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Home My WebLink About7821-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7821 Z Permission is hereby granted to: ............ J~es~o~.t ............................................ to .$.T,.e.Q.t...~d..m~in.tain..wal ~ ~...pler~..&..l~§~ting...o~..pe~ime.te~...o~..~eml~eB .............. A~... ~p~.~.e~..l~y... ~ra~..of... Ap p~ala ...................................................................... at premises located at .... .}.'~f~.~...~g~d...C..Ee~..S.uff. o],k..Age. ...................................................... ............................................... .~.a...t..t...t..t..u...e.~......~L.. X .: ............................................................................. pursuant to application dated ...................... ~.~. ......1..~. .............. , 19.~..~...., and approved by the Building Inspector. Fee $.!~. ~.,.Q.O. ........... ~ ~ FOR~ NO. ~ / ~? TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. / )-- 7 No. Exam,ned ........~: .......... C5' 19...~. Appl,cat,on ~..~. ..... /. ............ pproved ............. ~:~ ................... , 19 ........... ~ ........................... ...... .... ..... ....... .......................... ................................. (Bufidin~ Inspector) .............. ........ , a This application must be completely f~lled in by ,'-ypewriter or' in ink and submitted in triplicate to the Buildin Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee according to schedule. b. PJot plan showing Jocat~on of Jot and of buildings on premises, relationship to adjoining premises or public streets c areas, and gwmg a detaded description of layout ofproperty must be drawn on the d~agram which ~s part of th~s apphcatior c The work covered by this application may not be comrnepced before ~ssuonce of Building Permit. d. Upon approval of this apphcatlon, the Budding Inspector w~ll ~ssue a Building Permit to the applicant Such perm 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 Occupanc shell have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the ~ssuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinances c Regulations, for the construction of buildings, addmons or alterations, or for removal or demohhon, as hereto describe; The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and t admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of apphcont, or name, if o corporation) '"" (Adder's ~:f- '~/p' ~i~:~;3 ~ .................. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: If apphcont is o corporate, signature of duly authorized officer. (Name and title of corporate officer) Budder's License No ..................................................... Plumber's L~cense No ................................................ Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work w~ll be done. Map No .... ~ ......................../~' Lot No ...................... Street and Number ,~.~. ..... ~..~ .~... ........ /~..?~...¥././'.... ~...~....~.... .A/f.?2~..~..~../. ?..~...C'9..~.. Municipality State existing use and occupancy of premises and m.~ended use and occupancy of proposed construction: a Exisiting use and occupancy ............. ~ ............................. --..... ....................... b intended use and occupancy ........................................... 3 Nature of work (check which applicable). New Building .................. Addition .................. Alteration . .~-~....... [~epatr .................. Removal .................. Demolition .................. Other Work ~.,/~'~ .............. ....... ................................... (to be pa~d on filing th~s opphcatlon) 5. If dwelling, number of dwelling units ......................... 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 t ..... 7 Dimensions of existing structures, if any- Front ..... gO...(. ............ Rear ......... ~?~.../'. ............ Depth .7.~-~...~.~.?.. Height ...... ~--1..(. ......... Number of Stones ........ ~:::l~.~ .................................................................................... D,menslons of same structure with alterations or add,t,ons. Front ........... -- '~.~...'.. ............. Rear ...~.~../.. ....... Depth ..... ~.~_~/...~.~.(.~. .......He,ght .... '~j ............ Number of Stones ......... ~....~...,~.. ........... 8. Dimensions of entire new construction. Front .................................. Rear ............................ Depth ..................... Height .................... Number of Stories ........................................................................................................ 9 Size of lot' Front ....... /~.~ ................................ Rear __ ..... ~..Z.~... ~. ................. Depth ..~. ............... 10 Dote of Purchase ............ /..//.....~...~.. .......................... Name of Former Owner ....,~..~.....~.~..~..~.. ................. : ......... 11. Zone or use district in which premises are s~tuated ..... 7~.~..~Z4}~ ................................................................ 12 Does proposed construction violate any zoning law, ordinance or regulation ................... .~..~ ............................ 13 Will lot be regraded .... /~4) .................. Will excess fill be removed from premises: ( ) Yes (r~) No 14 Name of Owner of premises .~..~.~...~.,~.~.~.~r.~.~. ....... Address~...~.~.~..?'~.f.q~...~ Phone No.Z~T.~ ...... Name of .~._.~...~,~----------------~...~.. ~.,..~./..~../~...~/.P.~.-- -- ....... Add ress~..~~sJ'~ff?-Ph one N o.7...Z~..~..~...~.... Name of Contractor ~/~.../T/Z~..~ ..7~..~.~ ...................... Add ress ~.~x~/~r~,~ .... Phone N o~r~.'.Z ..'~../..~.... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and red,cate all set-back dimensions from property hnes. G,ve street and block number or description according to deed, and show street names and indicate whether interior or corner lot STATE OF NEW YORK, [ ¢ ¢ COUNTY OF ............................ f~'~ ................... ~~.~..~'...~.. ............ being duly sworn, deposes and s~ys that he is the opphcont (Nome of ,ndividual s,gn,ng c~racf) above named. ,s the ............................... - ,~....~.~~ ............................................................... He of so~d owner or owners, and is duly authorized to perform or have performed the sa~d work and to ~ke and file th~s application; that all statements contained in this application ore true to the best of his knowledge and bekef, and that the work wl]l be performed m the manner set fo~h ~n the apphcat~on filed therewith Sworn to before me th~s ~ ......... /~..~... ~oy of .... .~ ................ ~ , ~Z~ ~ ~ , ~ ~ ~ - ...... .................. ~YA~ PUBliC, STATE OF N~W FO~ .1 ~q ",.4 2?,0 :' :Gordon' K.:Ahlets, P. E; "AlteratiOn of this' po~um~nJ exr..ept by, u Licensed Profes-- slon,~l,En§inegr l~ Iltegal SeCtion 7209 Subdivision N.~Y, [,St~le E~U~ati~n .1 ~q ",.4 2?,0 :' :Gordon' K.:Ahlets, P. E; "AlteratiOn of this' po~um~nJ exr..ept by, u Licensed Profes-- slon,~l,En§inegr l~ Iltegal SeCtion 7209 Subdivision N.~Y, [,St~le E~U~ati~n