The URL can be used to link to this page

Home My WebLink About5888-z FORM 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) N? 5888 Z Permission is hereby granted to: .... r.~,ueze~...La~ae&pt~l...Lt~d..A~g..~l~os Sh/~ley ~ to ... ~:,~ cf,.. ~u~... aaAmtaZu...f, eaee.....(.pna t.. &. t~.,tl.) ........................................................... at premises located at ..... ~..~.... ................ .~...~.~-...e~..~...~.gk..~..a.,~,~. ..................................................... ........................................... ~l~Lth.~ead ............. I~eee~ie...ll.,.~ .................................................. pursuant to application dated ........................~1~1~ .......... ~.~ .......... , 19.~,.., and approved by the Building Inspector. TOWN OF SOUTHOLD RUILDING DEPARTMENT TOWN CLERK'S OFFICE ~/,.- ~- ' -~ ~ " '~:z" '~' SOUT.OLD, N.y. / .... APPLICATION FOR BUILDING PERMIT ~' " Date ~'(~ ~ 'r // ~9..2....~.. ,~ ~"~ ~ INSTRU~IONS ~ a. This appli~tion must ~ ~mPletely filled in by W~writer or in ink and submitted in tripli~te to the Building Ins~ctor, wi 3 ~ of plans, a~urate plot plan to scale. Fee a~ording to schedule. ~] b. Plot plan showing location df lot and of buildin~ on premiss, relationship to adjoining premiss or public stme~ or areas, an~ giving a detailed description ~ ~out of pro~rty m~t ~ drawn on diagram which is pa~ of this application. c. T~ wo~ ~vered by this application may not ~ commen~d ~fore issuan~ of Building PermR. d. U~n approval of this application, the Building Ins~or will i~ue a Building Permit to the appli~nt. Such ~rmit shall be kept on~ the premiss available for ins~ction throughout the work. d. No ~il~ng shall ~ occupied or u~d in whole or in ~ ~or any purp0~ whatever until a ~ifi~te of Occu~nw shall have ~en~ gren~ by the Building Ins~ctor. APPLICATION IS HEREBY MADE to the Building Department for the issuar~e of a Building PRrrpit pursuant to the Building Zone O~i.n;~.qLe_f ~.~, .~_ ._ ' . .... ma~l~ee!~ ~m13 .t~;l~ws; Onti. a.ces =F~.the cor~, truction of .... , '~, of~ e~denM~ttlen, es herein described. The applicant agrees to comply with ell applicable lews. ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises end in buildings for necessary inspections. (Signature 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. ....... /,,.~.~:~.t'~' ........ .~...e .~..~..*~.....t~..../~... ....................... . ............................. : ................................................. ~ ........ · 7.-7. ~, ...~ ~ Name of ~vner of premises ..... ..J~'..~..(..(..J.~......~.../~/.i~.f~.~..~x~....~.P...~..~,~ ..................................................................... ...'~rt*.e..~.....~.......%..x.~..~.~..L~....,~ ........... ~ .... '~ (Name and title of corporate officer) Location of lend on wh,ch ro osed work 111 be done Ma No ~.5 ,I Lot NO ~ 1. ' p p ~ , p ,: ............................................................... Street and Number ...... ~....~7..,(..~....~:....~ ,~...~..~...~./...~.. ................................................. Municipality 2. State existing use and occupancy of premises and4ntanded use and occupancy of proposed construction: a. Existing use and occupancy ....... J.......~.~..~...!..~..:t~ ...... i...../~...~.~../...~..rR~.....c..~:.. .......................................................... Intan o&~' ~1, A- ~ t, I~ b. ded use and occupancy ........ ~ .................. .'/. ................................ ..~::~.....~ ................................................. 3. ' Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration.....,..,= ..... Repair ......................... Removal ......................... Demolition ........................ Other Work .~..'~ ....... ,....~ ........ 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 any: Front ..................... Rear ........................... Depth ................................... Height ........................................................... Number of Stories*. ............................................................................ Dimensions of same structure with alterations or additions: Front .......................... Rear ......................................... am De th ............................................. Height ......................................... Number of Stories ........................................ P . / t Dimensions of entire new construction: Front ....~....0.., .......... Rear ....... ..~1....~..~;... .......... Depth ...J....~ ................. Height ......... ..~....~...../.:....: ...................... Number of Stories ............ .~..Z~ .............................................................. x', / I_ I Size of lot: Front ...'../.." .~........~.....~. ........... Rear ............ /....~... .................... Depth ~: ............... o~,~-/e- /.~.. ......................... ~t.re/co Height .................................................... Number of Stories ...................................................................................... Date of Pumhasa ....... Name of Former Owner 11. Zone or usa district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... .~.......~.. 13. Will lot be regraded,. __/?....O..~,. /_J ~ ~J_, ,'~,,_._ .................... Will excess fill be removDd from premises: [ ]Yes, L, ,/ ,,~ , 14. Name of Owner of premises~l~.e~.,.{~-.~t.~'..~;[~....../~.~...'..~..~...^J....~.../m'..~.t~..~"l'....¥.~.{i-...t'..-~... ........... .~.,,~',.oo~l~......o~r~...~...{~ .... (Address) (Phone No.) Name of Architect ..................................................................................................................................................... (Phone No.) (Address) Name of Contractor..~../. ............. ~J~.~.e.e~ .......... I~...~ ............... '/~.~...~....~J~e.~ .................... .~r~.~ (Address) (Phone No.) PLOT DIAG RAM ,- '1~ , L, ,o~a, te, c early ,and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from 'p~o'~erty lines; Gt~e stree~ a~d block r{umber or description according to deed, and show str, ,~et names and indicate wheth- er interior or corner lot. - .... I (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to performor have performed the said work and to make and file this application; that all statements contained in this application are true tO ~J~eJ3e~tu~F~'~"~g~ end belief; and that the work wi I be performed in the manner set forth in the application filed therewith. , ,No. 52-0344963 Suff~ik Coun~a,' ,/ ~ ¥~f'~ G'~"~'~ Commission Expi~:~6~h 30, 1~..~//~',,~ ~ ................. .......... /..../....day of ........... ~--'7'"'"'")1 ............. 'g/:': ..........."~'/' ~ ') Notary Public~,~...~~...~u nty ...~~.~..~ --.,~.. ............. .~...~ .......................