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Home My WebLink About7503-z IPOILM NO. ~ TOWN OF SOUT#OLD BUILDING DEPARTMENT TOWN CLERK'S OPFICE SOUTHOLD, N~ Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N°. 7503 Z Permission is hereby granted to: ., ...... ..~. ~..r.L.Z.f;b~ ...................................... ~ &eoesooz7 at premises located at ...~LDO..Jk~]I ................................................................................................. ................................................... IPJ. ahez.~..Zs3~nt ........ .l~.,, ........................................................ pursuant to application dated ....................... ~.1~1~....~ ................ , 19.~.., and approved by the Building Inspector. '~:)WN OF sOuTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ApprOved "'""!'~ ................ : ............ , 19....~..cL/Permit No...TZ.~:.~)...~....~_-z~.-- ../' (/ Application No .............. :~ ........ Disapproved a/c ............................................. ~- ....... ~ ................ ~L .... ............ : ........ ......................................................................... ~Z....:~.=...__~_ - ............................. ................... ~ (Building Inspector) / APPLICATION FOR BUILDING//PPERMi~' _ ~- -: .... iNSTRucTiONS o. This apRlic~tion must be completely filled in by typewriter or in ink and submitted in duplicatu to the L3~ilding Inspector. ';' "' b. Plot plan showing location of lot and of buildings?6~n premises, relationship to adjoining premises or publ:: streets areas, and gi~i~g,o detailed description of layoaf of property must be drawn on the diagram Which is pert o? this application. c. Thetwork covered by this application may not be commenced before issuance of Building Permit. d. IJp~ approval of this application, the Buildimg Inspector will issue a Building Permit to the appli, shall be ke~t 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 shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Euildmg Permit pbr~ua~-t t: Building Zone Ordinance of the Town of Southoid, Suffolk County, New York, and other applicable La~*s, Ordmcnze_ Regulations, for thq construction of buildings, additions or alterations, or for removal or demolition, as ,ere,n described The applicant agrees to comply with ell aoalicable laws. ordmances building code housing coae :.nd r~!] (Signcr('ure of apalicont, c~f name f a c3rporation) (/~,ddress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor electrician, otur)ber cr Dd,lder ............................................ ................................................................................... Name of owner of premises ....... '~/ -- ' ~..z./..~.....~.~..~. ....... .~..41'/.'~.~.~: .................................................................. If applicant is a corporate, signature of duly authorized officer (Name and title of corporate officer) 1. Location of land On which proposed work will be done. Map No ..... _ ............. Street and Number ...... ...~...~....~~ .............. .¢.~ "~'"'- ........ -~.~.~..~:...( ............. / . ' Municil::~'fity 2. Stare'existing use and occupancy of premises and intended use and occupancy of proposed const-uction and ........ ............................. : ........................... b. ntended use and occupancy ./.'~.¢.0 Z .~../j~c~...¢~. ~.,¢~F ~..~.~..f F.:.. 3. Nature of work (check which applicable): New Building .... ~ ....... Addition .................. Alteration ............. Repair .................. Removal .................. Demolition .................. Other Work (Describe) ......................... 4. Est mated Cost ~ ,Z. ~6,,~'~ ~__ /D -~'~ ......... .~,'. ~'. . ,,'.. , (to be paid on filing this apphcation) 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 ~.'~.4~.¢i ~7~./~ 7. Dimensions of existing structures, if any: Front ............................ Rear ............................... Depth ............. Height ........................ Number of Stories ................... / ..................................................... Dimensions of same structure wJt,h alterations or additions: Front ....................................Rear .................... Depth ................................ Height ............................ Number of Stories ............................... 8. Dimensions of entire new construcbon Front ........ ~.....~(..../..~ ....... Rear .....~..4C./..,~,, ...... Depth/.~.,~ r .~ ........ Height ...~. ............. Number of Stories / 9. Size of lot: Front ......................... Rear .................................... Depth ............................ 10. Date of Purchase ....................................................... Name of Former Owner ............................................. 11. Zone or use district n which premises are s~tuated ................................................................................... 12 Does proposea construction violate any zoning law, ordinance or regulation? .................. x..'~.,~ .................... 13 Name of Owner of oremises ........................................ Address ........................................... Phone No ......... Ngme of Architect ...................................................... Address .......................................... Phone No ....... Name of Contractor ...Z~.y. 4.~,'./~.~L: ........................... Address .......................................... Ph~n~e' ~','o ?.~ /..~..~.~. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-b;~ck dimens,~ ~ from property lines. Give street and block numaer or descriation according to deed, and show street names and ~nd~cate whether interior or corner lot. ' STATE OF NLq/V YORK, [ c e O C >UbI.~TY OF ............... ,,~ .............. / · ' '(Name at individual ~igning application) above named. He is the ............... ~'.~ ............... (Contractor, agent, corporate officeh 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 al stot. eme,3ts contained in this appl cation are true to the best of his knowledge and belief; and that the .WOrk will be perfor~,~ed i~ tJ~e mariner set forth in the application filed therewith. 3worn to~eetere rnethis J ~-: ': . ~e// /7 // , ......... , . ......... Coun ........................ / ~ "~ i'*'~"~rl. ' ' -' 52-9509185