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Home My WebLink About7509-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMEN~ TOWN CLERK'S OFFICE SOUTH'OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 7509 Z Permission is hereby granted to: ~.~.~....-~...~...,..../~.~.~.~.: .... ....Z~.~..~....-......~..:.~;. ................ ~o ......... ~ .~...~ ./....,,(.~....~.z .~...-...~...~.c~...~ ..z~......~.~..*.~.....~ .... ~' ............................................. :~ .......................... ~:C'"": ................ Z: ................... ~ ....... o, ~,em,,e, ~o,e~ o, ..~...~..~......~~.~--~. ...... .~......~./.-..~.~...~ .......... ...,,.~i~...~.. ~.., ...... ../.,~ ~.~ ~.....~.~.~ ~. ~,~._...~~ ~....,.. .......... ../..~ ?. ....... ~/~..... ........ ~.~an, ,o opp,,~o,,o~ ~o,e~ .... ~.C~ ........ .~ .......... ~ ...... ,,~. o,~ o~o~e~ b~ ~e Building Inspector. Building Inspector FORM NO. 1 TOWN OF $O~T~OL~ BUILDING DEPARTMENT~ TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ...... .................. ........... Approved ....... ........ Perm,t No. ....... Disapproved a/c ............... ;.,.-."~.':......,,....J~Z~. ........ .........~ ................... ~.. ~ ~' ~- (B~lding Inspector) : APPLICATION FOR BUILDING P~ERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter o~' in ipk and submitted in triplicate to the Building 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, relati(~nship to adjoining premises or public streets or areas, and giving a detailed description of layout ofproperty must be drawn ~)n the diagram which is part of this application. c. The work covered by this application may not be commenced befor& issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue b Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the world. e. No building shall be occupied or used in whole or in part for any purpose whatever until o 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 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 inJ~pections. ":'~" (Si~n~dture of applicant, or name, if a corporation) (Address of applicant) 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 ............................................... 1. Location of land on which proposed work will be done. Map No.: ........................................ Lot No. ~ ....................... Street and Number ./~,./.?,~/....C~....~..!.Z..../)..f..R.~/~...~....~... ~%;" Z~¢~ ~ · : Municipality 2. State existing use and accupancy of premises and intended use and~ occupancy of proposed construction: a. Exisiting use and occupancy ...... /~s~/-£~?~."~~.~.~ ................................................ b, Intended use and occupancy 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ............. ~.., Repair .................. Removal .................. Demolition .......... ; ......... Other Work ......... ./-.-..~..~. ?./..~...o. ....................... . ..... /aO:~',, ~k~-~ ~ ~/.~ ~ (Description) 4. Estimated Cost ......... ../T....~.~m...~-....7....::: ................. Fee ..../...~... .............................................................................. (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 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. a~ze of lot. Front .................................... /. .................. Rear ..../..~...~ ............................. Depth ................................ 10. Date of Purchase ...... ./~.../.../...~.~../...Z..55..... .................. Name of Former Owner-~.~0,~o.~...5~./:~.'..~.,.~ ......... 11. Zone or use district in which premises are situated ..... ..-]T....~......TT..; ..................................................... ~/ ................. 12. Does proposed construction violate eny zoning law, ordinance or regulation: .... ,,~../~.....:'. ................................... 13. V/ill lot be regraded' . ........................... Wdl excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...8.~r.t.r..8~a..'..//~.a..~:~,s .................. Address .~.,r.~.~a,....w...y., ....... Phone No...~...?¢e..-...W..W..~.~... Name of Architect .............................................................. Address ................................Phone No ....................... Name of Contractor ............................................................ Address ................................Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set~ck dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW %ORK~ ~ [ S S ................. ,,,~...~,....~...~..~..?........~.....~...~..'~....~.~..~.~... .......... being duly sworn~ deposes and says th,t he is the opp~icam (Blame of individual signing contracf) above named. He is the .......................................... ..~..~K./...~....~.. ................................................................................................................. (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 performed in the manner set forth in the application filed therewith. Swam to before me this ...... :.-..~.~...-~-~r. day of ..... ~.~,d~4'm'a'~ ........... , 19 .~.-.O~.. Nota,¥ Public, ...~...~-,~.~ ................ County ...~... ~~..~m.....~..~. ~ ....................... ~"-~.- /~'// /'2 (~' · (Signature of applicant) NOTARY PUI~L)C, S~afo of Now Yor~ No, 52-4522026 - Suffolk Counfy C~mrnis~ion Expires March GiN / Lot · -' MONI./MEN 1' OF THE CLERK OF SUFFOLK COI, INTI" ON ,IUN£ Z.~., 19 ?0 AS FILE .ILO. 54~. SEPT t0~197~ YOUNG & YOUNG 400 OSTRANDER AVENUE, RIVERHEAD, NEW YORK ALDEN W, YOUNG HOWAIID W. YOUN6 SURVEY FOR: ' ' INLAND HOMES, INC. LOT .37 "LAUREL COUNTRY ESTATES" AT LAUREL TOWN OF $0UTHOLD SLJFFO[ K CO~ N.Y.