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Home My WebLink About7732-z FO~M NO. · TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N~ Y. BUILDING PERMIT COMPLETION OF THE WORK AUTHORIZED) N? 7732 Z Date ........................ ,~l~b ......... ~ ......... , 19.~.. Permission is hereby granted to: ...... .~r~.~or.~; .................................................... t^bu~.ld an add~ttolt (8ero porch) at premises located at .~.&..0&k,~....J~ ..................................... ,; ............................................. ............................................... · ;~f,J~o,~ ...... 3~,~'~ ............................................................................. pursuant to application dated ..................... Feb ......... ~8 ............. , 1~.I .....and approved by the Building Inspector. ddng! Inspectir / APPLIGATION FOR BUILDING PERMIT INSTRUCTIONS Application No ................................. Date 1 9 ............ ~; ~ o. This application must be completely filled in by typewriter at 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 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 ~vailable 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 applicant 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. ......... is'6 ...... ii'",";; g,:;';, 6 ' g i:/,iiggi ...... ............... /., ..................... ~:...J. ......... :..!/. ....... ~..../.Z...,E.. ........ (Address of applicant) State whether applicant is owner, lessee, c/gent, amhitect, engineer, general contractor, electrician, plumber or builder. · ...................................................................................................................... Nome of owner of premises ..... ~...~..~../...Z...~.......~....g/.,~./....~.....*~....~. .............................................................................. If apa31icant is {a corporate, sigrIptvre of dul,~ authorized officer· ........ (Name and tit e o corporate of icer) Builder's License No ..... ~./...~....~...,~..... .................... Plumber's License No ................................................. Electrician's License No .... ...~....'.....~....~.~.'..~...~ .......... Other Trade's License No. / Location of land on which propgsedwork will be done. ,Map No.: .......................................Lot No ......................... Number .<T~..Z.('~.. Z~..~...~. .# ~. ~...~....*.d...~'-~.~ / Street and ...~ ....................... ~ .............. .............. ~ ...................................................... Munlci~liW State existing use aod ~cu~ncy of premises and intended use and ~cuponcy of pr~ed c~mctiOn: ~. ~isiting use a~ ~cupancy ..... ~.~..~ ..................................................................................................... ,nte. ed use =.=:, ......... ....... q 3~ ture of work (check which applicable): New Building.. ................. Addition ........... Alteration ................. Repair .................. Removal .................. Demolition .................... Other Work ................................................ . .... (Description) 4. Estimated Cost .............. .~./...x...~..-~....~.....C?.x..O.....~.. ......... Fee ./.C. (to be paid on filing this application) 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 ............................ 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 ...................................................................................................................... 9., Size of lot: Front ................/...~......C~.. ............................ Rear .......... 4(...~.......C~.. ................. Depth ...... ,~.~.~ ............ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 1. Zone or use district in which premises are situated ................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~..fD. ....................................... 13. Will lot be ~egraded ..... ...~/.~:~..... .......... Will exc,es, s fill be removed frOm pre, mises: (, ) Yes (~-")~No 14. Name of Owner of premises ..~...~.~..I..~..../.~..../~..I././.I.H...,~.,,,T..... Address~...~...~../~.°../....1~ ....... Phone No ....................... Name of Architect .............................................................. Address ................................ Phone No ....................... Name of Contractor~ --__ -- ~.~ ./)- .~..~. - .~.....~....~....~ ............ .~----~/~ ~0 Address .~.~..~.'"~'"..~...~..~..~...~ Phone No. ~..22.~.~..X~... PLOT DIAGRAM Locate 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. STATE OF NEW Y~RJ~/,~,~', COUNTY 0~..~ .............................................. ~ .................................................. being duly sworn, deposes and soys that he is the applicant (Name of individual signing contract0 above named. 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 that the work will be performed in the manner set forth in the application filed therewith. Sw.~..e_j re me this FO~M NO. 6 TOWN OF SOUTHOLD Building Delmrl'ment Town Clerics Office Southold, N. ¥. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A. This application must be filled in typewriter OR ink, and submitted in triplicate to the Building Inspector with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approval of Health Dept. of water supply and sewerage dispcsal--(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installotlons, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey cT property showing all property lines, streets, buildings and unusual natural or topographic features. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent in- formation required to prepare a certificate. C. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 New Building ..a..d...d.~.~.i..o..n... Old or Pre-existing Building ............................ Vacant Land ............................ Location Of Property ..... .~/..~...~.~..k.],.~D....~..v..e..n...Ll.~. ......... .S.p.~..~.b.g.~,.~ .............................................................. Owner Or Owners Of Property Dev-ld Id~.],:L:J, ame . Subdivision ................................................................ Lot No ............. Block No ............. House No ............. PermitNo. 7732 Z Date Of Permit 2/28/75 Applicant Richter Home Improvement Cc.,Inc. Health Dept. Approval ............................................ Labor Dept. Approval ................................................ Underwriters Approval ...~./......c~.....c~.....~....~../...~.~. ......... Planning Board Approval ........................................ Request For Temporary Certificate ........................................ Final Certificate ........... X. ............................. Fee Submitted $ ....5.;.~ ......................... Construction on above described building aP~Rermit meet,.~e~l-~e~pli~le co~,l~i-d-'regulations. A ? 7 pplicant. · .-~.~...~.~.....~...?./~. i./~ .............................. Sworn to before me t ......... .... day of ..~ Notary Public ~ (stamp or seal)~-'~J 5/o tV'IAi;}- ' ~1= LANI3 ~SOLJT~OLE:) , N-Y. ~0 J