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Home My WebLink About7832-z FOI~.~ NO. 2 TOWN OF SOUTHOLD 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) 7832 Z Permission is hereby granted to: .......... La ~to~...¢,...~ .~,~. ,P.~ ........................ .......... ~B/~Ib~s,~...l~ct ............... C~u~,hog~o ......... lo ~ ~'~ d-~.. a-r~d-.-~.ir~ ~.$n--.f. e~e.~.nf~ .. a-s...~,- ..a ,~.~-c a-~ ~n- ............................................ c,t premises located at .....]3./B...B.:t.~.ie~::L'd...J~a~ ................................................................................ ................................................................... C~t,¢~-~t~ ...................................................................... pursuont to application dated ........................... Ap,l~.;~ ...... ~1~...., 19.~'.~.., and approved by the Building Inspector. Fee $..1.~,.,L0~ .......... FO~tM NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined .~.i.:.. ! .C ................... Application No...~..~...~';..~ ........... Approved / ~'- 19/~ Permit No. ~...~....~.'...~.......~... ............ Disapproved a/c .......................................................... (~....~ APPLICAT;BoU;Id;n~ ':SluPleC~L~IING ,,RMIT Date ................ ~....~ .................... 19 .......... INSTRUCTIONS a. Th~s application must be completely filled ,n by typewriter or in ink and submitted in triplicate to the Bu~ldin_~ Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing Iocahon of lot and of buildings on premises, relationship to adjoining premises or pubhc streets o areas, and giving a detaded description of layout ofproperty must be drawn on the diagram which ~s 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 permi shall be kept on the premises available for inspection throughout the work. e No building shall be occupied or used m whole or in part for any purpose whatever until a Certificate of Occupanc: 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 th, 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 describer_. The apphcant agrees to comply with all apphcable lows, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in, buildings for necessary inspections. (Signature of applicant, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises ........ ;....~.: ........... '~ ........... '.....'...!~:....'..::. ~.:.¥. ........ '.....) ........... ..~...."~.. ............................................... If apphcant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's bcense No ..... ~..'. ................ Plumber's License 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 ...... !..: .............. ~..z....,~..~. .......... .h....: ..... .¥....¥ .............. .~ ...... .r.~:=-~. ........................................ Municipality State existing use and occupancy of premises and intended use an~_ occupancy of proposed construction: o Exisiting use and occupancy ........ .':....: ............. · b. Intended use and occupancy ......................................... ~ ................ ~ ....... [ ....................... [.~ .............................. 3. Nature of work (check which apphcable). New Building ................. Addition ................. Alteration ............. Repair ................Removal .............. Demolmor. .......... Other Work ............................................. /5 ~ (Description) 4. Estimated Cost .......................................................... Fee ................................................................................... (to be paid on fihng this application) 5. If dwelling, number of dwelhng units ........................ Number of dwelling umts 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 D~mens~ons of existing structures, if any. Front ..................... Rear ................................ Depth .................... Height ....................... Number of Stones ..................................................................................................... Dimensions of same structure with alterations or addmons' Front .................................... Rear .................... Depth ................................ Height ........................ Number of Stories ............................. 8 D~mensions of entire new construction: Front .................. , ................ Rear ............................ Depth .................. Height .................. Number of Stories .............................................................. 9 Size of lot. Front ..................................................... Rear ....................................... Depth .............................. 10 Date of Purchase .................................................... Name of Former Owner ...................................................... 1 1. Zone or use distnct in which premises are situated ....................................................................................... 12 Does proposed construction wolate any zomng law, ordinance or regulahon ..................................................... 13 Wdl lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No 14 Name of Owner of premises ................................................... Address ................................ Phone No ...................... Name of Architect ....................................... Address ................................ Phone No ...................... Name of Contractor ......................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and dmtmctly all buddings, whether exmting or proposed, and indicate all set-back dimensions fron in&cat, property hnes whether interior or corner lot OF COUNTY ..... .......... ~~.: ...................... being duly sworn, deposes and says that he ~s the apphcan~ (Name of red,vidal s~gning contracf) above named ~He ,s the ............ (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the sad work and to m~ke and this apphcat~on, that all statements contained in thru apphcat~on are true to the best of his knowledge and behef; ant tha~ the work will be performed in the manner set fo~h in the apphcation filed therewith Swo~fore me thru ~; . ~ _ ~ ...................... o{ .............. ~ .............. , 19 .... 4 ~ .... /~[*'.~ (S gn~ure of app cant) ~ ~ZABETH~ rN F,~V~L~c Yo / I~ LL ' ' ~ ~k NOIARY PUBLIC. St~l~ ol NO 52 8125850, Suffolk Te~m Expires M~ch 80, Gwe street and block number or description according to deed, and show street names t~t,~ \-