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Home My WebLink About4408-z YOR~ NO. ~ 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? 4408 Z Permission is hereby granted to: ........ ~e,t~t..{~..1.~ez~ ................................... to .......... ~d. aA..aa..~ct4,~.tiea..ea~.aa ..e~ s.tt~..~t~ Lta~ ............................................ at premises I~at~ at .................................. ~ ................. ~ ............................................... ........................................... a~a~ ......... .~,~. .............................................................................. pursu~ to application dated ........................... &~ ....... ~. ........ , 19...~ a~ appr~ by the Building Ins~ctor. Fee $.5.,01~ ............ Building Inspector '-~ TOWN OF SOUTHOLD BUILDING DEPAliTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No. ' Application No ............................. D sapproved a/c .......~ . ~ ........ '" .~ (Building InspectOr) APPLICATION FOR BUILDING PERMrI' Date ........ ....~...~'....~...~..~....7'.....,, ,~ ..~ .............. , 19....~...,?... 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 shawJng 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 property must be drown on the diagram which is po~t 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/v~DE to the Building Department for the issu~--e~ a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New y~,l~, ond~ther applicable Laws, O~d~nances Or Regulations, for the construction of buildings, additions or alterotions~or re~al or demolition, as herje~n described. The applicant agrees to comply with all applicable laws, ordinances~ujl ~nc~Tn~e~(te, housing cad, e, ~,t'e~.ula~tions. .......... n) ""' (Address of applicant) State whether applicant is owner, lessee, agent, architect, engis~eer, general contractor, electrician, plumber or builder. ................ ................................................................................................................... :... Name of owner of premises .......... ~/.../...~....~....~..........~..,.....~/..Z....~...~...~.. ........................................................................ 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. N~ap No.: ..................................... Lot No · Street and Number ~./...~..~....,~...~...../~...b...,~..o. /~A"~*~,O,,Z~' *.S'.;r~oA='~"~' ~,-~O,7',~o~:> ,/'~,,~xo ~>~" .~/'0~-"~--~- ~-,)~'~>~,~/ ~,~/C~.d- Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Existing use ond o~cul:mno/ ................................. ~....~ .................................... .~ .......... ~ ...................... :.~... b. ,nt, nded use and occapancy ......................... .................................. .' ............ 3. Nature of work (check which applicable): New Buildihg ................... Addition .................. Alteration .................. Repair .................. Removal .................. DemOlition .................. Other Work (Describe) ........................................ 4. Estimated Cost ......... ?..../....~...~..:..~.~7.~. .............. ; .......... ..Fee .......................................................................................... (to be paid on filing this application) 5. It 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 epch type of,use ......~-...' ................. 7. Dimensions of existing structures, if any: Front ...... ...~....~.*....':~.. ........ Rear ...~'.../..~...~....~..~..~..~.. Depth .....~......~..~.. ...... Height ...... ....... Number of Stories .....~.../~...~.......'~-../~......'~. ............................................................................. Dimensions of same structure with olterations or additions: FrOnt ........... ~b.~.'~..~.i ......... Rear ~'~'Z'~'....~,~../.~. J ../....,~.. Depth ...... ................. Height ..... ............... Number of Stories ..... ;.c.~-.-..~..¢~.. ............... 8. Dimensions of entire new construction: Front ......... /~. ....................Rea .r~......~'.../...~..~..../~°...~../.. Depth ..... ...~...O...~. ...... Height .../..~...: ....... Number of Stories ....~...'~..~. ....................................................................................................... 9. Size of lot: Front ....... ~.~..../. .......... Reor ......... .~',.~..'~. ............... Depth ..~./~.....~-~....~...../...~...7. 10. Date of Purchase ......~.~...~...~..-..~.~..x...../...~...~..~.. ............N~__ of Former Owner ~...~...,~...,~...)~...~.....~....~_?~'.....z~.../..4~...4~.....7~.. 11. Zone or use district in which premises are situated ..... ...~..~.~....~...'~...~../..~'...~.......-: ............................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .....~'...O. ................................................... 13. Name of Owner of premises ~.~...~..~..m.....~.'.....~../..z.~...~ddress ...~...~..~..../..~./....~.~.~hone No..~'....~....-..../..~.../..~ Name of Architect ....~ ........................................... Address ................ ~ .......................... Phone No. ' Nome of Co~ntr~ac)tor ~,~.~Z~g..~.~.~/..4-4~ ......... Address ~...~?.~..../..~../.......~.....~...~./.?..'~Phone No...7.~....~..-.~../...~.. 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 number or description according to deed, and show street names and indicate whether interior or corner lot. ,- _/7/__ ii COUNTY c~ ':.~ ........... ~.S. __ / ~ ................. ............ .. '[Nohne of individual signing ¢~oplieation) U above named. He is the ........................ ~.....~....~...~.. ........................................................................................................... (Co~tmctor, agent, corporate officer, etc.) of said owner or owners, end is duly outhorized to perform or hove performed the said work and to make and file this application; that all statements cont(~ined in this application are tru?.to~l~est of his knowledgjJ'~nd belief; end that the work will be performed in the manner set forth in the appJicati_on ~trld tJ3~rewith. swo . ........... ...... ............. ......... · [/ i'tOTARY PUBLIC. State of New YoK( ' [ k./ I%. 52-3233120 Suffolk County Term [xpires ~arcb 30.