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Home My WebLink About3586-z FOr~l NO. ~ TOWN OF SOuTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. N? 3586 ~Z BUILDING DEliMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL ' .COMPLETION OF THE WORK AUTHORIZED) ,de .......... .......... -~.~,~.....~ ........... , ~Z... Permission is hereby granted to: at premises located at ..~.~..~.~ ....... ~.~:,i.,~4;~..~;~..~';~.~ ........................................................... ........... i ................... ~...~:Lut..~e~; .......... ~.~tt~:L~ ............ ~ ................................................ pursuozW to application cited ........................... ~'~::~.....~ ........ )., 19.[~.., and approved by the Building lnspector~ Fee $..,.~,~,l)0 ........ ''g P i1 TOWN OF SOUTHOLD BUILDING DEI~ARTMBNT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Approved ........................................ , Disapproved ~ ....... ~ APPLICATION FOR BUILDING PERMIT Date ...................... . .A..~. KL1._ ...S...~.......~...~. ............. , 19..~.'~.....i INSTRUCTIONS a. This application must be completely filled in by typewriter or in in~k and submitted in duplicate to the Building Inspector. b. Plot .pi.an showin.g, location, of lot and of bu.ildings on premises, relationship to adjoining premises or public streets or areas, and giving a detaded description of layout ot 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 applicant. Such permit shall be kept on the premises available for ir-~pection 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 granted by the Building Inspector. RB .A..P. PLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the ui~a!ng Zone. O~inance of the Town of Southold, Suffolk County, New York, and other applicable Laws, .Ordinances or egulations, tot the constructJan of buildings, additions or alterations, or for removal or demolition, as here,n 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) Matt ituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, ,hgi~eer, general contractor, electrician, plumber or builder. Owner Builders agent Name of owner of premises ...~,S~).Qr...~D,9. .......................................................................................................................... If a~plicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) ,. Cedar Beach Park .. 13~ 1. Location of land on which proposed work. will be done. Map No.: ........................................Lot No.: ........................ Street and Number ..C..e. dar Point Dr - West, Southold Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..~.~,.Q~.~...~..O..~. ........................................... ..................... b. Intended use and occupancy one family, dwellin~ 3. Nature of work (check which applicable): New Building i~ ..... Addition .................. Alterotion .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...~..t.~.O...0....?.~... ............... : .................... Fee 10.00 (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... Q:Ig,~. .............. Number of dwelling units on each floor ............................ If garage, numbe~ 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: Frbnt ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~.~ .................... Rear ..... ~ .................. Depth Height Number of Stories one 9. Size of lot: Front ............................ Rear .................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated !!It!! .~l,~,lr~.~.t<! ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ...... zt~ ................................................ 13. Name of Owner of premises ...C..~..s...b..o...~....I...~..c. ............... Address ........~.....~..~...::]..~.~...O.~ ................. Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor~......C..a...S..b..9.~...~.~...C...Address Mattituck . Phone No ..................... PLOT DIAGRAM Locate 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, and show street names and indicate whether interior or corner lot. ~/ju~L ,~_......_. STATE OF NEW ~/.O.E[(:~. COUNTY OF ....i~....~'u"L...'s'..u..... ....................... ~. ~i~ ~.:1. ~0,.. ~.~ ;~(~ ....................... ': ............ .~...being (Nameof individual signing application) ~uly sworn, deposes and says thor he is the applicant above named. He is the ...... ..q~.r.~.....O.~..f..:J:.o..e..?.....~......]~....~.c]..e..~. ............................................................................................. (Controctor, agent, corporote officer, etc.) of soid owner or owners, ond is duly authorized to perform or hove performed the said work and to rnoke ond file this opplication; that oll statements contained in this applicotion are true to the best of his knowledge ond belief; and that the work will be performed in-the manner set forth in the application filed therewith: Sworn to before me this ........................~8 dayo, ........................ Au~st ............... ,19 ........ 67 .//'~. ,/~(~ ~, //) ~ . , .... Notary Public,~..l.i../.~t..~..m,n.,...J~:.. C_oMn,..ty /' (Signa/rgfe c~f 13pplicant) f~IARION A, REUI~i'H ~' JO0. 52-3233[20 Suffolk County ]l'erla Expires I~rch ~0, tg~_