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Home My WebLink About7329-z FOKM TOWN OF SOUTHOLD BUILDING DEPARTMENT, TOWN CLERK'S OFFICEI SOUTHOLD, N~ Y. BUILDIHG PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 7329 Z Date ~ ,~'tZ13e 1 ~. , 19 71+ Permission is hereby granted to: Rob%. Hawkin~ .............. Ea.t,t. it uck ............................................ to ..~z'~c.f,..az~d..za~:Lrzt~aa,u../~.z'~m.~.,X~.~'~..$'e~ e, ........... ; ......................................................... at premises located at ....~.~r.t,.},~.oa~....~/~o...*.e,~.t, pb. ct]L~ft...~O~d. ................................................. .................................................... ~iat~lt~ck ...... N.,.¥., ............ i ......................................................... ........................... ~i'.~r~e. ....... .1,~ ........ , lg.?..bc.., and approved by the pursuant to application dated f Building. Inspector. Fee $,.1.-~;~0 ........... Building Inspector INSTRUCTIONS a. This application must be completely filled in by typewriter or. in i,hk and submitted in tripl cate to the Building_l Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according ~o echedule b. Plot p an showing location of Jot and of buildings on premises, relatiq/nship to adjoining premises or public streets or c~ areas, and giving a 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 befor~ issuance of Building Permit. 1~) d. Upon approval of this application, the Building Inspector will issue ~ Building Permit to the applicant. Such permit {j 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 ~ork, 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 necessary inspections. (Signatu(e of applicant, or name, if a corporation) ............... ~J~. ~./Z'~'~--,~... ,~. ~. ~/, .......................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Electrician's License No ............................................ Other Trade's License No ....................................... 1. Location of land on which proposed work will be done. /V, ep~.~~~,~Z'~. Lot' No.....~.~/ Municipality 2. State existing use and occupancy of pr ses and in,ended use and occupancy of proposed construction: b. Intended use ond occupancy ...... 3. Nature of work (check which applicable): New Building .................. Additio~¢ ' ' Alteration .................. Repair .................. Removal .................. Demolition .................... Other Work .,,'~'.~..,ff.~-..~.~',,'~?..m~..,.~.~r.,~m~.... (Description) 4. Estimated Cost ...........~_~st~. ........................................ Fee ....j/~....~.~.:i ................................................................... (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 addmons: Front ...~.~.~. ......................... Rear .....~'.~1~...~.. Depth .~..~,.'....,,....~,~l~.....ox He~ght4~'*.°:...~.-~-~wt~.,~.NumDer ot 5tot es ................................ 8. Dimensions of entire new construction: F~...-..~.~..~.~. ............... ~ ........................... ~ ....................... ............... ......................................... T ................................... Size of lot: Front ............ ~'~...,...'~'.~..: ..................... Rear ...~..~,.~-~..~. ....................... Depth~.~.."~,~i~.....~... Date of Purchase ......t:::~...~....~..~1. ......................... Name of Former Owner Zone or use district in which premises are situated ...... ,~lJ~-w~.~lr~t'.~'ff'~./,,..t..~..~ ............................................................ Does proposed construction violate any zoning law, ordinance or regulation: ........... .~'.~. ....................................... Will lot be regraded . ......~lt/~ .............. Will excess fill be removed from premises: ( ) Yes ( ) No Name of Owner of premises .~1~...~1~.~.~4.~./~.~4-~. ..... Address~~..~..s~-,~ Phone No. 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. 12. 13. 14. S-FATE OF NEW YORK, ~ c ¢ COUNTY OF .~'t4~'...~.~ ......... ~'~"~ ~" -- L~zzz'~~'~ ........ be ng duly sworn, deposes and says that he is the applicant (Name of individual signing contracf) above named. He is the ................... ~.~ ........................................................................................................................................... (Contractor, agent, corporate officer, etc.) off, id e'"~cr ~' e'.'.'~e'~, 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 kngwledge and belief; and that the work wiJl be performed in the manner set fo~h in th~icafJon filed ~rewith. ~ / ~ , Sworn to b~, me this ~ f //~ ~ ~ ~ ~ ~ .... ~ ._. ........... /.I ........ ..... ....:...' ' _ 11. , , ,,. -- ~ ~ (S gnature of appl cant)