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Home My WebLink About8750-z ~Ol~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT 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) 8750 Z Permission is hereby granted to: ,bJ,.EY,. ...... Z.L/..fJ...O...$ .~...I ......... .~....$.~t/.P..L~..:( Z U t-~ t~ ~z ! at premises located at .............. L.!...~...~)..~.. ..... ~.~.~./~.~-] ........ .-]~.g,~,J~;:~ ..................... J ................ - ..................................................................... ~.U..T...z2.~..a..c~.u..L:-. ........... M.-..~ ......................... \ pursuant to application dated ......................... ..~J..~..L.~.....~,,,~...., 19~.6..., and approved by the Building Inspector. ....... Building Inspector I~OIUtE NO. 1 TOWN OF $OUTHOLD BUILDING DEI~,RT~ENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ~ A I No ................................. Examined .............. ~..~. ..... J9 ........ pp ication ~ 7~ ~ ~s~Ti;~ve;..~;;.,.~~...~., 19.~ Permit No....~.Z~..~ ..... ..... .............. ..................... {Buildino Inspector) .................... .... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildin5 Inspector, with 3 sets of pl'ans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing Iocahon of lot and of buddings on premises, relationship to odloming premises or public streets oF areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. c The work covered by this apphcation may not be commenced before ~ssuance of Building Permit. d Upon approval of this application, the Building Inspector wdl issue a Budding Permit to the apphcant. Such permiL 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 whatever until a 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 o, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and tc admit authorized inspectors on premises and in buildings for necessary inspections. Teb ............................... .............................. State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder: Name of owner of premises ............................................................... t~ ~-~Kl ~ .......... ................................................................... If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... .~...P.. ...... .... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's L~cense No ............................................... Locahon of land on which proposed work will be done. Map No ..... ,... ...... ~ ................. Lot No ....................... Street and Number ......... J..]...~..~...l~....t~..-~...~....~.. o....~. ...... ..?....o...~....~...,,, ........ ~..u...T. ..~....~....o....~.....u. ~.. .......... / Munici~;iity ....... State existing use and occupancy of premises and ~ntended use and occupancy of proposed construction' a Exisiting use and occupancy .............. I ....... ..~'. -~..-.J~. · ......... ~.....~. ............... L ...................................................... b Intended use and occupancy ......~....~..!..~....~.. ........... ...~...~ ........ ...'~....."~....,~....(....-~'....~...~......J~".. ............................... 3 Nature of work (check which applicable) New Building ................. Addition .................. Alteration Repair .................. Removal ................. Demohhar ......... ~ ..... Other Work ................................................ 4. ~) 0 ~ (Description) Est,mated Cost ................... ............................. Cee ........................ : ........................................... (to be pa~d on fihng th~s applicahon) 5. If dwelhng, number of dwelhng units ....................... Number of dwelhng units on each floor .......................... If garage, number of c~rs .............................................................................................................................. 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....................... 7 Dimensions of ex~sting structures, if any. Front .......................... Rear ................................Depth ................ Height ....................... Number of Stones ......................................................................................................... D~mensions of same structure with alterabons or addmons' Front .................................... Rear ...................... Depth .............................. Height ............................ Number of Star,es .............................. 8 D~mensions of entire new constructmn' Front .................................... Rear ............................ Depth ...................... Height ................... Number of Stories ............................................................................................... 9 S,ze of lot Front .................. .?...~..~....~.. .................Rear ..................................... Depth ............................... 70 Dote of Purchase .................................................... Nome of Former Owner ....................................................... 11. Zone or use district in wh,ch pram,sas are s,tuated ................. ...~....~.~.(....~.. ............................................... 12 Does proposed construchon wolate any zoning law, ordinance or regulahon' . ............ .[~('....~.. i3. Will lot be regraded ..................... Wdl excess fill be removed from premises: ( ) Yes (~o ....... 7 ff- - 14 Name of Owner of premises .j~I..L...~...~. ....... ..Z...~..~...O....~....~..I ...... Address ................................Phone No ....................... Name of Architect ................................................. Address ................................Phone No ....................... Name of Contractor .... ..~....'~... ..... ..~...~-~....U.. ~.~)~...~....! ........... Address ,.~.~..~.~.~..U....~.. Phone No ....................... PLOT DIAGRAM Locate clearly and dmtinctly all buddings, whether existing or proposed, and mdmate all set-back dimensions frarn property hnes. G~ve street and block number or description according to deed, and show street names and indmate whether interior or corner lot A ................. ~h.~.~ ....... ~.~..~.~..~ ................... be,rig duly sworn, deposes and says that he ,s the apphco (Name of md,vidual signing contrac0 above named. He (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have per¢ormed ~he sa~d work and to make and this application, that all statements contained in th~s applicchon are true to the best of hm knowledge and belief; that the work will be performed m the manner set fo~h in the application filed the~rewith. Sworn to before me this __ ~ , NOTARy PUBLIC ~ta~f of N~w Yor