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Home My WebLink About7433-zTOWN OF SOUTHOLD BUILDINg I)EPAITMINT TOW~ CLERK'S OFFICE SOU'mOLD, I~. Y. BUILDING PEIf~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7433 Z Permission is hereby granted to: · .~,~¢~,~. ~. ~,c~e.t.t,~...~.tme ~ ............... ~o ..~.C~. ~.~J~.~.~ .~.9.c.t.~..o,.n. of fe..n..c.e not over ~ft higah c~ · ...C..e..d.,a~ Ave front line ( not to block aeees~ along high water line) at premises located at . .Lots 1'~2/19~ Goose '~ay ~stmtes ..... ~.~.~r. ~..v.~ ..~ .9..a..k.. hv~. . southo~.~ }~.~ · pursuant to opplic~fl'ion d~l'ed .......................... .,J.l~......~..~ .......... , 19...~..~., ~nd ~prov~:l by th~ Building Inspector. Fee $o.!'~.'.~.O. ........... · ' Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMI:N~T TOWN GLERK'S OFFIGI~ : ~:../ ~UTHOLD, N. Y. ......... :.... ~,~ ~ ........ ?..1. ........ '..~ .......... , ~ ....~,~ ~ .......... ~...~ ................ D~sopproved o/c ............................................................................................ ~-i;. _____._ ~"i;~;~ , INSTRUCTIONS a. This application must be completely filled in by typewriter o~. in ink and submitted in triplicate to the BuiJdin~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises relationship to adjo n ng prem ses or pub c streets or 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 before issuance of Building Permit. d. Upa approval of th s appl cat on, the Bu Id ng Inspector w II ~ssue o Bu Id ng Permit to the app cant. 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 Yor removal or demolition, as herein described. The applicant agrees to comply with all applicable Paws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (S'gnature of appllcont, or name, if a corporati;~'i ........ 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) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of ' . ............. '. ............ ~. ..... land on wh ch proposed work Street and Number ..,~...~.~.~..:~..~.'.~... Municipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .... .Z .~,. :......~~: ~. .................................................. 3. Nature of work (check which applicable): New Building.. ................. Addition .................. Alteratior~ . ............... Repair .................. Removal .................. Demolition .................... Oth~W ,,/ , ~'~/~ ~,r .( D,esc rip~io~ ..... 4. Estimated Cost ...~.,/..~....~...?. ...................................... Fee ..~../..,~..:..~..r.,~.... ~,~- ..... (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 some 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 ...:. ................................................... Nome of Former Owner ........................................................ 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ........................................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14. Nome of Owner of premises .................................................... Address ................................ Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ............................................................ Address ................................ Phone No .................... '... PLOT DIAGRAM Locate dearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions frarn property lines. Give street (=nd block number or description according to deed, and show street names and indica}e whether interior or corner lot.c-~-"~/~ o.$ z_~ ~, ./~__ ....... ~~C~TY~~ffZ ~ 0 F~ ~'~'~ ~'~ ~ (Nam~ of indi~ual ~igning contracf) ~bov~ named.~' ~ ~ ~ _..~.Z~ .............. ~ ............................................................................................................................................. ~,.. that the work will be per~ed in the manner set fo~h in the application filed therewith. Sworn to b~re me this ~'~ ..... ,.' .......... , , ....... _ 777"7' ,'",~ '. .......... / ,o,a .................. ........ ....................... ~ ,/,~" ~,/,/ , , [ (Signature of applicant) ~ / - ~ ~ ~ ]~ /~ /~ARY PUBLIC, State of N~ Y~ ~~ ~ J, ~/~~ No.~/~.8~2150 , ~ ' / QuaL in Queens Co., C~, / with Queens Co. Ctks. ~, ' ~ Term Expires ~rch 30, 19~