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Home My WebLink About2095-z TOWN OF BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS P~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 2095, Z Date ...................... .~ne..-..~O ................ 1963 .... Permission is hereby granted to: ~ta~l~y..... H~.r.~.~ ................................................ ...... ~/'~-t~al'~h. --Ave ............................................. ........... Gl~ee~tpo~.~...~..T., .................................. to...ttu~t.t'd...an .. adcl~ t,/:or~ ..or~. · a-ri.. ~x/:~t~:,g - -d~ce t~g ...................................................... at premises located at ..~/~...-.~.t.~r~ar,~h-..Av~ ................................................................................. ................................................ Gr~enpor t.~.'.'..l~-¥'~ .......................................................................... pursuaM to application dated ............................. ~:~t~e ....... ~ ............. 196;~...., and approved by the Building Inspector Fee $. ~:~.OO ............. Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOI. D, N. Y. Approved ........................................ , 19 ........ Permit No .................... (BuildiWg Inspector) APPLICATION FOR BUILDING PERMIT Date ........................ J.~'t~.... 20...~.. ~ 19.6.~ ........... INSTRUCTIONS /., ~.. a. This application must be compIbtely filled in by typewriter or in ink and submitted in duplidat~ to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises o~l~ublic streets or areas, and giving o detailed description of layout of property must be drown on the diagram which is port of this application. c. The work covered by th~s apphcahon may not be commenced before issuance of Building Perm~, d. Upon approval of this application, the Building Inspector will issue a Building Permit to ~he'i.applicont. Such permit shall be kept on the premises available for inspection throughout the progress of the work.', e. No budding shall be occupied or used ~n whole or m pa rt for any purpose whatever untd a Cert~f.qq~e of Qccupancy sha have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of o Budding Permit t~ursuogt to the Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other opphcoble Laws, Ordm~ances or Regulations, for the construction of buildings additions or alterations, or for removal or demolition, as Fi~erein dbscribed. The opp cant agrees to comply w~th all apphcable lows, ord~nanves and regulations. ..S~a~!e~;....~a~.t.~. ......................... ;.....,: ............... ~ .......... ~3ignarure o~applicant, or nome, it a ~orporatiol~ ......... · W.ilm~.th...A~, .......... G~4.en~..L. I,.. ......... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician,.plu~,ber or builder. ..................................... o.~n,~..,-...bu$1de~. ......................................................................................................................... Nome of owner of premises ...StanleT.....Har~iS .............................................................................. i'. ............................. 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: -'~J~l~ ............................ Eot No: ..~110'~, ....... Street and Number .~/~;.....W.~.~maiC.¢~..A.~.e,.1~ ........I~.e~n~0o~'.¢~...~,.~', ............................................................. Municipality State existing use end occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ]QW~I] ~ .............................................. b. Intended use and occupancy " Wi~h ~ a~di~io~ 3. Nature of work (check which applicable): New Building .................. Addition ...~*~O[ ..... Alteration Rept~ir .................... Removal .................... Demolition .................... Other Work (Describe) ......................... 4. Esti~nated Cost .................... ~ ...................................... Fee .......................................................................... ~ ............ (to be paid on filing this application) 5. If dwelling, number of dwelling units ........ .~.~.e. .............. 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 Dinjensions of existing structures, if any: Front .......................... Rear .......................... Depth ..... 7. Hei.ght~ ............................ Number of Stories ...... ~. ' Dimlensions of same structure with alterations or additions: Front ................................ Rear ........................... Dep'th ............................ Height ................................ Number of Stories ........................................ 8. Dimensions of entire new construction: Front..,....~'l!.P/M ............ Rear ......~,.I...~,/M ..... Depth ..,..~.8 ........... Height ............................ Number of Stories.,.,,.Ol'Ll~ ..................... 9. Size of lot: Front ....~LO0 ..................... Rear ............. ~100 ........ Depth ....... ..~.0..]~/.1~1 .............. 10. Dat~ of Purchase ........................................................ Name of Former Owner 11. Zon]e or use district in which premises are sltuated~ ........ A,.....~.~5.t, ................ 12. Doe~ proposed construction violate any zoning law, ordinance or regulation? ....... 110 ................ 13. Name of Owner of p, remises ...~..e...~lgT'.~.~,~. ............... Address ..... Gr.qf~rtpo,~..~ .................. Phone No. # Name of Architect ...................................................... Address ............................................ Phone No. Na~e of Contractor ......................... .". ........................ Address ............................................ Phone No. PLOT DIAGRAM kocat~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property Ifnes. Give street and block numbers or description according to deed, and show street names and indk whether interior or corner lot. STATE OF NEW Y,.OR,~ ) COUNTY OF ...... ~_~..~L-~.¢~.~.....) S.S. ............... J ................. ~.~.~.~.~e.~.......H..~?..~.~.i~. ....................... be ng duly sworn, deposes and says t~at he i~ the app[icc (~.ame of individual signing application) ~ above named. He is the ........... ~..~..~de~.. ~' , (Contractor, agent, corporate officer, etc.) of said owher or owners, and is duly authorized ~ ~erform or have performed the said work and to ~ake and f this applicbtion; that all statement~O6~i;~J~t~ft~j"~ ~lication are true to the best of his knowle and bell and that the work will be perform~l~~k~n~t~ in the application filed therewith. ~ Sworn to blefore me this Nom~tssion ~xpires March 30, lg~ / ~ ............. i ....... . ,, .~/ ~ .~L..~.,:~: .......... (.~...~,.....: ........................................ .... , :t _, ..... ,,, TOWN OF SOUTHOLD Building Inspector's Office Town Clerk, Building $outhold, N.Y. 765-2560 BUILDING DEPARTMENT T~N cLERK's OFFICE ~UTH~D, N. Y. ........................................ , Dimppr~ved a~, (Building In~ctor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewrit~er 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 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 o Building Permit pursuant to the Building ~one 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. q'he applicant agrees to comply with all applicable laws, ordinances and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................................... c~W~,~...m..'~..cl.e.~, ........................................................................................................................ Name of owner of premises .S...f<.a...~..~..e.Z ,~..,a.,~,?. ~,s. . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Location of land on which proposed work will be done. Map No: ..... ~ ............... ; .......... Lot No: ....~ ...... Street and Number ...S/~....~,t,].[0~Z~.t3..~,.l/.~.,..j ........ P~.~..~..~.p..o.~..t.~....~.....¥.:. ........................................................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ...g...~.~.~..]:.$...qj[......~ ....................................................................................................... " with an addition b. Intended use and occupancy ............................................................................................................. ~ ................... 3. Nature of work (check which 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 ........ .o...~..e. ............... Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify natureond 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 ......i+.l}....~/4M- ..... Depth .....2~. .................. Height ............................ Number of Stories......O~e ...................... 9. Size of lot: Front ...~l,~).0. ..................... Rear ............ 'J0~). ........ Depth ......... ].~-0..~.Z~ .............. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated.......?..A..l!....~..~..D..~.. .................... ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~ ........................................... 13. Name of Owner of premises ....~.:.....~...e..~?..~.s. ................ Address .....~..~:~.T~.0~.~ .................. Phone No ..................... Name of Architect .......................... .?. ......................... Address ............................................ Phone No ..................... Name of Contractor ........................ !! .......................... Address ............................................ Phone No ..................... PLOT DIAGRAM locate clearly and distinctly oil buildings, whether existing or proposed, and indicate oll set-bock dimensions from proper~ lines. Give street and block numbers or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y_OP~, ) couNTY; OF ..... ..~.~.~..9..1..~......) S.S. .................... .~...~.~..t't..~. e.~.......~...~.~?..~...c .............. be ng duly sworn, deposes and,says that he is the applicant (Nome of individual signing application) above named. He is the ........... ~.~....-...lq~J.].cte:~ .......................................... ............................................................ !i:~ ~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly_a_u.th, prj~to ~erform or have performed the said work and to make and file this application; that oil stote.m, en_l;~'li~t~' application are true to the best of his knowledge and belief; and that the work will be perf~j~'.~",~-,~t/f_.grth in the application filed therewith. Sworn to before me this ~ssion Ex.' ' ............... ........ ................................. N°taryP~bl'~'"'~~~'~"~"~'T ~ - / (Signature°fopplicant) ___