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Home My WebLink About9037-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH'OLD, N.. Y. BUILDING PERMIT (THIS. PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) M9037 Z Date ..........................PP-b.......!f.............. 19.rT7.. Permission is hereby granted to: S�.k•................................................ ...................lkxlh...B".Viaw..Roa&..........Southold ................................................................................ to ..}3, �1c1 . ?4�4 s.:,Q.FX...jn? ixA*Jll .g..c�—fark e........................................................................ at premises located at ..... 35......50TV11-DAY..new....1 Raaa........................................................... ...............................................00)XV 01d....... ................................................I............................ ................................................................................................................................................................. pursuant to application dated .......................Feb......../................1 19..77.., and approved by the Building Inspector. Fee $..V t.CO......... Tz-�....... ... .. ..................... ....Building .Inspector TOWN OF SOUTHOLD Building Inspector's Office Town Clerk Eluilding -/ x, ,x' TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE $OUTHOLD, N. Y. £xomined ........ ~..~...~. ...... .2 ............, r~ ~proved .............~ .......... '.(. ............ , 19..~.;... Permit No..~.~..~..~...~ ........... APPLICATION FOR BUILDING PERMIT Dote .................... .................. , INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ in ink and submitted in triplicate to the Building 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 or areas, and giving a detailed description of layout of property must be drawn on the 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 been granted by the Building 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 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) .................. ~ '~ ~"~7, ,'~Addr~s, oj~gpplicant), ~ ............. State whether applicant is owner, I~s.see,.age. nt, architect, engineer, general contractor, electrician, plumber or builder. . If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........... ~....~.~~,.....T;... Plumber's License No ................................................. Electrician's License No ............................................. Other Trode's License No ............................................... Mo o 78 74' Location of land on which proposed work ~1 be done. p~ r~ ........... .~.;..~. ............Lot No ......... '.~ .......... Street and Number ....... .~;~.~....~....~.~..~.~z~'~.'~.~.....~../..'~.. ...... ...~...~~ ...................................... Municipality State existing use and occupancy of premises/crud' intended use aIad occu~u~p?ncy of proposed construction: b. Intended use and occupancy ............................................ .~...'.:r. ...... ../..~..~....~.~..~ .................................... 3. Nature of work (check which applicable): New Building'. ................. Addition ..... _~ ....... Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work .~J..:.t..~...%.~..~. .............................. (Description) (t~ be paid on filing this application) b. If clwelHng, number o~ dwelling arfits ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commercial or mixed occupancy, 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 ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ........ ~ ...................... Rear ....... ~..~. ............ Depth ..... ~ ............... Height ...... Z ........... Number of S~ories ....... ~...~ .................................... : .............................................................. Size of lot: Front .............. ''Z.).~..; ............................... ........... ...................... Depth ...... . ............. Date of Purchase .............. /~.~.Z .............................. Name of Former Owner ..~....~~ ............ Zone or use district in which premises are situated .................................................................................................... Does proposed construction violate any zoning Iow, ordinance or regulation: ..... .(~.~ ........................................... Will lot be regroded ......... /~...~ ...... W[II e~ss fill be removed from premises: ( ) Yes ( ~No ~ome o{ Architect .............................................................. Address ................................ ~hon* ~o ....................... ~ome of Controctor ............................................................ Addross ................................ Phono ~o ....................... 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 YOR](, ~ ~, ~ .............................. ~..7..~.~..~~ ........... boin~ duiv sworn, doposos ~nd soys that he is the (~ome of individual sionin~ obovo nomod. He is the ................................................................................................................................................................................. (Controctor, o~ont, corpor*to officer~ etc.) of soid owner or owners, ond is duly outhorized to perform or h~vo performed the soid work and to moke ond file this opplic~tion; thor oll statements cont, ined in this ~pplicotion oro truo to tho~best o{ his knowle~Oo ond belie~i end thor tho work will be per{ormod in the marmot set fo~h in the op~licotion filed thorowith. Sworn to boforo me this 9. 10. 11. 12.. 13. 14. cytc 49 y FORM NO. I � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ............k................ ...... .. 19�!... Application No. /� .7............... Approved .......................... ./............. 19 1.... Permit No. .. U. ..7.. ............ 'V Disapproved a/c ... .. ................. ... ................................................................ ....... ............................. . . ............................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .................... ..7........... ., 19..' .. INSTRUCTIONS 57_ 7 747, a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building 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 or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this application. n 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 buildingshall be occupied or used in whole or in art for an p p y purpose whatever until a Certificate of Occupancy 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 the�� 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 described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to i admit authorized inspectors on premises and in buildings for necessary inspe tions. .................... ... .... ....... ...... c?i'..... .................... L . (Signature of applicant, or name, if a corporation) ....sV. Z .................................. �(f�G � cant) State whether applicant is own l�esse', agent, architect, engineer, general contractor, electrician, plumber or builder. .............. . 4.... . .�.......��::�........ .. .............. Name of owner of premises ..... ... ..J.�.�. . ... ... ...................................................................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. ......... . ...................... Plumber's License No. ................................................ l000 —7$ 8 — !/o. 2 Electrician's License No. ............................................ Other Trade's License No. .............................................. 1. Location of land on which proposed ork will done. Mop No.: . ... .. of No. ../��. ........... Street and Number ........ :.. % ......... ....: .. .. ... ........... ................. ................... Municipality 2. State existing use and occupancy of premis a d i. Mende use and occupancy of proposed construction: a. Exisiting use and occupancy ......................... ................ . . ................(................................................................ b. Intended use and occupancy ............................ ....../............ x ... ......................................... I v _ v 3. Nature of work (check which applicable): New Buildirig .................. Addition .................. Alteration .................. Repair .................. Removal .................. Demolition.........:.......... Other Work .. .................... ......................: .... /0'�-y lvice _ (D scription) ��. Estimated Cost .............f.r��i.......................................Fee .��...............�:::::L ......................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................Number of dwelling units on each floor ............................ Ifgarage, number of cars .............................. .. ............................................................ ........................................... 6. If business, commercial or mixed occupancy, 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ............................Number of Stories .................. 8. Dimensions of entire new construction: Front ..........,1'1.................... Rear ....... ............... Depth ..... ................ Height .......7.......... Number of Stories �Z ......... ............................................... .............. i 9. Size of lot: Front .................... .......................... Rear ...........13 ........... .Depth .. � ............... 11 10. Date of Purchase .........dr.ZY....................................Name of Former Owner ........ .......... ................ 11. Zone or use district in which premises are situated ........:............................................................................................ 12. Does proposed construction violate any zoning law, ordinance or regulation: �0............................................ 13. Will lot be regraded ......!!'.a...... Will xcess fill be removed fro��m�� premises: ( ) Yes ( {' ) No / 14. Name of Owner of premises ....... ..... ................I...... Address Y.:.��.. / !�/.. Phone.No. .........I.03 Name of Architect .............................................................. Address ................................ Phone No. ...................... Name of Contractor ............................................................ 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. �S I� 1✓SIN�� REVr�_ _l .�R� ` Exi s rr�c- Ilk ffods� ya, 33. ( / STATE OF NE OR< O W COUNYF .. 'SS.S ................... ................ ............................................being duly sworn, deposes and says that he is the applicant (Name of individual signing contract? above named. �. Heis the ..... .............. .......... ............... .............................................................. (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 than the work will be performed in the manner set forth in the application filed therewith. Sworn /to before me this _ ......... 1�. .... day of .....�.:..�- .h.u, r.. ........ .. 19.7.7.. NotaryPublic. ................................ 1 . . r/. County ..................................... .... ............... ... ............................... (Signature of app it cant) ,INN NEVILLE NOTAP,S' PUSLIC, 3:ate of Nely York No. 52-8121,i8151, Suffolk CeW Term Erphes March 30, 19 f7y . K So (v9 .grst'} • 5 'T3 05-'50,`E o •LI y''1_ .\wry �3 S E 1 1 75r SfI9IL. `I5 / l � SQM�cIr ? i . 1 ko Q a FYI i ogKt, •� Z tI 5a v li k �oava { �` —_._� I Y. •Yip' ��N 'ljCZyc!q,e It N FEf ♦ / .44 -Z =- well z well ceaitlY l ve. , Vn_ . i V O pa-7 }--1 i ' n v 6`��f �• N . Vy(. '�0 iA,11 fit" C° w 16 E a { UNAUTHORIZED ALTERAT{ON OR ADDITION TO iH15 SURVEY VIOLATIONYoR OF !— —"-- -- ~' SECTION 72G9 OF THE,NEWEY�yORK STATE F - . '/ .. •. 'EDUCATION.LAW. r _ - •,•i - COPIES OF THIS SURVEY MAP NOT BEARING I ..THE LAND SUVEYOR'S IN SEAL OR S /^•�' I EMBOSSED SEAL SHALL N37 BE CONSIDERED P v .' L.f••1.�•+p - - TO BE'A VALID TRUE COPY. _•� - - _- " ' - GUAL'AWE`E"NDICAiED HEREON SHALL RUN SURVEY ( 'SURVEYED'.. .•;• �' _ ONLY TO TFI"c'FE 501J FOR V7F{01A THE 5 ' - _ - .-IS FRET ARED, A::D ON HIS GEHALF TOENTAH CY AND" } GEF'�./r, '-"j, - �� ''. � ,�fCati�',�C� - � - TITLE'CO1dFAl�Y,GOVEP,f:GiEN'iAl AG } t`•••/^'°�P`+• LENDING INSTiTUTfOTi LI57E�H-REONIySTID 3 •i `i' - .u. TO THE ASSIGNEES OF THE'LENDING TUT{O;•d,•GUARANTEES VaiE NOT TRANSFERABLE EQUENT' ` ,70,ADDITIONAL'INSTITUTIONS OR-S Q�. : r- .-': (.._'L•r,. J, ',.,,„ '.� •'�`�a•fi�e�;; �Q"S.�ou��tQ4c� 5d�tinc� • ( :gcas�k . . . i' ;.��P.�"te •i't•tss++�cTj-�� 4.1�7.G?ttl�; oS • i / �; �i.1.1(1�=:.�G� �Otir•@tN��Y t''�� tr.J_7�. - �' X � 1