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Home My WebLink About6052-zFOll~I NO. ~ TOWN OF $OUTHOLD i 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) No. 6052 Z Permission is hereby granted to: : [~w~*ence & E[le ~ H~'doek Cutcho[ue ~o ..~ ~.g ~ Z ..~P~-~..A~.~P,X~.~h .,~,X~:X.~... ~ ................................ ~ ............ ,~. ......................................... .~.~......~...~7.~ ......... ~.:.~..~..,~f~:~:~...~.~ .............................. : ........................................................ . : ~/S Track Ave at premises Iocoted ot .................................................................... : ........................................................ pursuant ~o application dated .................................................... ,..., 19 ........ , and approved by the Building Iqspector, Fee $~ ~'eO~ ' .... 7't"~ ............ ............. '~?~V~ Building .............................. Inspector 'l .................. FO~M NO. 1 TOWN OF SOUTHOLD~ BUILDING DEPARTM£N~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...................... 19..~..'.~~' Approved ~ ~' , 19..;.~... Pemif No. ~ 0 .~..:..~.. ~ Disapproved a/c ......................................................................................... ......................... ...................... APPLICATION FOR B~.-D~G P~RMIT , · INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and iubmitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. P~ot p~an 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 application. c. The work covered by this application may not be commenced before issuance ~ff Building Permit. d. Upon approval of this application, the Building Inspector will issue a Buildin~ Permit to the applicant. Such permit shal[ 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 wl~atever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION lB HEREBY MADE to the Building Department for the issuane~ of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffotl~ County, New York, and other applicable ~aws, O~din~nces or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herei~ described. ~he applican~ agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized ins~-~,c:-r~ on premises and in buildings for necessary inspections. (Address of a State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .............. ~.:.,f.~..)...L.~..),..; ................. ~ ............................................................ ~;.....4 ........................... ~;~,.z:~ ...................... ; ..... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) / 7,3 7 1. Location of land on which proposed wgrk will be ~d.one. Map No.: ../~,~,~, ........... Lot No...,~,,~ ...... ~,.~.T. ................ .,~,. Street and Number ....~ .................... ~ ......... - ......... ~..~., .......... ~. ~ Municipality 2. State existin~ use and occupancg of premises and intended use and occupancy of p?oposed construction: a. fix[stin0 us* and occupan*V ....~.~:~.~2.(.:.~ .................... ~ ....................................................................... b. Intended use and occupancy 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work ...../.~.~.~; ........... (Description) 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, commercia~ 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 .....~.~.. .................... Height ......................... ..../,, ., /.,'~' ................ ; ....... Number of Stories ................................................. -'-D i l / /. . /b"_' ............. ; ...................... ,0. Dateof ..... Nameof ormer ............... 1 1. Zone or use district in which premises are situated .~..~/~.5.~ .................................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............................................................ 13. Will lot be regraded ........ ...v~....o. ..................... Will ex,:ess fill be_removed f~om premises:.[ ] Yes [~'] No 14 ................ ~ ............................................................... i~,'~;~ssi ........................ ~' .......i~;~'~;~' '~'~:i ............. Name of Architect ...................................................................................................................... i~[~'~'~"gl'~i ............... (Address) Name of Contractor ................................................................................................................................................... (Address) (Phone No.) PLOT DIAGRAM Locate 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 nam~.s and indicate wheth- COUNTY C~P~.~ .. ................ ) .......................................................................................................... being duly sworn, deposes and says that he is the applicant above named. (Name of individual signing contract) He is the ................................................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of sa d owner or owners, a~r~Hd~l~Br~[~o zocri d to perform or have performed the said work and to make and file th~s' apphcat~on,' ' . that all statements contmned ~s ~rc~on are. tr~ ~o the best of his knowledq~d belief; and that the work will be performed in the manner set forth 'n the app 'ca~b~'?~'t~'~;;e~";'~'"~ ~' '/~ / ~ ....... ...... .......... /) ...............~ ,~' ~ . / ' ~ ........................ ........................... ~ ' (Signature of appticant~ '