The URL can be used to link to this page

Home My WebLink About5900-z FOl~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTM£NT ;: 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? 5900 Z Date ............. .................................................. Permission is hereby granted to: .~.~;.~....~.~.~.z....~... ~.,. ~.~.,...~ 19....~,~ and approved pursuant to application dated .........................~y--.-2-~ ........;...., Building Inspector. Fee $..'J-~,O0- ......... TOWN OF SOUTHOLD[ 67~'~%~''~ ~. BUILDING ~ DEPARTMEN~ ~ ............. ~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Application No ........ ~.. ...................... Approved ........................................ , 19 ........ Pemit No .......................... , ........... Disapproved a/c ............................... ......... ..................... APPLICATION FOR I~UILDING PERMIT Date ~ay 2 ~ INSTRUCTIONS ; 3 b. Plot plan showing location of lot and of buildings on premises, relat~onsh!p to adjo ning premises or pub c streets or areas, and~ giving a detai~ed 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 ~ssuance of Building Permit. d. Upon approval of this apphcation, the Building Inspector will ~ssue a Build~r~g Permit to the applicant. Such permit shall be kept on ~,, the premises available for inspectto~ throughout the work. e. 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 Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance oi a Budding 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 buddings, additions or alterations, or for removal or demolition, as here~n described,;The applicant agrees to comply with all applicable laws, ordinances, budding code, housing code, and regulations, and to admit authorized inspec'~ors On premises and in buildings for necessary inspections. Hallock ~utnZll (Signature of applicant, or name, if a corporation) .................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, gene~ral contractor, electrician, plumber or builder. Contractor Name of owner of premises ~'[~. D.. ],,.,..,0.r~Z'~Z[.aJ.~,~ ................... ',....~ .................................................................... If applicant is a corporate, signature of duly authorized officer· {Name and tide of corporate officer) 1. Location of land on which proposed work will be done. Map No.: ....... ~. ...................................... Lot No.....?;Z~... Street and Number ........ .b.'.~.~..,~.~;-~..~...~..o. .............. ¢.~>::.~,.k,~.~.~g.~ .............................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupa9cy of proposed construction: · . D~e]] lng : a. Existing use and occupancy ................. -.;;; ....................................... , ....................................................................... b. Intended use and occupancy ........... ~.~.g~L~...~(~%~...~1;;.~`d.~...~.~...~.~.~...~g~.~...¢]~.~(e~..~.~ ......... 3. ' Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ........ : ...... Repair ............. - ............ Removal Demolition ........................ Other Work ......~..~...~..C.~ .................... ......................... {Description) 4. Estimated Cost ............................................. ~;' Fee 1,~o00 ........................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....~o~... 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 ......................................... Depth ............................................. Height ......................................... Number of Stories ........................................ 8. Dimensions of entire new construction: Front ......................... Rear ............................ Depth ................................. Height ................................................. Number of Stories ......................................................................................... 9. Size of lot: Front ...................................... Rear .......................................... Depth .................................................. 10. Date of Purchase ..................................... Name of Former Owner ............................................................................ .............. 3, f, ...................................................................... 11. Zone or use district in which premises are situated "'" ' 12. Does proposed construction violate any zoning law, ordinance or regulation: ......... ~.o. .............................................. 13. Will lot be regraded ................................. Will excess fill be removed from premises: [ ] Yes [ ] No 14. Name of Owner of premises .~.~..~.,~,G~;c~.~.;~.~ ..................... ~%~;.~:~;~.c~ ......................................... (Address) (Phone No.) Name of Architect ..................................................................................... (Address) (Phone No.) Name of Contractor .~3.~.o~;..~u.~;[;]~7. ....................... .C~A~r~s~so ................................................................. (Phone No.) PLOT DIAGRAM I'ocate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- STATE OF NEW YORK, ) COUNTY OF ...... t .......................................... ;~,~.~.~.,t3~,~i*..~.~.~}..2,~;~,~1:;; .................... being duly sworn, deposes and says that he is the applicant above named. (Name of inatwauat si~ing conrracu He is the ...................... ~.....~.O~.~LC.~ .......................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to ~rform 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 his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. ......................... ~.~..~..day of ............................ ~...:~ ....... Notary Public, ..~~....~.,....7~~Y ~..~ ................................... '~'~ .............. ~ ~ -- - . (Si~ature olappticanu