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HomeMy WebLinkAbout1348-zTOWN 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? 1348 Z Date ......................... ~,far.~h.... 29. .......... 19.6]L.. Permission is hereby granted to: Robe~.t...HF~¢.¢...~.C.-G.,-L.,.2% ................................... ........... · S o~¢ho~d.f.....N~..~¥ ................................ to .... ~u~ld...n~w...bu~i~e c~...bu.i, ld&.~ ...................................................................................... at premises located at .~/.~..l~tltt-~'llel..A,~e. ...... ~ .................................................................................. ............................................ ¢~e~t%hei. cl.r.....N~.% ................................................................................ pursuant to application dated ............................ t~I~t~t..-.R~ .............. 19.6~1..., and approved by the Building Inspector Fee $10,00 ............ Building Inspector 3. Nature of work (check which applicable): New,,l~ .................... Addition .................... Alteration .................... Repair .............. 7~,~.Removal,/ ........ , ............ Demolitio~n .................... Other Work (Describe) Estimated Cost~...~ /--- ,~ .~.~, ,~.,o Fee (to be paid on filing this application) 5. If dwelling, number of ~welling 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 ............... i .............. 7. Dimensions of existing structures, if" any: Front ....... .~...~. ............. Rear ........ /.~.- ............... Depth Height ..... /. .................... Number of Stories .:.4~.../.g.:.'~ ........................................................................................... Dimensions of same structure with alteratigns or additions: Front ............ .,~.:...~.. ........ Rear ......... ~... .................. ~[/~- ...../...~ ................................................. / Depth .....~...~.........~.. ........ Height Number of Stories 8. Di;'nensions of entire new construction: Front.,..~.~.....~.~ .............Rear ...~;:'::.~.: ................ Depth ..~..~./'.:'.~' ........... Height ....... J...~,../. ........... Number of Stories ._~. ...................... 9. Size of lot: Front ............................ Rear ............................ Depth ............................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ................................................................................................ 12. Does proposed construction vi~late any zoning law, ordinance or regulation? ................................................. 13, Name of Owner of premises ~."...!....I..~. ................... Address .~.O.. ,~.,/. ,~..~...L...,~.. ......... Phone NO ............... '" Name of Architect ...................................... '~7~,~.//. ~Z'.:'Address ............................................ ~~'~ Phone NO ..................... Name of .......... Phone NO. ~PLOT DIAGRAM [_acate clearly {nnd distinctly oll buildings, whether existing ar proposed~ and indicate oll set-back dimensions from property lines. Give street and block numbers or description according to deed, and show slreet names and indicate whether interior or corner lot. STATE OF NEW~YQ,~K, ~7 ) S S COUNTY OF ........................ .......~......~:]~::]~......~.~.~]]]:] .............. being duly sworn, deposes and soys that he is the applicant (Name of individual signing application) above ......................................................................... ~".""'" ~ ........................... ~ .............................................. (Contractor, agent, corporate of(ice~ etc.) of said owner or owners, and is duly authorized to perform or have performed the ~'~-a~d work and to make and file this application; that a statements contained in this appli~n are true to the best of his knowledge and belief; and that the work will be performed in the manner se~bl~t~lication filed therewith. ., TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Examined ........................................ 19 ........ Approved ........................................ 19 ........ Permit No ............................... Disapproved a/c .............................................................................................. Application No ............................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ............................................................ 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and su6mitted 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 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 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 alterations, or for removal or demolition, os herein described. The applicant agrees to comply with ali applicable laws, ordinances and regulations. (Signature..of ap~ant, or na~, if a corporation) ........... .................. ............................... State wheth,er applicant is owner, lessee, agent, architect, engineer, general contractor, electriciah, plumber or builder. Name of owner of ~- ........................... ., .................. ,....?! ...................................................................................................... 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: ............................................ Eot No: .................... Street and Number Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy .............. St* .............. ¼..,.-;.~..~¢';; ...................................................................................... b. Intended use and .....