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Home My WebLink About6974-z FO]h4~ NO, 2 TOWN OF $OUTHOLD BUILDIbiG DEPARTbtEbiT TOWbi CLERK'S OFFICE SOUTHOLD, bi. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6974 Z Permission is hereby granted to: ..... ~..~.:.,.~..~. ........... ~...~.. ~...,.z3.. ............. .......... ~,~.~. ..... w.,e.~.~z~.~. ....... ~:~.z ..... ~ ,~ .................................. C..c,L.,-....¢.~.Le2.. ..... 'd...c ........ / t '::) 3.~ ,o .... ..e...~..~...c.._..~ ............... ~ ....... ~e...C.,...c.=~.'. .......................................................................... .,.../:.~...L....~../..?. ...... ~..r.~..s..~.~.?. ..... ?..~..~..,;: ........................................................................ pursuant to application doted ............................... 7. ..... ...~....~.....J~-., 1Z.."~....., and approved by the Building Inspector. Fee $.../....~..'...~ .... Building Inspector FOR~g~ NO. 2 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? 1447 Z Date ........................... ~ .~[ ... 19..6~.. '~ Permission is hereby granted to. ~ ..... ~ ./,~,.. l~.e.~g..e~. ............................. , .... I~t,J,'b~ ,o_~ ,... I~ew '~'~ ......................... ~ .. to ...~....~..~ .~.e~....~ .~...~...e.~:.....t~...~.z..~...~ ................................................................................. pursuant to opphcat~on doted .............................. ~____n~....~L,~ ............. I~]L ....., and approved by the Building Inspector Fee $.~-.0.~.~...IJ~$.~ ~Ld Building Inspector TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. Approved .................................. , 19 ........ Permit No ..................................... D,sapproved a/c ......... ~Z~.~ ......... .......................................................................... ........ - ................ ...................... (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~...7....c.~... ........... Date ................................................ , 19 .......... INSTRUCTIONS a. Th~s apphcat~on must be completely filled ~n by typewriter or ,n ink and submitted in triphcate to the Buildin. Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocat,on of lot and of buildings on premises, relat~onsh,p to adloming premsses or pubhc streets o areas, and g~wng a detailed description of layout ofproperty must be drawn on the diagram which ~s part of th~s application c. The work covered by th~s application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector wdl 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 ~n whole or in pa rt for any purpose whatever until a Certificate of Occupanc shall have been granted by 1he Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Braiding Permit pursuant to th Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances o Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe~ The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in buildings for necessary inspections. (S~gnature of applicant, or name, i{ a corporation) (Address o~ appt icant) ' State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of prem,ses ............ ~./. ............... :..~(~. ..................................................................................................... If applicant is a corporate, signature of duly authc~rized officer. (Name 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 done Map No · . .................. ~ ......... ~ ........ Lot No....~:....~ ............ Street and Number ...................... ! .......................... .~. ......... ' ........................ Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction: a Exisitmg use and occupancy ....'....: ........ ~ ...................................................................................................... b. Intended use and occupancy ......................................... ~ ................................................................................. 3. Nature of work (check which applicable): New Building .................. Addition ............... Alteration Repair .................. Removal .................. Demoht~an .................Other Work .......................................... ~ (Description) 4 Estimated Cost ....... .~. ..... ~ ........ ! ............................. Fee .................... ~ ......................................................... (to be pa~d on filing thins application) 5. If dwelling, number of dwelling units .......................... Number of dwelhng unmts 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 ............... Hemght ........................ Number of Stories ............................................................................................... Dimensions of same structure with alterations or additions: Front ................................... Rear ................. Dept'h ................................ Height ........................ Number of Stones ............................. 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 whmch premises are s~tuated ...................................................................................... 12 Does proposed construction violate any zomng law, ordinance or regulation 13 Will lot be regraded ........................... Wdl excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises ................................................... Address ........ :.:. ............ .' ....... Phone No ...................... Name of Architect ...................................................... Address ................................ Phone No ...................... Name of Contractor ..................................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and indicate all set-back dimensions fror~ property hnes G~ve street and block number or description according to deed, and show street names and md~cat~ whether interior or corner lot. STATE OF NEW YORK, ~ ¢ c COUNTY OF .............................. ............................................................................................ being duly sworn, deposes and says that he ,s the apphcnn (Name of, mdjwdual signing contracf) above named. He ~s the ................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of sa~d owner or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and th~s application; that all statements contained ~n this apphcat~on are true to the best of h~s knowledge and behef, that the work will be performed ~n the mannsr~,s, et, forth ~n the application filed therewith Sworn to before me th~s ........................ day of., ........................................ , 19 ........ .~ ~ '/ Nota~ Pubhc, . .........~ ....... ~ ....... :.:.:: ..... ,~ ......County (Signature of applicant)