The URL can be used to link to this page

Home My WebLink About7844-z FOEt~ NO. l~ 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? 7844 Z Permission is hereby granted to: ~.~'c~..~ex~e..t:~. Jt/~t..,~otm. ......... ~.~t,l..'~"o~l¢ ................................................ to ~.~.t,..~,..~ ~,n.~.~..~'.ermJ,~g..~3,.o~..~.~ ~ ~...~e.....~...~.~.~...~.~ ~.~...~e~ ....t.r-elk.~;..A f~..~.t ~k~.,3. e,...c~...~.~ r...a;.~ ~Lia ~t i~ ................................................................ at premises located at -.Z~.(;....V.~-e.w...AV~ ....... ~%:~.~o.i~ .......;..>,.~.,- ............................................ pursuant to application doted ..................... 2i.~:L!- ..... t~. ............ , 19~.~..., and approved by the Building Inspector. Fee $.1.~'~.00. ........... l~O~I NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Exam,ned ................................... ,,~..0T ^pp,,cat,on No. '7 0~ U 't ~o~ ........................................ , ,~ ~ ~or~,~ ~o~..~...L..~ ........... Disopproved ~/c ....................................................................... INSTRUCTIONS a Th~s application must be completely filled ~n by typewriter or' in ink and submitted in triplicate to the Buildif Inspector, wtth 3 sets of plans, accurate plot plan to scale. Fee accord,ng to schedule. b. Plot plan s¼owing location of iot and of buildings on premises, relationship to adjoining premises or pubJic streets. areas, and gwing a detailed description of layout ofproperty must be drawn on the diagram which ~s part of this applicatio c. The work covered by th~s apphcatton may not be commenced before issuance of Building Permit d Upon approval of this apphcation, the Building Inspector will ~ssue a Building Permit to the applicant Such pern- 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 Occupan, shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of o Building Permit pursuant to ti~ Bu,ldmg Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances · Regulations, for the construchon of buildings, additions or alterations, or for removal or demohtion, as herein describe The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. .... ............ (~natuj;e of applicant,~)name,, if,~b',corpgra~) State whether applLcant i~ owneG lessee, agent, architect, engineer, general contractor, electrician, plumber or but[dc ............... .......................................................... I f apphcant ,s o corporate, ilgna't~r~"~i duly ~t'~~e'i. ' .................................................................. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's L~cense No ............................................... 1. Location of land on which proposed work, will be ~ne./.Map No: ................................ Lot F,~o....~.l....../..~. Street and Number ~ ], ~r~....~ ~' ~.,~r~. ~ ~ Municipality 2 State ex~sting use and occupancy of premises and Lntended use,~and occupancy of proposed construction: a Exisiting use and occupancy ................... ; ....................................... b Intended use and occupancy ........ ~.. ...... /(.. ........................... ~~ .......................................... / //7 3. Nature of work (check which apphcable): New Building ................. Addition .................. Alteration .............. Repair .................. Removal .................. Demolition .................. Other Work ....... ""~~l~'i ........... 4. Estimated Cost ................................... ....~../~.2},,.. 2~ Fee ........ i~.o~l~.~ ~..~d..~. fiii.~.~.. ;l~i; ..~i; ;~l~i~)r;i ............... 5. If dwelling, number of dwelling 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 Dimensions of existing structures, if any: Front ........................... Rear ................................Depth ................... Height ........................ Number of Stones ............................................................................................................ Dimensions of same structure with alterahons or odd~hons. Front .................................... Rear ...................... Depth ................................Height ....................... Number of Stories ............................... 8 Dimensions of entire new construction' Front .................................... Rear ............................ Depth .................. Height ................... Number of Stones ................................................................................................................ 9 S~ze of lot' Front ............ .//~.~) .................................. Rear ...........II'J//~'"'t~ .................... Depth ........................... /-~ (,/ 10. Date of Purchase ...................................................... Name of Form~r t'~wner 11. Zone or use d~stnct in which premises are situated ........................................................................................... 12. Does proposed construchon wolate any zoning law, ordinance or 'regulation' . ..................................................... 13 Will lot be regraded ........................... Will excess ~11 be removed from premises: ( ) Yes ( ) No 14. Nl~m.e of ?~erh~~ ~em,ses .~..~'?~..: ......................... Addres~.l.[~,~.~, Phone No ................... ame ot rc ,ec .... /¢ ........................................ Address ................................Phone No.'.-'".'-..;...;:..;. Name of Contractor ..................................................... Address ................................Phone No ..................... PLOT DIAGRAM Locate clearly and dishnctly all buildings, whether exmting Icf~proposed, and indicate all set-back dimensions fro[ property lines. Give street and block number or descnpt~on according to deed, and show street names and indicat whether interior or corner lot. STATE OF COl above named. He ~s the being duly sworn, deposes and says that he ~s the apphca, (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the sa~d work and to make and f~ this application; that all statements contained m this apphcation are true to the best of his knowledge and behef; thor the work will be performed in the manner set forth m the apphcation filed therewith. Sworn to bef6re me this . . ~ / / .... ....... ............. , /._// ,,///¥ Notary Public, ...~~j.//,~ ............... County ~,.?,~......~......~¢~,.~.~-¢~,~ ...... ~ .......... - J' ,/ ./ r~Signature of applicant) · t I'/'~Y }'~;3U~, S,a,e o'~ ,~'ew York