HomeMy WebLinkAbout1516-z FO~M NO. 2
TOWN OF SOUTHOLD
BUILDING DI~PARTMENT
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? 1516 Z
Permission is hereby granted to:
Hat ol. ~l...R-,...~e eve'. '&'. ~ e.ns...~/.~.-~-, ~,~.I~a~.i.t-¢on
...~a~ti.tu~k .......................................................
to... Bu.~.ld...a~ .. ac~ d&t .ion...o~ ·. a'nt>~.~s.~.n~, s s..~ui:l.~t.i.ng .........................................................
at premises located at ~g.~Q~..~.~. ....................................................................................................
......................................... ~a ~.t .i.t~¢.k .................................................................................................
pursuant to application doted .................................. ~.~§~J~.....~0 ......19~...., and approved by the
Building Inspector
Fee $..~.,, O0 .............
Building Inspector /
/
FORI~[ NO.
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N, Y.
Examlned.,,,~,/,, ¢, ,..~.,~..,.~.. ~;? .............. 1 ¢) ........
Approved ........................................ 19 ........ Perm,t No. T...~..;¥.J.....i
Disapproved o/c / '~' --'-
............... ...... ;....%....: ........................
'(Building I~cto r)
APPLICATION FOR B~ILDING PERMIT
Application No ................. '; ...........
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 end 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 location.
c. The work coy, areal by this application may not be commenced before 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 port for any purpose whatever until a Certificate of Occupancy
shall hove 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 o Iterations, or for removal or demolition, os hereia described.
Zhe applicant agrees to comply with all applicable lows, ordinances and regulations.
H~rold R. Reeve & Sons, Inc.
(Signature of applicant, or name, if o corporation)
Main Road, Mattituck, N.Y.
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
General Contractor
Stephen B. Hamilton ''
Nome of owner of premises .....................................................................................................................................................
If applicant is a corporate, signature of duly authorized officer.
HaroZd R. Reeve, Jr., Vice P~-eaident
(Name ond title of corporate officer)
1. Location of land on which proposed work will be done. Map No: ............................................ Lot No: ....................
Legion Avenue~ Mattituck, N
Street and Number
Municipality
2, State existing use and occupancy of pr, emises and intended use and occupancy of proposed construction:
Potato Packing Shed
a. Existing use and occupancy .............................................................................................................................. ;i .....
b. Intended use and occuponcy ................................................................................................................................
., . .... ~: New Building .................... Addition .................... Alteration ...............
~ ...................... Removal .................... Demolition .................... Other Work (Describe)
4, Estimated Cost ....... .~..],~.0..',,0.0.. ..................................... Fee ....~.1~..'..0..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 ..............................
7, Dimensions of existing structures, if any: Front ...... ,7 .................... Rear ,.,~,,.O-I. .................. Depth ...~'. .....................
1' 1 .....................................
Height ..... ,0, .................... Number of Stories .............................
Dimensions of same structore with alterations or additions: Front ..... ,~..~,,.~..~. .................. Rear ................................
Depth .............................. Height .............................. Number of Stories
Roof only 31' . . 9'
8. Dimensions of entire new construction. Front.....,~ .................... Rear .......................... Depth
Height ' ]'01 Number of Stories
9. Size of lot: Front ]'l~tl'l Rear 1~0~ Depth
10. Date of Purchase ........................................................ Name of Former Owner ........................................................
11, Zone or use district in which premises are situated ................................................................................................
12. Does proposed construction v~e~[,l~'~ ~p~ing Iow, ordinance or regulation? ....................................................
llama. ~ ~"~ Address ~&~&~;~k Phone NO
13. Name of Owner of premises ............ .~.~.~,,.' ...................................................................................
Name of Archite~t ...... ~,,, .......... ,.~ ............ ,, .................. Address ............................................ Phone NO .....................
Name of Contractor .................................... II~, ....... Address .........~..~..~..~...~..~...~..~. ................ Phone NO...~....~. ...
PLOT DIAGRAM
Locate deorly and distinctly all buildings, whether existing or proposed, and indicate all set-back 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.
,,I
STATE OF NE~ Y_~R,~,~ ~. ~ : q q
COUN. T~ O P~'~¢~-/'.,
(Name of individMI si
above named. He is the .......... ~~~ ...........................................................................................................
(Contractor, agent, corporate officer, etc.)
of said owner or owners, and s duly authorized to perform or have peffbr~¢d the said work and to make and file
this epplicatlon; that all statements contained in this application are,,f'rueW~o the best of his knowledge and belief;
and that the work will be performed n the manner set forth in fhe~agp~i¢ filed therewlt~
Sworn to afore me this