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Home My WebLink About1432-z FOI~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 1432 Z Dote ............................. .,Tl~.e. ....... Permission is hereby granted to~ Ao P,o.a f~he.. A/~CL. S. he.l 1...0±1.. g,o ............................. ............. Baby. lon....L.~,Z .................................... to ...e~eat..~.m~rL.ma~tt, aJ, n...a...r,~.],V.±.ng...ty~oe...~euz~]....slg.n.,~x,.~.~.~..,~..~.~.6.~.. ......... ~.t...wss~erly,..e n~%.. ~Z...p p.. ~.is e.s ~ .th. eve ..a¢..-]:e a.s%...t£.%.- etea~.a~tee...f~...P, L, at premises located at ..~, td...,q..-ta.te...R~ad-~-.-~y'...Av~..?~..~.2,..~ ............................................. ............................................................... Laurel ................................................................................... pursuant to application dated ............................. }¢~<%~..,..~.~ .................. 19..~.1.., and approved by the Building Inspector 8~d Special exception gran%ed by Bd/ AppeaZs Fee $.3.60..p~ ...... .......... ~.x,~A~,,., ,.~ ....-,-....¥ ......... ',,.~.w...v..:.. :.~ ................ Building Inspector ( TOWN OF SOUTHOLD I~UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............. .......... ,("T' Approved ................................................ Permit No ............................... Application No. /g/''~ 2.~ Disapproved a/c ............................ '; ............ /'?"i'~'~i'ld,n~ Insp ~i ...................... APPLICATION FOR 'B'dIL~iNG PERMIT 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 co~ered 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 ~'Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION ~S HEREBY MADE to the Building Department for the issuonc.e of a Building Permit p~rsuont 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 a corporation) (Address of applicant) State wheth.er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................. ........................................................................................................................................... Name of owner of premises .......... ,ShG~.,~,...OL'i ..Co ............................................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ............. -~ ....................... Lot No:Z,~:, .............. Street and Number ~(~/~`~.~(~'~.~..)~&~.~.~.~.~.~.~L~ .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy.....~...e.?...~.~..O.~...~.~...~..~..:~.O.~ ............................................................................................ b. Intended usi~ and ~ccupancy~$~e.?...~..~..Ct.~.~.~'~.~.~/~t~.~t~c]...~.`~. ............................................. 3. Nature of work (check which applicable): New Bui.lding .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) 4. Estimated Cost .............................................................. Fee ...... '[0¢...~t.¢1....~ ....... '",..~...~.~(~0 ................ : ................... (to be paid on ri ing this app ication) 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 ....................... :L;,. Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth Height .............................. Number of Stories ..................... L. ......... 8. Dimensions of entire new construction: Front ............................Rear ............................ . Depth Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ..........~8,~....~L.9~.'1. ......................... Name of Former Owner ..... ~...[.*.~[~..&..,.-~te] ................. 11. Zone or use district in which premises are situated ...... .~.~!.~..J~e;l~e.l~ ....................... ..?., .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? .......... .~1~ .................................. 13. Name of Owner of premJses~,.~..O£.~...~ .......... Address ............................................ ~hone NO ..................... Name of Architect ........................................................ Address ............................................ ~hone .NO ..................... Name of Contractor .................................................... Address ..................................... ...,...;.Pl~one NO ..................... PLOT DIAGRAM ' . ';' Locate clearly and distinctly all buildings, whether existing or proposed, and indicate ell set-ba~k dirh,ensions from property lines. Give street and block numbers or description according to deed, and show street ngmes and indicate whether interior or corner lot. '.. STATE OF NEWs_yg~Y-... ) S S. COUNTY OF ..... ~ /'~' ~ · ............................. ~.r..~....~.~.(:'fC~. .............................. be.rig duly sworn, deposes and says that he is 'the applicant (Name of individual ~ignlng application) above named. He Is [ne ............................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or hQve performed the said work and to make and file this appl cation; that all statements contained in this application are true to t~est of his knowledge and belief; and that the work will be performed in the manner s~t~L,fRrth ~e applicatio~fil~ therew~ ~,, ' Sworn ;0 Dfit~ru .............. /.~ ..... ~oy of ....... ~/~.~,.~.....~... 'lg.~.~.t~l~r~s ~r,:h ~, t~l~R [~lgnoture o..vp,lcanu Nota~ Public, FORM ' NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ............................. Disapproved a/c .............................................................................................. (Building Inspecto~ ~ 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 commehced 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 a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuanc.e 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 a~terations, 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, Iessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent fo~ Shell Oil CO p r em ises....~..: ..~..'...~.?,..e,.~..~.....~.....0...~..~. ~..~,.8,. ,. Name of owner of .............................. 7 ..................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and tide of corporate officer) 1. Location of land on which proposed work will be done. Map No: .~ ............................... Lot No: ~ .......... Street and Number H.~..~..J:..~.°.. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ............................................................................................................................ ; ........ 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 .............................................................. Fee .~OJ~...~...~.~.....,,...~....~,~O ........................................... (to be paid on filing this application) §. 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.....~l~e~.B ...... 7. Dimensions of existing structures, if any: Front ............................ Rear ............................ Depth ............................ Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additionsi 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 ............................ Rear ............................ . Depth ............................ 10. Date of ....... ................ Name .of F~,,~wner ...... }['i'~'~'J~/'~"~"Og~'eJ"~ ...... 11. Zone or use district in which premises are situated .......... ~.!.l,l~.t~...b.~;~J'i~.g~ ....................................................... 12. Does proposed construction violate any zoning law, ordin6nce or regulation? ...... ~1~ ...................................... 13. Name of :~J~e~r~of premises....~,Jl.e.]l.~...O,J,.':l...eO ....... Address'i. .................................... '"....Phone NO ..................... .\ Name of Architect .........:,. ............................................ Address ~ ........................................... Phone NO ..................... Name of Contractor .................................................... Address ............................................ Phone 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 acco,~ding to deed, and show street names and indicate whether interior or corner lot. ' STATE OF NEW YORK, ) COUNTY OF ~£o'];~' .......... ) SS. ............................ .,/._~..,.~t~....~..4,~:.¢,~ ........................... being dul~ sworn, deposes and says that he is the applicant (Name ~'f' individ6al sign ng 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 appli.cation are true to the best of his knowledge and belief; ~,,,, .. ,~ac'n'Jrt~h~a~t~- .- ...~ -..---~o~li~e performed in the manner set forth in the application ~d ther~ /~ dav of .~/~ .. 1~[~,~ Jl~lk~, Skl,e o~ ,e,~ York ~ignalure of applicant) ............ r'~ ......... · .... ~ .,' ~.a~, s.~o,~ ~.~,t~