The URL can be used to link to this page

Home My WebLink About7347-z FOI~M NO, 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PltEMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7347 Z Permission is hereby granted to: ~ ~':~ '~ b l " :i~' at premi~' I,o,~,ated at ...J/X..~.,'~,..~:~.~.~:'.,J~,~..~,~JJ&~...~/'~ ..................................................... ... ,,.....:.:./..,:~..,: ..... ~ :~2:~ ~ ~ :~,~ . ...................................... ~: ....................... and approved by the TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE .~ SOUTHOLD, No Y. ............ ^pp,cat on .......... Examined Approved ......... (~......h.~ ......... ~..., 19..~.~/. Permit No.?....~.....C.'(..?.....~ ...... Disapproved a~.~~, ................. .~.;z..~x..;~ INSTRUCTIONS a. This application must be completely filled in by typewriter o~ 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 or 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 far inspection throughout the wo~k. e. No building shall be occupied or used in whole or in part for any purpose whatever until o 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. Halesite I~.Y. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. of rem ses Walt whitman Fed Savings ~a~an Name of owner p .................................................................................................................................................... If 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 proposed work will be done. Map No.: ......... ..~.~ ....................... Lot No....~..~...~. ............... Street and Number .... ~'h~.Z..A~.e.....6t.".......~..~..$.~...~.°..~..~ .............. .].~.J.~..~..i..~..~...o..~.. .......................................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ...... ~.~..~....~...~.~.C]:.J:.~..~ .......................................................................................... b. Intended use end occupancy ......... .~'..~.~.e....?...J:.~..~.~..e.~..~.~(!~...~...~.~..~..z?~.~.?.:.~.~.....~..e.'~.9. ................................ 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ...... ;['.~.~¢.f~ .................................. (Description) 4. Estimated Cost ................... ..~..~ ................ 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. 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 .................... 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 ~1~B-'I 12. Does proposed construction violate any zoning law, ordinance or regulation: .... .~...O. ............................................... 13. Will lot be regraded. .......... ~Q ............ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...... ".~a~.~...~0~.::J-..~.~...a..~.....~...~.~....8.../-~Ad~clress ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ...~?..o.....}.~.~.y.~.?.~ ................................. Address Hs:LesiCe Phone No. PLOT DIAGRAM Locate clearly end distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frorn property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~ee filed plot plan STA'1-E OF NEW Y,,OPd.Q - - ~ c c COUNTY OF ...... .b.'..u..z.-..z..o..J,...~. ......... ~-~.~ ....................... ~..o....~.'..&.~z..~..e...i~. .................................................. being duly sworn, deposes and says that he is the applicanl (Name of individual signing contract) above named. He is the ............................. ~il~er~ (Contractor, agent, corporate officer, etc.) of said owner or owners, end 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 thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this 20 a~y of. ~June ....... ................................................ //(Signature of applicant) JUDITH T. BOKEN t~l~tory Public, Stale of New York No~ ¢3~.0844963 Suffolk Counlh Commission Expires March 80, R, P. ARiCHITECTS ENGIN PLANNERS 120 8~HPAGE ROAD, HICKSVILLE, N.Y. * 93~2556 I I i 0 0 O 0 DE NIGRIS & MAIER, P.C. AI~ICHITECTS · ENC-INEER$ · PLANNEP.$ 120 BETHPAGE ROAD, HICKSVlLLE, N.Y." DE NIGRIS & MAIER, P.C. ARC;HITECTS . ENGINEERS ' PLANNERS 120 BIETHPAGE ROAD, HICKSVILLE, N.Y. * 935-2S56