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Home My WebLink About5850-z FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 5850 Z Permission is hereby granted to: ,~I~.. C~. ~ at premises located at ........... ~ll~..~l&~l~.~l~l~ll, ...... 4~J~;l~r~lee.~ll~;) ................................... ........................................................................ I~ $,t,~.tllek ....... ~i,~. .................................................. pursuant to application dated ........................... ~..~. ......... ~ ......... , 19...~..., and approved by the Building Inspector. Fee $..~ 5*,~0 ......... TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ , 19 ........ Pernit No .................................. ~ Approved Disapproved a/c ..~ .............................. ~ ......... z (Building Inspector) ApPlication No ................................. (~ APPLICATION FOR BUILDING PERMIT ~ Dote Hay ~' 72 ~ INSTRUCTIONS ~ e. This epplication must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, w~th~.. 3 sets of plans, a~urate plot plan to scale. Fee aecording to-schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, andn~l giving a detailed description of layout, of property must be drawn on diagram which is pert of this application. c. The work covered 'by this application may not be commenced 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 work. a. 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 MAD~ to the Building Dep'~ment for the issdahce 'of'a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New YorE, and other applicable Laws, Ordinances or Regulations for the construct on of build{ngs, additions or alterations, or for removal or demoJitio~,'i~e~iri described. The applicant agrees to comply with all applicable law-~ ordinances, building code housing code and regulations and t.o, admit authorized nspectors on pram scs and n bud ngs for necessary nspect ons ~t~./~ {Signature of applicant, or name, if a comoration} {Address of applicant} State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Rgb. V. Bah erhaa Name of owner of premises .......................... ,9. ............ ~ ................................................................................................... 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 /~ ~e.:Lt~ ~oe. cl. ~a'c~:L~c~: ................. ........... 7~;~'~'~'"~ ..................................................................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~...~..s...~..~..e...s..s.....b..g..~.~,.G..~.~jz ............ .(..~.~)~..]:...e.~.z'...e..e....~.e...s..~..,...). ............................. Intended use and occupancy ...... .s..a...~..e.....~.;:J,.!~.~..~.~..~..t~[~,~.l~...;['.e,~14g.~...(.6;['.t,~ .............................................. J~ · 4. 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration...: ........... FENCE Repair ......................... Removal ......................... Demolition ........................ Other Work .................................... (Description) Estimated Cost ............................................... Fee ................................................................................................. (to be paid on filing this application) 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 usa ....... .~.~.~.~A'~$~. .......... 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 ................................................... ; ..................................... 9. ·Size of lot: Front ............ .1..?..0....?. .............. Rear ............ ~ ..................Depth ............. .2..~.2....._+. ......................... Height .................................................... Number of Stories ...................................................................................... 10. Date of Purchase ..................................... Name o4 Former Owner .................. : ......................................................... 11. Zone or use district in which premises am situated ......... ..~.....1. ..................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............. ~ ......................................... 13. Will lot be regraded .... __~__o, ........................... Will excess fill be mmoved from premisas: [ ] Yes [ ] No 14. Name of Owner of pmmisas ........ ~[o~:..C.....~h~e~;~a. aAt ......................... .N~.t~.:l,~,u~,k ....................................... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (AddresS) (Phone No.) Name of Contractor ....~,0,1i~e. ..................................................................................................................................... (Address) (Phone No.) PLOT DIAG RAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sat-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. See filed plan STATE OF NEWYORK~[ffoi~ ) COUNTY OF ...................................................... ) .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of indtviclual signing contract/ He is the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.} of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in 'this application are true to the best of hi;ol~,~ledge and belief; and that the work will be performed in the manner JUDITH T. B set forth n the appl cat on f ed thq, rew th °'a Pub'ic' 'ia' ;~,r N ty S Court 5 - , may ,o s~-o~'~'~9~?,..!~o I /X , I ...................................... aay or ...................... ............ Notar~ Public ............................................ ~' ~/ (l~onature of applicant} ,/ \, joseO~ ,rdOT£ : YOUNG · YOUNG 400 OSTRANDER Av£NUE, RIV£RHEAD, N£W YoRK W. YOUNG HOWARD W. YOUNG ~ FOR: ROY C. SCHOENHAAR AT MATTITUCK SOLITHOLD ~4JiAIIdlll~ T wi~l~ TO: NOIl£ TITLE CO, C. ~E~AAR SUFFOLK CO., N.Y.