The URL can be used to link to this page

Home My WebLink About5446-z FOKbi NO. :~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? Z Permission is hereby granted to: ~., ................. ho;:..2.95. ............................................. ...................... ~uth~,~ ...................................... to ......~ ~.~ ..~fLW...g~#...~t~,IL ~Z~.~ .....L ..a~tzze,~.e~ ..ixlt .. ~..A ~,) ............................ at premises located at ........... .~.~d~!...g.Q.~'.~....~..~,.V.~..&..~e.~l~l~...J:~:J ......... ~ ..................... pursuant to application dated ............................... /s.~l~ .......... ~1 .......... , 19~.~ ..... and approved by the Building Inspector. Building Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENTI TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ....... &..~J.4~........7..., 19..~'./ ............ ........ 'r. ....... , ..... Disapproved a c ............................................................................................. ................................. INSTRUCTIONS a. This application must be completely filled in by typewriter or in i~k and submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises, relatic~nship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn .~n the diagram which is part of this application. c. The work covered by this application may not be commenced befor9 issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue ~ Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the progiess of the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the!issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other 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, buildiing code, housing code, and regulations. ... t cl, ler. ............................................................ (Signature of applicant, or name, if a corporation) ...... ~X'"'~/9~' ........ (~c~ess thO' ~ 'dapplicant) .............................................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .......................................... ~E~ ................................................................. ; ............................................................................ Name of owner of prem ses ..Wtlll~**l'l,...~.:l~dle~ ........................... i .......................................................................... If applicant is a corporate, signature of duly authorized officer. ................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ,,,;...~ .......... ~ .................. Lot No ...... ~ .............. Street and Number ~./;~.}~.~`~t~`~&~.~{~.~.~r1q/~*~&~~~¢~ .............. State existing use and occupancy of premises and intended use an~J occupancy of proposed construction: o. Exisiting use and occupancy ........... ~E~'.'~ ................ ! ......................................................................... b, Intended use and occupancy ...... ~'i'Va'~'"g~&~ ....... {~'L"~'~') ............................................................ 3. Nature of work (check which applicable): New Building ....;II~I:~IIL... Addition .................. Alterotion .................. Repair .................. Removal .................. Demolition ........... ....... Other Work (Describe) ........................................ 4. Estimated Cost ............ .~.f~)(]~)..~, ............................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............~O"~ ............................................................................................................... 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 ............. %2. .......... Depth .............. .~ ..... Height .................... Number of Stories ........ ~1~.~ ....................................................................................................... 9. Size of lot: Front ...$~,../...t[(~).... Rear ............... .1.'l. 8../....~O~Depth ................................ 10. Date of Purchase .......... .'1.966 .................................... Nome of Former Owner .......... ~,1~ .................................... 11. Zone or use district in which premises are situated ..It~ll.,~./~.,~,. ............................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ......... ~ .............................................. 13. Name of Owner of premises .~lll.,...~..~.~.~,~.]e~,.....Address ............. I]~1..~,~el.6 ............ Phone No ..................... Name of Architect ...................................................... Address ............................................ Phone No ..................... Name of Controctor ........... ~...~&~l~ ........................ Address ............................................ 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. STATE OF NEW YOR~ .... ~ S S j ~bove named. He is the ........................... ~ .................................................................................................................. (Contractor, ~gent, corporate officer, etc.) of s~id owner or owners, ~nd is duly ~uthorized to perform or h~w performed the s~id work ~nd to m~ke and fil~ this ~pplic~tion; that qll statements contained in this application ~re true to the best of his knowledge ~nd belief; ~nd th~ the work will be performed in the m~nner set fo~h in the ~pplic~tion' filed therewith. Sworn to before me this