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Home My WebLink About4635-z FORM N'O.2 TOWN OF SOUTHOLD 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 N? 4635 Z Dote ............:........x&Xch.. . . .......... .. Permission is hereby granted to: .............. ....... ................. * . .............................................. ................................................................................ to .... .d•'11m'•id�Ei:+ :. '.�itatt .. �cs�3ae► �68 .. t �+dt",t �............................... ..................... ..................................................................................................... ... ................................ at premises located at .............Y .�,�1 ',Q.,J ,.1,�,.+ tQr Q#,.............................................................. ...................................................................OV4e1at.........SAY............................................................ ................................................................................................................................4............................... pursuant to application dated ..............................mar.......a............. 19.....To and approved by the Building Inspector. Fee $.. . . ....... ....... ... rel..:�.r.,..... ........ •Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK~ OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF: THE WORK AUTHORIZED) N.° 1635 Z Dote ............. Permission is hereby granted to: ............... ~J,.~.,l,~,~..~ ..~.J,e m:t~..1t,~,t~ ....... to .... l~lL~L4-.~m.-eAeJ~,e~o~.-~m.-~z~r~ll.-am,~wmqt-.~~Ii ............................... at premises located at ............. .~~.-~J~l,.&. ~ij'--J~l, ........................... t .................................. .................................................................. ~l'~e~% ......... ~,~, ............................................................ pursuc~r~t to application dated .............................. ~ ...... '~t' ............ , 19.....~0 and approved by the Building Inspector. Fee $.....~J~tt~ ......... TOWN OF souTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~UTHOLD, N.Y. ' ......................................' ........ .... A~mved ~ ....................................... , ........ ..................... Di~ppr~ed a/c ......... ~ .................... ............................................................................ ........ ........................ APPLICATION FOR BUILDING PERMIT Date ........................ ~...a....~..~..~.. .................. , 197.0 .......... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Buildinl~ Inspector. ' . b. Plot .pi.an showin.g, location, of. lot and of bu.ildings on premises, relationship to adjoining premises or public streets areas, and g~wng a detailed description of layout et property must be drawn 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 pe~rnit shall be kept on the premises available for iospection 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. 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 othe~ 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~,~code,..~.~ housi~ons.~ (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Owner Name of owner of premises .~l,~..l..e...e.....a..n..d.....~..l...e..a...n..o...~....H...a..z'...r..~.?. .................................................................................... If applicant is a corporate, signature of duly authorized officer. ' ~, x:,, (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.:: ........................... iiii.i.ii... Lot No.: ........................ ~.. ~orner of X~n& ~treet an~ V~lla~e Lane,'Orient,T'.~.,~.Y. Street and Nu ........ .~ , ..~ ............... ,~ ~ ~ ~7' ~, c~.(~ ~ Municipality ....... ~ ................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use andll~j~o~l~x.....~...,C~&z'~e...~,.~le...g.e,r~ ................................................................................ b. Intended use and occupancy ~l:..t..r..~ g~.a..r..a.~e ,f...o...r..o. ne 'more car~ A.l. so m.a.,ye present sarage D' 10" cl6eper. 3. Nature of Work (check which applicable): New Building .................. Addition ...lr ............ Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ~475'00 F (to be paid on filing this application) 5. If dwelling, number of dwelling units ..... ~l~J~t~ ............. Number of dwelling units on each floor ............................ If garage, number of cars ...... L...oz~e...at,...p~.e~e~t~l,~.~.ZZ..~e...t,w.c~ ................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ...~..o..~..e. ................ 7. Dimensions of existing structures, if any: Front ...],~.~. .................. Rear .....~7. ...................... Depth .[~,.I. ............ Height........................1]-t Number of Stories ..... OZle ..................................................................................................... Dimensions of same structure with olterations or additions: Front ...~,.~. .............. ' ............. Rear ...~.~. .................... Depth ....... ~.~...~,.0. ............ Height .zT..~.f~.n. ................. Number of Stories .....~.TLIit ..................... 3 ' lOt' 8. Dimensions of entire new construction: FrOnt ...~.~.~. .......................... Rear .,~.~ ..................... Depth .~_~.t.~.O.n. ......... Height ...... .7..t.l~.". ..... Number of Stories ....,.(~Txe. ............................................ ~..; ..................... ~ ................ ; ...... ;; ......... 9. Size of lot: Front ...7..~....J~8 ........... Rear ......... ~t~.~01~l ............... Depth ..],~.~.0. ............... 10. Date of Purchase .~..e.p...e..~...1p..e. Es..~.~.~.7. ....................... Nome of Former Owner . .~..e...t..e.~..]:...e....D...e.~..~..~.o.~ ............... 11. Zone or use district in which premises are situated ..... ..0.~'.~..~.~. ............................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation? .....~.o. .................................................... 13. Name of Owner of premise~l'~Lea~i~j~m ...... Address ¥;L-~latD~. ~.ZID. It~.O.~'~,~.D,~Phone No. 3.2.~.J..~.5;~.~. Name of Architect .................. ~o. ne. ......................... Address ............................................ Phone No ..................... Name of Contractor ....... ..~..e..]:...~. ................................... Address ............................................ Phone No ..................... whether interior or corner lot. 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 STATE OF NEM/yORK, lee COUNTY OF ................................ ~'~'~' . ' ....... O.h~l.e~..~.~Z'J.~.; ................ ~, .................................... being duly sworn, deposes and says that he is the applicant ~N~me Of i~dividual signing application) above named. He is the ................ ~...~.~'l~'...c.O~.t,~.O.:~.¢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 rna~e and file this application; that all statements contained 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. i'!ia~'~p~b"ii!;~ ~a;Y th°~s "' ]ii~II]]I]II:~~; ......~6~/).~'., ,..,~,', ..., ........ )' ll~;~f" ~ '~" ~'~ ~1~ ;,~)' ": .................... NOTARY PUBLIC, State of New ~or~ No. 52-8125850, Suffolk County Term Expire~ March 30, 19~_~