The URL can be used to link to this page

Home My WebLink About8450-z 1~01~'~ ~O. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PT~EMISES UNTIL FULL COMPL~ION OF THE WORK AUTHORIZED) No. 8450 Z Permission is hereby granted to: '~.,.O,..~e.t,,t.....~.c...r~e_.-_~J.~a..la~, ................. :.. ~, .............. ~.~. ......................................... ,o ..~..~..~~..~..e~s~.~..~.~- ........... ..~ ........... : .................................. TOWbl OF $OUTHOLD BUILDIblG DEPARTNIEblT TOWbl (;LERK°S OFFI¢! SOUTHOLD, N. Y. ~amined ......... ~.....~..., ~.~.~. ~p,icotion No...~..~..~.~. .............. ~opro~ .................. L'. ......... ~.~.... ~..~.. ~rmit No..~.~.~¢...~ .......... Di~ppr~ed o/c ~....~~ ..... ~...~ ~ .............................. ~;g;~ ................................. ~U~TIO~ ~OR 8~1~1~ ~lT ~ot~ ..... ~[~.,.~, ...................... , ~¢:25 ..... I~STRH~IO~S o. 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 oF areas, and giving a detailed description of layout ofproperty 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 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 with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections, ........ ......... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ............. ~..~.~.~.~.~L.....C~..~.~*-- , ........................................................................................................................................ ~d,~ ~ Name of owner of premises ..... ~%~.).~ .... ~x:,..~ ...................................................................................................... If applicant is a co~orate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ........ .~.~.C>.....-:...~.:.J~,: ................ Plumber's License No ................................................. Electrician's License No ............................................. Locohon of land on which proposed work will be done. Mop No.: .:...~. ............................ Lot No. Street and Number ..¥.~.. ~,... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a Exis,ting use and occupancy .~.~.~..~.,..()...C.~ .~ b. intended use and occupancy ..... ),.~,.~.;..Cz..?.~ ...... .~.(--h~.~-.~.~......~.....~..~.~ ................................................... 3. Nature of work (check wh,ch opphcoble). New Budding ................. Addition .................. Alteration ...~'..'.' ..... Repair ................. Removal ................. Demoht~or ............. Other Work ............................................... (Description) 4. Estimated Cost .~....~..~..(~.0..,.z,.~..' .................................... Fee / (to be po~d on fihng th~s opphcat~on) 5. If dwelhng~ number of dwelling umts .......................... Number of dwelling umts 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 7 Dimensions of existing structures, ~f any: Front ...,~. ~ ./ ............. Rear ............................... Depth .5..7.../. ....... Height ..... .~..../ ............. Number of Stones ...... .~.:.r?...~.. ............................................................................................... D~mensions of same structure with alterations or add~t,ons: Front ..... ~.d..~ ...................... Rear ....................... Depth ....~...7...r. .................... Height .. ~....~. ............... Number of Stories ..... ..~?.!?...~...~ ............. 8 D~mensions of entire new construction: Front ..~.:.~'../. ...................... Rear ............................ Depth ...~..:.Z ........... Height ...... ~.. ........... Number of Stones ....... G:.()...c..~.. ........................................................................................ 9. Size of lot Front ........ ~.[.~ ..................................... Rear ....... ~..P..' ....................... Depth ..... ,./.~.~L..'~... ........... 10. Date of Purchase .................................................... Name of Former Owner ........................................................ 11. Zone or use district in which premises ore situated ................................................................................................ 12 Does proposed construction wolate any zomng Iow, ordinance or regulation ......... .'L..O. .......................................... 13. Wdl lot be regroded ............................ W,II excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises ...~.t'~.k~).r~j..G.. ..... .~.¢.~..h.I ............. Address~.~J;~..~.~,.~'x~,.l~mm Phone No. ~...q.~...':..~. J..~..~.. Name of Architect ......................................................... Address ................................ Phone No ....................... Name of Contractor ~..~:.¢.t.~....~.~J~.. ............................ Addres~.~.c.~.~...t~.~]~.~..' Phone PLOT DIAGRAM Locate, clearly and d~st~nctly all buddings, whether existing or proposed, and red,cate all set-back dimensions from property lines. G~ve street and block number or description according to deed, and show street names and red,cate whether interior or corner lot STATE OF NEW YJDR~/~ I/N Icc COUNTY OF .... ~..~:~¢~-~'~....~...I...~. ~ ~.~ ............................................ .~.~...~..c,,.~ ...................... Being duly sworn, doposes ~nd s~ys that he ~s the ~ppltcan~ (Name of individual s~gning contrac0 above named. He Is the ......... ~.g.~.~.~ ......................................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to ~erform or have performed the said work and to ~ke and file this apphcat~on; that oil statements contained m this apphcat~on are true to the best of his knowledge and behef; and t~,o~ the work w~]l be performed ~n the manner set fo~h m the opphcot~on filed therewith Sworn to ~fore me this