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Home My WebLink About7262-z FO]g~ NO, ~ TOWN OF ~OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ ¥. BUILDING PSRMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7262 Z Permissio~ is hereby granted to: s~1,~.ez~...~aalaml, a ........... ,,: ........................... .......... 822.....C~maet~uat..~a ........................ ................... .T. slA.t~.. -2 ex*.z'aa e ....................... ;... at premises located at ~11~,..~'. ....... Orllnt..hy,.,Rea ....................................................................... ................ ; ..................... a~mn~..gl~...]haad ......... ~rlent ................ ; ............................................. pursuant to application dated .................................. J4.&~....6 ....... , 19.~1~.., and approved by the Building Inspector. Fee ~.,~ ............. ~ I'~ BuildiBg Ins~pe~or' ~J TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE__ ~/-~ /) SOUTHOLD, N. Y. ........ ..... APPLICATION ~ BUI~ ~IT Dote ~_.~,...~g~ ..................... 19 ............ INSTR~IONS a. This application must be completely filled in by typewriter or in ink and submit~e~l' in triplicate to 'the Buildin~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan Showing locution Of lot and of buildings on premises, relationship to adjoining'-p~emises or public streets o~; areas, and giving c~ 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 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 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 necessanA inspections 822Connetquot Avenue / . Isli!q Terrace~ New Yo~k 11752 (Address of opp~kont) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ....Sa.]..T~i.:I;/3:~e...T~.~L13~.8, ............ I~D.0,..~41~..~,~,f~.'G...~.I~.~.B...T%~!~. ............................................. If applicunt is a corporote, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... 1. Location of land on which proposed work will be done. Map No.: ..~7..7.7. ............................. Lot No...2..br. .................. Street and Number .... ~LL~...~i~w..l~o~..~N~be~...n~..~&aiF~ns.~...O~'~en~...~.~W ..~D~.k, ............. Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: o. Exisiting use and occupancy ...lq'Q.1Aae. e..33.e~,,~i]3g.,.&o]it~3],e.~.:il::)~3 ................................................................ b. Intended use and occupancy ...... ~{~],~.;~l~.,,...0z).et...F. IE~:[,],~' .......................................................................... ,3.' Nature of work (check which applicable): New Building .................. Addition ~ .......... Alteration · · Repair .................. Removal .................. Demolition ................. ~... Other Work ...................................................... (Descriptk~n) 4. ~timated Co~t ............................................................ Fee ..... t.:...~. ................................................... ~ ......................... (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 Z../.:~/~ .............. Height .......... ~; ........ ~Number of- ~tgr~"zm~m~'"m';Z:i ............ :'Z ..................................... 9. Size of lot: Frorlt .~,~.~.7......' .................... ~ ........ R~ar .]..~..1..:..&...~. ............................ Depthg. S1.56...e~...a:~cte 10. 'Date of Purchase .~,~.~L~/..~.Q .................................... l~lame of Former Owner .~.tl~.~...~§.~,g.9. ..................... 11. Zone or use district in which premises are situated ..~ ............................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ~ ................................................. 13. Will lot be regraded' ...TX9. .................... Will excess fill be r~moved from premises: ( ) Yes ( ' ) No ~$22 Connetquot Aven 14. Name of Owner of premises .~.wJ~a..Ia~a .......... Addressi.s.~t~...~,~,~c~. Phone No.U~...~,..-..8.~.~,.8... NameName °f Architect of Contractor ''''~/. .~..~'~ .............. ..... U '~' '~/'"'~· ............... - ~''-- AddressAdd ress: -'L~~;;~(-' Ph°ne N°-~,--~'"~-r --~'~ Phone N c~..7/~..~(~;~ ....................... PLOT DIAGRAM 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 comer lot. ..2,,2 ""\ STATE OF NEW )JqDP-4¢/.,/ ~,, COUNTY OF ~.....J'3'3 i 11-'T"~' ................................................................................................. being duly sworn, deposes and says that he is the applicant (Nome of individual signing contractO above named. He is the ................................................................................................................................................................................. (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform o~' hove 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 that the work will be performed in the manner set forth in the application filed therewith. Swam to ~ me this ......... ./... .:. o.f ........ . Notary Publi~~.-~-..Z~..~nty ...... ~.....?..~....~.......[~...~.:. ......................... (Signature of applicant) JUD',TH T. BOKEN ~i,; ~; -: ~44963 Suffolk Count,?( Cornrni~io~ ~x~irss March 30,