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HomeMy WebLinkAbout7337-z 1~O1~i~ NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING FERMtT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7337 Z Permission is hereby granted to: ...~ ~.r.~....L.,...B~.;~ ............................................... ........ ~ag~..~ .~...:~ ............................................. ............. ~.~o~-~.~ ............................................... to ............................................................................... o. rcc2 and ,,,a~z.~ain," ' ',+' a fron% yard ~'+..e.~:.c..e. .................................................................. at premises located at ...... .~.~:O.....~...~OJ]~... ,,O~,O. ........................................................................... ............................................................. ~o~th~c~ ................................................................................ pursuant to application dated ................................. ,T~Z~,~......1.~.... 19..~.%., and approved by the Building Inspector. Building Inspector FORUM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT  TOWN CLERK'S OFFICE Examined ...... ~..~.....t....~., 19....~...~f SOUTHOLD, N. Y. Approved ...... ....~...... ,, I, , ,9 ? .~ Permit No....~...~...~...~....~ ..... Disapproved a/c ............................................................. ~ __ (Building Inspector) APPUCATION FOR BUILDING PERMIT (~ Dote ...................... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building-< Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plat'plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ ~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application, o c. · The work covered by this application may not be commenced before issuance of Building Permit. 2L d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit ,~. j shall be kept on the premises available for inspection throughout the work. t i e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in. buildings for necessary inspections. (Signature of appl;~cant, or na~e, if a corporation) .... ~...~..~....~..~..61, .... ~t ~.y~J~,,.....~.4..,..~.Li.~.~L,.~./..,~aaress o, applicant) ~ State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....'J'~.~..~...~....~,~.~......~..~(..[...~.. ..................................................................................... ff applicant is 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 propos~;~ work wjl. I be done. Map, No.: .................................... Lot No ......................... Street and Number .....~..~..JL....IS~L..~/....JCJ./~..m~,,...~., ..................................... .~'~.~..~.r~.~'~.~ ~......~., ...... ' Mun'ii~ipalit~ State existing use and occupancy of premises and in.~ended use and occupancy of proposed construction: ! a. Exisiting use and occupancy ........ .~.l~.*?~.~r~r......~,~LD..~,~, ......................................................................... b. Intended use and occupancy ......... O.....k.~'%....~.O..l~ ....... ~ .......~.~...~.~ ~..~.~ ......................................... 3. Nature of work (check which applicable): New Building .................. Addition ........ ~;~ ...... Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ...... .1¢..~..1~. ~,.~,,~ ............................. ~ · (Description) 4. Estimated Cost ......... I.~.~. .......................................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. ~f business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ..... ~ ........ ..~. ........ Rear ................................ Depth ...~i..~..~. ....... 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 .................... Numbe~r of Stories .................................................................................................... ~. ................. 9. Size of lot: Front ........ .~.~. .......................................... Rear ................................. ,~ ....... Depth ..~.~..0. ................... 10. Date of Purchase ....L~.,~...~ ........................................ Name of Former Owner ...~.~,..t~.l~.~..~ ......................... 11. Zone or use district in which premises are situated ..... .~.~.G.t'.~.~.~4,.L~].~J~'......~'....t.~,~'l~.,~:~ .............................. 12. Does proposed construction violate any zoning Iow, ordinance or regulation: .... .~,..0. ............................................. 13. Will lot be regraded . ........................... Will excess ~l be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises .~.~-.~..~/~. ~.0...~/L~ ~hone No. Name of Architect .............................................................. Address ................................ Phone No ....................... Nome of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ., STATE OF NEW-YORK, . [ c c COUNTX OF ¢~.~..~.'.~..-.'.~...~z../.~.. .......... Z~,:'~.~..~....~Z..~ ...................... being duly sworn, deposes and soys that he is the applicant (Nam~ of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that oil statements contained in this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn tp before me this Nota~ Public, ...~Z~:~,..~ ........... Coun~ ................. ~..Z'~,...~;u,~.L.~...~..C~ ............ , ..4._ o. opp.ic t Quahfied m S~ffolk County No. 52-0508300 Commission Expires March FO]~M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ..... .~.. [.: ~..~.. ....... 19.)...~. Approved ........................................ , 19.2..0). Permit No..2...~.....,~.,...1!...?......~. Application No.....-~......~...i~..,~. ........... Disapproved a/c ....... ~....~ ....... ~....... .................... (Building Inspector) APPLICATION FOR BUILDING PERMIT ;,~ Date ........... ~ ....................... , 19..?..C~. .... a. -['his application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. 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 issue a Building Permit to the applicant. Such permit 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 Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in. buildings for necessary inspections. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ....................... ............... 'F ............... ....... '. ............................................................................................ (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~ork will [~e done. Map No.: ................................. ,~. Lot No ......................... Street and Number ...... .~..4. L....~.~.~....~..I,.~-~....~.~.....i ................................. ..~.~.&./~.~..1..21..2...~.~. ' Municipality ' 2. State existing use and occupancy of premises and in~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... ~..~,L,~,...'..~,.V~,~ ........................................................................... b. Intended use and occupancy ........ t..O ..... ~ .~ ..... ~.~l....t;,~ .................................................. 3. Nature of work (check which applicable): New Building .................. Addition ........... ;~... Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work ..........~.~..'~ ~..~.. .......................... I~ (Description) 4. Estimated Cost ........... 1.~¥.~. ....................................... Fee l ~ ~ (to be paid on filing this application) 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 occupancy, specif~yna,t, ure and extent of each type of use ............. 'r ............. 7. Dimensions of existing structures, if any: Front ......~{.u ................ ~ 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 ......................................................................................................... t ............ 9. Size of lot: Front ................~.O. .................................. Rear .................................... ,,~.. Depth ..... ~....~ ................ 10. Date of Purchase ........ .................................... Name of For. mar Owner ..:-..~.:t,~.l~..~.~..~. ....................... 11. Zone or use district in which premises are situated ..... ~.~..~..~.~..~.l.~./,aw~.....~.....[..~l.~1,4~#~,~ .................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ ' -.~.D. ..................................... 13. Will lot be regraded. ........................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises. Ot.~.~..E~.'/X.qrk .~,.t~,.... Address D. ~t Phone No.r~.~.~q..;. 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 from property lines. Give street and block number or description according to deed, and show street names and indicate whether interioror corner lot) I~~ ~pffot)~r~[-~{ ~(X~ ~' STATE OF N~ Y~K. / ~ c S Z r,~' ~ Z,~M~ ~.~ ........... be ng duly sworn, deposes and says that he is the applicanl (Nam~of individual signing contract) above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of, said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ......... ~.~.~. day of ............. ~'~.~:~ ., 19 .~ ~ ~ ~ ' .................. cou. .................. ....... 4 .........