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Home My WebLink About2600-zFORM ~0. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ,~OUTNOLD, N. Y. Approved ........................................ , I¥ ........ etmlt 140...~f;.. ......................... APPLICATION FOR BUILDING PERMIT Dec. L~th, 1964 Date ............................................................ , 19 ............ INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to th· 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 propertymust 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 af 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 %~,sd~adl, have been granted by the Buila~.l~f~j~eef411r.'W-~i~ APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pumuant ~uilding Zone Ordinance of the Town of Southold, Suffolk County, N~ York, and other applicable Laws, Regulations for the construction of buildings, oddities or alterations, or for removal or demolit on, as The applicant ~rees to comply with all ~plicable laws, ordin0nc~, build and regulc . (Signature of applier, or name, if a co~omti~) ~/. ~ddre~ of applicant) j?~tate whether apphc~t ~s owner, le~, agent, amh~tect, engraft, g~eral contractor, el~tnman, plumber or .................. ............... ,., ............ ....................................... Name of owner of pr~e~ se~~:~:~.~ ................................................ ~ ...................... If applicant is a corp~ate, signature of duly authorized officer. .................................... ............................................................ (Name and title of co~orate officer) Stre~ and Number Cap~. K[~ ~s~a~es ~ Ha~c~ N.~. Municipali~ 2. State existing use and ~cupancy of premises and intended use and ~cupancy of pr~osed construction: a. Existing use and ~cupancy ...~.~ ................................................................................................................ b. Intended use and occupancy ...... ~.~.~.~.~ ................................................................................................ FORI~ NO. ~ 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? 2600 z Date .................. J)~CRl. ll~er~' .......~.. ............. , 19.....6~... Permission is hereby granted to' ...... .......................................................... ........... ~ _,,:L~t~t.o~ ..... ~,.L .............................. to ...~B~.t4..~e~..m~e.. £m~:L:F..~l~eXa,~uag... ' at premises located at .~.~j~.~ ~Jl~..~t.-6~ - ]~LOI:J~. J~t..~l~pt..J~L~(~~e~L~ll~t~te~ ..................... .............................. ,T~Le~..~.f,~.. &.. r, oana..~. ~ ................................................................ ...................................................... ~at~._~__~ .................................................................................... pursuant to application dated .... .(Ig~.el~dl~) ........ ])/aet~ ..... .l~ ....19._~.., and approved by the Building Inspector ! ~O't.41 i l~tbaek ~uet tm 3~£t ~tni~m fro~ all st,~eet :Libel Fee $...'1.~4:X~ ......... ~~ d ng Inspect r 3. Nature of work (check which applicable): New Building ........ .~.. ....... Addition .................. Alteration ................. Repair .................... Removal .................... Demolition .................... Other Work (Describe) ..................................... 10.00 4. Estimated Cost .......$,1,.0. ,.0.Q.0. ., .................................. Fee .......... .~ ............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ..4m~ .................. Number of dwelling umts on each floor ........................... If garage, number of cars .......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................... 7. Dimensions of existing structures, Jf any: Front ..........................Rear .......................... Depth .......................... Height ............................ Number of Stories ............................................................................................................. Dimensions of same structure with alterations or additions: Front ................................ Rear .............................. Depth .............................. Height .............................. Number of Stories ........................................ 8. D~mensions of entire new construction: Front ........ $~ ............... Rear .......... 3~ ............. Depth ....... 2.8 .............. Height ane-.s~ar.y ....... Number of Stories ...... ], .................... 9. S,ze of lot: Front ...7.2.,,B.8. ............. Rear ...... .7..~,.,.~Z .......... Depth .......2...2...1.:..Z..~...~...s..1;..erly line 260,32 10. Date of Purc~a's'e'::...~.L~l.~4:..~..t..~.~l..~%,.Lq.~....ur ...... Name of Former OwnerJb~m%¢.Fa.~JX't.k~-.____ .................. I1. Zone or use district in which premises are situated...~a~.t,;L'c,,.~,Jc.,...~...Y..(..~..~.~...N......~..~...~.~..~.~.~ ....................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... ~Q ......................................... Owner of ~remises wilhelm Lghr Address189 Woodhull Ave. ~, N~A.....7..~'..2..3...1..7. 13. Name of ~ ................................................................................. ~none Archite(ctcontractors plans AH4~--- Rt. 58, Calverton ,,, PA 7-231 Name of ............................................................. ~ ............................................ I~none No ................... Name of Contra~or I2kL & R & H Bldg. ~rp~. ,, Rt 58 " " .................................................... ~aaress ............................................ Phone No ................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fro, property lines. Gwe street and black numbers or description according to deed, and show street names and indical whether interior or corner Iot.co~ner lot, par t of lot No. 63 and all of lot # 62 Map #1672%.q_apt. Kidd ~statas Mattituck, N.Y. -~- \ 1 ~k~~' PART OF LOT 6~ ~ , . kX' ¢ LOT 62; cc~') ~ W~Zhe~m ~h~ ~ . being duly e is the applic (Name of indwidual signing application) 0~ above named. He is the .................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and is duly authorized to perform or have performed the said work and to make and th~s applicahon; that all statements contained in this application are true ta the best of his knowledge and bel and that the work will be perform~ in the manner set forth in the application filed therewith. Swam to before me this ............... .... ....... ....... ......., / ' / .......... ~Signature of app~cant) .U: ....... : ........................ Nota~ Nota~ ~bllc {n thc State o[ New YO~ ~3 8 ~ 90