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Home My WebLink About1350-zTOWN OF $O~JTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS P'ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 1350 Z Date ..................... ~L%P~3~'"'~O ............... 19.63.... Permission is hereby granted to: R~-eharc~'' Y/bt~fi ~'' '~7'C~'' T~t~66 Z ~h'' ']B'f ff~:J~'' '3'1~ ............. ........... 1~.~'~¥f h'~' ~"'"'i~';'~'; .............................. to ' ']~tt;tTd" '~ ~" ~i~;~'".t"~f~tL'I~' "~_'¢/~TI'i'fi~' ................................................................................... at premises located at '"'~..~f,"'~-'",2]~'~"'"'1~'~':~'~'4~"'~'~' .............................................................. .......................................... '~:t:tt,2.'e'"?e'eon':t.e'"Raa, O:;' ....... Ot~¢e~og~e'f'" ~¢';' ~-'~' .......................... pursuant to application dated ....................... ~'~}1"'"~'~ ................... 19...~:]., .and approved by the Building Inspector Fee $"TO';'OO ......... 'TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ............... Y..~./ ............ ,~....19.~ ..... t~ ~l . ~ 1:~ Approved ........................................ ]9 ........ Permit No ............ ..~_,L~.. f~ ...... Disapproved a/c ................. t ............. ................................... ~...f .................. .: ......... ............................................. ~nspector) Application No..../.2..~.?.?. ........... APPLICATION FOR BUILDING PERMIT Dote ......................... Mar.ah....~.0 ............. 19...~1. .... 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 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 ar a Iterations, or far 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) ............. ~£~.e:ha~ ............................................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... Agent f,e~', o,~n~z~ ........................ Name of owner of premises.....~ol~0~..]~.~...J~ ......................................................................................................... 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: ....~fl~.Rlkl...~.D.J, rJ.~; ........... Lot No: ...~. ......... Street and Number ~L£~.`~e~.~P.e~:~e~.~e~'~t~ae~sa~.?.~.~t~u.~ahc~ue*~ ........................ Municipality 2. State existing use and occupancy of p~emises and intended use and occupancy of proposed construction: a. Existing use and occupancy.....tc/'.~t~..]La~¢1. ...................................................................................................... b. Intended use and occupancy......O...~.~....~...~..~..~...~.~.....~.~.t~..]:.]r..~..~.'~ ............................................................................. property lines. Give street and block whether interior or corner lot. 3. Nature of work (check which applicable): New Building...~ .......... Addition .................... Alteration .................... Repair .................... Removal .................... Demolition .................... Other Work (Describe) .................... 4. Estimated Cost,....~.~,/O0~..]~.~ ................................. Fee ....~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 ............. ~..~1~. .................................................................................................................. 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 ............... t ............................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ Jt'~ ............... Rear ....... ~.~,~14,...Ja ...... Depth ..6~...8 ................ Height ............................ Number of Stories ..... .~ .................... 9. Size of lot: Front ......... 96'"~' ......... Rear ....... S~"*""6 ....... Depth .'1.6~.~.'1)4.b ...... 10. Date of Purchase ............... .l',~(~J~ ............................. Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ........ lt&~..J~l~d~.~d.~.~. .................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? .... ~ ........................................... 13. Name of Owner of premises.~U.a~J;~..]B~e~' ....... Address ............................................ Phone NO ..................... Name of Architect.....(J,...J~,~ ............................ Address ......~.~'~/~1~..~".~, ................ Phone NO ..................... Name of Contractor ........... ]B~'. ............................ Address ............................................ Phone NO ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from and show street names and indicate numbers or descr~t!p~ according to deed, STATE OF NEW YORK, ) S S. COUNTY OF ~'.£~]~, .......... ) ....................................... J~.e~P.~..,~'~t~Tl~ .......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing app~cation) above named. He is the .........~..~O~...O~.~e~ ........................................ : ...................................................................... . (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 o statements contained in this a~ation are true to the best of his knowledge and belief; and that the work will be performed in the manne~ ~.~N application filed therewith. ~., ..,,~, arate of New Sworn to before me th s ~ldin~ in surf0 ,, ~ ~ ! L__J ,44"-4' NOTE: All piers %o be built of 8w ce~en% block, %led Jn%o main walls wi%h duro-~all and stopped betow grade. ApDI¥ a~phal% damp-prooi RIVERHEAD BUILDING SUPPLY CO. 303 OSTRANOER AVENUE RIVERHEAD. N, Y. PLANS ~a~ M~:~. ~' /~'~ ~u~o~-~i~ ~I~.u~F_t=~ NO ~q;~;~ SHEET t t I ~!/3"-~"z'zt ~':', /'%. 25'- S," Ail interior ~oors to be, 1 ~/8' %hick 5 ~helve~. , ' L RIVERHEAD BUILDING SUPPLY 303 OST~'A'~DER AVENUE RIVEIqHEAD. N. Y. I j 'RIVERHEAD BUILDING SUPPLY COi RIV£r~HFAD, N. Y, 'ii I I RIVERHEAD BUILD.lNG SUPPLY 2D3 {IBTf~A'-JDER AVENUE RI','EP. HEAD, N, y. z~,q op ~ DATE 2:d r FL.