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Home My WebLink About8836-z FORM N~o 2 TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8836 Z Date ........................... Permission is hereby granted to: ~t,,..Het~ma.~_n..&.S. ola..llae..A/.l~. ~ortl~..~ork Clttb · lil/a Hoore~l Lane ( Linden Ave) premises located ar ............................................................................................................................ .................................................... Cl~t~hoaue ....... lt.~.. ............................. : ........................................ pu~uant ~ application dated ...................................................... ~ -~ 2 , 19~.. and approved by the Building Inspector. Fee $.'J. ,~. P....(~. ............ ~il ,jng Inspector l~O~ NO. 1 TOWN OP $OUTltO/D BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. ........................................ . .......... Disapproved a/c ........................................ Application No. ~.-...~. ............. INSTRUCTIONS a Th~s apphcation must be completely filled in by typewriter or in ink and submitted in triplicate to the Buildi~ 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, relationship to adjoining premises or public streets, areas, and giving a detailed descnption of layout of property must be drawn on the d~agram which is part of this apphcatio. c. The work covered by this application may not be commenced before issuance of Budding Permit. d. Upon approval of this application, the Budding Inspector w~ll issue a Braiding Permit to the apphcant. Such perm 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 Occupan, 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 t} Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances, Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe. The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and; admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bullde .................................................... lt. il .e. ........................................................................................................................ Nome of owner of premises ......... !lOl¢.tl~,..l~O~k..C~;)tl~i:;C'~..~,l,tl~ ........................................................................ If applic_~t ~s a corporate,, ,~ignature//of duly authorized officer. · ......... ( d rp t 'c ] Builder's License No ...... ],1,). .......................................... Plumber's License No ...... }lOlla ................................. Electrician's License No. -:~O~e ................................. Other' Trade's License No .... i'lOl~a ................................. Location of land on which proposed work will be done. Map No ................................... Lot No ....................... Struet and Number .... ~,t;~..'},5.~...Cl.tt::~.tlO~-r~ ........................................................................ Municipality Stale existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy b. Intended use and occupancy ~~.~.~/~...~...~.....~...~~..~.~.~~ 3. Nature of work (check which applicable) New Building .................. Addition .... ..~. ........... Alteration ............ Repair ................. Removal ................. Demoht~ar. ................... Other Work .............................................. (Description) ,, Estimated Cast ...... ........................... ............................................................ (to be paid on filing th~s application) 5. If dwelhng, number of dwelling units ............................ Number of dwelhng umts on each floor ........................ If garage, number of cars .......................................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ......................... 7. Dimensions of existing structures, ~f any: Front .......................... Rear ................................Depth ................. Height ........................ Number of Stories ..................................................................................................... Dm~ensions of same structure with alterahons or add,hans' Front .................................... Rear ........................ Depth ................................Height ......................... Number of Stories .............................. 8. D,mensions of entire new construction: Front ....... ~.0..0..~ ..................... Rear ....... .]:...0..0..~. ............ Depth ...... .3...0..~ ......... He:ght ..... .]-..~. ........ Number of Stones ................. ~ ............................................................................................ 9 Size of lot Front ........................................................ Rear ......................................... Depth ............................. 10. Date of Purchase ....................................................... Name of Former Owner ...................................................... 11. Zone or use d~strict ~n which premises are situated ...l~D.g,~l~.~...~.~,l~. ................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation: ....... ~C~ .......................................... 13. Wdl lot be regraded ..... ~'e'8' ................ Will excess fill be removed from premises: ( ) Yes (~[) No 14 Name of Owner of premises ..~ClZ'.t:~..~'l~J~J~..(~D.l~.~...~.l,-1~dress ..... ~lZg.~ .................Phone No ..................... Name of Architect .................................................... Address ................................Phone No ..................... Name of Contractor ..... ~e:Ld~4z~man..~. Soz~ ................. Address ................................Phone No ..................... PLOT DIAGRAM Locale clearly and distinctly all bJ.u~ldmgs, whether existing or proposed, and red,cate all set-back dimensions fro~ property hnes Gwe street and block number or description according to deed, and show street nQmes and ind~caJ whether ir.tenor or corner lot STATE OF NEW~OJ~If,/~ ........................................................................................ being duly sworn, deposes and says that he ~s the apphca. (Nome of individual s~gning contract0 above named. He ~s ~he ..................................................................................................................................................................... (Contractor, agen¢, corporate officer, etc ) of sa~d owner or owners, and this application; that all s~atements contained m thaw ~he work will be performed in Che m~nner set fo~h in the apphca~ion filed therewith. Sworn~re me this ........ .. [~,~ys~e~~y' ~ ~ ~ (Signature of applicant) Com,msslon [xp~r~ ~rch