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Home My WebLink About1344-zTOWN OF $OUTHOLD 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? 1344 Z Date ........................... ]/&rch..29 ............ 19..~1. Permission is hereby granted to: -.- ~.u-t-~%o~,~-.. ~e~..-York ............................... to... bu.i.~d., ne~..0ne ...f&m~.l.y.. ~lwe~.l. in~ .................................................................................. at premises located at ..~:~r~s.ed..~;~d~..nf:~...~`n~..Vie~..Av..~.~...~i~...q.~.~.~.~.r..~.~...La~ ....................................... i~ou'tho!di-'"New"¥o~k .............................................................................. pursuant to application dated ................................ llt~iE'i~h-..2~ ............19...61., and approved by the Buildin9 Inspector Fee $..1.O.llO...Check paid TOWN OF SOUTHOLD BUILDING DEPART/vt ENT TOWN CLERK'S OFFICE SOUT,OLD, N. ¥. Examined ........... ~..~:'...... 19 .~'~....z~'. Approved ............ ~..~¢~..~.~G. 19.(/~.~...Permit No ......... ¢~.~.~..~.~..~'... .... Disapproved o/c ..~.::~ ........................ ~... ......... ............ (Building Inspector) /¢',//~' -- Application No...~..'.~./..~...~... ........... APPLICATION FOR BUILDING PERMIT Date ................................... 19 ........... 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 commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to tbe 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 issuanoe of a Building Permit pursuant to the Bdilding' 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. Thb;bpplicant agrees to comply with all applicable laws, ordinanc~nd¢ regulatlons¢-'~'~-~ .,4 (SigngtUt'e of appILcant, or name, if a corporation) .............................. ...................... State wheth.er(;0~plicant is o2~nerK'r]~ssee, ,~.~-~t, of~TE~f, engineer, general contractor, electrician, plumber or builder. ....................................... ~ ............................................................ Z,...z~t ............................. '~'i"n~i '~; owner of premises.....~..:...~.....~.:...:i: If applicant is a corporate, signature of duly authorized officer. 1. Location of land,c~wF~i~h proposed w~,rkr~ilJ~be dooe. Map Nj~: ~..;)..:..:,; ....... .r/.~........~......:.l,.~ ~qo,~: .........~.~.'....,~ Street and NumlY~r ........... ~.. ........................................................................................................................................ Municipality 2. State existing use and occupancy of p~mises an~)in~' use and occupancy of proposed construction: a. Existing use and occupancy ............. [J.' .................... Z~..~.~. ............. ~ ................ ~....,¢'..../~. ............................................ b. Intended use and occupancy .................................................. [ ......................................................................... 3. Nature of work (check whlch applicable): New Building .................... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost ........... ./...,.~...~ ....................................... Fee ....................... ,~..,.~...:..~ ................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ......~ .................. Number of dwelling units on each floor.......c~...~Z...~ ...... 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......~...:~ ............ Rear ...... ',~..~.../ ............. Depth "~"'~' ............... Height ...... /.(~.../. ............ Number of Stories ..... ff~.'~..~:;r;::., 9. Size of lot: Front ....... /...(~..~...~. ..... Rear ..... /..~..~ ........... Depth ..... ./...~....~ ..... ~ ._~,, 10. Dote of Purchase ..~...,0~..../...~...~ .~... ..................... Name of F?mer Owner .....~...:.....J~.~. ..................... 11. Zone or use distri~in-'~hich premises are situated....C~~,zi~..t~-i.,~..% ................................. 12. Does proposed construction violate any zoning Iow, ordinan~qe, or regulation? .... ~..."~.. ......................................... p r e m i ses'},~.: .~. J~¥.~.~. ,./i.)~.~dd r ess 13. Name of Owner of ~~....~..%~...: ...... Phone NO ..................... Name of Architect ........................................................ Address ............................................ Phone NO ..................... Contractor...~.i~-~,,,~,~;. ......... Address ~"~- /~ - ""-' /~ 'V, Name of ..~.~: ........... ~....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 b~ock numbers or description according to deed, and show street names and indicate whether interi,or or corner~Jot. ~ STATE NEW YO~'I~,~ ~/ ) S ~ COUNTY OF ..... ~z~4~,~'~'~..'.f~. · ) ........................... ~ ........................ being duly sworn, deposes and soys that he is the applicant ~di~cotion) above named. He is the ...... ~~~ ................................................................................................................ (Contractor, agent, corporate officer, etc.) of ~aid 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 ond belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to befo~ me this " ' ~ D T~ ~ day o~ ~(.~,,,.~-;~,../~Jt,,; .................. ,' 2 .... ~?~-~ ,¢.,-~ Z' ;~o. 52.0344963, Suffolk Nota~ Public, .,~f,~.~,f";~;/:~-:~f~....~:;.:;~'.~~ ~,c~,