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Home My WebLink About3019-zTOWN OF ~O~ITHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No ............................. Disapproved o/ c ....~~ No. ,' ? APPLICATION FOR BUILDING PERMIT Date Naz'eh 21 .6..6.. ............................................................ ,19 ....... INSTRUCTIONS a. This application must be completely filled in by typewrit_er 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-descripfidn of laybut of p~operty must be drown on the diagram which is port of this bpplication. 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 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 or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder, Name of owner of premises ..~.z'~r~..~e.~.m~z~t,..~,A....,A2:~u;~...~,u .................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ......... ~ ....................... Lot No.: ...iIEIEIr. ............. Street and Number ~.~.....]~[~...~e.....,..~ia/cfgS,t,~ .............. t .............. i~:~ ................ ~ ................................ Municipality 2. State existing use and occupancy of premises and intended use a~d occupancy of proposed construction: a. Existing use and occupancy ...~.;[D,~I.~,.~II~,~.Dg ....................................................................... : ........ ; ..... b. Intended use and occupancy ........ ~.ll~.~....~..~.~..~1,..&~:;I.~51,~Xl ..................................................................... F~ 3. Nature of work (check which applicable): New Building ,,~ ............... Addition ..XXX. ....... Alteration .................. Repair ...~ .............. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ....... ]J~,~'...l~.~ .................................... Fee ...~ ....... ~ ............................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units .......... J ................. Number of dwelling units on each floor ............................ If garage, number of cars ................................................................................. t ............................................ ..,-.,,..;-... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .~13~lD, el~...:.,. 7. Dimensions of existing structures, if any: Front ...................... i ..... 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 ...C/ ......... .'. .................... Rear ........ 9 .................. Depth ....:1~..~ .......... Height .................... Number of Stories ...Se ................................................................... ~.~~.~-- .............. 9. Size of lot: Front ........ ~ ................... Rear .................................... Depth ................................ 10. Date of Purchase ....................... ; ................................ Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated ....... ."..B...a.....~.~.s..t:} ........................................................................... 12.'~ Does proposed conStruction Violate any zoning law, ordinance or regulation? ...................... :...De ............................. 13. Name of Owner of premiSes ...JLl:u::ho:...I~:l ............ Address ........ Ma:~l;:L.t~,,Ir .............. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... .................................................... Address ............................................ Phone No ..................... Name of Contractor same PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back property lines. Give street and block number or description according to deed, and show street nan whether interior or comer lot. I :limensions from ms and indicate STATE OF NEW YORK, ~ t c c COUNTY OF ........ I a Z lk ...... ........................ ~I,~n..,I~],~,&~LI~A ................................... ..,.being duly ~rn, d~s a~says he is the applicam (Na~ of i~vI~ol signi~ a~li~a~on) a~ve name. He is t~ .............. ~e~..~..~ ............. : .......................................................................................... (~tmctor, ag~t, co~omte officer, ~c.) of said ~r or ~ne~, and is .duly a~horized to peH0rm~o~ have perfo~d t~ ~id w~k ~ to ~e ~d file thi~ application; ~t all statements contoin~ in this ~plicati~ am t~ ~ the ~st of his k~wledge a~ belief; and that the work will ~ ~or~ in the ~nner Set 'fo~ in the a~lic~i~, fil~ th~ewith. J ~ ~ S~m to ~fore ~ ~is A I II II 21 9 66 6~ ~ ~ ~ ~ ~ ...... ~...~.~..~.~..~:: ..... ~...~.~ ....................... ~m,~ioA ~pims ~arch 30, J~/ ~ ~, ~ ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES.UN~FIL FUlL COMPLETION OF THE WORK AU:THORiZED) N°'3019 Z Pate...,..,.,,...:.:.....:,...:~'~t*.~..~..; ' ........ ' , '~..~ Permission is hereb~ ~rontOd t~: ~ .~ ~ · ........,~e~%~e~,.....~.~-~w..-.~'---;,": ...... ~.'"::'~' ................................................ ~.~gueg.....~. ~. pursuant to application dated ............................. ~b.-..-~-..; ....... 19~6..., and approved by the Building Inspector Fee $.5~.Q0 .............. Building Inspector EXTRA DRY as good to your taste Rheingold after Rheingold ~HEINGOLD BREW£RI6S [NC, NEW yORK as it is/to your t[~irst