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Home My WebLink About7377-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENI~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PR. EMISI:S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 7377 Z Date ............. Permission is hereby granted to: t~e~. ~'ohn l~e~u~re ....... ~ .t..z...z..e.~ ..Lz.~ .e. .......................... i ................. · .~...o.~.e..~....(.~.e..~?.....o.~,...e.~.~.~ .t.~.e... ~.,...z.,z.....~... ............................................................................... W/B Prlva~;e R.O,Wo off ~:/~ BayV~e~ LRead at premises located at ........................................................................................................................... ( PVt Rd .# ) Bouthol~ }~ pursuant 'to cpplicafion d~ted ................................... .~_~.l.y, ....... ~.., 19...~..~., end opproved by the Building Inspe~:tor~. Fee $ t.0. O0 Building Inspector \ APPLICATION FOR BUILDING ~I~ERMIT INSTRUCTIONS This application must be completely filled in by o~ in ink and submitted in triplicate to the Building a. by typewriter Inspector, with 3 set~ of plato, accurat~ plat plan to scale. Fee according to schedule. b. Plot Plan showing location of lot and of buildings on premises, relationsh o to adio n na arerni~,~ n, r, areas, and gw~ng a detmled descnphon of layout ofpraperty must be drown on the d~gmm wh,ch is part of this app icatiom c. The .work covered by this application may not be commenced before issuance of Building Permit. d. Upo~ approval of this applicat on, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be ~ 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 sna nave oeen granted by the Bu Iding Inspector. S .A,P, pLI ~CATION IS HEREBY MADE to the Build ng Department for the ssuance of a Buildina Permit oursuan* uiJa!ng :one Ordinance of the Town of Southold, Suffo k Cour~h, New York and otb-- .,,..d~'.a.~ i-LZ.I-A-~,;-_'-'_'_% "" Regulations, for the construction of buildings, additions or altera~'i'~r~s, or for ~moval o;",demoliflem.,~'v''~''' as"uWa'herein~'m'nancesdescribed.°r The applicant agrees to, comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on promises and in buildings for necessary inspections. ehn Mc ire (Signature of applicant, or name, if a corporation) Miller Place Roa~ Miller Place (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electriciQn, plumber or builder. Owne~ Name of owner of premises ~Toh~ McC-~tre & ~t~e If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's L. icense No. ................................................ Electrician's License No ............................................. Other Trade's License No ............................................... Iooo- 0 9'x- oo b - . ', ? Location of land on whi.ch proposed work will be done. Map No.: .....:~.. ................................. Lot No ,1~ . Street and I'Juml~,r ~/S R.O.W. (PYT ~D ~ ) S/S BaTview Road ~outh~ .............. Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ..~1(.¢0~.~ ............................................................................................................ b. Intended use and occupancy ~1[.~..~.~..t..h...~.q~l~.9~.~.~ .~,~.lv.a.,.t..e....~.a...~..~9.' 3. Nature of work (check which applicable): New Building.....,.:~..; ......... Addition .................. Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ..................................................... (Description) 4. Estimated Cost ............................................................ Fee ....11..0......0..0.. ........................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... .0. ................. 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 ....~..O..~...e..S...S..o...~.~'.... 7. DJrr~sions 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 .............. .1~. ................. Rear ..... .1~ .................. Depth ..~.~. ................. Height .................... Number of Stories .............oz3e .................................................................................................. 9. Size of let: Front ..... .1..~. ........................................... Rear ...... .1t....~... ............................ Depth .c~.~.../....1...6..0. ............ 10~' Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ....... ,iL...~,;l,~q.~ ............................................................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~. ................................................... 13. Will Jot be regrade~..O. ......................... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ....'T...O. ...... ~ ........ .e.....~. .............. Address ~L].].eZ' P].~ee PhoneNo. Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ........... ~.~R¢~ ....................................... Address ................................ Phone No ....................... PLOT DIAGP~M Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-bock 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 NE~ Yi~L COUNTY OF .~..~..;~.O.....~.. ............... ~.~ ................. ,~e.~....~T.Q~333...~,{~/.l~,~,~.II ....................................... being duly sworne d.epo.ses and says tl~t he is the applicam (Name of individual Signing controct~ above named. He is the .............. ~.e.?.. ...................................................................................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performecr 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 tha~ the work will be performed in the mannar set forth in the application filed therewith. Swam to before me this '. ~ ~ (Signature of 6pplicant) JUDITH ?, ~KE~ Nota~ Public, Slate o~ N~ y~ No. 52'0344963 Suffo~