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Home My WebLink About6082-z FO~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING~ PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISE CQMPLETION OF THE WORK AUTHORIZED) N.o 6082 Z UNTIL FULL .pursuant to application dated ...................... 'Building Inspector. Fee $;.?..~..~ -~.,. .......... Permission is hereby granted to: t~.~..~e~k..~.~a~,. C~. JL/e...~.~...l,et~n .............. ~*~t~.: ......................... :~ ................. to lJ~ee ~... ~d,..mnd~n..e~.,£enee-"~n -.fl, u~t '-&'~de'"l~ ........................................... at premises located at ...L...~...II.~,,~J,.,.J~ ......... .~.-'.-;.'.~.' ....................................................... .................... i~ti~hetd~ l~:g, ~' I ' 19..~.,, ond approved by the Building Inspector TOWN OF SOUTHOLD BUILOING DEPART/vIEbI~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19......~... Approved ............... "J.L.~ .......... :.: ......... , 19.1.?.(~emit No....~....0...~.....).::..~ ...... Disapproved a/c ~.~~.., ~ ......... (Building InspeCtor) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and 3 sets of plans, accurate plot pJan to scale. Fee according ~o schedule. Application No....~....O...~..~ ............ Dote ................................ , 19 ............ ubmitted in triplicate to the Building Inspector, b. Plot plan showing location of lot and of buildings on premises, relationshil~ to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram Whi(h is part of this application. c, The work covered by this application may not be commenced before issuance f Building Permit. d. Upon approval of this application, the Budding Inspector will issue a Buildin Permit to the applicant. Such permit shall be kept on the premises avadable for inspection throughout the work. ~ ,,~ e. No building shall be occupied or Used in whole or in part for any purpose wl~atever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION tS HEREBY MADE to the Budding Department for the issuane~ of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffotl~ County, New York, and other appli,a, ebie iLaws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. ~he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectgrs on premises and in buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether apl~licant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name o ' odZif prem,ses .... .......... ........................................ If applican'~ 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.I'X..~L,i; .......... Lot No.t..., ...... ~.l ......... , ..... i.., ........... Street and Number ....[..~.~ .................~0..~,.....~ .......................... ~ ............... : ......................... :.1 ............. L..~ ........ ~ ~unicipality 2. State existing use and occupancy of premises~ a~d_ ~U ~ ~~~intend? ~e and oc~cy of p~s~d construction: a Existing use and occupancy ...... .~ ............. .~;,.~~.....'..'.~~ . , ~ ~ a .... b. Intended use and occupancy .......................................................................... , ......... : ........................................... 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration. Repair ......................... Removal ......................... Demolition ........................ Other Work .....J~..~ (Deseripti 4. Estimated Cost .....~..~.. ................................. 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 .............................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....................... 7. Dimensions of existing structures, if anv: 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 construchon Front ......................... Rear ............................ Depth .................. Height ................................................. Number of Stories .......................................................................... 9. Size. of lot: Fro~....~.....~... .................. Rear ...... .~...~.... ........... ~. ......... Depth ....~...~ ............... . Height ......... .~..v,- ................................... Number of Stories .................................................................... 10. Date of Purchase ..................................... Name of Former O~}r..~ ..................... .~,. ............... 11. Zone or use district in which premises are situated ~ ""'~ 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................. 13. Will lot be regraded ....................... / ~lk ~'7 II //; ........ Will excess fi[Lbo re. moved from prem, ises: [ ] Yes [ ] N 14. Name of Owner of premises ...I...~..;~LL.~,..~.~...~......~.I~-~.~.t......,.L~..¢,~.I~..Vc~....~..~..'L .............. ~.% (Add,ss) (Phone No. Name of Arch tect ...... , ................................. ~.~..~. ..... __ (Address) _ (F~l~c~rle No. Name of Contractor .~.~x:~..~.....~.~., .,O...~..~.~...,~..~..E.~...~..~......~t.~.~.~.,{ .... {Phone No, (Address) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimen~ property lines. Give street and block number or description according to deed, and show street names and inc er interior or corner lot. "5 4-. of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this applicl statements contained in this application are true to the best of his knowledge and be~ie~snd that the wo~ill be performed i ~e[ forth n the ~pp cat on f ed there~ ions from tion; that all ~rt.h~ manner