HomeMy WebLinkAbout7205-z FOR~ NO. 2
TOWN OF SOUTHOLD i
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE P~REMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N? 7205 Z
Permission is hereby granted to:
pursuant to application dated ..................... Ap~.ll...,.i~. ...... ~....., 19~..1~.,.,, and approved by the
Building Inspector.
4
Olive
Rore nce
Wickham Estate
,~uchon
Gertrude oedric,~
Approved ........................................ , 19. .
FOI~ NO. 1
TOWN OF $OUTItOLD ·
BUILDING DEPARTMEN~
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Perm,t No.
Disapproved a/c ...............................................................
' (Bl~ilding I~p~tof i
:Date Ap~'i-~. 18 1974
INSTRUCTIONS
a. This application must be completely filled in by typewriter or' in ihk and submitted in triplicate to the Building
Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according t~o schedule.
b. Plot plan showing location of lot and of buildings on premises, relati6nship to adjoining premises or public streets or
areas, and giving a detailed description of layout ofproperty must be drawn an 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 a 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 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, buildihg code, housing code, and regulations, and to
admit authorized inspectors on premises and in, buildings for necessary inspections.
(Signatur~ of applicant, or name(i~ a corporat on)
L .........
(Address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, gener~I contractor, electrician, plumber or builder.
Name of owner of premises (~,~*.],~. ~,..~r~..~..~..~..~...~.~.~.....~..,....~...U..~...~.~. ..............................................................
If applicant is a corporate, signature of duly authorized officer.
.................................... .no~c..apt~.cahl~ .................
(Name and tide of corporate officer)
Builder's License No ..... ~t,...aDp.~.l.e~,b.~.~ ..............
Plumber's License No. IJOt'..tlDp~L~.~,b~L~ ..............
Electrician's License No. .rl.~lJ:...llp. p]L:J,c~,~]i,e .........
Other Zrade's License No.....~..~..~....~.p~..~..~...~..b..~..~ .........
Location of land on which proposed work will be done. Map No.:
Street and Number ..~IILQ..~IIII~e~i...}~n__z._.~l:DOJ~..]J~lLd,...-z~jtl~l'Ue~..~...Yo~ .............................
Municipality
State existing use and occupancy of premises and intended use and' occupancy of proposed construction:
a. Exisiting use and occupancy ...~'~L~&J~e...~si~J~:L~.J,...d~i?~l~L.~-il:l~ .........................................................
b. Intended use and occupancy ~..~..~..~...~..~...~..~.~.~.~.~..~..~j~.~.~..~..~.~.j.~j~~~g.~ ................
~ence al. on8 side ~tine~
3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .....
Repair .................. Removal .................. Demolition .................... Other Work-erec~il:~l..of...fence..-... ....
(Description}
4. Estimated Cost ....~l;~,50...00 ...................................... Fee ...... ~l.15...00 .....................................................................
(to be paid on filing this application)
5. If dwelling, number of dwelling units I:~O~..app~L:L¢8~l,~mber of dwelling units on each floor
If garage, number of cars ..........t~o~:...app.~.~abto ................................................................................................
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use
7. Dimensions of existing structures, if any: Front ~Ot...app~;c~b~.P,~lor ............................. 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 ....... ]]~e~l.~.d~n~.~a.t..~ ..............................................................
12. Does proposed construction violate any zoning law, ordinance or regulation: ...... no .............................................
13. Will lot be regraded ~e%-,..a. pp.l~.~b~'~jll excess fill be removed from premises: ( ) Yes ( ) No
14. Name of Owner of premises ....~.~.p...~..~..~...~..l)..~. ........................... Address ................................ Phone No .......................
Name of Architect ...l~ot...aj~p.l.~.e&h.le ......................... Address ................................ Phone No .......................
Name of Contractor ....~.~..~ ............................................... Address ................................ Phone No .......................
PLOT DIAGRAM
I.ocate 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.
SEE ETTACHED SURVEY
Applicant seeks per~tt for erection of ~ence along
southerly side line o~ property. Fence is sp~it-
rat1 type being 3* 10'* at highest point.
STATE OF NEW YORK, ~ c c
COUNTY OF ..... $.UFF. OLI~ ......... f ~'~
................................. .I~..lr.:~..~...CI~D~. ........................ being duly sworn, deposes and says that he is the applicant
(Name of individual signing contract)
above named.
He is the ...... ..O. 10,~. ...................................................................................................................................................................
(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
tha~ the work will be performed in the manner set forth in the application filed therewith.
Sworn to before me this
...... .~ ............... day of ......... ~P.I¢~! ...................... , ~9.7..~...
Notary Public,. ......~.~ ..t~.. ............... County
'PATRrCfA ~. CLARK
NOTARY PUBLIC, Slate of New Ye, th
Suffolk 'Counfy- INc. 52-5711005
Term Expires 'March 30, 1976
(Signature of applicant~J
(Charles R. Cuddy) V
. i/
YOUNG & YOUNG
SURVEY FOR:
CtdANLES t?. CUDDY
I~IA T TI TUCK
$OUTHOLO
SUFFOLK CO., N.Y.