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Home My WebLink About6613-z FORM :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) No. 6613 Z Permission is hereby granted to: SJ,IJ.~,~..h:L~ e.~,.e.~., s~.... A./~..,s o.u~hold.. ~avfn~ s ]Bank ....~tl2..Z. em~l~...Ave .................................. ..... ~-~..'.....~.z. ....... .1.1..~.~;3 ................. to ...~.~c.tani..matn~ n...a. £r, onA ~a~ ]- .sign .o£ .l£~.3C..2.1'...f.%...(~a.!r~..S.t..£~.on%) at premises located at ..~.Q%l,t;bD.],~,..~g~l%F~..Darik ...................................................................... ........................ · ~...~a.in.. ,}kl...~ ..¥~'~'~ s...Ave ......... S~u-'bh~-t-d.....~.,,~.,, .................................. : .... pursuant to application dated ........................~.~ ....... ~ .............. , 19.~..~..., and approved by the Building Inspector. Building InspectoI FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ...................................... 19..?...~.''. Approved ........................................ , 19 ........ Pemit No /o ~ /-,' 7-.-- Disapproved a/c ...................... ...... (Building Inspector) APPLICATION FOR BUILDING PERMIT Dote ............. lllll ¥...,~l ....................... 19..~.~.. INSTRUCTIONS a This apphcatlon must be completely filled ~n by typewriter or in tnk and submttted in tnphcate to the Budding Inspector, ~ 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relationship to adlommg premtses or pubho streets or areas, gwmg a detaded description of layout of property must be drawn on diagram which is part of this apphcat~on. c. The work covered by th~s application may not be commenced before ~ssuance of Budding Permit. d Upon approval of this apphcatlon, the Budding Inspector will issue a Building Permit to the apphcant. Such permit,shall be kept 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 untd a Cemfmate of Occupancy shall have I: granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Budding Permit pursuant to the Budding Ordinance gl the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances or Regulations, for the construct~o buddings, additions or alterations, or for removal or demohtmn, as herein described The applicant agrees to comply w~th all apphcable ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary mspectic (Slgnatu roe~o~ ~x~:~phca nt, or S~GNS by SEV~SON {Address of apphcant) State whetiher applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bull, ............................................................................. ....................................................................... Name of owner of premises ...i~.([~.~l~]g~..~31'.t~..~lli~dL ....................................................................................... If applicant is a corporate, signature of duly authorized officer, (Name and title of corporate officer) Builder's License No .......................................................... Plumber's License No ......................................................... Electncmn'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 ....... ,~..~3.~...~...~...~....~....R..{;~ .................................................................................................. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .................... ,.~?,,,,~,,~,.~ ............................................................................................. b. Intended use and occupancy ............................................................................................................ .~ ................... 3. Nature of work (check which applicable): New Building ....................... Addition ..................... Alteration .............. Repair ......................... Removal ......................... Demolition ........................ Other Work (Descn ptmn) 4. Estimated Cost .... ~ ..... ~. ........... Fee (to be paid on fdmg this application) 5. If dwelling, number of dwelling units .................Number of dwelling units on each floor ....................................... If garage, number of cars ........................................................................................................................................... 6. If bu,,dness, commercial or mixed occuoancv, specify nature and extent of each type of use .................................... 7. Dimensions of existing structures, if any: Front .....................Rear ........................... Depth .................................. Height ........................................................... Number of Stories ............................................................................ Dimensions of same structure with alterations 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 ........ ~,~.~.~ ........................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~ ................................................ 13. Will lot be regraded ........... = ..... t.~....~..:...,~ill exces~fill be r~dfrp~ premises: [ ] Yes [ ] Ng 14. Name of Owner of premises ~O~ (Address) (Phone No ) Name of Architect ................................................................................................................................................... ...... (Address) (Phone No.) Name of Contractor ~ (Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions fr( properW lines. Give ~reet and block number or description according to deed, and show street names and indicate whe, er interior or corner lot. .... ,, ~le d~w~ o~ e~ ~eloeed STATE OF NEW YORK, , ) ~q~ COUNTY OF . . .Z¢~/,5'~, ~YF~..'- ...... ) St~nle~ ~. Atkhae ........................................................ being duly sworn, deposes and says that he ~s the apphcant above nam: (Name of mdzvtdual s~gntng contract) He ~s the ........... 8 ~l~')'t~ (Contractor, agent, corporate officer, etc ) of smd ownel or owners, and ~s duly authorized to perform or have performed the smd work and to make and hie th~s apphcaBon; thai ~tatements ccntamed m th~s apphcat{on are true to the best of h~s knowledge and behef; and that the work wdl be performed m the mar set forth m the apphcaBon hied therewith ........... day of ..... ............ ./_____ ~/~-t~ssA ~ sm/s~ ' , Notary Publ c ............................ ~1o..30.-~9~5'~_ty tv.¢~'~""~ .~, .~r.. cx__~........6~....~.._ ..~,~f'~...?~.~ ...... o....?.~i~_e'~:~.~Z~Z~°lr~.~.?,~ ( S,$~nature of applicant) d07C; ,YENOVE D6 L'E;OUI<°' LAWN 5PR/N/{ffA /1E905 f5 gKE$19,¢y 1 15 caafoew 11 ,PE P.1VK E4 to>• ryy. d9 a� ♦ h o �)1 .�4 31 t14 T% �'W �Y o ♦ - POLK nn 0.N ZID LooD N 17 0 1-1 50 W! 2Z I -11 , LIGE- TYFE�A I%TIIIRE 'jl • SM SHEET e- Q V hl0'. •• 1 _ R_DToPI �Q� Pa ryiD M1unl l4ni 1. - _. • yt 6 ry __ — TME: SW ITOH oB _ L,r Lo of c, c.:rtA P �EP2 Slav mY L 2" FS Pn n�Tl cc.Icncc+ I h� I • p L. N _ 1 all' n PPTCH CUM1A. 1 N r •DD NI y'-- J__ I LIML' OF EYr$T PAVCFICpI( F rtoJrDe S"TH 5' :- 4" orpe aVlvp _ _ _ lo•sT o• Lev Ex/i/ h Sfq.'L LINN I/ U I z"uuop n<v V� f¢ ,,,lwnow nnen �� - y ,nrfl<�eulmN Lm ° A-1 A•tIe H9: � . O N V U � w.L�4 a d ' / `6ou wr`Joow : )Ecp.96E P7� h I _ 40 _ . (�♦♦ �� 11 v I � 1�. Q'V) l �]�D ILMMT SlM1lpl 0 1 4•CC.O.' I ryP^ kr'n TLL '1 I A� L � h�i r ,��• \ J � / 1 � Iw�at J f Z t0 3 �` P {"ROOf ORA/N LOND U,UIl 1 V I -. S�(N• `�,�� T� Ro HO TJ DG. RooFInG.SeG Snr.cS L I I `� •- C " IL 555 N 1,W FAN A10, L .n .1 FA RE SM YyPG A ryss I z SOU71-IOLD SAVINGS 13AN14 J �r PI o"� Z Z I d FlRGfsEesR.t-1� _ Q _ .J IG j Ir c� 3CNTROLgt,, �. 1 FIN IrzsT PL eLcv 2s s" OA O a ] iC-- h r _ INTI I. JSY TME SWITCH - M FOR CONTNu ON U- G u V SEE $N. 6-1 0 Y :r 5'•tl 1�'LCYaY__ I V rvY 250 1 2pp„ E - d p9 UNDERGROUND TE L,cO1.HD41'T��J1, � F PLg UNDERGRpUNI ELECT COI.Z'_ I� ^� y ^� A — p LnG • yl i r— __ _ yb• 1 f �v.'� _—UI{-SEG Dt.v '11,ISSMf '^I SIMC t!LO.ATfON OF MANhb E 1 �•SHAL L gE n5 pIRECiEp I _ Y I y"o St' POWER cpManryY 11' ybry Y1y 'r5 I I r _ I • 2�i$ -I- u I 6" Y n-- I f o e.fr Go 4G cru A ev� I ' o sH. i vp t�- • °_• _ �ROPErLTY LrnC tV __ _ C`•r ST �Ib4 WM1lLL � + I Er ryVry STO N1 WdTf4. q tv b tut Y° 9p y1, a hY h• L p' PnTG1n pVlLq 0p'4 r 5'5' T11ca Nc�itt &pm.n�ne.1 - 5 � 9 L LD.�_ 148 yb 116 11 L b Y Y1' rye. i