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Home My WebLink About4437-z FORM 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? 4437 Z Permission is hereby granted to: ........... ................ Matt~t.*alek....lo[, ........................... to .............. at premises located at ............... JJ~..~4~..~O~l~..~,1~d~...gl~'~..][~J,~l~I[ .......................... .................................................................. Ma~t:tt~ek ......... lI.Z. ..................................................... pursuant to application dated ........................... ~ ......... ~ .......... , 19..~JL, and opproved by the Building Inspector. INSTRUCTIONS . a. This' application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building I r~oector. b. Plot .pi.an showin.g, location, o.f lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and g~wng a detailed descnphon of layout of property must be drawn on the d ngram wh ch is part of this application. c. The work covered by this application may not be commenced before is,~la~ce of Building Permit. d. Upon approval of this ¢koplicatiorL the Building Inspector will issue a Building Permit to the applicant. Such permit eh&Il be kept on the premises available for inspection throughout the prngrras 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 hove 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, housing code, and regulations. Charles Abrahams P.E. (Signature of applicant, or na~e, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electriqian, plumber or builder. .................................. Ag.e~t..o~..~r~er. ........................................................................................................................... I~me of owner of premises :...~V~l~;L~Ll,~,~...~[~k~..~.~:,l,~.ii~..~.~.q~.t,~ ..................................... :. ........................... 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 dorm. Nk~ No.: Mal:titu¢~: ~.state~.. ~u .... Main Roa~ & C~r~lnal Drive Mattituck Street and Number .................................................................................................................................................... Pt .... I¢,,,~0 _0 ....~... . .-p,,....,.. /~ ~ . · Municipality 2. State existing use and occupancy of premise~ and intended use ~ occupancy of prel~, construction: a Existi-,, uee ~ occ,.:C~;, .... .'.., '~.:~s~6orlcal ~o~let;~' ~l. seB ' ~ b. ~nteoded use an~ occupancy ....... ~....:..~&~.~;.~.~.t~1~.A~&~:J`~A~;~L~1~.~.~`.~.e.&~.~.~$~¢.~g~..f~....%~% .... ezbibit 3. Nature of work (check which applicable): New Bud ng .... ~ ..... Addition .................. Alteration .................. Repair .................. Removal Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ............................................................ ~,X~X Fee ........ ,. ................................................................................ ~ (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ..~...o...~..e. ........... Number of dwelling units on each floor ............................ If garage, number of c. ors ............................................................................................................................................. 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 ..:: ........ ~ ................... Dimensions of entire new construction: Front ........ (~.'x' ....2_1..~ ...... Rear ...... ~J..-.,.~. ............ Depth ..... ~.0.-.~ ......... Height .................... Number of Stories ..............OM ................................................................................................ 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 ..... !!~,!!...d.-i.s~- ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? ....... ~),.9. ............................................... 13. Name of Owner of premises ..~-..a..t2.t..,...H.~.$..~....~..Q~.Y..Address ................ .~..~..~..~,.I;.~,.9~ ...... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .......... ?..~...~..e. ................................. Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck 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. STATE OF Nk'%V ~'(~4~K I ~: ~ COUNTY OF ..... .......... Charles Abrahams T.E. bei ................................................................................................. ng duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the .................... ..A.g~.T%~...9.~...Q.~,~. .................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to ma~e anti file this application; that oil statements contained in this application are true to the best of his khowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ~6 day of ~. ~,. , 19~