HomeMy WebLinkAbout6956-z FOI::V~ NO. g
TO~VN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
6956 Z
Permission is hereby granted to:
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to ~.~ ~...a~..maJ,~.t~:L~.. ,~ ~.ct~.. 7:~ z,~.. £ez,~.e ........ (1~,~t .. ~,~ z ..2~,£:t;.. 3.,o~4~ .................
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at premises located at .... ~[/.~..]~;~L..~...*~..~...~O~,~..,T,~ ....................................................
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pursuant to application dated ......................0~ .........;~ ............ , 1~.~.~ .... and opproved by,the
Building Inspector.
Fee $.~.,~.. L-'~ ...........
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BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
....... ........
Approved ...................................... , ....................................
D sopprove a,c .....
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
o. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showmg location of iot and of buildings on premises, relationsh~p to adjoining premises or public streets
areas, and gwmg o detailed description of layout ofproperty must be drown on the diagram which is part of th~s apphcatk
c The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will ~ssue a Building Permit to the applicant Such parr.
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 Occupar
shall have been granted by the Building inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Buildmg Permit pursuant to t
BuHdmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the construction of buddings, additions or olterahons, or.~or removal or demohtion, as herein describ,
The apphcant agrees to comply with all apphcoble laws, ordinances, b~rding code, housing code, and regulations, and
admit outhori zed inspectors on premises oaf in buildings for n~~ons~.~,j~
...... '" ....
I~Iain Road, ISattituck, l~Tew York (Address of applicant)
State whefl~er applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
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Name of owner of premises ...I'..']..i.~..1.$.~...~:,!~.9...~.....E~.. .........................................................................................................
If apphcant is a corporate, signature of duly authorized officer.
(Name and t~tle 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 done Mop No ...................................... Lot No .....................
Street and Number ................ : ............................... ~.~..i:.~..~..o..~.~. ....................................... ~[..&..~..~.i.~.~. ...........
Municipality
2 State existing use and occupancy of premises and intended use and occupancy of proposed construction.
a. Exisiting use and occupancy .......... ~.Y.....0..f..~g.9~ ...............................................................................
b Intended use and occupancy ~.~,'~, r~_ ..................................