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Home My WebLink About2786-z RM NO. 2 WN OF SOUTHOLD UILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT V V (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FUL COMPLETION OF THE WORK AUTHORIZED) N? 2786 Z Date ........................... .hma.....7............., 19..65. Permission is hereby granted to: Harold ..................... ......Ifttatu*................. ........................... .............................................. ................................. to .....Su3.ld..an..addition..on-.an-•axist no•-buainesa-bul-ldIng............................... ........................................................................... ...................................................................................... at premises located at .....OfF•.8 $.....g ......................................................... ......................................................Wt. #.11 kp... .X«Yw..................................................................... ......................................................... ........................................................................................................ pursuant to application dated ... .................................T=@....4....... 19...65, and approved by the Building Inspector Fee00........... ......: .... ... .�..:{. �� . :.:.... ............... Building Inspector I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. am,ned ........ .?.. ...... , A ,iL./ t~ .......................... pprove ......................................... , 19 ........ Permit No. ~.~., Disapproved a/c ...~ ........................ i ;i ......................... Application No. '~ ?0~-'~ APPLICATION FOR BUILDING PERMIT ............... 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 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 thi.~ 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 pa rt for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY M,~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. / ,~_ (Sig~ure o~ appli,ce~t,,~r-~ame, if ~,corp~,at]~) ..... · ......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises /.~.~.. ~'~?~ .4~ ~~).~,~..¢~-~/~.~. ~ ~ ..~.~...~..,~.,, ~ ... is a corporate, signature of duly authorized officeD (Name and titl} of corj~orate o.~,~) ' o,'~- 1. Location of land on which proposed work will be done. Map No.: ~..~., ~(.~..~./,~ ......... ~ Lot No' . Street and Number ..~..~4~.~:~.....~...~.~.. ..................... ~: Municipblity '' ...... ~""~'J 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction. a. Existing use and occupancy ....~..~fff'...~./.~Z~,,~'~.". b. Intended use and occupancy ....~/,,~...~.,.~.~'.~..~ .............. 3. Nature of work (check which applicable): New Buitding .................... Addition f Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) .................. 4. Estimated Cost ....................... X~....~.~.~.-...~.~.. ............... 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 occupat~cy, specify nature and extent of each typ,e of use .~.. ~.~.~..~.~..~, ...... 7. Dimensions of existing structures, if any: Front ........ ./.~...~..~ .......Rear ....... /..'~.~....~. ...... Depth ............ ..J......~....~?...~' Height ......... /~...: ........ Number of Stories ............... ~.. ............................................................................................ Dimensions of same structure with alterations or additions: Front ......... ,~...~....~ .........Rear ......... ~.....~...~....~. ...... Depth ......... /..~?~...5'.. ........ Height ............ ~..~,~..~ ....... Number of Stories ............ ~.. ............... 8. Dimensions of entire new construction: Front ........... .~...~...:: ........ Rear ............'~..', ..........Depth ........ ./.~...::. ........ Height ........ ,~,~..:m ........ Number of Stories ........ L .................. 9. Size of lot: Front ......... .~...~..~..~. .......... Rear ................~...~.,-~..?.'.... Depth ...Z .~...7 .~.....~.-~.. 10. Date of Purchase... ~~..;~,Z..y~,~.... Name of Former Owner .,~,¢~'.,~..~..~......,,_.~.~,~ ........... 11. Zone or use district in which premises are situated....,~./-,,~..--~',(',,~f.~.,,~'~. ................................................................. 12. Does proposed construct on v o ate any zon ng law, ordinance or regu at on~ ,~.~. 13. N a me of Owner o f p re raises/.'.~'.."2~'~./,-~.. ~'.~ .~'.~t~'It~'d~'s:r......./~2.~..").../."V..../k~). ~).. ~.~?~ ' ~i~ Name of Architect ........................... ..4:. ...................... Address ...................... ./~. ...................... Phone No ........ ..?. ........ Name of Contractor ......................... ~ ...................... Address .................... /~. ........................ Phone No ........ ..?.. ...... PLOT DIAGRAM LocoCe clearly and distinctly a}i 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 Jot. STATE Of NE'~//~Y~/~' ) S S COUNTY OF~/'~.z~"~ff~q./k. ......... ) '' (Name of individu~[/signing appl~atio~ above named. He s the ~.L~........../?.~.~...~../~ ~?~.~'...~... ........................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ...... .................... ,9,f:.... , Notary ll~l~/~8J~ ,.....~.: ~./'~..~, ...:......7~.. ~//~ou nty .... ( S~'~'~~ ................ ........ Residing in Suffolk County / ( /// ~l~rnissio~ Expires March 30, 19