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Home My WebLink About6852-z FORI~ NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~ .:- BUILDING PERMIT CT'HIS. PERMIT~MUST BE KEPT ON THE PREMISES UNTIL FULL ' C~OA4~ON OF THE WORK AUTHORIZED) PermisSion is hereby granted to: · 1~, ..-E dw~-l~d.--Ae~ e-~ .................................. at premises located at ..... ~¥~'"'~"r~Dl:l'"A'9'e .................................................................................... ......... , .............................................. l~$ocm.~....~,~, ......................................................................... purs, uant to application dated ......................... ~'~C ...... 1'0 ......... , 19.~.., and approved by the Bui!ding Inspector. / Fe~ $1.~..'...0..O. ............. = ~ ............... s~-~ct~r~oz~n~e ~.*o~zn proceea to f~Me the necessa~Isg~ ~teps to remedy such wo~tzon ~, Yours respectfully, ~ HOWARD M. TERRY Building lnspecto~ Approved .............. .~.~. ...... :.'. .............. , 192~. Permit No./_O..~.......~.?....~ ...... Disapproved a/c .............~ .......... ~ .................. ................................... :'"l' ................................ · / ;"' '~' ~ ¢ ~,lvfill~ n' ' r, ter ,,n,~a~s~m,-~,nt,-I a. ~is ~licatim ~st bCmpletely.fil~ i ~y ~w ' ~ ' ' ',,~ ' In~r, with 3 ~ ¢~ accurate pl~ pl~ ~ ~le. F~ ~co~i~ to ~h~ule. ....... b. Plot plan ~~atian of lot a~ of. buildi~ m premiss, ml~ionsMp ar~s, and givi~ a Ceteil~ de~ripti~ of la~ ofpr~ must ~ drawn on the diagram which is ~ ¢ ~ ~l~at~.~ c. ~e w~ ~erM ~ ~is a~licoti0n ~y n~ b comme~ before i~e of Buildi~ Pe~it. · .. d. ~n ~1 of ~is ~licati~, ~e Building Inserat will i~ue a Building Permit to the ~lic~t. ~ch permit~ shall ~'~t m the prami~s ~ail~le ~r in~im ~r~t ~ ~rk. . . e. No buildi~ ~all be ~cupi~ or ~ in whole or in ~ ~ for any pu~ose whatever until a Ce~if~e of ~c~o~y shall ~ ~n gmn~ ~ the Building In--or. APPLI~TION IS HEREBY ~DE to the ~ildi~ ~ment for ~e issuance of a Bui~ing P~lt ~ ~ ~e-- Building Z~e O~inance of the T~ of ~, ~k C~n~, N~ Yo~, and ~her ~1~ ~ ~ or R~ul~ions, for the c~tr~tlm of buildi~s, ~d~t~ or altemti~s, or for m~l or ~lt~, ~e applicant ogres to co~ly with oll ~licable I~, ordinal, bildi~ c~, h~i~ admit authoriz~ in~ecto~ on premiss and in blBi~ ~r ~e~ i~~ . ' ........ ........ ~d~ ..... ~.~ ~..~.~~.....c~.... ~Qte whe~er Qpplicunt iS ~ner, le~, ~ent, Q~it~, engineer, general contractCr, el~trician, plu~r or buil~r. ................. ~ ................ ~.~t~ ................................. ......... - ............................................................................ ~": .................. ~'~'~"r~'~'"~',,~ .... I~ appllcam is a co.orate, sig~ture of duly au~riz~ officer. (Nome and title of corporate officer) Builder's License No ................................. ;;. .................. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1. Location of land on which proposed work will be donel Map ~o.: ........................................ Lot No ......................... Street and Number ........................... ;,~.I~.~OJ~......~'...t...~....L4R ........ .l~..v.....~r/.. ................................................................ Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: ExisJting use and occupancy ....................... ~ ................................................. ~ .............................................. ......... ! ............ .d .& ,. ..-.' ............. , ................... Intended use and occupancy . .... .~. . ~ .............................. - 3:. ~;~l(ll~e of work (check which applicable): N Building ......... Addition .................. Altero ion .......... '~ RePair Removal .................. · .................. Demoht, on .................... Other Work ....................... ~ ........................ ....~ ~' I (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, 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 ...........I .................................................................................. : ................... Dimensions of same structure with alterations or additions: Front Rear Depth ................................ Height .................... Number of Stories ................................ 8. Dimensions of entire new construction: Front ........... ~...O. ................. Re6r ~ Depth ....~..?- Height ...... /.5. .......... Number of Stories .................. ..~.X3..~P~ .................... 10. Date of Purchase -.~:~ ...................... .~ ........... 1.....Name of Former Owner .,~,~,....~,~,.....,,,'~,,.....,~.,,~.,v'.....O, ........... 11. Zone or use district in which premises are situated ..................................................................................... 12, Does proposed construction violate any zoning lawi ordinance or regulation: ........................................................ 13. Will lot be regroded~ ......... ,,~,,,o, ............. Will.~excess fill be removed from pram?sas: ( ) Yes (~) No 14. Name of Owner of premises ...~.~.~.gL~.....?...:.....~....~.4~.. ..... Address .~...~...~..Lt~J.:.......~...'..~.. Phone No. ~..~..:...~'..~./.('... Name of Architect ~) e)e~ e I ................................................... Address ................................ Phone No ....................... Name of Contractor .................... .~-.~.~.? ........... ~ ............. Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether exJ.~ting or proposed, and indicate all set-back dimensions from 'property lines. Give street and block number or desc~'iption according to deed, and show street names and indicate whether interior or comer lot. STATE OF NEW ~.OP~. ~1.. I S S COUNTY OF ....~..u...~..~,..]..,~,,? ...... ~ · ........................... · .~..~...~.....{d~0. ......................... ; ...................... being duly sworn, deposes and says that he is the opplicam (Name of individual signing contracf) I above named. He is the (Contractor, agef~t, corporate officer, etc.) of said owner or owners, end Js duly authorized to perform or have performed the said work and to make and file tl~is application; that all statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Swam to before me this ........................ day of ...i ........................................ , 19.~ ....... Notary Pubhc, County .,~.....~~.).'~ ( ~ / ~L~ .............................