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Home My WebLink About1586-z· FOI~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1586' Z Dote ............................. ~T~t~.e-, ·.. - .~ ~ .......... 19-/O~.. Permission is hereby granted to: · ',.~.-...~.0~.. ,J~.~..~,. e~, ~)n .................................. ....... ,,h d~l~ oa~ .................. ....................... ~L~t.ti~uc~ .................................... to ...r e.~'~o~,c ,%., a..-~-~,f:,].~ i.~g..-mev~., en,t;~...tcd?' .~n.t.o...dw~ t.1,$ n.~ ........................................ at premises located ot ....... N./~.-.}~t~d.]:e...~ead....(e,R.a7~') .............................................................. ........................................................................ i~a~.2i.2ugk.f ......]~;.~;. .......................................... : ....... Oct lB. 196! pursuant to application dated ..~.p~:LO~...L-~..~,l.0¢.t,. ~0- ]9 6.1. , and approved by the Building Inspector Fee $...~.Q. L~0 ......... Building Inspector FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 1586' Z Date ............................. ~Tlltl~'... 2~* .......... 19.(:~. Permission is hereby granted to: l~.~..,Tob, n...$~.t.t*~,sen. ................................. .......... ~ltd~,;;t~.. R~ad ........................................... ....................... l~t.ttt, u~lg .................................... to * · *1~ e*~o~:~*~.. · a...b~* ~**1~ i~tg. **movml** on%o...lot ***].rl.t.o..d~.~g ........................................ at premises located at ~/~ ]~.x4d.]:e '~08.d '{OR',?~*) .................................................... ........................................................................ Y~J¢ t¢t~ele'f*'....N; '~; .................................................. Oc~1 13. 196 p~r,~on, ~o a~p"eotion da~ed ..ap~o~.e~...]~:~..a~.A..Oe.t,...~O ......... ~.61.., ond approved b~ the Building Inspector Fee $..1.0.~)0 ......... "Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. E×am,ned...... ............ , ,>/ ^pp',co,an ................................ ~'~'~'~'~'3~'?C~[¢;~B;~ ............................... APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. This application must be comple}ely 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 o detailed description of layout of property must be drown 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 shah 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 po rt 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 o 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 comply with oil applicable lows, ordinances and regulations. (Signature of applicant, or name, if a corporation) 7",~f~.~' (Address of ~plicont) ~ State wh,~'h/er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................................'"'~p ............. R(~<" ............. ?')'" -' "-:5:~ ............................................................................... Name of owner of premises ........................................... ./.. ...... :....,x ..................................................................................... .... x If applicant is o corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on whic~p,)sopos,~,~work wi~l~/~one, x~Aap ~o: ........... ~.....~.~.,..~ ............... Lo~ No: .~..~ .......... btreet and Number ................................................................................................. ~......~ ............................................ Municipolity o. Ex st ng use and occupancy b. n~enaea use ana occupancy ................................................................... ~ .. ;. .............................. 3. Nature of work (check which applicable): New Building .................. Addition .................. ~/Mteration .............. ~... Repair ....................Removal .................... De ol m ition .................... Other Work (Describe) ............. L .......... (to be paid on filing this application) nit 5. If dwelling, number of dwelling u s .............................. 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 or additions: Front ................................ Rear ................................ Depth ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front Height ............................Number of Stories ....... ~ ....... te of P hose .............................. Name., ¢/f Former (~wner ............... /f./... ............................... . 11. Zone or use dstrct n whch premses are stuated i3. Name of Owner of premises J..~.~..~.~Address ..... .L:,.~.~.~!.cX,.4~.,.*~ .,~..... .......... Phone No ..................... Name of Architect ........................ .¥....~.....'~../. .............. Address .............. :: ............................ Phone No ..................... Name of Contractor .................................................... Address ............................................ Phone No ..................... pLOT DIAGRAM Locote clearly and distinctly all buildings, whether existing or proposed, and indicme all set-bczck 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. ~0o t STA'¥E OF NEW-,YOI~K, / ) __ ............................ ..v~...:_.t.~..~,~...~xT.'.~..~.~.. .......... being duly sworn, deposes ond soys thot he is the opplicont (N,a nd (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 performe~ in the manne~u~ f~r~K~ the application filed therewith. ~Ot~ Publmc Sat o Sworn to before me this ~ ~ ~ , ~} f New York ~---~ kl / ,~ ................ l .da ......... ........... 0, 'D"b/t . L' z ~/~ ./j .~, .' ~/~ (..' ~. / .. .... ,~, ........................................ . ~'T' ............. .