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Home My WebLink About6864-z FOB, M 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? 6864 Z Permission is hereby granted to: M. Andrews & P. heeker Erect and maintain setional fence M~in St ~ Knapp ~lace at premises located at ............................................................................................................................ ................................................. .q .r..e..e...n. mo. r...t. ......................................................................................... pursuant to application dated .................. ..~..e.~..~. ........ ]1..~. ................ , 1~...., and approved by the Building Inspector. Fee $!. ~.:..0..0.. ............ App roved I I ' ~ 19 ........ Disapproved a/c .................................. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the Buildin Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets, areas, and giving a detailed description of layout ofproperty must be drawn on the d~agram which is part of this applicat~o, c. The work covered by this application may not be commenced before ~ssuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl ~ssue a Budding Permit to the apphcant Such perm shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or m pa rt for any purpose whatever until a Certificate of Occupant shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to tF Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances, Regulations, for the construction of buddings, additions or aJterations, or for removal or demolition, as herren describe. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. ......... ....... (Address of applicant) ~/' ~ State whether opphcont is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buildr ........ ............................................................................................... Name of owner of prer~ises .~.iii~i~.'i~ ~,'i~i...' .. ~ P J~ ~"" ~"~ ~'~"" ~. If apphcant ,s a corporate, s,gnature of duly authorized offlc-~er. '~ ~/~'~xc~¢, /,~, ~ ~-C(~' ~-'~ ~ ~ ~ 0 (Name and title of corporate officer) Budder's L~cense No ..................................................... Plumber's bcense No ................................................. Electrician's License No ............................................ Other Trade's License No ............................................... Locahon of land on which proposed work w~ll be done/~Aap No · . ...... ~ ......... :. ,., .......... Lot No .................... Street and Number ../.jJ..~l~ .....~.~.j~. ......~,~.. ...... ~..ll~J~l~..~)l~.... ..... ..~....~... ............................................. / ! Municipality State exzstmg use and occupancy of premises and ~n:ended use and occupancy of proposed construction: a Exisitmg use and occupancy .... ~...~.¢~..1~..~..~...... b. Intended use and occupancy ......... ......................................................................................... ' 3 Nature of work (check which applicable). New Building .................. Addition ................ Alteration . . ..................~1~ Removal .................. Demolition ..................---'~Other Work "' '~'"~'"~' '~' "'~'"'-'r'~l~ti~'~'i'--(Desc ' Repair 4 Estimated Cost .... /.. ...... ~. ......................................... Fee ...~..~ .................................................................. (to be paid on filing this opphcation) 5. If dwelling, number of dwelling units ........................ Number of dweihng umts on each floor .................... If garage, number of cars .................................................................................................................... 6. If business, commercial or re,xed occupancy, spec,fy nature and extent of each type of use .................... 7 Dimensions of existing structures, if any: Front ........................Rear, ................................ Depth ............. ¥ ..... Height ........................ Number of Stories .............. ~.~...~ ..... ..~. ...... ../..~.....~.~.~.......~t../l Dimensions of same structure with alterabons or additions:~ ~/~Front ~. ................................... Rear ..... ~... Depth ................................ Height ......................... Number of Stor~es .............................. 8. D~mensions of entire new construction' Front ................................... Rear ............................ Depth .............. Height .................... Number of Stories ............................................................... ' '.,.. 9 Size of lot: Front ....... Z~.~.. .......................................... Rear .......... /../...~.../. ..................... pth ................. 10. Date of Purchase ......... /...~..~.~/ ............................... Name of Former Owner .... ~.......[~...~. .................. 11. Zone or use district in whtch~premises are s~tuated .......... L.~.. ................................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation .... ~ ....................................... 13 W~II lot be regraded ...~....~. ................ Will excqss fill be removed from premise,s: ( ) Yes (X) No 14. Name of Owner of premises ~.,.~.~..C..(.~./~...~.....~..Z~.~..~....~...~..~lAddress .~..//.~.....~..~.~.~,...~.. .... Phone No....~...?..?...q..~...J.. Name of ArcMtect ..................................................... Address ................................ Phone No ....................... Name of Contractor .................................................. Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and d~stmctly all buddings, whether ex~sting or proposed, and red,cate all set-back dimensions from property lines. Give street and block number or descripbon according to deed, and show street names and indicate whether interior or corner lot ! STATE OF NEV((~JD]~I~'. ~ t c ~ COUNTY O F~./,,~x~z~,,-~.. ~' ~'~ ................ .~.~//.~.~~.~ ...................... being duly sworn, deposes and says that he ,s the appJlcanl (N'c~,~/6~ ~ndividual s~gning contract) above named. '[/ He ~s the (Contractor, agent, corporate officer, etc ) of sam owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and file th~s applicahon; that all statements contained ~n th~s apphcation are true to the be,~t of h~s knowledge and belief, and tha~ the work will be performed in the manner set forth m the apphcation filed therewith, Sworn to befor~ me th~s ;,;;;;;....;.: ,:,o,, o, ..... ........... ;:o'u y ', .................................................... y ...... / (J (~'/ature~Of apphcant)