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Home My WebLink About3727-zTOWN OF SOUTHOLD BUILDING DEPARTMENT 'TOWN CLERK'S OFFICE : ,SOUTHOLD, N. Y. N?~-3727~ · BUiLDiNG PERMIT (THIS p~RMIT MUST BE KEpT'ON THE PREMISEs UNTIL FULL coMPIlaTION OF THE WoRK AUTHORIZED) ~ Z Permission is hereby granted to:, ~ ~JlltJq~!~$~f(l~ ~ ~ ..... ~.z~,~..~..~,............ ......... pursuon¢ to applicatioff dated ..... ~ ................... ...,..~,,..,..J~ .......... ~'~ '1;9..~'..;, and approved by the S-9 SCHD SUFFOLK COUNTY DEPARTMENT OF HEALTH Date Bldg. Permit No. SO-hll TO WHOM IT MAY CONCERN: The sewage disposal facilities for a structure at Little Peconic Bay Lane 2~0' S of Cedar Pt. Lane (Give deed location) located Southold have been inspected by this department and found to be satisfactory. District EngineaW .... FOI~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....................................... , 19. ....... Approved ..~....~.~.....~ ............ , 19...~..~.. Permit No....~....~....~....7..~ .... . . Application No.....~.....2..~.....~. ........ APPLICATION FOR BUILDING PERMIT 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 showing 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 port 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 sh.all be occupied or used in whole or in port for any purpose whatever until o 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 otherqpplicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, mL~for removal orxi'emolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances,,bdjJZ~ing code~l~ ;~ing.code, and regulations. ....................................... ,;': ......................... ......... .-,x ............ (Addr~.ss of applicant) State whether applicant is owner, lessee, agen,_t, architect, engi.neer, general contractor, electrician, plumber or builder. ................................................ ................................................................................................................... .Nome o~ owner o~ premises ................................................................................................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) .~- ~I¢~Z~//L'//' .,~/~,<_.. /,~.~ 1. Location of land on which proposed work will be done~ Map No.: ..: ..................................... Lot INa.: ........................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ................................................................................................................................... b. Intended use and occupancy ...........................~...,~,...~..~,.~. ...................................................................................... 3. Nature of work (check which cl~II~icable): New Building .................................... Altera,tion .................. Repair .................. Removal .................. Demolition .................. Ot,~he~r Work (Describe) ........................................ 4. Estimated Cost ....... (...~z...°. ........................................ Fee ...... ~...q .............................................................................. (to be paid on filing this application) / 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6, If business, commercial or mixed occupancy, specif~ nature and extent of,each type of use .................. / ......... 7. Dimensions of existing structures, if any: Front ........' ................ :.. Rear ................................ Dap h ..................... /v · '/ Height ........................ Number of Stories ................................................................................................................ ,x, Dimensions of same structure with alterations or additions: Front ......... .~ ................ Rear Depth ................................ Height ............................ Number of*Stories ................................ 8. Dimensions of entre new construction: Front ......... ..~'..~.. ..................... Rear ....... ...~...~. .............. Depth ..,~...~... .......... Height ......... / ......... Number of Stories ................ ., .................................................. .! ................................................ 9. Size of lot: Front ........./..~.~...'.. ......... Rear ...... ./...~.~...~. .................. Depth ...... ./...~....O. ................. .,-r, ~// 10. Date of Purchase ........................................................ Name of Former Owner ~',~/.~.~.~../~........,-../..~,,('..:.{~....7....~../.~...~.~: 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any z~ning law, ordinance or renulotion? ...... ,,.~ ................................................ 13. Nome of Owner of premises .................... ~:/..~..~...Addres ............. ~......~...:../-,~-~.~..J?...~./. one No ....... .L.~..~..O.. Name of Architect ..................................................... Address .......................................... Phone ~N~ ,~ . Name of Contractor .....~".~...~.~.....~....~..~...F.~...d..~(..~...~.......Address4..~./..~..~..~.~..~..`.~..?~.~..~.~z~. i.~'~.'i*~ PLOT DIAGRAM t.ocote 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, end show street names and indicate whether interior or corner lot. " '.1 F I.,' ,*w,'.: STATE OFcNEW YORK, ,/- /tcc COUNTY/~ / .-~¢//~/__'OF ............ (Name of~divid~ sig ningcqpplication) H, the ............. .................................................................................................. (Contractor, agent, corporate officer, afc.) of said owner or owners, and is duly aut, horized to perform or have performed the said work and to make and ilia this application; that all statements contained in this application are true t~ the best of his~knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewi~ Sworn to before me this ~ . - /' / /¢ .,- / Not y Publi , ' *~u~f ~o 52~r~'~ ~,.~'_,:'~ ~omm~SS~on