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Home My WebLink About6163-z ~'0~,~ ~0..~ TOWN OF $OUTHO!~D BUILDING DEPARTMEN' TOWN GLERK'$ oFFIGE SOUTHOLD, N~. Y, BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMI~ES UNT L FULL COMPLETION OF THE WORK AUTHORIZED) ,a ..Z~..~...~.~ ....... ..~-~~..~ ........ i.~..~..~.~..~/~-~--.....~....Z~ · ~'"~"C/~'~ ....... ,C~'..: ..................... ' ~~ ........................................................... ~t preZ~, ,=ted ~,..~.~....'......~......~....!....(..~Z..I~..J ................. ......................... ~..-~:y ............................... T ......... ............................... 'pursuant to application dated ........................ ;~.~c ...... .~..~'~.~...., 19~.~,,, and approved by the Building Inspector. S-234713 SURVEY FOR EUGENE B.,JR. ,~ SALLY MARTENS AT CUTCHOGUE TOWN OF SOUTHOLD SUFFOLK COUNTY, N. Y. SCALE: 1"=40° MAY 5, 1970 SEPT. $0, 1971 JAN. 17, 1972 REFERENCE: BUARANTEED TO ' INTER'COUNTY TITLE GUARANTY 8 MORTGAGE CO. EUGE~'E B.,JR. '~ SALLY MARTENS SOUTHOLD SAVINGS BANK LANO SURVEYOR N.Y. :~. L lC. NO. RIYERHEAD. N Y. FOI~M NO. ! TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .... ........................... , 19..:....:~ Approved t, ~' , 197.~]. Pemit No ..... 'L~'/ :3 ~ (Buildin~tf~spector) APPLICATION FOR BUILDING PjERMIT Application No. (/ INSTRUCTIONS a. This application must be completely filled ~n by typewriter or in mk and submitted in triplicate to the Building inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationshil~ to adjoining premises or pubhc streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of this application. c. The work covered by this application may not be commenced before issuance df Building Permit. d. Upon approval of this application, the Budding Inspector will issue a Build,n9 Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used m whole or in part for any purpose wi~atever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuancj~ of a 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 hereto described. ~l-he applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectgrs on premises and m buddings for necessary inspections. ; (Signature of applicant, or name, if a corporation) '"'"'" .................. i .......... ~ ........ ';;"." ','t: ......................... ~i State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... .O...~..~.~.~ ................................................................................. : ......................................................................... Name of owner of premises 6~ . /- / 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 ............. .7.( Street and Number ........................................................ ¢ .............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: ?47/~~lq ?'~- // ,*~ ¢ . . a. Existing use and occupancy .................... ~,c_¢. ................................. ' ...................................................................... b. Intended use and occupancy .......................................................... ' ........................................................................ 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ............. Repar . . . ........ _ Removal ......................... Demolition ........................ Other Work ..........'.~....~.....)~'.. ~....~'.;... ee .. · ~ D~scriptior e 4. Estimated Cost ...r/.... ...................................... F ............................................................................................ (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, }pacify nature and ext. ent of each type of use ................................... 7. Dimensions of existing structures, if 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 ............................ Depth ................................. Height ................................................. Number of Stories ........................................................................................ Size of lot: Front ........ .~./.~.....o. ..................... Rear ................ .~..~. ................... Depth ..,~..~..~ ...... ~. ........... : ................ 9. , Nameo,,ormerOwner ' 10.Date of Purcnase ...~.f.. ........ ... .................................................. 11. ',Zone or use district in which premises are situated ................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..../f~.... ............................................... ^! 6 . 13. Will lot be regraded .--~..~.. ....................... .~. Will excess fill be remove, d from premises; [ ] Yes [ .] Nc 14. Name of Owner of premises ...... L,.,~'/,.~ ......... ~,..d..~.....~~;2...~....~.'..(..;../?.--~ ...... (Address) (Phone No.) Name of Architect .................................................................................................................................................... (Address) (Phone No,) Name of Contractor .................................................................................................................................................. (Address) (Phone No.) PLOT DIAGRAM Eocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensi ~ns from property lines. Give street and block number or description according to deed, and show street names and indica~ e wheth- er interior or corner lot. STATE OF NEW YORK, COUN'rY O F ,../~..~,,,.,.~..O.{k.(..~ ............... I ....... ./.?._~.~.:...J~'.,L,.'~. ....... ..~.....:.......~.. ,.~..../~, ...... ~-.~.'~..~......~.j,.~.. ..... being duly sworn, deposes and says that he is the applicant ab, ,va named. (Name of individual signing contract) He is the ................................................................................................................................................................................................................ {Contractor, agent, corporate officer, etc.) of-~ald ~w~7-~r-ew~ers, and is duly authorized to perform or have performed the said work and to make and file this applicat on; that all statements contained in this application are true to th~best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ~,~,~¢~ ~,~?-~ ,q I ............ ...... ............. /-'/ // k.~~...'--'~¢ ~ ,o~c' 3.'.~ '~'~ ' / I ~, .. I [ I/in Notary Pubhc, , ~~\~ County .'~~.~.~;~