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Home My WebLink About6606-z FOR~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE Pi~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6606 Z F~ermission is hereby gronted to: ....... E&,,~-z,d. - .Y~g~r t.~ o-z,r,~ ............................... ......... /,~-3~. ....... ~**1~...~t .................................. ......... Fon'e*s~;-'/tta:ts'-'.~,,¥ o ..... .l.1.B.7**.F. .... to .... ~am~...a~&.~ta~m..a..~.ence ...... (.~o~t..&..]~La~ ~t)...on..c.o~ner...&.~Z..~L ........ at premises located at .... ~.O~;..~J~ ......... ]~a. sS&tt..~.O~lPt;..~Z'.O~ ................................................... ..................................... ~a~t~t;e~-.. ~oe4[ .......... ~a~a~..,~ ~,.~t~ ......... (~t~hmtp~ ................... pursuont to cpplicction doted ........................~ ....... .~.~ ............ , 19..~,~., ond opproved by the Building Inspector. Fee $"'~.~i,'t~) ......... Building Inspeltor Approved ........................................ , FORM NO. '1 ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Disapproved a/c .... ~.,,,,. ~....i~F:..~,. (Budding ~1 Date .~.,.,~,.~ ........ , 19.~2 INSTRUCTIONS a. This apphcat~on must be completely filled in by typewriter or ~n ink and submitted mn triplicate to the Budding Inspector, w 3 sets of phlns, accurate plot plan to scale. Fee according to schedule. b. Plot pilan showing location of lot and of buddings on premises, relationsh~p to adjmnmg premises or pubhc streets or areas, giving a detiHled description of layout of property must be drawn on diagram which is part of th~s application. c. The w~rk covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this apphcation, the Building Inspector will issue a Braiding Permit to the applicant Such permit,shall be kept the premises available for ~nspectmn throughout the work. e, No bu,.Idmg shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have b granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Budding Permit pursuant to the Budding Z, Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construct~o buddings, ad,ribbons or alterations, or for removal or demolition, as harem described The applicant agrees to comply with all applicable la ordinances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspectio State whether applicant is~essee, agent, architect, engineer, general contractor, electrician, plumber or buil¢ Name of owner of premises ~..~.....~~..~..~....~...*..~~...~.:?.-: If applicant is a corporate, signature of duly authorized officer. fName and title of corporate officer) Builder's License No .......................................................... Plumber's L~cense No ......................................................... Eh,ctncian's License No ..................................................... Other Trade's License No ................................................... ,.· . . ...... 2. a. E,,JstJng',' use and occu pancy ...~~.., · ' ............................................................... 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteratio9 .............. Repair. ........................ Removal ......................... Demolition ........................ Other Work/..~...~....' "'~' 0 ~ ~1~ '"' . (D~script~on) 4. Estimated Cost ~ .. . Fee .......................................... .................................. (to'be .............................. 5. If dwelling, number of dwelling units ..~.~ ..... Number of dwelling units on each floor ......... ~.~.~...., ............... If gar;~ge, number of cars ......... ~.~.~ ........................................................................................................................ 6. If businem, commercial or mixed occupancy, specify nature and extent of e~ch type of use ................................. 7. Dimensions o~ existing structures, if any: Front ..~ ......... Rear ...~.~ ................ Depth .~.....~....~.~.~. Height ........ /~..~ ....................................... Number of Stories ...... ~.~.~ ............................................................ Dime~3sions of same structure with alterations or additions: Front .......................... Rear ........................................ Depth ............................................. Height ......................................... Number of Stories ....................................... 8. Dimensions of entire new construction: Front ....~J...~ ........ Rear ............................ Depth ................................ Height ...................... ,. ....... ~ ................ Nu tuber ~r~s ~ ...................................................................................... 9. Size of lot: Front ...~.~ ..........................Rear ............ /~.a.~ ................. Depth ....~..~.~;~ ............................ 10. Date of Purchase ~.~.~.J,.~.~..~... Name of Former Owner~O.~Z..~_~..,~{.~ .................... 11. Zone or u~ district in which premises are situated ..~.~...~..~.~.~...~~{~..~.~.~ 12. Does propo~d construct~o~ violate any zoning law, ordinance or regulation: ...~ .............................................. 13. Will lot be regraded ~.~.~. ............... Will exc[ss fill be removed from premises: [ ] Ye~ [ ] No 14. Name of Owner of prem,ses ..~~,~ .... ~..~ ....... ~.Z~ ...... ~ .................... ~~../~.~ ........ ; .................................. ~.~ ...... ~ ........................ ~xr.~..t....t .............. (Address~~1 ~ I ~ /~ ~ ~ iEn~ne~ i~o~ N me of .................................................................................................................... ...... ........... (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions ftc property lines. Give street and block number or description according to deed, and show street names and indicate whe~ er interior or corner lot. STATE OF NEW YORK, COUNTY OF .......... (Name oftndtvldual signing contract) being duly sworn, deposes and says that he is the applicant above naa He ~s the ......................................................................................... (Contractor, agent, corporate officer, etc. ) of sa~d owr~er or owners, and ~s duly authorized to perform or have performed the sa~d work and to make and file this apphcatmn; th. statements contained m th~s apphcat~on are true to the best of his knowledge and behef, and that the work wdl be performed ~n the m; set forth m the apphcat~on hied therewith .......... day of .......................... 19. Notary Pubhc .................................. County (S~gnature of apphcant)