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Home My WebLink About6632-z ~FOR~ NO. ~ TOWtl OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 6632 Z Permission is hereby gronted to: ~a~-..F~k-..Fene~.- ~ o*--.-Av~C~.-G ~*Ange-~' -' ................ 3ta.tt~tuck .......................................... ~o ..e**r**e~:b...~,..m~f;n:~,~....,~ff.~..~.g~..C,,.L.,...ffenee ........................................................... at premises located ot .~/.~ ....... fi'~rL.J3~D~ ........................................................................................ ........................................................... F,~ at ..~ rion.....E.,¥., ............................................................ pursuont to opplicotion doted ....................... Y~r.:~,.~ .................. , 19~.~...., ond opproved by the Building Inspector. Fee $15~.Q ............ · o~ o~ sou~o~~.~ ~ TOWN CLERK'S OFFICE~ ~ ~ ~ ~ ~ ~ SOUTHOLD, N.Y. ~'~ ~ /~ ~ ~' ............ , ........ .... ....... ...... ................ , ......... ~ ~,~ ~, ......... ~ ............ ~ ............. ~ ......... ~~ ~ .................................... ~,--~ ............... ,, ~ ~ ~ ~ ~ ~ ~'~ ................ ~...: ................................. / ................................. F~ ~~ (Build,ng Inspect of) ~ ..... ~3 ......................... , ~..Z.~ INSTRUCTIONS a. Th~s apphcat~on must be completely filled m by typewriter or in ink and submitted m tr~phcate 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 adjmnmg premises or pubhc streets or areas, gwmg a detaded description of layout of property must be drawn on d~agram which ~s part of th~s apphcat~on. c. The work covered by th~s apphcat~on may not be commenced before ~ssuance of Budding Permit d. Upon approval of th~s apphcation, the Budding Inspector wdl ~ssue a Budding Permit to the apphcant Such permit,shall be kept the premises available for ~nspectmn throughout the work e. No budding shall be occupied or used m whole or m part for any purpose whatever untd a Cert~fmate of Occupancy shall have t: granted by tile Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Building Permit pursuant to the Building Z Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the constructlo buildings, additions or alterations, or for removal or demoht~on, as here~n described The apphcant agrees to comply w~th all apphcable la ordinances, budding code, housing code, and regulations, and to admit authorized ~nspectors on premises and m buddings for necessarv inspect~o (S~gnature of applicant, or name, if a corporation) ...................... (Address of applicant) State whe, th~/applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bulk ~'..~.~.; ~,., ~,r..~-... ~ ...... .y- ................................. ;.~ ........... , ......... ~ ........................... ;;, .................................................................................... Nam~ of owner of premises ...~/~....'/...~.)...~q~.~.....~'.~.,.'~...~.~',:~ .................................................................................... If applicant ~s a corporate, signature of duly authorized 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 propose([worlgwill be done. Map~No .............................................. Lot No ....................... Street and Number .~.~,4~ ..... ~-.L ..... ~[ ...... ~~"~ .................................................................. Municipality 2. State existing use and occupancy of premises and, intended//J~u~e and o,ccupancy of proposed construction: a. Existing use and occupancy .... ~?..,:~,~....~.~:,~.~.z~..~...~..-~..~ ...................................................................... b. Intended use and occupancy ...~.~ ................................... ~,..~....~.~ .................... Repair ......................... Removal ......................... Demolition ........................ Other Work ..~..%~. ~ ............. (Descr~on) 4. Estimated Cost ....... .~T.....~.. :~t...c,.;...9. ................ Fee ................................... ~...~. ..... ~..~. ........................................... (to be pa~d on flhng this apphcat~on) 5. If dwelling, number of dwelling units ................. Number of dwelling units on each floor ......................................... If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occuoancy, specify nature and extent of each type of use ..................................... 7. Dimensions of existing structures, if any: Front ..................... Rear ...........................Depth ................................... Height ........................................................... Number of Stories ....................................................................a~.....,. Dimensions of same structure with alterations or additions: Front .......................... Rear .................................. Depth ...~ ............................. Height ......................................... Number of Stories ...~ ...... 8. Dimensions of entire new construction: Front ........................ Rear ...........................l~epth ....... ,..,~ ....... Hmght ................................................. Number of Stones ....................................... ~.., ........................................... 9. S,ze of lot: Front .... ~b.t.~...Z .................. Rear .................E~. ..................Depth ...... t..~.~.~.:...~4 .......;..~ ...... 10. Date of Purchase ..................................... Name of Former Owner ........................................................................... 11. Zone or use district in which premises are situated ................................................................................................... 12. Does prepared construction violate any zoning law, ordinance or regulation: ........ ~.tJ~. ....................................... 13. Will lot be regraded .... ~ ........... ~ ....Will excess f~ be r~oved f~m pr~ise~: [, ] Yes [~] *No 14. Name of Owner of premmses ..~...,...~...~~ ......... ,.~,~.~,..~F~.~ ........................... (Address) (Phone No.) Name of Architect ............................................ y ...................................................................................................... ~ ~ /' j / /' (Address) (Phone No.) Name of Contractor ..~.~.~..~....~ ............................................................................... ~' / (Address) (Phone No.) PLOT DIAGRAM Locate clearl~ and distinctly all buildings, whether existing or proposed, and indicate all ~t-back dimensions fro property lines. Give street and block number or description according to deed, and ~ow s~e~na~es and indicate whet er interior or corner lot; [,~ ~'[x~ ,~ '~ ' -'~ r~ ~-~ [ / ~ 0 / / STATE OF NEWYOR~ J/'/d ) ~ -'~t,'"~f'~....~.~, ~ /~'~.... be,ng duly sworn, deposes and says that he ,s the apphcant above nam (N~m~[~ s,~ ~tract) ' ~ ~ (Contractor, agent, corporate officer, eW ) of sa~d owner or owners, and ~s duly authonze~f~ have performed the smd work and to make and file th~s aB~hcatmn; tha s~tements contained m th~s aBphcatlon a~o~l~b~bN~wled~e and behef, and that the work wdl be performed m the mm set forth m the aB~hcatmn filed thejew~t~o 52-03a~9~3 5uh~lk Cou~t~ ~/ JCommission Expires March 30, 19~ -- .... ..... ..... ...... // / . ....... AspFI^L< ,j 8" Sq'[ P ["l'i~lqqql Il Il!! 11 I I I1tl II ° PKOPOSEi) ,, KLSIbEMCT_ , FOP,, '0 K' ou ND AT Io ki P,LAN CLx, l GL, T-L O0 PN PLAN tI 4'~ v~' fsRo tbo~- B£AM.~ 41' O.C. :z'¥ c.," 14 OIL'"' Sl'u~.~ it." -PLUF1BINt~ blAGKAFt , CK055 ¥ C C 'i--lO L F T- E L E T i 0 kl