The URL can be used to link to this page

Home My WebLink About4944-z FORM NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE~ UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permission is hereby granted to: .......... :..,~h-.~ ...................... r Apt ,l~. 1.$. ~].~.,9.QX,~..I~nIi~[......~ ................ ........... ~t,.~tea ....... II.1[. ........ ! ................ to .t~f~.a.. ~..~.. ~...f.~,...~ Illus.....[li~J~l~...~ ..~,~,.~A..~..~.~) at premises located at ........ ,..~lrtl...1.t'/~...,~l~ft~lllt...ltjil~jll-!:~,..JJil~r,.J~J-~t~J~t~l~ .............. ..................................... ~/~...~r,r~r~e.-.r.~.,-....o~:!..~.;~* ........................................... pursuan¢ to application dated ..: ........................... {?~ltll3jJ~..?.~...;i'...., ' 19..~J., ,Fee $.1.~..a~ ........... ~ e~J ' and approved by the · - ~ ~uildlng m§pector [ INSTRUCTIONS ~:~ a. Thll aPPlication mu~t be completely filled in by typewriter or In Ink and miffed In duplicato to the Bulldlng~' In.la~m. b. PI,~ .I) .lan d~v, .In;l .Ion?loft, .~. Io~ ?.nd of.b~jldlngl .on pre.m!~e~< mlatk~.. Ip .t~ mlj~nl.nl) I~ .mmlel? m'. L~b. Ik: ~.melt m,.~ orea~ aha gmng a ama, ma ~ecflptm m ,ayem m prelam/must ~e arawn on me diagram vmmn m lan m mm al~ca~on.~ y. c. The wink eaverod by thll agpllcetlon may not be eammenCed before i~uonce of Building Pem~it, ~,/~ d.. Upon. al~..mval of this pp~llcatlon, the Building Impector .will ~ a B~lldlng Permit to the a~N~lleant. S~h larmit ~hall ~e ~ an t~e pmmlm available for Inelactlon ~mughout the .m~gre~l of the ~ shael, i No b~llding d~all be occuplod ar u~cl in whole or In port for ar~ purlaee whatever until a Cer~lflceto of Occupancy have been gmntod by the Building In~ector. B APPLICATION IS HEREBY MADE to the B~lldlng Delartmem for. the luuance of a Building Permit I~re~nt to the ullding Zone Ordinance of the Town of ~ld, S~olk County, New York, and other airilY, able I.awi, OMtnance~ or Regulatlom, for the comtructlon of I~lldlng~ additions or alterations, or for remaval m' demolition, el he~lln d~c~lbed. The applicant agrees to comply with all pppllcable law~, ordina?.,ll< building code, ~ouslng code, and ~g~latlanl. - . /' · (Signature of applicant, m' n~e, if a-eaq~rafm) .......... (Add~ ~ pppllcent) State whether applicant 18 ~vnar, levee, agent, architect, engineer, general contractor, ele¢trlelan, plumbs, or b~lder. Name of .n', of """ ~' ... (Name and title 'of corlarate officer) I. Lacotlan of land on Which pralaeod v~rk will be done. Map No.:...~..~..~'..c~.......~....~ Na.: .LZ...~............~. ~ ~ ~lUrflDer .... A~,.~...~..,...--~ ./ ,,,,.,,.,,,..,,,,,,.,..9.,,o..o..,.,,,.,,..,.,.,..,,,..,,,,,,.,,, ............... M~nl¢llallty - 2. State ex ~'ing u~e a.nd o~eulaney of Prem u~ and Intended uu and ~cculaney of pmlaeed comtm~lon. o. ........ ......................................................... ' b. Intend. dm. upa ! """'"'"'~-"'""'T ,l, ........................... 3. Nature of work (check which applicable): New Building .,..~... Addition .................. Alteration .................. Repair .................. Removal ..;:~.....~.,~. Demolition .................. Other Work (Descr be) ........................ ~.~ ~'tx/ o" 1,~ Oq ............. 4. Estimated Cost ........... .L...~....I..t....% ................ ; ....... Fee ....~...?....';.. ....... (to be paid on fi!ing this application) 5. If dwe[llng, number of dwelling units ~ 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 alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front /..'~.. . /~-- (.~.. ~e~ .................................. Reor ............................ Depth ..................... Height .................... Number of Stories ................................................................. /,)~'~ ~ 9. Size of lot: Frc,nt ........ .~....!'(~) ............. Rear ......... ~..0. ................... Depth ..... /.....~....~... ............ 10. Date of Purchase ........................................................ Name of Former Qwner ............................................... 11. Zone or use district in which premises are situated ....... c~.,~ ~ ................................ ................ ....... . ........ 12. Does proposed construction vil~ate any zoging law, ordinance or regulation? .......... .l~...O.. ................. 13. Name of Owner of premises ~....~...~...Address ...... ~..~~ ........... Phone No ..................... Name of Architect ..................................................... Address ............................................ Phone No ..................... Nomeof Contractor ~ ~.~-~...~A~ ~ ........................................ ress ....................... 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 comer lot. COL qTY OF .~.ja~. ~ ............................... ~/....~~....~:.~being duly sworn, d~oses and says tMt he is the applicant (Name of individual signi~a~li~ti~) ~ a~ve named. He is the .............. ~...~..~ /~ (~ntractor, ag~t, co~orate officer, of said owner or owners, and is duly authorized ~ pe~orm or h~e peffo~ed the said work and to ~ke ~d file this application; that all statements contained in this application are tree to the best of his knowl~ge and ~lief; and that the work will be performed Jn the manner set fo~h in the application fil~ ther~ith. Swam to ~fore me this ................... ........ , ELIZABETH ANN N~ILLE NOTARy PUBLIC, ~ate of N~ York No. 52-8125850, Su~k Co~yn Term Expires March ~,