The URL can be used to link to this page

Home My WebLink About7444-z FOE~I NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N*. Y. BUILDING PrERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 7444 Z Permission is hereby granted to: A..~.Gillen. ~ Wife Southold erect am~ mai~ts~n a 6 £t side & rear ..7~..~ fenee at premises located.at ~t..~. ........... .~xLl~..~&~e~'J~ ............................................................... A~ ow la & Wt~ _~a_Y_ 8¢mthol~ pursuant to application dated .........................,~I~],~ ...... ~l~..!....., 1~.~.., and approved by the Building Inspector. r Building Inspectd~ FO~M NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~._.~ ~ SOUTHOLD, N. Y. /~provod ........................................ , ..................................... Application No. Disapproved a/c ..~ .................................................. ~- (Building Inspecto~'"[ ~ APPLICATION FOR BUILDING PERMIT ~ ~ C~ Date ........ INSTRUCTIONS ~ ~ ~. This ~pplicetion must be completely filled in by typewriter o~ in inE end submitted in triplicate to the Buil~g inspector, with 3 sets of plans, occur~te plot plan to ~ale. Fee ~ccording to schedule~ b. Pbt plan showing loc~tio~ of lot end of buiJdings on premises, relationship to edjoining premises or public streets~ o~ ore,s, ~nd giving e detailed description of leyout ofproper~ must be dr~wn on the di~grom which is pa~ of this epplic~ti c. The wore covered by this opplic~tion mey not be commenced before issuonce of Building Permit. ~' d. Upon ~pprovel of this ~pplicetion, the Building Inspector will issue e Building Permit to the ~pplicont. Such per'it shell be Eept on the premises ~wileble for inspection throughout the worE. ~ e. No building sh~ll be occupied or used in whole or in pert ~or ony purpose wherever until e Ce~ificote of ~cupency sh~ll h~ve been gr~nted 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 necessary inspections. (Signottl~ of c~i~:ant, or hc~ne~ i~'corporatio~i ........ ........ .................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder· Name of owner of premises ..... ,/~ ............................................. ~ ................ k ........................... 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 ............................................... 1. Location of land on wh ch prcoosed work will be done Mop No' .~...~..)L/~-j~t~/44 ~- Lot No .......... .................... Street and Number Municipality 2. State existing use and occupancy of premises and in.~ended use and occupancy of proposed construction: a. Exisiting use and occupancy ........ .~..~...~ ~..'.L/..!...~./..[~ ....... ;; ;"D .......................................................... b. Intended use and occupancy ~<~..~ ........... -. -.-~ ........... ! Nature of work (check which applicable): New Building.. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ....~....~..~ ................... 4. Estimated Cost .................~-' O ~--~..=....Q........-..... .................... Fee (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~.~..L. ......... 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 oddJtJons: 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 ........................................................ N~me o. LFormer Owner ........................................................ r ' ' ' lc' 1 1. Zone o use district in which premises are s~tuated .....¢..~ ............. .. ............................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will lot be regroded. .............. ~h, ........ Will excess fill be removed from premises: ( } Yes ( ) No 14. Name of Owner of premises .../~t.,.~.'....~..I.~,..L..~...L}.....~.....(~.. ...... Address .;~.~..?...!.0.~.t:..~. ..... Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor ....... .C.~..(...,~)....~'~...[~.... ............................ 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 interilr or corner lot. STATE OF NEV,~.~'O~_ .~ ~ t S S COUNT ,9F ....... f .......... ~~~ ....... .,e~..~L.~.L%.~ ............. being duly sworn, deposes and soys that he is the applicanl (Nam~ of individual signing contract) above named. Fie 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 true to the best of his knowledge and belief; and that the work will be performe, d~n the manner set forth in the application filed therewith. Sworn to before me this I I ,~ , ,19..~..( V Pub,c,. ................. ........................... Coun .............. <~'~ f-S~notu re o a¢,~lico~