HomeMy WebLinkAbout8824-z ~OILM NO. ~
TOWN OF SOUTHOLD
BUiLDiNG DEFARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
fO
N. 88 4 Z
Permission is hereby granted to:
. ~e~....~.is~a~i.. ~Z~. ....................................
.................. ~o.ck~...P.~ ~n~; ......... Eas.t..
to ..]~...i...1..d....~..~..o.r.$.E,~... ~.~3.~.5.,.. ~.~.~.~I~.. ~n .. ~ x~ ~.t ~n g.. a~t a~ .. ~ ~a$e.. ~ ..e~ at ~ ~
at premises located at .P,,r.'~.",L.e,t,m..,R~O.^~.~ ..... O£f'..L~oc:'g...P.o.LD.:t..hd. ......................................
............................................ ~.~..~;..~.~ ....... .~.L,I, ................................................... ~ .....................
' pursuant to application doted ..................... ~.~¢.....~0 ................... ~9..~.6., and approved by ~the '~
;~: > Building Inspector.
............
J"V~..~TM,'OOD, MA 5 $. 'ozogo
~ ~%
. TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, N. Y.
Examined ..... ~!~?(~..~...~..
............ ........ .......... , ....
Disapproved a/c ..............
...................... .................................
~P~U~TIO~ ~OR 8~1~1~ ~RMIT
Application No. ~...~....~..~.. ...............
Date .... ~.0..Aug. us.% ......................, 19.7..~ .....
INSTRUCTIONS
a. Th,s apphcation must be completely filled in by typewriter or in ink and submitted in triplicate to the 8uildin,
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, relattonsh~p to adjmnmg premises or public streets o
areas, and giving a detailed description of layout ofproperty must be drawn on the d~agram which is part of th,s 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 Budding Permit to the applicant. Such permi
shall be kupt 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 Occupanc'
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 th
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, an~d other applicable Laws, Ordinances o
Regulations, for the construction of buildings, additions or alterations, or for reFf6va'l~r demolition, as herein describe,
The applicant agrees to comply with all apphcable laws, ordinances, building 96de, hou¥ing codel and regulations, and t
admit authorized inspectors on premises and in buildings for necessary inspe/~tion~ I ~ .
(Signature of appficant, obr name, if a corporation)
H. Viscardi, Jr. (by: August Molnar,Jr.
t{4. ~s~ M=~ Consulta
4~8...R~l~..~int. . .~_ _ ..~-~,,~.v.,~., ......................
..... CAddr~ss of applicant) NY 11939
State whether applicant :s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde~
Name of owner of premises ............ ~.~.~...~.~...~.o..~.e. .........
If applicant is a corporate, signature of duly authorized officer.
(Name and title of corporate officer)
Builder's License No ............. .O..~.~,.e.~ ............................
Plumber's License No. --
Electrician's License No .......... .':.r. ..............................
Other Trade's License No ............................................. )~- j-
Location of land on which proposed work will be done. Mcp No .........................../...L Lot No ......................
Street and Number ....... ..~..5..Q....~...~..~...k~....?.g~.~..~...~....~...~..~.~.t.....~..~...~..~g...~.~..~..~.~...~.~..~.~.~.~ ..................................
Municipality
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a Exisitmg use and occupancy ............ .~..e...s.~.~.e.~g..e....
; '4;' ZiiiZZZi ..............................
b lntended use and occupancy Woodshed ..............................
3 Nature of work (check which applicable) New Buil&ng ...... ~X×. Addmon .............. Alteration ...
P, epet r ................. Removal ................. Demoht~or .......... Other Work .........................................
(Description)
4 Estimated Cost ........................................................... Fee ..... ~.l~ ...................................................................
(to be pa~d on filing thru application)
5 If dwelhng, number of dwelhng umts ....................... Number of dwelhng umts on each floor ....................
If garage, number of cars ................................................................................................................................
6 If bus~ness, commercial or m~xed occupancy, speofy nature and extent of each type of use .....................
7 D~menmons of exmtmg structures, if any: Front ..................... Rear ................................ Depth .............
Height ....................... Number of Stories ........................................................................................................
D~mens~ons of same structure with alteratmns or addmons Front .................................... Rear .....................
Deplh ................................ Hmght ........................ Number of Storms ...............................
8 D~menstons of entire new constructmn' Front ................................. Rear .......................... Depth ................
Height ................... Number of Stories .........................................................................................................
9 S~ze of lot Front ................................................Rear ..................................... Depth ..............................
10 Date of Purchase ....................................................... Name of Former Owner .......................................................
11. Zone or use district m which premises are situated
12 Does proposed construchon violate any zoning law, ordinance or regulation: ........................................................
13 W~II lot be regraded ............................ Wdl excess fill be removed from premises: ( ) Yes ( ) No
14 Name of Owner of prem,ses .... ~......V.I$.CA..P,]D.1:.,....~I' ...... Address 450 Rocklf Pt. RI:~ ~,~ unliste¢
..... ~.'~ ~ %"'~'~ 1'6 ~i' ~'" N Y ~['I ~]~'9 ......................
Name of Architect ......................................... Address ................................ Phone No .......................
Nome of Contractor ............................... Address ................................ Phone No .......................
PLOT DIAGRAM
Locate clearly and distinctly all braidings, whether exmting or proposed, and re&cate all set-back dimenmons frorn
propcrty lines G,ve street and block number or descnpt,on according to deed, and show street names and in&cate
whether interior ar corner lot
STATE OF N~ORK, [ S S
COUNTY OF .lr./~l~¢~-~.. ...... h.,.f~a
................ ~'~]~~J:312~ ............... be,rig duly sworn, deposes and says that he ,s the appl,can
above named
He ~s the ..................................................................................................................................
(Contractor, agent, corporate officer, etc )
of smd owner or owners, and ~s duly authorized to perform or have pe~d the sa,d wgrk and to make and ill.
th~s applicahon; that ali statements contained in thru apphcahon are~ue to ~e best of hi,knowledge and behef;
tha~ the work wdt be performed in the manner set fo~h in the apphca~on filed t~erewith. /
Sworn to ~efore me th,s ~ ~ / _ I /~
t?~NOIS p pmt.~,,... / k (5~g¢~ture of applicant)
m~s~lon ~xp~res March 30,
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