.i.o,~ .. g.r an ted .. ~y..-B/A.) ............................................................................ at premises located at '"{J~OFI~8~"~'~I'~Z~'~IT~'"~IV~ .................................................................... ........................................................ ~h~s'-'lL~t~d ....................................................................... pursuant to application dated ........................... il, pF.~.t..-.-.1.~ ............... 191~]:...., and approved by the Building Inspector Fee $"5'i0~ ............ FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CL C'S OPPICE SOUTHOLD, N. Y. Examined .~. ~i:~_..:,~...I..~.. ............ 1~;~..{... Approved ....... ':Y]4. ~'-~/-.. · ~ · .~- ......... 19.~l...Permit No...Z..~..~..~.~..~. ...... L Disapproved a/c ..~.~,~t...~...,~..~.,.~....~,.~,,~..cz~~__ .... ........ ............ ........................ ' ' (Building Inspector) Application No../..~..~....~ ........... APPLICATION FOR BUILDING PERMIT Date...~..k.q,. .................................. 1~i...~.~ ....... 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 p~emises or public streets or areas, and giving a detailed description of layout of property must be drown 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 tl~e ?pplicant. 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 I~art for any purpose whatever until a CertificJie of Occupancy shall have bee~%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, ,,O~'din~3nceS 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 a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrican, plumber or builder. Name of owner of premises.......~]...e...a....~.:...~.e.~.~. ........................................................................................................ If applicant is a corporate, signature of duly authorized officer. ............................................................ I{,..~I~.Y~,. Jro P~e~tde~% (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No ................................... Block .................................. Street and Number ..llil..~e~..i~l~z~ee~14m.~c~,t~.411~.~31,~t,..~lre~...l~t,,ez~..][~ .................. 2. State existing use and occupancy of premieses and intended use and occupancy of proposed construction: a. Existing use and occupancy ...... ~ozs,-ecm~-~.~mt~.e%,.~..l~8].e..~..~],ez~jr ................................. b. Intended use and occupancy ........ ~..(&d. dltJ-a~..~.'[]...be..a..l.~,Ct)..;~i~'...l~.e...~....~..~.~. ............ aa az~tst eo that the exist~n~ batldin~ (a fo~v ba~n) can be u~ed exelual~ly 3. Nature of work (check which applicable): New B~ilding .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition, .;.....:....;.....Othe~ Work (Describe) .................... 4. Estimated Cost ..............~lJ. ............................. ee ....~& ........................................................................... ¢ll~c~ 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 ....... ~.~JlJ~ .... 7. Dimensions of existing structures, if any: Front,.....,~l,~l~ll ......... Rear .....~ll,,~ll ........... Depth .....~ ........... Height ..,~! ................... Number of Stories ....~11~ ................................................................................................... Dimensions of same structure with alterations or additions: FrOnt ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories 8. Dimensions of entire new construction: Front ......... :..'i.".~ ........ i. Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ~...."~..~t,~ ........... Rear ...~l~..f¢~ ........... Depth ...~l~e~l ............. 10. Zone or use district in which pre_mises are situated ................. #&ll..~jlljtlell~l~ ................................................. 11. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~j~_11~..~ ................... 12~ Name of Owner of premises..~alj*Jeil..~..Jlll!l~Jll~JlJel/kcldressJ~l~.JlJ~e~ulJ.~t~ee ...... Phone NO ..................... Name of Contract .. .~~~ .~11~.~ ............ Phone NO. .~ .......... PLO~DIAGRAM j' Locate clearly and distinctly ~11 buildings, whether existing or ~sed~ and indicate all set-back dimensions from property lipes. Give street and bilk numbers or desc accordin~ to deed, and show street names and indicate STATE OF NEW YORK, ) S S. COUNTY OF ""~JJ'J'~,lJ ......... ) (Name of individual signing application) duly swor~/deposes and says that he is the applicant above named. He is the ....... ~ ............................. : ........... ~ ...................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and iSi~iuly authorized to perform or have performed the said work and to make and file this applicaton; that all statements contained in this application are true to the bes~t of his knowledge and belief; and that the work wi I be performed in the manner set forth in the application filed ~erewith. Sworn to before me this Notary Pub ic .. ~ .......... County