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Home My WebLink About1433-z FOI~M NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFF~CE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 1433 Z ote ............................. ........... V.6Z.. Permission is hereby granted to: A, Ro aab~.. ~./C......~.he. lL..0i.%., go ............................. .... ~..by a,o ~.. ~,,,. I_., ............................................... to .. es ~.et...a ng.. ma i.n .ia i ~.. a... s.taral a~d...po le.. :by ~.. er ~,nn4, .. ~t ga.. 6 .~. (.HJ... ~6 .~ ~ .,...OA o at premises located at ....~[~.~.t.~.OB...~c.,~.i~l[lt.~t~t'.'~e,' ....... (....l~ve..~.~a.~-.folq.) ...................... ...................................................... $ia.t l;&tuck. ................................................................................... pursuant to application doted ................................... l~[a~r.....;L~ ............ 19.1~.~..., and approved by the Building Inspector and special exception granted by Bd/Appeals Fee $..3.60...pfl ..... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ 19 ........ Permit No. --- Applicotion No ............................. Disapproved a/c .............................................................................................. ....................... ............ ..... ........................ ................ APPLICATION FOR ~ PERMIT INSTRUCTIONS o. 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 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 prem!ses available for inspection throughout th~ 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 issuanoe 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 Iterations, 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 o corporation) Box ~12~ BaSylont L,I., (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Agent for Shell Oil Oo Name of owner of premises....~.,:..~.?.~?.e..~.~....~....0..~.~.?...~.~. .............................. 'i ....................................................................... 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. Mop No: .~ ............................... Lot No: ~ .......... Street and Number ~ilto..n .A.~.e..~..~.&.g~.b....~......&..~.... ~.¢.,,1~.,~./~). ~.t,~;L~.~ct~ Municipality 2. State existing use and occupancy of pr.emises and intended use and occupancy of proposed construction: o. 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 .~,0~...1~.,£~.....-...~...,~0. .......................................... (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.....~tl, eS.s ...... 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 ............................Rear ............................ Depth ............................ Height ............................ Number of Stories ............................ 9. Size of lot: Front ............................ Rear ............................. Depth ............................ I0. Date of 'tease ....... '3:en""196'1 ................ Name ,of Fj~zOwner ...... H'~'~R';~e"&"O~;}t'e~'~ ...... 11. Zone or use district in which premises are situated ........ :.?!,l~fl...~S~',e.~ ....................................................... 12. Does proRosed construction violate any zoning law, ordin6nce or regulation? ...... .~'~1~ ...................................... 13. Name of e~r of prem~ses....~[n.e.~.l...0~l...(]O ....... Address,~ ............................................ Phone NO ..................... Name of Architect .........: .............................................. Address ............................................ Phone NO ..................... Nome of Contractor .................................................... Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly end 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, ) S S. : ~ COUNTY OF ~'11~£O'~' .......... ) ~, '. ~ 2/ ~ .~;/~¢,.,~., , .being dul~, sworn, deposes and soys that he is the applicant (Name ~T nd vld6al s~gning app ~catlon) above named. He ~s the ...................................... (Contractor, agent, car[borate 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 ail 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 fort'h in the application,f~ therew~t~ Sworn to before me this ~ r t ~0 /" '~/// /,~ ~a' of ~..~..~ 19~..~?.' IMi,,Staeo,~,,w¥ok J~g~'~u-~r~ of applicant) ............ ,.'.~ ........ ~ y ....................... ~'"7~";',' .... ,~;..?~?,~-~,~3, s.~rol~ .~, -- / ~-.-.--~p/ / , '~C~...~res Ma[ch 30, J.~, Notary Public, .~./.~t~../.~,~,~...,~tj~Y.,,P4;,,',"~f¥:'z4::,,""'""~/' ....