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Home My WebLink About3221-z / ~ORM 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°. 3221 Z Date ........................... ~ep.tembe~..~,..., 1~66.... Permission is hereby granted to: Eaete~.-Su~fo.~..~oo~era~ve...~n~ .... ............... Co~.-.La-~e ............................................. ......................... Catcho~ua ................................. to . .Bund..~n..acaesee~j..bu.l.l.d..~n~..-(.ret rea~c.~ cm.. 6~.. ~duc a~L~na.¥.. ~)el~t.) .......... ct premises located at ..¥//~../~o~../u/arte ............ Ol~te~o~'~.-.]~.~.¥.~ .................................................. pursuant to application dated ..................... S~]3~ ........... 't~' ............. 1966.... and approved by the Building Inspector Fee $..~0~. ............ Building Inspector l~OP~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ....................................... , 19 ........ Permit No ~:~ ~ ''~ I ~ Application No. ~ ''~ ~' / APPLICATION FOR BUILDING PERMIT ~ ~SeDte~ber l~- Dote ..,T~.~m.~.~....~.~ ............. , 196.,.~....~.... INSTRUCTIONS a This opplicahon must be completely filled in by typewriter or in ink and submitted in duplicate to the Bulldin_~ Inspector. b Plot plan showing Iocatton of lot and of buildings on premises, relahonship to adloining premises or public streets o areas, and gw~ng a detailed descnpt~on of layout of propertymust be drawn on the diagram which is part of this application c. The work covered by th~s opphcat~on may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Building Inspector will ~ssue a Building Permit to the applicant. Sucl permit shall be kept on the premises available for inspection throughout the progress of the work. e No budding shall be occupied or used in whole or m part For any purpose whatever until a Certificate of Occupancy. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the ~ssuonce of a Building Permit pursuant to th, Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buddings, addittons or alterations, or for removal or demolition, as herein described The apphcant agrees to comply w,th oil applicable lows, ordinances, building code and regulations. Alta Standiford A/O.....Eaatem~..f31~t'f~lk..g.o.o~era:b±Me...Tmc .............. (Signature of opphcant, or name, ~f a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or builder .................................... ,, p..L z. ........................................................................................................................... Name of owner of premises ....E..~.~.~....~1~.~.g.g.~...C...o..o.~)..~.~.9,~.~.'vj..9. ..... Igo ................................................................... If applicant is a corporate, signature of duly authorized officer. (Nome and title of corporate officer) 1. Location of land on which proposed work will be done. Map No .... ~T,l~J-~ ............................ Lot No: ~ ........ Street and Number ....~../.~.....0..o.~....~.9,~..~. ....... .g...'g..~.g..~...o.[.'g,.e. ........................................................................................ Mumcipohty 2. State ex~stmg use and occupancy of premises and ~ntended use and occupancy of proposed construction: a Existing use and occupancy ..Eaz'~..~8~laoz'...(3~0 .......................................................................................... b. Intended use and occupancy . .s~1~...~/~.~..i~.¢.~e.~.~.Q;z~...J;~1~:~...-....~.~.~$~.~..'~ .............. 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. If 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 ............................................................................................................... Dimensions of same structure with alterations or additions: Front ................................ Rear ................................ Depth .............................. Height .............................. Number of Stories ........................................ 8. Dimensions of entire new construction: Front ............. ~. ............. Rear ...~. ....................... Depth .....8 ..................... Height ........... ~. .............. Number of Stories ........ one ............. 9. Size of lot: Front ............................ Rear ............................ Depth ................................ 10. Date of Purchase ............................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises are s~tuated .......... &....~.~, ...................................................................... 12. Does proposed construction ~;iolate any zoning law, ordinance or regulation? ........ -~O ......................................... 13. Name of Owner of premises .~&s~r,~'~..~l£.£o.]..k..~.&~,~L-~e.-.'~o~...(~~ne No ..................... Name of Architect ..~.o...~.Zt~.].l~.~. .......... Address ........... ~'~O~ ................ Phone No ..................... Name of Contractor ...... ~/'~,~'. ................................. Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all 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 lot. STATE OF NEW YORK, 1 S.S. C -, c? L,: < COUNTY OF ....~'o~1~. ........... t ' ........................ ~L'I ~,..~.~.'li['.Oil'¢l .................................... being duly sworn, deposes and says that h~ is the applicant (Name of individual signing application) above named. He is the ....................~.§eio, t,-.~i~...o~ltl'l.e-I~ ................................................................................................... (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 ~ 0~'~-~. ~ 1~, ................... '1 .~'.. day 9f ............... .i~t, eml~,...., 19...~6 ( S i'~ ~a p'"~t~a~¥~'