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Home My WebLink About7177-z FOEM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P'REMISF~ UNTIL FULL cOMPLETION OF THE WORK AUTHORIZED) N? 7177 Z Date ............. , ........................................... , 19 ........ Permission is hereby granted to: Joseph Cardia ........ ~t.~.~.....f~.....~.~..:[z.. ............. Uniondale ~.Y. 11~3) Build a~. addition on existing ~we~i{ng i R.O.W. elf Naugles DriVe (S~/S$ at premises located at ..................... , .............................. , ...................... ; .................................. ......................... ~k$.~.....~.:.L'. ....................................................... : ........................................... pursuant to application dated Apri~ i , 19~' and approved by the Building Inspector. · ~ FOI~B~ NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENTi TOWN CLERK'S OFFIGE~ SOUTHOLD, N. Y. Exemined ... ,z,~.~,,,,.,/,,,.?.. ....... 1~ .~..,, No,~,../...?....,~....~ ......... Appraved ............... '.: ........... LZ......, Permit (Building Ir~spector) APPLICATION FOR BUILDING PERMIT ~///~Z Dote ..................................... , INSTRUCTIONS Application No ................................. a. This application must be completely filled in by typewriter or' in ir~k and submitted in triplicate to the Building Inspector, with 3 sate of plans, accurate plot plan to scale. Fee according t~ schedule. b. Plot plan showing location of lot c~'rid'of buildings on premises, relatiohship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn qn the diagram which is part of this application. c. The work covered by this application may not be commenced beforeiissuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue d' Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the worE. 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 (ssuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold Suffolk County, New York, and other applicab e Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or fbr removal or demolition, as herein described. The applicant agrees to comply with oil applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises' and in. buildings for necesso~tr~ections. ~ig~afu~r~._c~'-appl~agt. or naF~, if o corporat on) .... ......... .............. ~ ~ ' 'r (Address of applicant) State whether applica~nt is o.w~er, lessee, agent, architect, engineer, genera contractor, electrician, p umber or builder 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 ............................................... Location of land on which proposed work will be done. Map No.: ........................................ Lot No ......................... Street and Number Municipality State existing use and occupancy of ~es and intcnded~e/anjcl ioccupancy of proposed construction: a. Exisiting use and occupancy ......~" ' '--'~""~'--.~.~..~..~,~,....L~)~ b ntended use and occupancy~ /f., W.--~F-.~~j,/,~ .,/,~,~,~..~.. ,.[.~:~ ' 3. Nature of work (check which applicable): New Building .................. ^dditJon ....~ ....... Alteration ................. Repair .................. ~$emoval .................. Demolition .................... Other Work ................................................... ~/~ (Description) 4. Estimated Cost .....~.L~..~...~.. ............................. ' .............. Fee .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... f. ................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specify naiure and extent of each type of use .......................... 7. Dimensions of existing structures, if any: Front .........~....~.. ........... Rear ........... .,~-....0.. ............ Depth ...... ~.~.'. ........ Height ......... /..~-. ...... Number of Stories / .............................. Dimensions of,same structure with alterations or additions: Front ........ i~..~......'~...~, .............. Rear ....~....'.~:.. ............... Depth ......... .~.~. ................. Heigh~ ............. .~.~.. ...... ;.l~.u, mber of Stories ....~...ff~' ....... , 8. Dimensions of entire new construction: Front ......... ~.~/~ ................ Rear ............................ Depth ....... ./'6 ............ Height /. ~ Num~ber of Stories ................................................ ~ ................................................. ~ ................ 9. Size of lot: Front .../..(..~. ............................................... Rear ......... ./...~..~.../. ...................... Degth ...~....~...~ ................... ~0. Date of Purchase ...... ~(:~.J. ........................................ Name of Former Owner ..~...d/~.~....~.. .............................. 11. Zone or use district in which premises are situated ...................................................... ~j.,/~ ......................................... 12. Does proposed construction via ate any zon ng ow, ord nonce or regulation: ......... ~..~ ....................................... 13. Will lot be regraded . ....... .i. .......... ~ ...... Will,,gxcess ~fill be removed fror~ premises: ( )re,Yes ( ) No 14. emi .... .~., .......................... , ...... N-..L ............ , .... N~ amn~: fo fOW;r~rh :~e cP: 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.~_,G~ive street and block number or description according to deed, and show street names and indicate whether interior or-~:-o~i~rqot: .............. -~ ~ / STATE OF NEW Y.~Y~,/. COUNTY OF ..?~..................~...~.~.o /' be n ................................................................................................ (Name of individual signing contract) above named. deposes and soys that he is the applicant 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 stetements contained in this application ore true to the best of his knowledge and belief; and Swo n tothatrthebefer~ metl~iS workwill beperformed in the m,anner set forth in the applic,9{iOn/rl filed therewith. ....... .......................... ~ 0344963 auflo~k ~ Comm'sN° 5:s,on E~p,,es March 30, 19~