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Home My WebLink About6301-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) No. 6301 Z Permission is hereby granted to: Ty~ahe~...~a~t~¢.,...Fen~e...C~:rt~.-.,.A/C..-~i.-~ -Telephone Go ...... t~6 ~., ,~r~-se .H~ to. ~c ~..a~.. ~a.z~&a~.n.. ~...Ye~ ~...o~..~/...~ ~.. ~1. -~..~a~...C a.. at premises located at ..... ,~-]~..-.~J~l~,--,~a~ .................................................................................. ................ : ........ Cn2~h~.g~ ....... N,~ ....................................... ~, pursuant to application dated ....................... De.e,....6 ............ ~,..~., 19..~2., and approved by the Building Inspector. i]OT~ f~ont fence not ovee jf~ h~h Fee $...1.~. ,.O.O .......... CO. TOW~ OF $OUTHOLD BUILDING DEPARTMEN~ TOWN CLERK'S OFFIC~E SOUTHOLD, N. Y. Fxamined ...A.~.~......~ ............ 19117...~.:' Approved ........................................ tx , 19 ........ Pemit .................... Application No.....~..~..0....J .................. Disapproved a/c ............................................................................................ (Building I nspecto~) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted m triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Pict plan showing location of lot and of buildings on premises, relationshi~ to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of this apphcation. c. The work covered by th~s application may not be commenced before issuance Of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Budding 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 in whole or in part for any purpose whatever until a Certificate of Qccupancv 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 Building ZoQe Ordinance of the Town of Southold, Suffoll~ County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buiidlngs, additions or alterations, or for removal or demolition, as herein described. 'The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (S~gnature of applicant, or name, if a corporation) ...................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ..¢ ~.Y~..¢~m~e.-~-~f .......................................................................................... If apBlican, t.is,,~ corporate, sianature 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 .¢,~z.~..;~...~.~'~c,t'~/./..c~Ci~..~.~l~.t~f.~,~..~...~.-./~i~i~.ii~ .......... 2. State existing use and occupancy of premises and intended use and ocdupancy of proposed construction: a. Existing use and occupancy ...~'~,¢.~.~..{~-",,z~,~,~,4,~..,..~~..~~.~r~-. ................. b. Intended use and occupancy ...... ~r~r~e.~..~.i ...................................................................................................... Repair ......................... ~emov~l ......................... Demolition ........................ Other Work~ Nature of work (check which applicable): New Building ....................... Addition ..................... !AIt~3ti0~; ............. 4. Estimated Cost ~0~00. ................................ Fee .................................................................. (to be paid on filing this application) (Descripti)n) 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 (;~ "~.~¢,,e ......... 7. Dimensions of existing structures, if any: Front ..~..~.t. ............. Rear ..... (~3..t ................ Depth ....~ .............. , ............. Hmght ..;[~. .................................................... Number of Stories ~ Dimensions of same structure with alterations or additions: Front ...~ ............... Rear ....... ~ Depth ..-~e .................................. Height ..... ~ ........................... Number of Stories ...~ ~ J 8. uimensions oT entire new construction: Fron~;~ ......... ~...,r. ........ Rear ......................... e ... Depth .................. I .............. Height ................................................. Number of Stories .......................................................................... ~ .............. 9. Size of lot: Front ,, .................................... Rear .......................................... Depth J Height .................................................... Number of Stories ...................................................................... T .............. 10. Date of Purchase ......~ ................. Name of Former Owner ............................................................ ~ .............. 11. Zone or use district in which premises are situated ..~ ...............................................................J .............. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................... 13. Will lot be regraded _..~ ............................ Will excess fill be removed from premises: [ ] Yes 14. Name of Owner of premises ........... ~ '~ ............................................. ~ ~, ~O~ ~)~; .................. ~ .................................... ~ ~ t~,~, ~ .............. (Address) Phone No.) Name of Architect ...................................................................... ~;~.;~ ................................... ~.~.~.~ ............. Name of Contractor ....~.a~.~-~.~q.~...~.~..::~...~..:;~,...'..r.~. (Address) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b ]ck dimensions from property lines. Give street and block number or description according to deed, and show street name~ and indic~ te wheth- er interior or corner lot. STATE OF NEW YOR~, ) COUNTY OF ............. ~.~:~ ................... ) ...... ~.~.~...~..,..~:~:~ ............................................ being duly sworn, deposes and says that he is t~ (Name of individual si~ing contract) (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have_..,,.,,¢..~rformed the said work and to make and fih statements contained in this application are true tqt[~95h~sl~[~'ffO~lff~g~ and belief;, and that the work will be s~t~' forth in the application filed themw;th gOTAR~ pOB.~UC S'IMt' ut '~"", ' ' ~ t i applicant above named. this application; that all ~erformed ib the manner t)