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Home My WebLink About3702-z FOl~I ~O 2 TOWN OF $OUTHOLD BUILDING ~EPARTMENT TOWN CLERK'S OFFICE SOUTHOLD~ N. N? ,' BUiLDiNG PER~IT (THIS PERMIT MUST BE. KEPT ON THE PREMISES` UNTIL FULL cOMPLETION ~OF THE ~/oRK AUTH~Of~,IZ'E 3702 Z Permission is hereby granted to: at premises located at , 2 ........ ~.; .............. ........................ .......................... ~.s.~....~,~..~ ...... ..e.~ ...................... : ....................... ,~ ..................... ~. pursuarut~ to application 'doted ............................ ~.1~.t~..].~..~......'.~.. ~.., ] 9.J~...,"and approved 'by the Building Inspector. ~LOaO0 . J:ee $ ........................ Building ~~ :{ FOI~V~ NO, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , 19 ........ Permit No. Disapproved a/c ........ ............ ........... ................................. Application No, '~ ? :') 2~-- APPLICATION FOR BUILDING pERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink ond submitted in duplicate to the Building Inspector. b. Plot plon showing I~cation of lot and of buildings on premises, relotionship to odjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown 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 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 grante.cl: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 constr~ctlon of buildings, additions or alteratipns, or for removal or demolition, as herein described. The applicant agrees to comPJy with all applicable laws, ordinances, building code, housing code, and regulations. Ruscon Constr~ctio~ Co In¢ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant iq ow!er,..lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner - bullde~ Nome of owner of ~Dremises'....~.~.~..~..O.'.O..~.~.....q.o.D.~cL~..~.Q.~.~.O-~..~.g...~.~ .................................................................................. f applicant'is a corporate,',signetgr~ qf ~uly authorized officer. ........ ,, (Nome and title df corperote officer) 1. Location of land on which proposed work will be done, ,Mop No.:G~G~OZ"~..D~$~ L~: ..... ~ .............. Street ond Number, .~.....~:~...~¢ ....... G~e~ ....................................................................................... ; ' Municipality 2. Store existing use a~d o~cupancy of premises ond intended use ond occupancy of propos~ construction: ~ , V&e ~z~,t 10¢ ..................................... a, Existing use ond eCcupancy b. Intended use ~n~'bccupancy ... ............ o~..,,.~,~$1~.,~.e.~Z$~g .................................................................... 3. Nature of work (check which applicable): New Building .... ;X, lf, II~.... Addition .................. Alteration .................. Repair ................... Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..,~;~$.000.....~ ................................... Fee ~(~ (t~ be paid on filing this application) 5, [f dwelling, number of dwelling units ..... Olle ................ Number of dwelling units on each floor ............................ If garage, number of cars .............................................................................................................................................. 6. If business, commercial or mixed occupancy, ~.~pec~fy nature ahd 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 .................. ~'i.~ ....... Numbgr 6f Stories ................................ 8.: Dimensions of entire new construction: Front..:;.,~ ............................. Rear ...... 38' ................. Depth ..2,~t'. ................ Height .................... Number of Stories,..~,'.,.....~Zl~ ........ 4.;.... .................................................................................... / 9. Size of lot: Front ...~0 ..................... R~ar.t..?~..: ...... ~'O ....... : ....... >.. Depth "~"~'2 ....................... 10. Date of Purchase ' ' ~/, .... "' Name of Former Owner .......... :1,9 :7 ............ . .... ,. .......................................... 11. Zone or use d'strict 'n wh'ch premiss are sitka ed ...... t! .;¢.. t< . ...... ................................................................... 12. Does proposed construction violate'any zoning Igw, ord~rldnce b? regulahon? ......... ~10 .............................................. 13. Name of Owner of premises .~l.8.Q~..~.O~.~ZPtl~i?J~.e~,.,llq~ ....... I~:1,'¢'~.'gt~8.0,.... Phone No ..................... Name of Architect ................................ i......., .............. Ad, d~ess i.~ ......................................... Phone No ..................... Name of Contractor ..............~.¢14[11~:5,;.,'.~ ................... Address ..,' ......................................... Phone No ..................... / ;' / /~,! PLOT DIAGP~AM, Locate clear y and dishnctly al bu,ld,ngs, ~hether ex,sbng 9r proposed~ and indicate all set-back dimensions from property hnes. G~ve street and block number'ior descnphon~, aecprd,ng to deed, and show street names and indicate whether interior or corner lot. ' STATE OF NEW ~01~1~ ,,., Icc '~ , , I,~~, COUNTY OF,/?'.....:~..%)f,~L$[.o.,I~..~;, .......... j'¢.-,. , I .................... ;.i'...' ......... .~.J'i{~.l~lil~.....,I~ll, D~ ...................... being duly sworn, deposes and sd that he is the applicant (N'ame of '~ ....... md~wdual~ s~gm~g ~pphcat~on) above named. He is,¢~he ¢ ' " ~' ............................ ................................................. ',' . : (Contractor, agent, corporate officer, etc.) of said owner or owners, a~d is'du~y authorized to perform or have performed the caid work and to make and file this application; that afl statements contained in thi~ application are true to the best of his knowledge and belief; and that the work will be performed in the manner set fortH' in the bpplication filed therewith..' Sworn to before me this ,~ , 'r '?~} ,~. ......................... day of ....: ......... /:'"~*~*~'~*'~'"'") ~ 19~.~... (.;~5*'a~', , ,,?" L..(F . ' .... . , ~t~ ~o ¢~'p ...... "'"'~ ....................... ¢' ................................... I-- iR O l'q T N' E '" ,,II ......, . ~.' ..... ,..:' :: --~;. C o:.~ ,