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Home My WebLink About1732-z FOI~M NO. 2 TOWN 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°. 1732 Permission is hereby granted to · ..~.?....~...z.~.,...,... ~./..e....?~..~ ......... ~ugm~es ~oad ~u~, ~ Yo~ ~e h~se ~ va~ at premises located at ~i/~J JJ~Ue~h~ BO~].~l~&~d, IJ~o'ld~ ]J~ 'J~O~'k ............ ; .............................. ~.u. ~.h....~..~...~..~...~.s.: ............................................................................ pursuanf to application doted . Jl~y :2 62 ......................................................... 19 ........ , and approved by the Building Inspector Budding Inspector FOKM NO, I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved ................ ~.~...~....., 19..~...~-P. ermit No ....... ~..z(.~..~.~. ..... Disapproved a/c ............................................................................................ (Buildin~ector) Application No. APPLICATION FOR BUILDING PERMIT 19..~-$. Date 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 Ioca¢ion of lot and of buildings on p remises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on thediagram Which is part of this application. 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 pa rt 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, as herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. Name of owner of premises ........... ~ ............ ~..'.~ ......... .~..C.~..~/ ............................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on wh ch proposed worl~will,be done Map No' ~ ~,~ ....'~..~ Lo, No' 1. Street and Number .....~..~ ........ Municipality 2. State existing use and occupancy of premixses and intended use and occupancy of proposed construction: am Existing use and occupancy ............ .~../..~ ~..~.~f..~... :'..~.?.~ .................................................................................... b. Intended use and occupancy ............. ........................................................................................ 3. NaCure of work (check which applicable): New Building .................. Addition .................. Alteration .................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) .~S~.,...~'~...,~/e~, 4. Estimated Cost .......... ~.~.~.O.. ....................................... Fee ..... ./~,~..~ ...................................................................... (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 natureand extent of each type of use ................................ 7. Dimensions of existing structures, if any: Front ........ ~ ............. Rear ........ ~..~ ............. Depth ..... ./.~. ..................... Height ........ Z.~. ............... Number of Stories Dimensions of same structure wi}h alterations or additions: Front ............... ~(). ........... Rear ....'.~.~. ...................... Depth ........... L~.. ............ Height .......... /..~.. ............... Number of Stories ........ ,~. ............................ 8. Dimensions of entire new construction: Front .............~.(-/ .............. Rear ........ .~'....O. .............. Depth ........ ./.~...~ ............ Height ........... ~. .............. Number of Stories ........... /..~ ..................... 11. Zone or use district in which premises are situated ............... ~ ................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation? ...................................................... 13. Name of Owner of premises ...~.J~.../~' ................... Address ..(!..~.~?'.~....~9..~.~.~...~.¢.?..~.*/m~ione No..~.(..~...(...Z..?...~ Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ...~,~.¢.....~.j~.~..C~; .................... Address ..~.~ff~.~:~....~,. ~)~%~...c. ..... Phone No..i.~..~..~.l?.!..o.... PLOT DIAGRAM Locate clearly 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. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorjrT.~J,t~ i~l~l~l~rm or have performed the said work and to make and file th*s apphcat on; that all statements cc~t~rl~j~i~t~ft~f f~L~ljogkat~on are true to the best of h~s knowledge and belief; and that the work will be performed in~2~rS~k~ in the application filed therewith. Sworn to beforp me this 68mmi~si0, Expires ~arch 30, 1~.~ Notary Pub ,c,~4~Z..~....~~...~ ~"~;oture of oppl,cont)