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Home My WebLink About3266-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 3266 Z D- October 13 ~9....~.... Permission is hereby granted to: ..... ~.~z..~.,... ~?..=.?..z..~..... ~.C......~.t..Z..~?.d....~.....~u~ ................... ~a.tt£t~ ...................................... to .. J~t~ ..naw...prA~ata.. gara§a..&..attach...to...e~t at lng.. dwalLt r~ ..................... at premises located at ....S/.S.....C~..latar...qt~.&..r./$.av~a, to~ka..l~ ...................................... ....................................................... .Nat :l:~tuck~ ................................................................................... pursuant to application dated ..............~.p~. ....... ~ ........................ , 19~..., and approved by the Building Inspector. approved by Bd appeals Fee $...~.~.00 ............ Building Inspector FO~M NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUT.O,D, N. Exam,ned ..... ~......~.... · ..'~... ..... 19...~....~· Approved ........~....../'...~.. ....... , 19.~'...~...Permit No.....~.....~.....~.......~....~ D,sapp roved a/c ..... ...~../.,,~...~.......~.......~........~~ ........................ (Building I n~{pector) ............ Application No ........................... APPLICATION FOR BUILDING PERMIT Date ..... ~~...........~.....~.r. ....................... , 19..~.....~... INSTRUCTIONS o Th~s apphcahon must be completely filled in by typewriter or ~n ink and submitted in duplicate to the Buildin Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets c areas, and giwng a detailed descnphon of layout of propertymust be drawn on the d~agram which is port of th~s applicatior c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d Upon approval of th~s application, the Building Inspector will issue a Building Permit to the applicant. Suc permit shall be kept on the premises available for ~nspection throughout the progress of the work. e No building shall be occupied or used in whole or m pa rt For any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance oW a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulohons, for the construchon of buildings, additions or alterahons, or for removal or demolihon, os here~n describe, The apphcant agrees to comply w~th all opphcable laws, ordinances, buildm~g code and regulations. (Signature of applicant, or name, Jf a corporahon) ' (Address of appli~nt) ~, ~ State whether~owner, les~~gineer, general contractor, electrician, plumber or builde Name of owner of premises ................. ~ ......... ,.~....: ......................... If applicant is a corporate, signature of d~ly authorized officer. - ' (Name and title of corporate officer) 1. Locahon of land on which proposed work will be done. Map No .............. : ....... ~ ..................... Lot No: .................. Street and Number ..~~...~......~..c~.....~...~,~..., ..... .~.~~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed constructionl. a. Existing use and occupancy ............................................................................................................................. b. Intended use ond occuponcy ........ ~..'~. ............ : ..................................................... 3 Nature of work (check which applicable): New Budding ..... ..~-,-xcC......... Addition .................. Alteration ................ Repair ................... Removal .................... Demolihon .................... Other Work (Describe) ..................................... 4. Est,mated Cost ...~...../.~.~.....~.....Q.......a~...--'~ -- .................... Fee ......................................................................................... ~' / (to be pard on fihng this application) 5If dwelhng, number of dwelling units ............................ Number of dwelling units on each floor ........................... If garage, number of cars ............... ~...~....(~...., ............................................................................................... 6. If bus~ness, commercml or mixed occupancy, spec~f~nature and extent of each type of use ............................... / "~ ~' ' r) ..~...~... /O 7. D,mensions of ex,sting structures, ,f any: Front ........ .~.../......~.. Rear ..... ~<....~,....-.;r... Depth .... ........... Height ............................Number of Stories .............................................................................................................. D~mens~ons of same structure w~th alterations or add,hans: Front ................................ Rear ............................... Depth ..............................Height .............................. Number of Stories ........................................ 8. D,mens,ons of entire new construct,on' Front .......... L..~........~..... Rear ....../....~....'..U ....... Depth .... .~....2......~.. ..... He,ght .../~..~,~..t...~. ......... Number of Stones ........ ~.. ................. 9. Size of lot: Front .... Z~../..!..[..Q... Rear ..... /....~.../...'../JC). Depth ..... ./...~..~.....'.1~.. ...... , ~ 11 Zone or use dmtrlct in which premises are situated ..................................................... ~. ............................. ' ........... 12. Does proposed construction violate any zoning law, ordinance or regulahon? .......... .~..: ............................... 13 Name of Owner of prem,ses ././~! ..~ddress~ .................... o ................... Name of Architect ...................................................... Address .......................... ..... ............. Phone No ................... Name of Contractor ..~J.~')J-~.....l~'~.~.~...Address ~.Z~...~..~..C...o..;,.,m~<~......J~ Phone No ~..~....~.~ PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exmtmg or proposed, and indicate all set-back dimensions trot property hnes. Give street and block numbers or descnphon according to deed, and show street names and radical whether interior or corner lot. STATE OF NEW "/~ORI~,/') ......................... eng duly sworn, deposes and says that he is the applic~ (Name of individual s~gmng apphcation) above named. He is the ..................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the smd work and to make and thts apphcation; that all statements contained m th~s a.pplicahon are true to the best of his knowledge and bell and that the work wdl be pe~rformed in the manner set torth in the application filed therewith. Sworn to before me this ................. z,., 5: ..... .. ........ Notary Public,/.~ff.~.~~G~~~ature of apphcan,) t0~ s~ttaL~ ~"' ' ' ...........