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Home My WebLink About8673-z FOI~M NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~. Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 8673 Z Date ........ ~...~.~ ............................. Permission is hereby granted to: Frallk Fo Vaneoek Sro Na~':~'ow River Road .............. 0;ri~t t..~...Y.. ................................... ~o ................. ~.?....?...,..e. ~.~...~ ...c..o...,..,...a.! ........................................................................................ at premises located at .....E../~....]~L~.~.~.~f...~J,~.~...~..~.~0,~...Q.~'~keD.~,..~.~...~.~. ................................. pursuant to opplication dated ................. .~,...~...e....~...~.a .................... , 19~..~...., and ~pproved by the Building Inspector. Fee $...~, ,~. ff. ?.C?. ......... Building Inspector TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Approved ~l~JJ~ ~2 19..?..~... Permit No. 867,~ ................ Disapproved a/c '1[*~Z]J[~J~ Application No....8.~..~. .................. ~ (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ~....~.~ .../.?.~;; ............... 19. a. This application must be completely filled in by typewriter or, in ink and submitted in triplicate to the Bu Idlr~ 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 o detailed description of layout ofproperty must be drawn on the diagram which is part of this applicatior~t--, 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 permi~-~,l 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 a 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 apphcant agrees to comply w~th all apphcable laws, ordinances, budding code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. (S,gnature of appl~i~an~corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises ./~......~¢2,¢~.~'¢~ ...... : ........... ~x.../.~< ..... ?. ........................ 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 ............................................... Location of land on whiqb,. . proposed work will. b.~/done.. Mop N~) ...................>>.~ ............ ,.... L~o~t_ No ......................... Street and Number ..~Z/~/~f?,,~.,~..C~4rz.?..;;;~,......~.,~./~.~,:/~.;C......4~.~x~ ............. ~'.~..~,,,.~/,L.-..~r..(.5. ,z~/.?.(,~ ............. Municipality State existing use and occupancy of premises and intended use and occuponcy of proposed construction: a. Exisiting use end occupancy ..~..~.z~...Z.:'.Y?.~-~'~~ b. Intended use and occupancy ......... (./.-Z...~.-.-.~.),..//.~..~/..-~..~.."..~,, ......................................................................... 3. Nature of work (check which applicable): New Bui]dir~g'. ................. Addition ........ epo,r .................. .................. .................... /~, ,,~ ,---- (Description) 4. Estimated Cost ............................... '~...~....~. ............... Fee ../..,-~.. .................................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ NTumber 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 .................... Number of Stories ..................................................................................................................... c). Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Farmer Owner ..........................i ............................. / 11. Zone or use district in which premises are situated ....................................................................... ~ ............................. 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ I3. Will lot be regraded ............................ Will excess fill be removed from pr~emises: ( ) Yes ( ) NO 1,4. Name of Owner of premisesX,-~.~...?../C~.~..~.. ....... ~~..~Phfone No. ~*~.~...J..,.7,.~...~...~ Name of Architect .............................................................. Address ................................ Phone No ....................... ~.~,~4ame of Contractor ............................... ~_.'~.'..~..7..".. ............... Address ................................ Phone No ........~ .............. PLOT DIAGRAM L.ocate 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. ELIZABE"[H ANN NEVILLE NOT:~RY PUBLIC, State of New York No. 52-~125850, Suffr~lk ~ ~TATE OF NEW YORK, ~.S.S COUN'FY OF ....... .q~/~'~) .1 ~ ........ ...................................(Name of ~vi~ucl"' . . ...~'~l~signing contract)~ .................. being duly sworn, deposes and says that he is the applicant a b ow,' named. Fie is the ........................................... O~,oe~tnt~.~.~i.~.r.,..~.~.~.~,..~.~.~.~.t~.~fi.c.~.r.~.'~'t'c...i ............................................................... 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 staternents contained in this application are true to the best of his knowledge and belief; th, ar the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this / /? .... 2~"~1~ .......... Y ..................................... '~' '" Notary PuNic, . ............................. SU~f~'k'"" County c,-~"*~~~, ' ............... ~ (Signature of oppl'~cant) /