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Home My WebLink About7067-zBUILDING DK~RTMBMT TOWN C, Lnl~ OFFICE SOUTHOLD, It. Y. BUILDING PEKMIT (THIS PERMIT MUST BE KEPT ON THE PI~J~ISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.o 7067 Z ~ ..k'~,..,e,~...e, d6,~..t~mLLamm~e.t~.e,~,L a~.*zJ.s.~:~,z~..:bu~L2d,J,n, ls ............................. at premises lacate~ at ...... ]~.~...~'~II~I~..~T~ ............................................................................... .............................................. ~er~..~X~d .............. ~.~. ........................................................ pursuant to application dated ............................ ~1'~1~ ....... ~ ........ , 19..~.., and approved by .the Building Inspector. -' NO, I TOWN OF soUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. 7~ d Permit No ............................. Application No. 7.~.~Z. ........... Disapproved a/c ...... ~.. - ~ ............................. ('~';,';i~',';~"i;;;~;;;.~' ............................. APPLICATION FOR BUILDING PER~I'I' D~t, .-.::~&.~....i~..o... ............................... , i~,Z~... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink und submitted in duplicate to the Building Inspector. b. Plot plan showing location of lot and of buildings on premises relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drown on the diagram which is I~rt of thio 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 progress of 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/V~DE to the Building Department for the issuance of a ?u ding Perm t pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and othe. applicable Laws, Ordinances or Regulations, for the construction of buildings additions or alterations, or for removal or demolition, as here n described. The appl cant agrees to comp y with all applicable laws, ordinances, building code, housing code, end regulations. _= ~., ~ .~.:. ;.:., ....................... ~.~,o..(~.,~:~c, ............... (Signature cf applicant, or name, if a corporation) .60 3~s' ' , , 0~3 0 . .~. ........... .,...~.sk,,,~..:Es.,.~.....Y .................. ..fi. ........ s (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. N eo..?,~p ?X_... .......... .~.~.........~.,~.......~r...,.~.a,..~.....~ ................................................................. If a~cant (~cor~ra~, s~gnature of duly a~ officer. (Name and title ~corporote officer) 1. L~atJon of land on which proposed work will be done ~ap No.: ........................................ Lot No.: ........................ Stre~ and Number .~~ ~ ,5~A~ ~, Munid~li~ 2. State existing use and occupancy of premises and intended use and occupancy of propos~ ¢onst~ction: ~. ~,,,,~, ~se ~ =~, ...~.~.~....~.~...~...~.~.e. ........................................ b. Intended use ond occuponr~ . ........................................... ~ ....................................... ~ talC,3 3. Nature of wo~k (check whicl~ applicable): New Buildin .................. Addition .................. Alteration ...~ ............. Repair .................. Re~ova~ .................. Demolitian .................. Other Work (Describe) 4. Estimated Cast ......... '~/.~-......~.;~-.~..¢....~..~) ................. Fee .......................................................................................... (to be paid on fi!ing this application) 5. If dwelling, number of dwelling units .....-..L..,.: .............. Number of dwelling units on each floor ' ~f garage, number of cars ................ ~A~ .............. 15...O.A,.t.--~.. ............................................ 6. If business, com~n)~cial or mixed occupancy,_ spec fy nature and extent of each tvDe of use ~.0.,.~,~.7. ~.-~......~~- ,,~,~ ~ 4~o ~o_ -- '~'~ ............. 7. D~mens~ec~_of existing s~ructures, f any: Front,~',,'~5 .................. Rear ~J[~.-~r'.i .................... Depth .~.o.. ............... Height .~.~....-= ............... Number of Stories .......... .~..../~,~ ........... ~.~....._~. .................................. ~ ....................... DImensm~p~o~?~~, structureSw.th a,,~J~%,ons or _additions: Front"~..t~-~j~ .................. Rear ~JlL.~ ............... Depth ...~r~./. ..................... Height .2..-~: ................... Number of Stories q6,~/~ ....................... 8. Dimensions of entire new construction: Front ....(~._/...~-.~.. ...... .~. ....... Rear ...~.~. ..................... Depth ../~ .................... Height ..../.~....'. ........ Number of Stories ..0.,,~/.~.. . ............ ........................ 9. Size of lot: Front ........................... Rear .,~. ....................................................... ~ '~-~ '~'~'~ 10. Date of Purchase ........................................................ Name~z/~Z~.~...~....(~.. ~.~..°f Former Owner, ~ ....................................... ........ 12. Does proposed constructlon violate any zoning law, ordinance or regu at on.>..= ..x~..(~.. .............. , t '~'i' "Z '" 13. Name of Owner of premises ~..I.C~.P.S.~;)~.)(~. ....... Address 5~L..3.~....~...~..~h.~.C~.. Phone No ..... .'.~f.~.~... Nome of t, Architect ...................................................... J~ /"t _~ Address ........... ]~" ............................... ~ D,_~.~ Phone No., ........ ~j.~.. Nome of Contractor ....... ,~,,/,,,~,;..,~,.O,,,L,~.,,~,. .............. Address Phone No....~,~./. .... 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 ~nterlor or corner lot. STATE OF NEW.,~Ot:~J~ ~ COUbLTY, OF ....~..."~.....~.. ....... I~'~' ................ - .............. ,. · .... .,, ~ ............................ oeing duly sworn, d~oses and says that he is the applicant tr~ame ot ~na~waual signing application) above named. He is the .~.~.(?~¢ (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 tru~e~.~tbe best of/his kr)ey4edge and belief; and that the work will be performed in the rnanner set forth in the appllca~efi~flled t,~erewith/. Swo~to before me this L..L_ //7-~ ~.~./~- // / ............. Noton! ~ub,c, ~'~..~.~.t.L~....~ ...... Court ......... ~'~'"~i-~i;;;,'~'f'~;~~ ....................... ......................... . ur. of apda,,., Not~r Public, State of New Yozk No. 52-0028880 (~ualified in ~,~,f~lk County Tezzn expkes Mazch 30, ,5' ~' 3q'Zo' E ~ASI.41o),,I CLEAVE;: ~,