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Home My WebLink About7060-z OF SOUTHO~.D TOWN BUILDING DEi~ARTMEN?: 'TOWN CLERK'S OFFICE SOUT~OLD, N~ Y. (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 7060 Z Dote ......... 4 ....... ;....~ ....... 2.~. ........... , 19.~...b¢.. - Permission is hereby granted to: F ,...t,f.u~.p~.~.....,,~/,C..~,..~e.pf. ............ : ................. .... r.~.z.nz.~uc~ .................................... ~ ................. to ere.c.t an.d_ ..~.L.a.~.~.~r~ ~.r.9.P,.l~ ~.9.~k~m...~.ez~c~e...~.f.~...t~Lgh..~;..in~.~a~...6~.~.. at premi~es located at ..: ....... ;~/.S..~a~..2[o~,~ ............ .(~.,~:~j~.[cg.)...,,.i ......... : ............................. ................................ k~.l;..~.~¢k....~...)~:, ..................... j: ...... : ......... ~ .............. ~ ........................ pursuant to application dat~d ................. :'"~"'"~'""'h'"'.i:"'-, Building Inspector. Fee $ ...!..~.. n .0.(~ .......... and approved by the /:'~F'~' Bt~ilding J~'.~ecfor ( Exomined~.. ................. ,i ii ......... Approved ..: ..................................... FOCal NO. 1 TOWN OF SOUTHOLD I BUILDING DEPARTMENy TOWN CLERK'S OFFicE SOUTHOLD, N.Y. ~ APPLICATION FOR BUILDING I~ERMIT INSTRUCTIONS Application No. '~/ / u L~i~ a. This application must be completely filled in by typewriter or in ink and !submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule· b. Pict plan showing Iocatmn of lot and of buddings on premises, relatlonsh!p to adjoining premises or pubhc streets or areas, and giving a detailed description of layout of property must be drawn on diagram which is part of tills application. c. The work covered by this application may not be commenced before issuance ~f Bu tding Perm t d. Upon approval of this application, the Building Inspector will issue a Buildin~l 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 w~atever until a Certificate of Occupancy shall have been granted by the Building Inspector. ' v APPLICATION IS HEREBY MADE to the Building Department for the i~suan(~e of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable:Laws,~ Ord nonces or Regu at oas, for the construct on of buildings, additions or alterations, or for removal or demolition, as herein described. IThe 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 necessary inspections. {Signature of applicant, or name, if a corporation) .. ~:~::~\ .,. ~ ......... !i~'i~ ................... ~.~'. ~(;L.u...~..'~-.~:: ~ .~..- · (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .;l~..t .I.~ ............. ...(,,~.~...~,~l ........ lI...~ .................................. .: ........................................................................... Name of ow,er of premises ......... .L:, ............. ~..,.c,.iC.~J ............................ ; ................. : ........................................................ If applicant is a corporate, signature of duly authorized officer. ..................... i iq'~'M~¥,'~i'~i~i~'~'~'~'i~:~'~¥~[~'~'ii ..................... Builder's License No .......................................................... Plumber's License No ......................................................... Electrician's License No ..................................................... Other Trade's License No ................................................... I. Location of land on which proposed work will be done. Map No .......... , .................................... Lot No ........................ Street and Number ....~.~;:i~:\Z~.~) ........ ~ilt',.~,/~.~.(~. .................................... i ................ i .................. Municipality 2. State existing use and occupancy of premises and intended use and occgpancy of proposed construction: a. Existing use and occupancy ............................................................ , ........................................................................ b. Intended use and occupancy ...~;..t:..,.....:,,.~., ........................................................................................................... N~ture of work (check which applicable): New Building ....................... Addition ..................... Alteration ............... Repair ......................... Removal ......................... Demolition ........................ Other Work ..J~.~..g.~.~..~-~... .......... y~ ~ .--- (J(~ (Description) 4. Estimated Cost ...... :..~'2.~.~..~...--~. ................. Fee ...~ :..5. .............................................................. (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 occuoancv, 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 ................................. 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 ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ ~..(~... ..................................... 13. 14. Wdl' lot be regraded ...... . ~ ................ Will~ .-excess fill be removed from premises: [ ] Yes .oD~' No Name of Owner of pram sas ....~'~'.: .~..~..~ J..-; ................................................................................................ (Address) (Phone No.) Name of Architect ................................................................. , (Address) .................... i~ [~'~ ~"~l'~i ............. Name of Contractor ~''~''~(~('~.'~)''~''&'~'~'~;~'~j~.~(~-`j~?.~'~'{~)~'~`~'~'[ .......... ..~...{'~.(t~. ...... ~.~.......~ ~j..: (Address) (Phone No.) PLOT DIAGRAM ~'~ ~ ~': Locate clearly and distinctly all bu'ildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or descript on according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK, COUNTY ~F .............................. ~.~ ) ~ ~'°° ~ ~' ~ ~ ~, of said owner or owners, and is duly authorize~to ~rform or have performed the said work and to make and file this application; that all statements contained in this applic~r~. ~ ~h~e~jt~f his knowledge and be cf; and that the work will be performed in the manner set forth in the application file~b~¢~d~e. ...................................... Y ~o~*¢~ .................... ....... ........... .......... ..............