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Home My WebLink About8851-z FOIlEr NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE Pi~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 8851 Permission is hereby granted to: Z~ehar8 ~'oster Atlantic Ave ......................................................... '.2 ............. ,j.?... ,.:..:: ........ ~ ....................... ~ ........... ,..;. ....................... at premises located at ..~ ./..~.......~..~..,.cl~..,.~..e.....~.~.~.~. ......................................................... .: ......................... , ~ conio .............................................................................. Building ~n~ector. Fee $ 1 ~ ' ......t .....~'~ ....... - ....... - ~ 'L ~ _,. .: ~ .~ ..... ~::~-L2~ . ................ ~ .......... ~-'z Idi~g In~ .... BUILDING DEPARTMENT .1- --~ - /. ~UTHOLD, N.Y. ~~~~~ ~.0 ~ ; 19~g~ Permit No..~.~..~.~.~ Application No ................. ~ ......... D~s~pproved ~/c ...~.....~ ............................................... .................. ~P~M~TIO~ ~OR 8~1~1~ ~R~IT ........... I~STRU~IO~S Examined .........~ ...... ~ ....... , Approved ............... ~.~. .......... Z ....... , a. Thru application must be completely filled in by typewriter or ~n ink and submitted m triplicate to the Buildi~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b Plot plan showing Iocahon of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and gwmg a detaded description of layout ofproperty must be drawn on the diagram which is part of this applicotio 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 Perm=t to the applicant. Such pern shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in port for any purpose whatever until a Certificate of Occupon. shall hQve been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Budding Permit pursuant to tl Building 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 in buildings for necessary inspections. ........ ................................. (Signature of applicant, or name, if a corporation) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budd.- ................................................................................................................................................................... Name of owner of premises ....... ~4. K.~..~ ...... .~..S.....~'..',.p.~..~. It .C~.~ ....................................................................... If applicant is a co~orote, signature of duly authorized officer. (Name and t~tle of co~orate ofhcer) Budder's License No ................ ~ ............. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work wdl be done. ~,qp No ...... J~,.°..o...o..:,_~..:. q.z/. Lot No./4~.. .......... ., ...... Street and Number ....... .~./~.. ....... ~~--r~....~..~......~tL- ........... .~...~...%~... .................... ~v{~-~ii~ ..... State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy .~..,.6~¥.!..~..~...t?.~..~.! ... !...~:...~..!...~..~../..~.. ...... ..-.....Jf.~..O.......~..?.':..t..~..}..¥.L..%~ ....... b. ~ntended useand~ccupancy~..~.~.~.~.~L~.~.~..~..~t~..~.M.~..~.~'~.~.~.'~.~.~:~.~i~.~.`~~. ....... .?..~ ........... 3 Nature of work (check which applicable) New Building ................ ~' .. Addition .... ..... ...... ... Alteration ........... Repair .................. Removal .................Demoht~or ............... Other Work .............................................. /~-'- 0 ~ (Description) 4 Estimated Cost ..................................................... ~-Zc~-o '- ~ ~o o ...... Fee .~...---- . (to be paid on fihng th~s applicahon) 5 If dwelling, number of dwelling units ...... ..[~....O....~....~.. ...... Number of dwelhng units 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 ..... JZLO...~....~-..... 7 Dmnensions of ex~stmg structures, if any: Front .....V~.C)..O~.....~. ....... Rear ................................ Depth ................... Hmght ........................ Number of Stones .............................................................................................................. Dimensions of same structure with alterations or addmons Front .................................... Rear ................... Depth ................................ Hmght .......................... Number of Stories ............................... 8 D~rnensions of entire new construct,on: Front ............ ~...C~.. .................. Rear ............ ..~...O. .......... Depth ...~ .......... Height ................... Number of Stones ............ ~ ........................................................................... 9 Size of lot' Front ........... .~..k~..~ ................................... Rear ....... ..~.~.~ .......................... Depth .~.¢'.~.:.~'.'~..:....:.~....'zr~...... 10. Date of Purchase . .J~'...g.C, ..... ~..~.l......I...r'~(~l.~. ........... Name~, --at Former Owner ~..~.¢.L.~..(~L....C~.. ,s...~......~..~.~-....~ ~ , 11. Zone or use distr,ct in wh,ch premises are situated ..... ..~..~.~)..(,,?.:.!~.~-:~.!...{ ...... .V~.~.~'~.~...~...~...~..t...~k.~. .............. 12 Does proposed construction violate any zoning law, ordinance or regulation: ........ ..1~...?. ....................................... 13. W~lJ lot be regraded .......~..~. .............. Will excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises ..~..!...CJ....')..~.:[..c~. ..... ~.O...~.'k~...~'..' ........ Address .~'..~.~..'k..,. ..... ..J~...'.~'~ .... Phone No....g~..~...~...~,... Name of Architect ....... ..~....O....v~....~ ....................................... Address ................................ Phone No ..................... Nome of Contractor ....... ~.l,.g..t.¢....~. .................................. Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly oil buildings, whether existing or proposed, and indicate all set-back dimensions fro~ block or property lines Gwe street and number descnpt~on according to deed, and show street names and ind~ca, whether interior or corner lot k~ O STATE OF NEV~F~~' I S S COUNTY O~ ............ f ' .......................................................................................... bmng duly sworn, deposes and says that he ~s the applico~ (Name of individual signing contracf) above nalned. He ~s the ..................................................................................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the so~d work and to make and fi this application, that oti statements contained ~n th~s apphcotion are true to the best of h~s knowledge and behef; a~ thaz the work will be performed m the manner set fo~h ~n the opphcahon filed therewith. Sworn to before me this / . ....... ~. ...... day qf ,. ........ ..~~..~.., 19~~. ~ - . . ~ -- ............ ........................ ~ ~ (Signature of app cant) ~ JUDITH T BO~EN~,~)~ ' '