HomeMy WebLinkAbout2336-z FOI~M NO. ~
~TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFIC:
$OUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MusT BE'K~PT ON THE PREMISES UNTIL FULL
COMPLETION OF.THE WORK AUTHORIZ£D)
N? 2336 z
Permission is. hereby granted toi
~w~.~h.~.~n~...I~....AZ.¢;~:.~t~on
............ ...South,id,., ........ ;...... ...........................
to ..... ~:kC.. a~.. a~l~, ~ on., cm.. ~r~.,~,s~l~,. ~w~!3~...,..... ..................................... ,..-:
~t premises locoted et ,.:~..~..~.,.9i~..i~.'.~..~,~,*: . ~'~.~ ~ .~.'[~.~. ........................
...................... [... ......... i... ~,~.~.t~ ~,~. a,,~,....so,~;~l,~ ................................
pursuant to application dated ....;.......] .............. ~?"~'.~;......~....J[ ....... 19.6~[i, .dnd approved bY the
Building Inspector
Fee $... ~,~.~0. ..........
............. .... :.....:~ .............................. .7. ......
Building Inspector~
FOI~I NO. I
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Disapproved a/c..... ............
(Building Insp;ector)
Application No .............................
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must be completely fili~d in by typewriter Or in ink and sub.rnitted in duplicate to the Building
~ nspector.
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 part for any purpose whatever until a Certificate of Occupancy
shall have been g~anted by the Building inspector.
APPLICATION iS HEREBY MADE to the Building Depaftn-/en't for th~ 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 buildingsf additions or a Iteratibns, or for rem. qy.ql .Qr_ demolition, as h'erein described.
The applicant agrees to comply with oil applicable lows,
. (S,i~n,~u~r~p/f applicant,;or name, if a corporation)
.... .............
(Address ot applicant)
State whether ap_p!icant is owner, lessee, agent, architect, engineer, generat contractor, electri(~ian, plumber or builder.
..................... ................................................................................. ......................................
Name of owner of premise~.~...?....~......~.~.~.~.'.~ .......................................................................................
If applicant is a corporate, sigr~re of duly, authorized officer.
(Name and title of corporate officer)
1. koc.a¢ion of land on wh~//ropos~e,.~d~w~i!l be d, one. Ma, p N .......
Street and Number~~....:...~...x'..::i.::..;'.;....::i,+.M:..::,..:..~r...~._. ........................
Municipality
2. State existing use and occupancy of premises a~nd intended use and occupancy of proposed construction:
a. Existing useandoccupancy....~/;>~~ ....................................................... '..; ..........................
b. Intended use and occupancy-~.~...~ ..................................................................................