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Home My WebLink About8345-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 8345 Z Permission is hereby granted to: ZOO,', .~,,?~u.,~ ....................... ........... ~.~:..~.~.~1 ........... ~.t,.e~ ... ~: ...... :.~ :.:.,::y.": ...... ,~ ......... ~...'.~.'...~ ....... ~ ........... , ........... to. ~.~ ~.~.. ~&..~ ~ ~ ~..~ ~.t~ ~.e... ~e ~.ea s~.. ~.. ~.. ~~.)... ~~... at premises Iocat~ ~ ? S, 44'48 '40"E. Cad¢~jan "r" Z c 0 0 Examined ...... .~ ..c~.......~Z...c. l ........... , Approved ........................................ , lrOB~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N, Y. 19..7..!.~- Permit No. ,.~...?,.~...?..~ .......... Application No ...... ~..~...~....V...~ .............. D,sapproved a/c ...~_:~. APPLICATION FOR BUILDING PERMIT Date ............ ./..~....:.../...~. ................ , 10.~. INSTRUCTIONS a. This application must be completely filled in by typewriter or' in ink and submitted in triplicate to the BuildinC 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 prem,ses, relationship to adjoining premises or public streets os 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 th~s application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector w~ll 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 Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o~ 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 tc admit authorized inspectors on premises and in buildings for necessary inspections. ............. ............................. ........ (Address of applicator)/ /' State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (Name and title of corporate officer) /~, Builder's License No .............. .~...Z .............................. Plumber's License No ................................................. Electrician s icense No ............................................. Other Trade's License No....~......O-~....~..~.....~~/¢-//~'~'~~ Location of land on whi_~_h propased wor~j?ill be done. /~ap ~o.' ...; ....... .~ ...................... Lot No ......................... Street and Number ..... ~-,~., ....... ~~~...K./m/. ...................................... ~ ~' Municipali~ State existing use and occupancy of premises and intended use and occupancy of proposed construction: · .............................................................................. b. Intended use ~nd ~ ............................................................................................. 3. Nature of work (check which applicable) New Building .................. Addition ........ Repair ................. Removal .............. Demoht,or. ............... Other Work ..~¥.~.....~....~..~ ('Description) 4 Estimated Cost ..........'.Z~..~ ...........................Fee ................. ~,~...~... ......................................................... (to be pa~d on filing thcs application) 5 If dwelhng, number of dwelling umts .......................... Number of dwelhng umts on each floor ......................... If garage, number of cars ................................................................................................................................... 6. If business, commercial or re,xed occupancy, specify nature and extent of each type of use ......................... 7. D~mens~ons of ex~stmg structures, if any: Front ........................... Rear ................................ Depth .................. Height ........................ Number of Stor,es .............................................................................................................. D~mensions of same structure with alterations or addmons' Front .................................... Rear ......................... Depth ................................ Height ................ Number of Stories ............................. , 8 D,mens~ons of entire new construction Front ...... .,~.....~....' ................. Reor ..... .,~..~.. .............. Depth ..../..o~.. ........... I ./. Height .../~. ....... Number of Stories ......... ............................~. ..................................... ~ ............. 9 S,ze of lot Front ........ -;ry. ................................. Rear ............--./..~. ..................... /~epth .,...r./,~..,.....~'.. ........ 10. Date of Purchase .............. /'7 '~''~'' ....................... Nam. e~.Forme.~r ?/wrier ....... 1 1 Zone or use distr,ct in which premises are s~tuated . ..~~.~ .............................. 12 Does proposed construction wolate any zoning law, ordinance or regulation .............. ~ ................................ 13 Wdl lot be regraded ..... ~ ..... ~ .... Will e/<ces_s/f,II be removed from premises; ( ) Yes ( ) No 14 Name of Owner of prem,ses~..,.J~~c;~Address ..~~ Phone No...~..~.....~.L.~...~..-' Name of Architect ... ~ .................................. Address ................................ Phone No ...................... h!ame of Contractor ......................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~stmg or proposed, and red,cate all set-back d~mens~ons fron property hnes Gwe street and block number or description according to deed, and show street names and indicat, whether mter~or or corner lot ........... ~.g..~.K ........ . .%~....~....'Z...':%....~T.....'::T....':~...7...--. being duly sworn, deposes and says that he ~s the apphcan // -'TN-amc of ind~vidual,.~igning contracf) abov~ named. He is the ..................... ~~ .............................................................................................. (Contractor, agent, corporate officer, etc ) of said owner or owners, and ~s duly authorized to perform or have performed the said work and to make and fd this applicahon; that all statements contained m th~s apphcat~on are true to the best of his knowledge and belief, an, that the work wdl be performed m the manner set forth in the apphcation filed therewith. Sworn to, before me this . /~ . .~.....~.....~.~.(. day of .~.^~...~ .................... , 19x~-''( ~ /) £, /7' · Notary PuN,c, ~.',,.~,~...~V-c..~b~.~.. ............ County .............. ...~<(z~x~. ..... ~..:...../....~......4~...~ ................ ,' ~ ' ' ~/ (Signature of applicant) J,~,Y~',IE MacDo~ALD //