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HomeMy WebLinkAbout7201-z FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT! TOWN CLERICS OFFICE SOUTHOLD, N,. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMIS~:S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 7201 Z Date !. A~Z~;~. ~.b.. ...... ~9.~..b... Permission is hereby granted to: · .i~.yr~r~ -. 6-.£~:n~... Gud¥~y ............ .................. ......... .l..~6a ....... ',;g~:P. Itl.~L.~..~;~'~,.. .................. ................ ~a.~.~b 5..t. ue, k .......................................... to ..~.~e e.~..on~...~.5~a.~:n-.'rm~ ~' "Trot ri: ..&.' '~±d'e"~:aTc~'"fe~e,' ........................................... at premises located at ...... .t.~ .......eJc.~%.v.:]:e~..:~::]:v,a' ......... i ............. " .......................................... ........................................................ · ~ia.t~d,~ek ....................... pursuant to opplicatlon dated .......................... A. IO~.~'~-'-"-~'~ ......... , 19...~., and approved by the Building Inspector. Fee $:J..~ ..QO ............ Examined Approved ........................................ , 19 ........ Permit No .................................. ............. ................. ................... :.. .............................. .......... ...... .................... (Building x}nspector) BU".,.G D.A*TME.'" ' TOWN CLERK'S OFFICE; ' SOUTHOLD, N. Y. Application APPLICATION FOR BUILDING P~RMIT Date ....... ........... INSTRUCTIONS ; a. This application must be completely filled in by typewriter o¢ in ih,k and submitted in triplicate to the Building Inspector~ with 3 sets of plans, accurate plot plan to scale. Fee according t?schedule. b. Plot plan showing location of lot and of buildings on preF,"dses, relationship to adjoining premises or public streets o~ areas, and giving a detailed description of layout ofproperty must be drawn ~n the diagram which is part of this application. c. The work covered by this application may not be commenced befor~ issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue ¢ Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the world. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy m~ 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 th 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 ~or removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, buildihg code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for n~ess~ inspections. e ' , (Sigd~t~r~e of applicant, or name, if,a c~ration) , ', (Address of ,gpplicant) 7 State whether applicant is owner, lessee, agent, architect, engineer, Xgen~r~l contractor, electrician, plumber or builder. nf nr~mi~ Ra~ond A. & Edna V. Cuddy , 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. n/a Other Trode's License No. n/a · 1. Location of land on which proposed work will be done. Man No -se~ at;~aohed - Lot No...: ...................... · ~ .-~.~ ........................... Street and Number .l~.~.Q ~.~.tL'cie~ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed cor~strbction: a. Exisiting use and occupancy ............ b. Intended use and occupancy ............ Nature of work (check which applicable): New Building -.; .............. Addition .................. Alteration ........... Repair Removal Demolition .................... Other Work erect; fence (Description) 4. Estimated Cost .......... .,n.~..&.. .......................... ~ ............... Fee ....... ~.~.5..:.0...©. ..................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ ~'~umDer 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 .....,t?../...~. .................... Depth ...~,/.,~. .......... Height ....... ,:n:/.8: .......... Number of Stories .......... ~../..a. ............................................................................................... Dimensions of same structure with a,lterations or additions: Front ......... ~/..8: .................... Rear ........ .q/,..~. ............. ................................ n/a n/a Depth n/a Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ka./.¢, ..................... Rear ............................ Depth ........................ Height .................... Number of Stories ................ .~./,.~ .............................................................................................. 9. Size of lot: Front ......... ~.5.,..O.Q..~'.~.~.I;;. ....................... Rear ....... ,~.~..,..0..O....~..e..e.~ ........... Depth .....l=.]~.r.,0.,0....~..e..e...'9.. 10. Date of Purchase ....~..¢.]~...~...~.g.7.~ .......................... Name of Former Owner ...... .:~.~..~.~-~.d.....~..o.D..e..s..~..Z.~g..: ......... 11. Zone or use district in which premises are situated .................. ~..~..s.~.C.p.~..a:~ ......................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: .............. P.P. ..................................... 13. Will lot be regraded'. ........ .q/..&. ............ Will excess fill be removed fromL~r~ises: ( ) Yes ( ) No 14. Name of Owner of premises~.SJfmf~kn, C,..A.,...~4...~t~.c,t~,.. Address .~..e...s.~..'f.~..e.~....D.~.:.... Phone No. ~.~.z.9.ELQ.~ .... 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 interior or corner lot. This is an application fo~ a permit to erect a wzre c ~ered, wooden, post and 2 r~zl fence~ approximately 4 feet high, at premises 1560 West~iew Drz~e, Mattztuck. Plot and building detail with fence location and linear dimens~ons are shown on attached copy of "Map of Property Sur?eyed for Raymond A. Cuddy & Edna V. Cuddy at Mattituck, Town of Southold, N.Y." by VanTuyl & Son, Licensed Surveyors, Greenport, N.Y. dated Jan.14, 1972; unchanged 4/20/74. STATE OF NEW YORK, ! ,- ,- COUNTY OF .... ~.~...6.~..~. ........... ~.~ ,..~..~.Z..~..O...~..~.....A..:...,Sg...~.~.D..&.....~..:.....O..~-.~.~ ....... :..', .................. being duly sworn, depose~ and say~ that~hec~'~he applicant r , (Name of individual signing contract) · , above named. ~le~/i~i the ................................................................................................................................................................................. ·lr¢ (Contractor, agent, corporate officer, etc.) of-scrM· owaer ar a','/norc, and Je duly authorized to perform or have p~rformed the said work and to make and file this application; that all statements conta:ined 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 ~ , / ,~9 . ...... .......... _ ,., ........ ............ ,, ....... .. , L/2 Notary Pub I lc, .~~]/.~.<.'....~'County ........... ~..~.. .......... ..'~....~:..~~ ................. ~ m--- 2T^~ IRENE KOMINO~I '~ "~!'I'~ ///(Signature of applicant) NO. 30-2174160 '~