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Home My WebLink About3588-z FOF,,I~ NO. ~ TOWN 01= $OUTHOLD 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? 3588 Z Permission is hereby granted to: ... ............ i~.~i~k .......................................... ~ et premises Io¢oted at ..... ~2~...~.....~.~.9~..~t~b.~.~...~.~ .......................................................... ....................................... hig.~L ~aa ~.a~..~'.. J~ar.~ ............ ~at.h_~Itl .................................. pursuon¢ to application dated ............................................................ , 19. .., and approved by the Building Inspector, Building Inspector FOR1H NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ......................... '.; ............. , 19...J;.. Permit No...~/.:~.~...~..~ Disapproved a/c .............................................................................................. ............................................... (:CZXr'~: ........................... '~ ......................... (Building I nspec~6r) Application No. f/ ? ~ ¢~r~' APPLICATION FOR BUILDING PERMIT Date ......................... AI1~8~; .......... 28....., 19...6~/. .... 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 ~djo n ng premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diag?am which is part of this application. c. The work covered by this application may not be commenced before issuence ~f 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 w~rk. e. No building shall be occupied or used in whole or in part for any purpose what's, er until a Certificate of Occupancy shall have been granted by the Building Inspector. J~l APPLICATION IS HEREBY MADE to the Building Deportment for the issuance o~?,a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and ~ther 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 g?~d regulations. F~ar~kl~n (Signature o appffcont, or name, if a corporation) .......... N ,t .......................................................... (Ad~'ress' of applicant). State whether applicant is owner, lessee, agent, architect, engineer, general contracfor, j~ ectr c an, plumber or builder. remJses Casbor i.n..~ ........................ ~ .....~.! ....... i ....... Name of owner of p ............................................................. /.~ ................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) 1. Location of land on which pro4~o~ed wo;~ will be done. Map~J~lo.~..,,~.~.~.~.~...~.]~.... Lot ~.~. ....................... Street and Nbmber .~..: .............................. .t,., ......... ~,.O.~...~..~..o..].:.~..,...~, ...... i/~[~:.i.t~.~.li.t~' ...................................... 2. State existing use and occupancy of premises and intended use and occupancy of prbl~osed construction: a. Existing use and occupancy ....~./~..~..~..~k~.(~ ......................................... ......~ .......... .~ .......................................... one famil~ dwelling ,~ ;~ . b. Intended use and occupancy ................................................................. f'~i ............. '~t.'!~ ...................................... ' i:' / 3~ No~ure of work (check which applicable): New Building ...... :Y,.ll:~.. Addition .................. Alteration Rep!air .................. Removal .................. Demolition .................. Other Work (Describe) .................................. 4. Est, atod Cost ..8~.~00..~./~ ..................................... eo be paid on filing this application) 5. If c~welling, number of dwelling units ....~J0.~ ................ Number of dwelling units on each floor If garage, number of cars 6. If business, commercial or mixed occupancy, specify nature and extent ofleach type of use 7. Di nsions of existing structures, if eny: Front ............................ Reef ........... I'. ................... Depth I-lei ht ........................ Number of Stories ....... ~ ...................... Di4ensions of same structure with a.lterations or additions: Front Rear De~th ................................ Height ............................ Number of Stories 8. Dir~ensions of entire new construction: Front ....... ,~6 ........................ Rear....:~, .................. Depth '"'2~ .......... Height .................... Number of Stories ..... O,~1.I 9. Siz~ of lot: Front ............................ Rear .................................... Depth ................................ DtJ'l F , ~ 10. oe of Purchase ............................ ....................... T.:.Nome of ormer Owner~...h 11. Zor}e or use district in which premises are situated .......llA~..¢I.~I.t~ ................. '..),....~b. 12. Do~s proposed construchon wolate any zomng law, ordinance or regulation? ....:./,....~ 13. Na'~ne of Owner of premises ~,~1~'~"~1~ .......... i....Address " ~xPhone' ' ' No. Name of Architect ...................................................... Address .......................... J.,.,.~ .......... PLoT DIAGRAM ~i ':" Locat,e dearly and distinctly oil buildings, whether existing or proposed, and indicc}te all set~bac~\dimensions property lines. Give street and block number or description eccording to deed, and s~b~w stree(/,na~rnes and whether in}erior or corner lot. . . STATE O~ NEW YORK, t c c COUNTY IOF ............ ,f .... ........................... ~.~.li~'l t~.~1::~ ......... '..... ........................ being duly sworn, deposes and sdys I(Name of individual signing application) I abow.~ named. He is the ..... ,~e~..o~...~u.~e~..~'..([o~..O:~:~..~r~....:~ .............. ; ......... ~'..,.~. (~,onTracror, agent, corporet'e officer, etc.) of said o~,ner or owners, and is duly authorized to perform or have performed the said worl~ and to make end this appli,:ation; that all statements contained in this application are true to the best of his kpowledge and belief; that the ~ ark will be performed in the manner set forth in the application filed therewith. Sworn to I efore me this (Signature that he is the applic ................ i..~8 day of ................. ,~'1,~'~ ............ , 19.~.. ~ NOT~"Y pUBL'C, State o~.?~u~Vr~ Term ~xcres ~rc~ -~?-~7