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HomeMy WebLinkAbout8939-z FOI~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8939 Z Permission is hereby granted to: AZher. t..Eo...Tre,~ose~ .................................. .... ..~2.....8am'.~ s~a .. at .......................................... ........... ~.l.a~,a~. ~.~.w ....... .~.,~.~......~1.~.3 ............. to Build an add~t!.o..n.' .~.. ~.e..a.~.e.F..a..t.!.o..~.~.~ .9..~...e...x..J,.~.t.~g ..d..v..e.~.[..~p..g............... et premises located at ....~/.~...~e~.ry...L.ar~e......(.Fo.ua~le~.s..ke.u~t:Lug). ...................................... ............................................... ~.m~,~h~.ld.....~ · X, ................................................................................ pursuant to application dated ............................. J~.e.P..~.....~. ........ , 19~.~...., and approved by the Building Inspector. 1 F.00 Fee $ ........................ ~B~'~' j n spector .................... :.,,: ..... ~~ ......... 70~N O~ SOUTHOLD TO~N CLERK'S OFFICE ~ ~ ~ // ~ > .................................. .... Z .... ' oto ..................... m..2.5...... o. Th~s opplicotion must be complotel~ {illed in by typewritor o~ in ink ond submitted in trlplicote to th~ 8uildln0~ Inspector, with 3 set~ of plans, ~ccurato plot plan to ~1~. ~e ~ccordin~ ~o schedutO. b. Plot p~on show}n~ Iocotion Of 1o~ ond of buildino~ on promiso% rolofionship to odjoinin~ premises or public streets or oreos, ond Oivin~ o detoil~ doscription of la,out ofpropor~ must bo drown on tho dio0rom which is po~ o{ this applicotion. c. The work covered by this oppl}ca~ion m~ not b~ commoncod bo~oro issuonce of Buildin~ Permit. d. Upon opprovol of this opplicotion, tho Buildin~ Insp*ctor will i~suo o guHdin0 Pormit to the oppl~cont. Such permit sholl be kept on tho premises ovoiloblo {or inspection lhrou~hout the work. e. No buildinfl sholl be occupied or used in wholo or in part for ony purpose wh~lever until ~ Ce~ificote o{ ~cupoecy sholl hove been oronted by tho Buildino Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or atterotions, 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 ~al~phcant, or name, if a corporation) 52 Sunrise Street ............... K z. .% t. . . . .¥.o., .z:.k. , . .z. .z. ................................ (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............... .g.~e.~. ..... : ............................ Name of owner of nrem se~ Albert F. Tr~mposch If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. - ...... Plumber's License No ................. .% ............................. Electrician's License No ...............-. ............................. Other Trade's License No ................. ~ ............................. V~,_ ~ Overton ~¢_. Location of land on which proposed work will be done. Map'l~.:~...~-~tbdi~isi~'.~.....-~.... Lot No ...... ] ................. Street and Number ....................... ~.~.~...~.e.~,Z...~.~,~.e. ......................................................................... S.o..ut.bo3.d. ...... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............... Seasonal..dwelli..n~... ' b. Intended use and occupancy ............................................................................................ 3. Nature of work (check which applicable): New Building'. ................. Addition ....... ..~. ........ Alteration .............. Repair .................. Removal .................. Demolition .................... Other Work ................................................ .... (Description) , .................................................................... 4Estimated Cost ............. .$.5.0.0. ...................................... ee (to be paid on filing this application) 5, It dwelhng, number of dwelling units ........... ..0.~.e. .......... Number of dwelling units on each floor ........ .~ .................. If garage, number of c~rs ..................... .7. .................................................................................................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .......... Z ................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................ .0. D.a. ........................................................................................... Dimensions of same structure with alterations or additions: Front ....................................P, ear ............................ Depth ................................ Height ............................ Number of Stories ..... :0~. 8. Dimensions of entire new construction: Front ................... , ................ Rear .; .......................... Depth ........................ Height .................... Number of Stories ............... .9.~e. ................................................................................................ 9. Size of lot: Front ....... ~.q.0...?..e..9..t. ................................ Rear ......... .],.0f)..~'.~.~.t,. ................ Depth ....~,c).0...[9.¢.~ ............ 10. Date of Purchase ................. ~T.~0..3.9.73. .................... Name of Former Owner ..... ..O~.,]-..t.e....0.Xg.,t[.~.9.~ ........................ 11. Zone or use district in which premises are situated ...................~..e..s.$~.e..~...t~.~. ............................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: ............ }{9. ........................................ 13. Will lot be regraded. .......... ~.o, ............. Will excess fill be removed from premises: ( ) Yes (X) NObl6 ]4. Name of Owner of premises ,...A.~.b.?...r.t...,.~.:.,.?.~..~..~.P.9..s..°.~ .......... Address .~.,2. o.~B.z:~.e.,,~.~.., Phone No. ~.~.[.q,3.[[.8. ...... Plainview, I~Y Name of Architect ................... .': ......................................... Address ................................ Phone No Nome of Contractor ................. 7: ......................................... 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 whether interior or corner lot. STATE OF NEW YORK, lc c COUNTY OF ...... ~assau .............. fo" ~' ' deposes and soys that he is tlxe opplicont ........................ ..JQ,he,~.t~..~.,...~r.a~Do,,~h ................................. be,ng duly sworn, (Name of individual signing contracf) above named. He is the Owner-Oonbr~ct~r (Contractor, agent, corporate officer, etc.) of s~id owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that ali statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set fo~h in the application filed therewith. Sworn to before me this ............... Y .................................................. ~~' of a~plicant) ~H ~. l~,A; ~ ' '. ~o~e~ ,Public, St~+,