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Home My WebLink About2113-z ~o~M ~o. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS F~ERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 2113, Z Dc, re ................. A,~.g:~-t.....9 ................... 1963 .... Permission is hereby granted to: l~eele~.~ek...A.,..-Re ~.g.g.. ...................................... · -..t7...Ne~nover ...Ptaee ...................................... ....... ~e~zv~-~-l.e.~..-~-~-~.~ .................................... to 'B~l'~d'un~w"o~"~m~¥"dweT~ff .................................................................................... at premises located of '~'/'~'"'"~'~'g~14'"~'V~ .............................................................................. . ............................................ ~t~ck~-"'.~'~i- .............................................................................. pursuant to application dated ...~tt:l~t,...~....~.6.~...a~..~,z~¢~l:.....19 ........ , and tipproved by the Building Inspector ~ Bd/ ,&~pe;,8,Z¢ July 8th~ 1963 Fee $"~'~).~' ~0 .......... Building Inspector ~'OWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. NOTICE OF DISAPPROVAL ~ile.~o ............................................................. ,~e ' .....~/ ...... l ............... 19 ~o ..p~..~.~.~..~.....~.// .... ..~..~ ..... 1~ ..... ~. . ~_,.... .~ ............... ./~,..~,~,.~ ,~,j,.~,~ ............ A..,...L.: ............ ,o, ~=,, ,~ ~o,~=~ .~,~.~,~..,f.... ,~ ~,.~ ,,.~,~=~,~'/. - ~ ..~ .................... ..~,~.~p~...~ .................. Map ...... r~tu~nea ~e,ewith ~na aisap~,ovea on the foi]owi~? ~,ou~a~ ...~v':f~.~~ ..... .... ~,~..~...: ............... ~......f..~..~ ..... ~,..~.....~..~,~....(//~.~ ....................... Building Inspector / NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined.... .Z ........ ./.i ........ Approved Disapproved a/c ..... ~: .c'.~.,, .~~ ........................... ........................................ ................... .......................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS o. 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 drown on the diagram which is part of this applica- tion. 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 applica.nt. 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 o Certificate of Occupancy shall have been granted by 'the Building Inspector. APPLICATION IS H.EREBY MA,DE 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, alterations, or for removal or demolition, os herein described. The applicant agrees to comply with all applicable laws, ordinances and regulations. ,, . .... (Signature of applicant, or name, if a' corpor~i~/~) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............................. . .................................................................................................................................... Name of owner of premises ........ ~. .............................................................. If applicant is o. 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.: .g~..'.'.~...$...~....~..!...~...J~... ...... Lot No.: ....t,,..C.~.. ............ Street and Number ~_~ ~--~ GT L~I'~L.~ ~'p~. Ig~.~ tL~ ~...~..'.~. I~y ~ C~ i~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. ~ a. Existing use and occupancy.. ...... ~--.... ....... ........ ..... .... ........................................................................................ .... b. Intended use and occupancy .......-~.....,.~..!.~..~....~... -~ ...... .?~....?..~.....~....~..~...j,..l~.......~. ............... 3. Nature of work (check which applicable): New Building ~ Addition .................. Alteration Repair .................. Remove! .................. Demolition .................. Other Work (Describe) .................. 4. Estirhated Cost .,~..t..~.....~....~....c~.. .................................. Fee ./,~.? (to be paid on filing this application) 5. If d~elling, number of dwelling units ...... ¢.....~......~ ........... Number of dwelling units on each floor If garage, number of cars ..................... .¢......~.......~._ ..... 6. If bL~siness, commercial or mixed occupancy, specify nature .and extent of each type of use 7. Dimensions of existing structures, if any: Front .......... ...":-m_ ............. Rear .,..,.~¢~,,, .................. Depth ~'~ Height ............................ Number of Stories ............. ~ ............... Dimbnsions of same structure with alterations or additions: Front ................................ Rear Depih ................................ Height ........ ~ ................... Number of Stories 8. Dimensions of entire new construction: Front .............................. Rear .............................. Depth Height .............................. Number of Stories .............................. 9. Size of lot: Front ...~...~r.:...~...~. .......... Rear ..t~.....O.. ................ t ..... Dep h .............................. 10. Date of Purchase ....... ..~.....~_....~7'; ......... t..~..,.~.~..'~.. ............ Ne,me of Former Owner /~1 ~,~..o....~.......~...~,...O..2...~....~....~.. 11. Zon~ or use district in which premises are situated ........ .~.~...~...%...!....b.....~.....~...~....!...~.. f2. Doe~ proposed construction violate any Tarring !o.~, ordinance or regulation? .~ ..~.. 13. Name of Owner of premises%~/lrF...~.....~¢...: dress .X.'/...~.~..~..o...¢....~...f~_...~.j, ...... Phone Name of Architect .................................................... Address ................................................ Phone No. Name of Contractor .................................................. Address ................................................ Phone No. PLOT DIAGRAM Locate clearly and distinctly e!i buildings, whether existing or proposed, and indicate all set-back dimensions fr property I',ines. Give street and block numbers or description .according to deed, and show street names and indic whether i6terior or corner lot. I~ C¢~ T'T' ~ 'F O ~ (<, I k-~ ~ ~=- ~- STATE OF" NEW )¢¢ORJ(,,¢ /)1 S COUNTY.%~ .,r .-¢/) ~,,OF ~~ .S. (Name of individual signing appfie6tf6n) e'bove named. He is the ............. ~ .......................................................... (Contractor, agent, corporate officer, etc.) of said owger or owners, and is duly authorized to perform or have performed the said work and to ma¢e and f e application" that ail statements contained in this application are true to the best of his knowled e and belief g that the wCrk will be performed in the manner set forth in the application filed therewith, ' Sworn to b~fore me this, .............. ........... 3 ........ .............................. Notary Public'~.~.~l~ ................. ~,Coun)y ,, (Signature of applicant)