The URL can be used to link to this page

Home My WebLink About4729-z FOI~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMEH~ TOWN CLERK'S OFFICE SOUTI.IOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHQRIZED) N? ~729 Z Permission is hereby granted to: .... ~..a..e. ~,~...~.....~:..~... ,~..t.~ ................. .............. ~ c.s..~.%~,...~:~.~w~ ...... ~ ................. pursuan¢ to application dated ....................... ,~.~.]L ...... ,~1~ ...... i.-.., 19...~.~., and approved by the Building Inspector. Building Inspector o L.~G~0 SURVEY FOR JOSEPH W. ~ MARY H. PETRAUSKAS AT MATTITUCK TOWN OF SOUTHOLO SUFFOLK COUNTY, N.Y. SCALE: 1"=40' NOV. ~.~, 1969 REFERENCE~ GUARANTEED TO: THE TITLE GUARANTEE COMPANY JOSEPH ~ aMARYH. PETRAUSKAS. LAND SURVEYOR N. Y.$. LICo NO. ,~87~'5 RIVERHEAD N. Y, mNO. l TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y, Application No...X./~..~,.~,..:~ ....... \ APPLICATION FOR BUILDING PERMIT Date ....................... a~l~ ~1 ......... ~) .......... , 19...~0 .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in duplicate to the Building Inspector. b. Plot pi.an showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giwng a detailed description of layout of property must be drawn on the d agram which is port of this application. c. The work covered by this applicatioh may not be co~mmenced 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 inspection 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 ~Build!ng Zone. Or.dinance of the Town of Southold, Suffolk County, New York and other applicable Laws, Ordinances or Kegu~ations, tar the construction of buildings, additions or a terations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations. (Signature of applicant, or name, if o corporation) t~ouress or applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .~.&..~r..~J~t~l~~ ........................................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) '~,i( I. Location of land on which proposed work will be done. Map No.: ............ ~l~l...... .................. Lot No.: .......... zee ......... Street and Number ...... 8~....a~L~l..~..~l.tt;~Ltl~le.....~,~., ................ ;....: .................................................. · Mumcipality 2. State e~isting use and occupancy of premiSes and intended use and occupancy of proposed construction: o. Exist and occuponcy ........ 'Uaat,...ZmI' ........ .......................... ............................................................ b. Intended use and occupancy ........ ~11~..~11~1~,..d11~3:1.~,1~ ............................................. ;.., ............ ::...:..: .... 3. Nature of work (check which applicable): New Building ~ ....... Addition .................. Alteration .................. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ........................................ 4. Estimated Cost ...8~O~.,t~ ....................................... Fee ..~OeO~ ..................................................................... ~ ..... (to be paid on filing this application) 5. If dwelling, number of dwelling units ...... ~.. ............ Number of dwelling units on each floor ....................... L~...~ 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, Jf 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 ...~ ........................... Rear ....... 60 ................ Depth .-10../..~ ..... Height .................... Number of Stories ....... ~ ........................................................................................................ 9. Size of lot: Front ...... t~00 ............... Rear .............. 9~,~! ............ Depth .......... 10. Date of Purchase ......... .1~1~ ..................................... Name of Former Owner ...... ~-,t~l~11~ ........................... 11. Zone or use district in which premises are situated ........ ~.~dt, lL..8.~.l~ ......................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ............... ~'~ ....................................... 13. Name of Owner of premises ~..&.Jt..]~et~&~l~ll:&l.Address ....~//~..~l~)t~..~e&(~ ..... Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Contractor .......... Ilel~e ................................ Address ............................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions f,rom property lines. Give street and block number or description according to deed, and show street names and indicate whether i~terior or corner lot. STATE OF NEW YORK, J COUNTY OF ..~lJ~ ............ S.S. .............................. ~.~e,~..~.~.t~A1~l~,,A~ ......................... being duly sworn, deposes and says that he is the applicant (Name of individual signing application) above named. He is the ............................... ~e~..m..~. ..................................................................................... (Contm~or, agar, co~orate officer, etc.) of said owner or owners, and is duly authorized to perform or h~e performed the said work and to ~ke and file this application; that all statements conta=ined in this application are tree to the be~ of his knowledge and belief; and that the work wJ[I be performed in the manner set fo~h in the ppplicati~, fil~ therewith. Swam to ~fore me this .................. o, ......... ............... , / _ I ) ..................... Noto~ Publ,~~/~.. Cou~~ (S,gnotur, of applicant) ~ARY PUBLIC, ~tate o~ New York ~ ' No. 52-8~25850, Suffolk Co~ty ~ ~erm ~pires March ~0, ~9~