The URL can be used to link to this page

Home My WebLink About2914-z FOI~M NO. 2 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.° 2914 Z Dote ......................... O~l~oJ)e~....~. ........ , 19.~.~. Permission is hereby granted to: G~org~..J~l,$~..~/.a ....... ~.~t~ ..P~lq~u~ .................. ................. Cuta~og.u~ ........................................ to ..... ]~.~2,~.. ~¢~.~I...~tle.. £,am;L],¥...d.~e3,].~ .................................................................................. at premises located at ...... ~/~....~..~Jt~..J~':J.¥e ....................................................................... ........................ Lc, ~.. JJ.. ~20~..... P.e d~a~...~e.h. · .P. ar.k~ .......... 8,ouf~h~Id. ...................................... pursuant to applicotion dated ........................... Oe.~ ...... ~/~ ............... 19..~, ond opproved by the Building Inspector Fee $..&OeO0 ......... -- Building Inspector j TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ........................... ~'~ ~. .~ .......... , 19 ........ (~ ~'-- Approved ........................................ , 19....~.~...Permit No .................. Disapproved a/c ............................ ~,.L..~L.::=..~,~. -. 7 · .~¢~r...~.~ ...... .... ............................... .............................. 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 propertymust be drown 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 granted by the Building Inspector. APPLICATION IS HEREBY MADE 1'o 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. ~ ~ ......................... (,~dress of applicant) ~/' State whether applicant is owner, lessee, agent, F~,~,~.neer, general contractor, electrician, plumber or builder· ........................................................ ................................................................. Name of owner of premises .................. ....~...~) ........ ~ ......... ~~ ........................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed ~ork will b~done. Map No: ....~ .................................. Lot No: .................... ~unicipalffy 2. S~ote existing use and occuponc~ of premises and intended use and occupancv o~ proposed construction: o. Existing use and occupancy ................................................................................................................................... ~J whether interior or corner lot. 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. f dwelling, number of dwelling units ............. '/ ............. 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 ............................ 7. Dimensions of existing structures, if any: Front ..........................Rear .......................... Depth ....................... Height ............................ Number of Stories ........................................................................................................... Dirqensions of same structure with alterations or additions: Front ................................ Rear ........................... Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............ ~..~.. ........ Rear ......... .~.....~,. ........... Depth ........................ Height ............. /~. .......... Number of Stories .......... ./. ................ 9. Size of tot: Front ............................ Rear ............................ Depth ................................ 41 ~/~ 10. Dote of Purchose ....... ~.~. ...... ~. ....... .,(...°l..(,¢.f~. ............. Nome of Former Owner .............. 1 ], Zone or use district in which premises ore situoted ............................................................. u ....................... ]2. Doe:s proposed construction violote ony~oning law, ordinance or regulatign?,,~...~, ............................... ~ .... Nome of Owner of pri g .i . ....Address ............ No ................ L.I ........................... ~/~ one Name of Contractor .,...~,&..~...~ ............. Address .~--~4~., .~...~...~.~ No ................ J .... PLOT DIAGRAM Loc~ti~ clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr property Ii,has. Give street and block numbers or description according to deed, and show street names and indic STATE ald NEW YORK, , 1S S COUNTY 'Of ............................... t '-' ,~ ,,~ ....... (~l'~'~ne of individuc~Jsigning application)~l~ ,~, v,~J above named. He is the ............................................. .-~.mm¢~.~.~...~ .................................................................... .~ ..... (Contractor, agent, corporate officer, etc.) of so d ow. nar or owners and is duly authorized to perform or have performed the said work and to make and file this app qation that all statements contained in this application are true to the best of his knowledge and belief; and that the work wi be performed n the manner set forth n the appl cot on f led therew th. Sworn to before me thisL'~' -- ~' ~'~.~¢',./¢z~ ~,, ...... ~-~'.~.... day of .......~ ......... , 19..~..~.. ~.. ?--~"Y~ "~ ' J~ /~,¢-~ ~/,~r~ ~"~^RlO~"A:'rt£c~-m'"'"*~"~"'~"~"'"2/'"'? ........ Y ....;....-,,. ...................... [. ..... Notary Pu'bli~'../.../g~X~.l~/ ...... ..c~... ........... ~,~'~,,~/~m~m~l~X, Sta~e ol '~lew York ~,r~ature at appllcant'l I ' / ~7 ~]o_, 52-3233120 Suffolk C0ulJty'~ Term Expires March 30, 19~_')