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Home My WebLink About8903-z TOWN OF SOUTHOLD BUILDflqG DEFARTMINT TOWNCLERK'SOFFICE SOUTHOU), H. Y. BUILMHG PERMIT (THIS PERMIT MUST BE KEPT ON THE P~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 8903 Z Permission is hereby granted to: Build new one family dwelling at premises IoGatecI at ...~..°.~....6..~.....~..[~.~....~,!~..t.~ ........................................................................ ............................................. ~.....~.v.l~w..~oa~..~:.~r~g~u~l~e..D.~ .......... ~am.I;Jaol& ........... pursuant to application dated ............................. .0...~.~ ....... .~. .......... , 19~..6....., and approved by the Building Inspector. ~5.00 F~ $ ........................ FO,B~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFIGE SOUTHOLD, N. Y. Examined .......... ~......~.., ......... Approved .................. ~..(. ...... .~.. ......... , 11~.~. Pemit No........~....~.....~....~.....~ Application No ................. ~. APPLICATION FOR Bt.qLDING PERMIT Date ~..~.--'~.. ....... ~ .......................... , 19...~ ...... INSTRUCTIONS> a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, vl~th 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 or areas, ~nd~ giving a detailed description of layout of property must be drawn on diagram which is part of this 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 Building Permit to the applicant. Such permit,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 granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zo~ne~,, Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction oJ 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 inspections. (Signature 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. Other Trade's License No ................................................... 1. Locat on of and on wh ch proposed work w be done. Map No~../~.~.~.~...Z(~..l~,~...~',.5../.~......Lot No..~.,-~.. ............... Street and Number `Z~//`4~r:/~s~~/~R~~Z~: ................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy b. Intended use and occupancy ...,O,,,f~., ,~.,...~.~ ./~..¢..c..~,~.....~../4~.J,~,4.,~.( ,~Yi,,,~,.: ................................................................. 3. Nature of work'(Che~k which applicable): New Building ...... ~ ........ Addition ..................... Aiteratic'~......~ ...... Repair ......................... Removal ......................... Demoht~on ........................ Other Work .................................... {Description) 4. Estimated Cost ;:~ ~ o O .. Fee Z7/~--~---~-'- 5. If dwelling, number of dwelling units ....~... ....... Number of dwelling units on each floor ..Z..~/.-~..°...~x...~../-.,, .................. If garage, number of cars ....~.....~..---~.~, ....................................................................................................................... 6. If business, commercial or mixed occuDancy, 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 ......................................... Denth He ght Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....-~..~...~. ......... Rear .w~-.~..i~. ............... Depth .~., ........................... ! . Heinht /Z~.. ........ Number of Stones .:../.. ............................................... .~ ................................. 9. Size of lot: Front ...../..~. ........................ Rear .....~'~ .............................. Depth ...~..2. ........................................ 10. Date of Purchase ~...~..~...:....I,.?[~..~. Name of Former Owner ....T. ...................................................................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ..... ~...~....T. ........................................... ill lot be re raded -~..~. Will excess f be remo. ved from__prem scs: [ ] Yes [X/J No 13. W g ......................... . _ _. _ 14. Name of Owner of premises .Z~...-~..~.Z~..Y'~.../~.~.-O. tEf-~'~-~...,~tA~,,~,-//-z~.-:, .......... '~-'~'"'~'~/"~'"; ......... (Address) (Phone No.) Name of Architect ...................................................................... i~,~;~;~'s';i ................................... i~'~;{~"lq'~'.i ............... Name of Contractor ~ ~' ~.. ,~.~=..~=.c ~G~ ~ $ ..H(,, - ~ ~--T~o~. ~.~.,~....,~...~..~....~.. ~ . ........................................ {Address) (Phone No.) PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate wheth- er interior or corner lot. STATE OF NEW YORK, ) SS COUNTY OF ...................................................... ) above named. He is the ................................... .-~....,~.....~K, .~..~.....~...~v'..~.~.?...~... ................................................................................................................................. {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. ............................ ~.......day of ....... ~.....~.....~. ¢ ......................... · ............ t ~ / Notary Public ........................ ~~~ ....... County ..~:.q~,...-~~~ ~ ~'~ -- ............................... ~ //// (Signature o] appncant] TO THIS SURVEY 15 A VIOLATION S,CflON 72C~ CF THE NEW YO[K EDUCATION LAW. F AppROVED AS, NOTED DATE: ~ DEPARTh~:-NT NOTIFY BUiLDiNG KEC~JIR- 76.5-2660 9A~ TO 4P~ FOK ED iNSPEcTIONS: 1. 8EFOKE ~ACKFtLLING FoUNDA' TION 0 .... ,ca G pIPELiNE t