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Home My WebLink About7687-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7687 Z Permission is hereby granted to: T.1~;~3...~g,v.~...~.e~qg.e....C..g.,..,~'..C....p.T:;..e.p. 9..o.~...t....(Permy) Lu~ber Co ............. N~ t.t,$ ~.uob; ............................................. to .~ncl~..~ld~.. fx..~.e~..~.ar.d...~£t~..6£.t ..chain.. · ~nk..~:enc~ .................................. at premises located at ~/~..~n..2oa~l.....A~me~le~..F,a~..~$c~n~c..J~...~s~af~s..~t ....... .!.~.~.~.,.!.~. ............. ~.~.o..~.~.u..,..,...9..r...e. ~ ~...o.~..t.... ...................................................... pursuant to application dated ...................... I~C.....2~ ................ , 10..~.~.., and approved by the Building Inspector. Fee $..:~.~.Q .......... Budding inspectorI ,( [ ~'~-~ BUILDING . TOWN OF ~ ......................................... APPLICATION FOR BUILDING PERMIT Date .................. ........... , I NSTRUCTION5 ~ o. This opplicotion must be completely filled in by typewriter or' in ink ond submitted in triplicote to the Buildlng Inspector, with ;3 set~ of plons, occurote plot plon to stole. Fee occording to schedule. b. Plot plon showing locotion of lot ond of buildings on premises relotionship to odioining prem ses or pub c streets or oreos, ond giving o detoiled description of Ioyout ofproperty must be drown on the diogrom which is port of this opplicotion. c. The work covered by this opplicotion moy not be commenced before issuonce of Building Permit. d. Upon opprovol of this opplicotion, the Building Inspector will issue o Building Permit to the opplicont. Such permit sholl be kept on the premises ovoiloble for inspection throughout the work. e. No building sholl be occupied or used in whole or in port for ony purpose whotever until o Certificote of Occuponcy sholl hove been gronted 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 applicant agri~es to comply with all applicable laws, ordinances, building c~te, housing code, and regulations, and to admit authorized inspectors on premises and in buildings for necessary inspections. ...... .,_,tS gna~ture ot applicant, or~gme, it ~ corporatioj~ (Address of applicant) 'A/'" State whether applicant js owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. If ap,~llican~-is a corporate, signature of duly authorized officer. (Namp.-~nd title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Zrade's License No ............................................... 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and b. Intended 10. 11. 13. 14. Locate clearly and distinctly all bu~ property lines. Give street and block~c whether interior or corner lot. .. Alteration .................. Nature of work (check which applicable): New Building ...~. ............. Addition .......... ...,~ Repair .................. Removal .................. Demolition .................... Other Work ....... "~~l~'~i~'i ........ :'" (to be paid on filing this application) If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................ Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... IJeight ........................ Number of Stories ................................................................................................................. ' Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ...................................................... ,, ............................................................... Date of Purchase ........................................................ Name of Former Owner ........................................................ Zone or use district in which premises are situated ,. ................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ W~ill lot be regraded. .......... ..~...~,~...~,~, ',.~ Will ex~.e~ss fill be rem,o~/~Adcrresaf,r.o~pr~]se~'~(,~/~VeSphone No( ) No Name of Architect ................................ .'? ............................ Address ................................ Phone No ....................... Name of Contractor .....................~ ......................... Address .........· ........ ,~.~..,~hone No ....................... ings, wheth'~) existing or I~roj~e~aj~/~'~c 11 Lmber or description acco ~BJ~'. ? ~t-back dimensions from eet names and indicate COUNTY O~..: ....... ........................... ///./. ............. : ................................................... being duly sworn, deposes and says that he is the applicant (Narr~ of individual sig~ing controcf) He is 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this ,~ l.~.....~..., day of ...~..~~~... Noto ............................ ~ JUDITH T. I~OKEN ' ! J~Signature of applicant) Notaw Public, Slale of Now York No. 52-0344963 SuffoJk r.:ounl~l