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Home My WebLink About6941-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT fi'HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6941 Z Date ....................... Jg~.t, ......... 23 ........... , 19.~.. Permission is hereby granted to: J~r~ ~US Juettne~' ......... F..~.~.t4..~.~.~ ................................................ to...e...r..e..q..t....a...n..~...~..a. ~ ~.~a.~,..~., .~. ~.~..cke.¢e... ,f.e.~.cs~...ea..,q~.u.t,h.. ;R.~.~. t;~... ~ ............. at premises located at .....~../.~.......~.~.~.~.~.q~...~3~ ............................................................................ gatt~tu~k ~,~, pursuant to application dated ~)~ ~. , 19~..~....., and approved by the Building Inspector. F~e $~.~..e....~.. ............ Examined Approved FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'$ OFFIGE $OUTHOLD, N. Y. APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This applicohon must be completely filled ~n by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showmg location of lot and of buddings on premises, retohonsh~p to adjolnmg premises or public streets or areas, and giving o detailed descnphon of layout ofproperty must be drawn on the diagram which ,s part of this application. c. The work covered by this application may not be commenced before ~ssuonce of Building Permit. d. Upon approval of th~s application, the Building Inspector will msue a Budding Permit to the apphcant Such permit shall be kept on the premises available for ~nspection throughout the work. e No budding shall be occupied or used in whole or in part for any purpose whatever until o Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuonce of o Bulld,ng Permit pursuant to the Bu,ldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildmgs, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspechons. Julius Juettner (S~gnoture of apphcont, or name, if o corporation) ~-attituck (Address of applicant) State whether applicant is owner, lessee, agent, architect, engmeer, general contractor, electrician, plumber or builder Name of owner of prem,ses .... ~..~..1..jr..~q~ ...,:T.?.:.e.~..t..rt..e..~ ....................... If opphcont is o corporate, s~gnoture of duly authorized offtcer. (Name and title of corporate officer) Builder's License No .................................................... Plumber's L~cense No ................................................. Electrician's License No ............................................. Other Zrade's License No ............................................... 1 Location of land on which proposed work will be done Map No' . ..i:9J~.¥..~:9.~'.z ................ Lot No. ~..~c.. ................ Street and Number ~festvie%,z Orive ~,~ttituck if.~. Municipality State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction' o. Exisiting use and occupancy clweZ linF~ LL ~ccessory buildinF~ b Intended use and ~cuponcy ....~.~..}~¢.~...~.~.~.. ~..~.~..~?.~.~ ...................................................... 3. Nature of work (check whmh applicable): New BuHdmg .................. Addition ................. Alteration ...... Fence Repair .................. Removal .................. Demolition .................. Other Work ............................................. (Description) 4. Estimated Cost ........................................................... Fee ...1..~..?..0...C). .................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .o...n...e. ........... Number of dwelhng 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 existmg structures, if any: Front ............................ Rear ................................ Depth ................... Height ........................ Number of Stories ....................................................................................................... D~mensions of same structure with alterahons 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 .............................................. 11. Zone or use district in which premises are situated . ..!!,,~.~.[...c!.~..~. ........................................................... 12 Does proposed construction violate any zoning law, ordinance or regulation' AP ................................................. 13. W~II lot be regraded ..... ..n..o. .................. W~II excess fill be removed from premises' ( ) Yes ( ) No 14 Name of Owner of premises .J..u..1..i..~..s.....J..~...e..t...~.z].e...r. ............... Address ................................ Phone No .................... Name of Architect .......................................................... Address ................................ Phone No ..................... Name of Contractor ....... ~.a.:a~:.e. ..................................... Address t.~ttzt~J.c.¢: Phone No. PLOT DIAGRAM Locale clearly and dishnctly all buildings, whether ex,~tmg or proposed, and ad,cate all set-back d~mens~ons fro: property hnes Give street and block number or descr,pt,on according to deed, and show street names and indica whether interior ar corner lot STATE OF NEW Y, QRI~. [ ¢ ¢ COUNTY O F-..S-u. t.~..r..°...z?..~ ............... ~'~ ........................ .J...~..l..$..~.~....J...~..e...L..t.?L?..r. .................................... be,ng duly sworn, deposes and soys that he is the apph~ (Name of ~ndiwdual s,gning contract) above named owner- builder Me ~s the ....................................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa,d work and to make and this applicahon, that all statements contained ,n this application are true to the best of h~s knowledge and behef, tk, a~ the work will be performed m the manner set forth in the applicahon filed therewith Sworn t.0 before me this ................... 2..~ day of ............. .U.?...t. ...................... , 197..3. Notary Public, . ................................................... County