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Home My WebLink About4548-z I~OF,,.~ NO. 2 TOW'N OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. ~548 Z Permission is hereby granted to: ............... ~...~.e...x.~.~ .................................... .................... l~t-tJ,~ek ...................................... to .......... lB~ff,l~ ..ma..aeca ~,~Q ~.g.. I~_~..~.~ .............................................................................. ...................... ................................................................... at premises located ot ............ ?....~....~....F....~........~..~.o.?...~.....~.~..~.?..~.. ............................................................. ........................................... m~l~.ee..~ ...... .lt.~lm~..~ .............. ~ti~W~i~ ...................... pursuant to application dcrted ............................. N~g...~ .........: ...... , 19...~t~, and approved by the Building Inspector. Fee $..~.0..~ .......... Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19....~... Permit No ....... Disapproved a/c .............................................................................................. Appl,cahon No..?..~....?....~..~... APPLICATION FOR BUILDING FERMI'[ Date ........................... NoTmlb.ez~......~O..., 19.69.. · INSTRUCTIONS a. This application must be completely filled in by typewriter or m ~nk and submitted in duphcate to the Buildin, Inspector. b Plot plan show,ng location of lot and of buildings on premises, relat,onship to adjoining premises or pubhc streets o areas, and g,ving a detailed description of layout of property must be drawn 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 apphcation, the Building Inspector will issue a Building Permit to the applicant. Such permi shall be kept on the premises available for inspection throughout the progress of the work. e. No build,ng shall be occupied or used in whole or ,n part for any purpose whatever unt,I a Certificate of Occupanc. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the ~ssuance of a Build,ng Permit pursuant to th- Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The applicant agrees to comply with alt opphcoble laws, ordinances, bu,ldmg code, housing code, and regulations ....... Howard..W.~.ll~. ...................................................... (Signature of applicant, or name, if a corporation) (Address of opphcont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budder ............................................. Owner.. ,,...b~_, ~ ~:de~ ........................................................................ Name of owner of premises ..... .~Jg~...~.~.~..~.e.l~.~.. ............................... 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 .S:J~ iLCtZ'~S ..... Lot No · ..~ ........... Street and Number ........ ~.8,~'...~.,~,~W....A..~.~...~....$.f~U,.~X..~..~ ....... .~.'.~...t4.t~,1~.t'..~9.~ .................................................. Municipality 2 State existing use and occupancy of premises and intended use and occupancy of proposed construction a. Existing use and occupancy ......... ~W~.I.~J,I't~..&..I~C..~I~.~.T~e.~ ............................................................. b. Intended use and occupancy ............ ~...~t~.,~..a~,~.~.~z)~..]~l~lCl//~ ..................................... 3. Nature of work (check which applicable): New Building ..~ ........ Addition .................. Alteration .. Repair .................. Removal .................. Demohtion .................. Other Work (Describe) ............................ 4. Estimated Cost ...................... .~.~,~lO..~,~ .................... Fee ..~.~).~. ........................................................................ (to be paid on filing th~s apphcation) 5 If dwelling, number of dwelling un~ts ............................ Number of dwelhng 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 D~mens~ons of ex~stmg structures, if any: Front .......................... Rear ................................ Depth .................... Height ........................ Number of Stories .............................................................................................................. D~mens~ons of same structure with alterabons or additions' Front .................................... Rear ........................ Depth ................................ He,ght ............................ Number of Stones ................................ 8 Dimensions of entire new construction: Front ...... ,~. ........................ Rear ......... .~..~.. ............. Depth Height .................... Number of Stories .......... ~...e. .......................................................... 9. Size of lot. Front .... ~.~.~..~.~[. .... Rear ...... .~0//..~.~ ........ Depth ..... ~,,~O..~....~.'k 10. Date of Purchase ...................................................... Name of Former Owner ..................................................... 11. Zone or use district in which premises are s~tuated ....... ~.~..~.~....~..:~..t¢ ...................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulat~onP .... .~.O.. ............................................. 13 Name of Owner of premises .~.~...~.~],¢~ ......... Address ...~.~..t..t.~..t.~.e...~. ................. Phone No .................. Name of Architect ..................................................... Address ............................................ Phone No .................. Name of Contractor ..... ~ ................................. Address ........................................ Phone No .............. PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and indicate all set-bock dimensions fron property hnes. Give street and block number or description according to deed, and show street names and indicat.- whether interior or corner lot. / ....................... ~,~.~...~,~. ........................... (Name of individual s~gning apphcat~on) STATE OF NEW YORK, ~ COUNTY OF ...~l~".O~l![ ............ j- S.S. · being duly sworn, deposes and says that he ~s the apphcant above named. He ,s the ................... (~...e..z'....~....~.~.]r..Ct:.~ .............................................................................................. (Contractor, agent, corporate officer, otc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fil~ thts application; that all statements contained in th~s opphcat~on are true to the best of his knowledge and belief; ant thor the work wdl be performed m the manner set forth m the application filed therewith Sworn to before me this ..................... Oda¥ of .................. ................. , o, ............................... ELiZABET~/I t ARY PUBL1C. State cf New York Term Exptres March ou, *~,