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Home My WebLink About3585-z , FOR.I~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOI~'N CLERK'S OFFICE SOUTHOLD; N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK /~OTHORIZED) Permission is hereby gr~ntecl to~ 2:' .~ . ............ ~.t;!.t;~i: ................ :., .......................... to ... !.~a ~,~ ..ra~...~.~ .. t:~l,iL~:., d,~'-~ ~., ~lr4 ................................................................................ at premises located at ~l.Gl~...,i~;~ ....... ;,~a,~...,~-f~.¢: ........ ~,,,a ............................................................. .... .:~ ................... ~.ll~..~.o.t,~l~..t~e.i~t;..~=., ....... [~o.~t~.~,~ ........ :.: ............................................... pur, suOn¢/to application,, ~ , . dated ............... ~ .................. li,~.~ .......... ~;~...., 19.~.~..., and approved by the Bui,lding -'lnspecto~ ' f TOWN OF SOUTHOLD BUILDING DIPAIITMENT 'TOWN CLID, IC'~ OFFICE SOUTHOLD, N. Y. Examined Approved Disopproved o/c ............................................................ - tor) APPLICATION FOR BUILDING PERMIT De~ ........ Aug~...st 28 ] 9...6.~ ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. PI.at plan showing location of lot and of bu!ldings on premises, relationship to adjoining premises o.r public streets or areas, ano giving a amailed description of layout at 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 application, the Building Inspector will issue a Building Permit to the appl'mant. Such permit shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occ%l~ied or used in whole or in port for any purpose whatever until a Certificate of Occupancy shall have been granted by the uilding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bui ding Permit pureuant to the ,BuJld!n.g. Zorn. Ordinance of ~e Town .o,f .Southold,. Suffolk Count, New York, and other aPPlicable Laws, Ordinances om Kegumtmons, ?or the constructton of budd,ngs, additions or alterations, or for removal or demolition, a~ herein described The applicant agrees to comply with all applicable laws, ordinances, building code and regulations. Franklin Born (Signature of applicant, or name, if a corporation) Ma t t ituc~ (Address of applicant) State whether applicant is owner, Ir~see, agent, architect, engineer, general contractor, electrician, plumber or builder. Corp officer & Builders agent Name of owner of premises .O.~L~.q~...~.D.(~ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) I. Location of land on which proposed work will be done. Map No.: ...O.e...~.~.r......]~....a.?...~...~..~..... Lot No.: '136 Street and Number . ..C..e...d..a..r., .P...o...L~...t ..W..e. st . Southold · Munlcipalfly 2. State existing use and occupancy of premises and intended use and occupancy of propc~cl construction: a. Existing use and occu-an- Yacht '1~.~. b. Intended use and occupancy .....~.~.~...~'.{~....~.~Y..~..~.~.Z..~in~. ..................... 3. Nature of work (check which applicable): New Building ~ Addition Alteration Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ..... .~..~..0..0.....~...~.. ................................. Fee ...... ~. 0. ... . .0. .0. ........................................................................ (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... .O~f~ ................ Number of dwelling 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. Dimensions of existing structures, if any: Front ............................ Rear ' Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with olterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ............ ~ ................... Rear ........ ..R..6. ............... Depth ....... ..2.L{;. ............ Height .................... Number of Stories .....o..n...e. ........................................................................................................... 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 ............ .t.'.A..~....d...i..s..~.. ..................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation.;) ..... ~Q .................................................. 13. Name of Owner of premises ...C..~.s...b..°..r...I...n..°. .............. Address ........~.~..t..t..l~..t..u. 9.~. ................ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor ..?...8:..s..b..o...r....I...n..c. .......................... Address ....~.t...t..i...t..~.?...k. .................. Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or ~/sc~on acted~ deed, and show street names and indicate \ STATE OF NEW,.¥QEK. - ~ S e COUNTY OF ...~.~...~..[.-.O.:~.~.. ............ ~ .,~. Fr~lin Borm be,n ,Ndul deposes and says that he is the applicant .................................................. ~ ............................. ~ ........... ' g y sworn, (Name of individual signing application) above named. He is the ......... .~...~..r.~....~...f.~..i..~..e..~....~.~..A.~.e...n...t..~.~...i~.~...B..u.~.~..d...e..r.. ....................................................... L ............ (Contractor, agent, corporate officer, etc.) Of said owner or owners, and is duly authorized to perform or have performed the said work and to rnoJke and file this application; that all statements cont<~ined in this 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 application filed therewith. Sworn to before me this __ .... .............. of ............... ............... . -.,,,, . . ........ Notary Public, .I.g.~..O.Z~d,~.....I.~ ..... County ~,~/~(Sigf'~ture o~pplicant) ~J NOTARY MPiUBLiC, State ,ot,,~t~oWunty ~'~ o 52-3233120 Suflo~ 19 , ~¥erm Expires ~rch 30,