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Home My WebLink About4646-zTGWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MU.ST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 4646 Z Permission is hereby granted to: ................... ...T.~.~...~~ ........................ ........................... ~,..~.,.~.?,.x.#. ................................. to ............. b,a~ ..~e~..~.~.~e ~_-~y.. ~.s.~ re:~e~..1~18~,-~ ................................................. · at premises located at ............................... .~..~]~....l~.......~.._...~......~...~.~...~...J~......~...~_~ .............................. ...................................................................... .e....~...~.o....~ .......... ~.t.~.:. ................................................... pursuan¢ to application dated ..............~. ............. ~.~.~l,..~J~ ........... , 19....~, and approved by the Building Inspector. ~:ee $....~.,,{:~ .......... , l~Ol?~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........... ....................................... , 19 ........ Permit No ............................. Disapproved =/c .............. g:: ..... ~ .......................................... .............. ................... APPLICATION FOR BUILDING PERMIT Date .............................. .~!&l~qh ..... .~.6...., 19 70.... INSTRUCTIONS a This application must be completely filled in by typewriter or m ink and submitted in duphcote to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o, areas, and giving a detailed description of layout of property must be drawn on the d~agrom which is part of this applicahon c The work covered by this apphcobon may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will ~ssue o Budding Permit to the apphcant Such permll shall be kept on the premises available for inspection throughout the progress of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever untd o Certificate of Occupanc5 shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Deportment for the issuance of a Building Permit pursuant to th~ Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Lows, Ordinances o, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The opphcant agrees to comply with all apphcab]e laws, ordinances, building code, housing code, and regulahons ......... ................................................. (Signature of applicant, or name, if a corporation) Southold ......................... ........................ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electncmn, plumber or budder owner - builder Name of owner of premises ......... ~[.ose.p~z..Pmly~mcl~ .............................................................. If applicant is a corporate, signature of duly authorized officer (Name and title of corporate officer) Locat,on of land on which proposed work wdl be done Mop No . ...XX. .................... Lot No ...X.~.. ............ Street an~ Number ............. .-E./..~..-~;aT.v.iew...Read...&..~-.1.el,m..G. t ........... ~o .'c!.tz~_~o~.~ ............................... State existing use and occupancy of premises and intended use and occupancy of proposed construction. a Existing use and occupancy ............ ,.c]...~...e. ?:.l..~.~..g. ............................................................................................. b. Intended use and occupancy ............. ,s..~..,~..e...~?..~..~...~,tq;.....~,.a...a..e...s.s.,o.,.~.~..,.b~,j:~.~.Jr~~ ....................................... 2 3. Nature of work (check whtch applicable): New Building :~;~ ........... Addition ................. Alteration ...... Repair .................. Removal .................. Demohtion .................. Other Work (Describe) ....................... 4. Estimated Cost ............................................................ Fee ....... ~,,DO ........................................................................ (to be paid on filing this application) 5 If dwelling, number of dwelhng units ........ .~...o..~..e.. .......... Number of dwelling umts on each floor ........................... If garage, number of cars .......................................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....A.~..e..e...s..s.:?~.... 7 Dimensions of ex~sting structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ......................................................................................................... Dimensions of same structure with alterations or addmons: Front .................................... Rear ................. Depth ................................ Height ........................... Number of Stories ............................... 8 Dimensions of entire new construction: Front .......... .8. ....................... Rear ......... ~. ................ Depth ...... 8 .......... Height .................... Number of Stories ........................................................................ 9. S~ze of lot: Front ............................ Rear ................................... Depth ............................. 10. Date of Purchase ........................................................ Name of Former Owner .................................................... 11. Zone or use d,str,ct in which premises are s~tuated ........... ~.~..~..~.~.....d:~.S...~. ................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulat~on~ ......... ~ ................................... 13 Name of Owner of premises ....a..O..?..e.~.P'....~..°..J:..'.~.......°.~.[t..Address ...S..o.~'.~.~...o..~...ct: ..................... Phone No ................ Name of Architect ................................................... Address .......................................... Phone No ............... Name of Contractor ........ ~.~,.~ ................................. Address ........................................ Phone No ......... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~stmg or proposed, and red,cate oil set-back dimensions fron property lines. G~ve street and block number or description according to deed, and show street names and ind~cat whether interior or corner lot STATE OF ~f~ } COUNTY OF .............. ..o..].~.. ......... S.S. .. being duly sworn, deposes and says that he ~s the apphcan (Name of indwidual s~gnmg application) above named. He is the ................................. ?...~.e...zt.?.....o...~.....o..'~'..:t'te~ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and fd this application; that all statements contained in this application are true to the best of his knowledge and belief; an that the work will be performed ~n the manner set forth m the application filed therewith. Swam to before me this ............... .... o, ............. .......... , , NOTARY PUBLIC, State o¢ [4ew zor~ No 52.8].2,5850, Suffolk County Term Exptres March 30, ~.9~J_.~