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Home My WebLink About7843-z /~OB~ NO. ~ 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) ,N? 7843 Z ....... ..A~.r il 2 Date ........................................ ~....., 19~..~... Permission is hereby granted to: Twin Fork Fence Co A/O Howard1 Hardy Mattituck ~o..e.r.e. ct misc sections stookade fencing in rear yam as pe~ applieatiem at premi~e~ located at ...~...~.~(1 ........................................................ Mattituck N.Y. pursuant to application dated ....................... A~E~'i.....2~ .......... , 19..2.~., and approved by the~ Building Insl:~:tor. Fee $.I.~.~.QQ ............ Building Inspecto~ FORM ~0. ! TOWN OF SOUTHOLD BUILDING DEFARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19.~..~... Application No ...... . .(~-..../...~. ............. Approved ,4 '\ '\ ~Z..~ /-/3 7~ ........................................ , 19 ........ Permit No ............. ' ...................... Disapproved a/c ................................................... APPLICATION FOR BUILDING ~ERMIT Date .............. ................. INSTRUCTIONS a. This application must be completely ftlled in by typewriter or in ink and submitted in triplicate to the Buildin.~ 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 premtses or public streets o areas, and giving a detailed description of layout ofproperty must be drawn on the dmgram whtch is part of this application c. The work covered by th~s application may not be commenced before issuance of Building Permit. d. gpon approval of this application, the Building Inspector will ~ssue a Building Permit to the apphcant. Such permi 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,. 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, Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buddings, additions or aiterat~ons, or for removal or demolition, as herein described The apphcant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, and t. admit authorized inspectors on premises and ir~ buildings for necessary inspections. (Signature of applicant, or name, if a corporation) .... .............. (Address of applicant) State whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or buitdm ........ (~ .0.. ~?... ~.-~ ~.~ g.... ~...../~ ............................................................ f.: .......................... ~ .................................... Name of owner of premises ........... ~..Q..%~...~...~...~. ......... ..~....'--~ ~. ~b. "/ ...... !......~..~..ZZ~-.i~......) ....................... If apphcant is a corporate, s~gnature of duly authorized officer. "" (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work wdl be done. Map No · . ............................. Lot No ..................... Street and Number ............... kl.z~.l./~. ..... ..l~...b. ........................................................... .~..~..~...~..!..'t.V...c..~ ............. Municipality State ex,sting use and occupancy of premises and intended use and occupancy of proposed construction: a Exisiting use and occupancy ........... ~).,,4.~..~ ....... ~.-...~'.q .~..~../,,/ ....... :.....,.~ .................. ~ ............ ; ................ " " b Intended use and occupancy ...................................................... 7 ......................... 'g ...................... 7' ......... 3. Nature of work (check which apphcoble). New Building .................. Add~hon ................. Alteration ......... Repair ................. Removal ................ Demoht~on .............. Other Work ...... : ......... .~,../.*. ...................... (Description) 4 Estimated Cost - " . .......... Fee ............... ./...]......'~.. ......................................................... (to be pa~d on filing th~s applicahon) 5. If dwelIing, number of dwelhng units ....................... Number of dwelhng umts on each floor ........................ If garage, number of cars .......................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ....................... 7 Dimensions of ex~stmg structures, ~f any' Front .................... Rear ................................ Depth ................ Height ....................... Number of Stones .......................................................................................................... D~mensJons of same structure with alterahons or add~hons Front .................................. Rear .................... Depth ............................... Height .................... Number of Stones ............................ 8 D~mens~ons of enhre new construction: Front .................................... Rear ............................ Depth ................... Height ................... Number of Stones ...................................................................................................... ~..~J....:~. 9 S,ze of lot Front' ......... .............................. Rear .......'.~*~...~ ........................ Depth .....Z.~.. .................. 10. Date of Purchase ............................................. Name of Former Owner ...................................................... 11 Zone or use d~stnct in which premises are situated ........................................................................................ 12 Does proposed construction wolate any zoning law, ordinance or regulation' . .................................................... 13 Wdl lot be regraded ........................Wdl excess fill be removed from premises. ( ) Yes ( ) No 14 Name of Owner of prem,ses .[.].....'.:..]..~...~..~!...;...~..:L~. ......... Address .].2.~'.~....~'.~..:").t:~.:... Phone No ...................... Name of Architect ........................................... Address ................................ Phone No ...................... Name of Contractor ....................................... Address ................................ Phone No ...................... PLOT DIAGRAM Locate clearly and distinctly all buddings, whether ex~sting or proposed, and red,cate all set-back d~mens~ons fron to deed, and show street names and ind~cat.- property hnes G~ve street and block number or description accordm~ whether ,n~erior or corne..r.J~t. ...... , . ),i ~TATE OF NEW ,yORK, . / ~ ~, ¥ I'/~' ,, ,]?~,~,~-LJ-.~,*-~- -"~ COUNTY OF ..~.~ /Z~:-f..~ ...... f~'~ ~ .......... t .... . ..'].: ..... ~:..;~.'~.~...;/.L...~.6,L.;...Z.~.~;Z.~ ..................... being duly sworn, deFoses ~nd seys that he ~s the epphc~n (NQme o~ individual signing contrec~ ebove n~med He ~s the .................................................................................................................................................... (Contractor, agent, corporate officer, etc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and th~s applicahon; that all statements contained in th~s apphcahon are true to the best of his knowledge and behef; an~ t~',ar the werk wdl be performed m the manner set forth m the apphcat~on filed therewith Sworn to before me this ,- ,.- ~ ..... ~.~(..z..,~... day of ........ ~,.z¢~ ........... , 19~ . ~ .z' ,'" . ................. ..... ..................... Nota~ Pubhc, NOTARY rUaLIC, Slate o{ Hew No, 52-45~2026 - Suffolk C~