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Home My WebLink About6895-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. BUILDING PERMIT CT'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 6895 Z Permission is hereby granted to: ~.~g~...~.~.~.~..o.~ .......................................... ........... g.~.~.~te .............................................. at p~mises located at .~..~.~. ...... .~.~..~.....~.$.~...~..~Qp. ......................................... .................................... .~~..~ ........... ~ sa ...~, ..... C~cho~ ........................... pursuant to application dated .................... ~.~.~.....~ ................ 19.~.., and approved by the Building Insp~tor. Fee $..'J..O..~..Q.Q .......... building 'Tnspecto/ I~OENI NO. 5 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ORDER TO REMEDY VIOLA~TION Zonin~ Ordinance / ~ ~ .~...~ .......... O~her ~plicable Laws, Ordinances or ~e~ulat~ons ............................................ at prem,ses hereinafter described in tha~~ .................... ~(stote~Zchor~cter ~~~. ~...~ ............................ (Store section or p~ro0roph of opplic~ble bw, ordinance or regulation) YOH AR[ TH[REFOR~ ~IR[CT[D AND ORDER[D to comply w~th the law .nd to remedy t~ conditionso~e ment,oned forthw,th on or before the .......... ~..~~..~ day of ..~~ ................... , of Failure to remedy the condition s~~~mply wi th the a ppi i cable p roy is ions of law may constitute an offense punishable by fine or imprisonment or both. BulldOg Inspector FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TO%VN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a~...~.. ...... ~.~.. APPLICATION FOR BUILDING PERMIT Date ............ ..~..'...~.~...?.........~...~..~......, 19...~..~. INSTRUCTIONS a. This appl~cabon must be completely f~lled ~n by typewriter o~ 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 Jot and of buildings on premises, relahonsh~p to adjoining premises or pubhc streets c areas, and giving a detmled descnpbon of layout ofproperty must be drawn on the diagram which is part of this applicatior c. The work covered by th~s application may not be commenced before issuance of Building Permit. d Upon approval of thzs apphcabon, the Budding Inspector w~il issue a Building Permit to the apphcant. Such permi shall 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 whatever until a Certificate of Occuponc shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances c Regulahons, for the construction of buildings, addmons or alterahons, or for removal or demolition, as herein describe, The applicant agrees to comply w~th all apphcable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builde, Name of owner of premises ..................... ..~...(. .................. ~ .~. ~.../. ........................................................................ If applicant is a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) Builder's License No. Plumber's License No.....~/...O../...~.A ...... ~...0~.....~.. ...... el ,' 5 Electrician's License No ..~...~..(..~..~ ....... Other Trode's License No. 1. Location of land on which proposed work will be do~ne. M~p No...4~...~....~.......~.....~..~.:.....~..... Lot No ....... ..~...?'....~.. Street and Number ...,~,Z<,~,,.,~., .~,./., .~,.,.~.~.,.~,. ...... ....... .~.,~..~. ~,..~..q.~-. ............................................ Municipality 2 Sto~e existing use and occupancy of premises and m,~ended use and occupancy of proposed construction: a. Exis~ting use and occupancy ........... ./..~.~.~.....'~.....~/~'~. ............................................................................................ b. Intended use and occupancy .~...~. ~.~/.....~.O...,~.. k..z......~....~.....~.....r.?...q..,?.~ ..... Z~..¢x~...~....~....~.~....?..e..o....,2?.. 3. Nature of work (check which applicable). New Budding ................. Addition ........ ~ .... Alterahon ....... Repair .................. Removal .................. Demohhon ................ Other Work ......................................... · c'/ /~ ~ (Description) (to be paid on filing this applicahon) 5 If dwelhng, number of dwelling umts ........................ Number of dwelhng umts 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 ............................................................................................... D~mensions of same structure with alterahons or addihons: Front .................................... Rear ......... Depth ................................ Height ....................... Number of Stories ............................ 8. Dimensions of entire new construction' Front ................................... Rear ........................... Depth ........ Hmght .................... Number of Stories ................................................................ 10 Date of Purchase .........../..~..~...~. ............................... Nome of Former Owner ...~./~.~~......~../.:..~ ~J 11 Zone or use district in which premmes are s~tuated ............................................................................... 12 Does proposed construchon violate any zoning law, ordinance or regulation ..... ../~....¢. ................................... 13 Wdl lot be regraded ............................ Wdl excess fill be removed from premmes. ( ) Yes ()(~) No Name of Owner of prem,ses ~...~....V(.(.~ /.~/...~..../¢....~...(...~.'.~. ..... .~..'~ Address .(.'...¢~4~...~.~.~.~..~.~ ~__ Phone No. 14. Name of Architect .................................................. Address ................................ Phone No ...................... Name of Contractor ....................................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and md~cate all set-back dimensions iron property lines. Give street and block number or descnphon according to deed, and show street names and red,cat, whether in~erior or corner lot STATE OF NEW~YO~K. lc c COUNTY OF ...~..u~...z..o....~.. ............... ,fo.,, .............. .N.a..n..c.~'...H...a~....r.~.?t..jCy...o..n. .............................................. be,ng duly sworn, deposes and says that he is the opphcan (Nome of mdiwdual s~gmng contracf) above named. He ,s the Contractor (Contractor, agent, corporate off,car, eta ) of sa~d owner or owners, and Is duly authonzed to perform or have performed the said work and to make and this applicabon; that all statements contained ~n this application are true to the best of h~s knowledge and behef, one tha~ the work will be performed m the manner set forth m the apphcation filed therewith Sworn to before me this ........ .2..8..t..h. ........ ~~~_da of September , 19 ...... ?.3 ~¢//9~, ~,__ ,c, ,, . . ..................... ......... Notary Publ 't~otary pubhc in Stat~;~eW York Ho, 52.7057150 Residing m Suffotk Cotmt~ Commission Exptres March 30, [9