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Home My WebLink About7849-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN GLERK'S OFFIGE SOUTH'OLD, N. Y. BUILDING PERMIT CI-HIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 7849 Z Permission is hereby granted to: .~i£11iam.._~ ~..l:,ma ot~ ................................ ...J~cap..~o!a..~rl.~ ...................................... .................. ¥~a.t.t...~eA~ ....................................... to .... .~.r.q.~.~...aiq~..~.l~a:Lu..~e.a~:Iaqg..~...ac.c. as.anr, y...hlill.~lllr, g ...................................... at premises located at ..D..e...e.12....H..o...~..e.....D..~.~.Y..e. ...................................................................................... ¥~ttituck N .Y. pursuant to application dated .........................A~/~.~.i ....... g~ .......19..~.~.., and approved by the Building Inspector. Fee $..1 .~. a .~. .......... Fonts NO.' I .�,.T' TOWN OF SOUTHOLD V BUILDING DEPARTMENT c TOWN CLERK'S OFFICE SOUTHOLD, N. Y. C ill � Examined ......0... ............ 7. Application No. ............. roved ..t.�.. . .�.... ' 19. �. Permit No. .�.• -:'••••• App .. ., ..... . Disapproved' a/c ........................................................................................... ........................................... ...... ......... (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................ ............................. 19. C INSTRUCTIONS • r a. This application must be completely filled in .by typewriter or 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 or areas,and giving a detailed description of layout of property 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 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 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 y admit authorized inspectors on premises and in buildings for necessary inspections. .. I.. . ................. .................... ignature o ap cant, or name, if a�cjor..oration) .... .�l o..... G'!�!. . . .�1A :. . ... ...... dress of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Nameof owner of premises ....... .......A.:.......... ............ ... ....................................................... If applicant is a corporate, signature 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. .............................................. 1. Location of land on which roposed workeNwill be done a No.: ........... of I)}o. ........................ Streetand Number .......... ................ .......... .-� .. .................. Va Y 0 Municipality 2. State existing use and occupancy of mises and intended'use and occupancy of proposed construction: ��a. Exisiting use and occupancy ... % ........................................................... b. Intended use and occupancy ......:........... �c1 ( N'` 3. Nature of work (check which applicable): New Building. .................. Addition —' Alteration ---._—. ' Ruooir —.----- Removal ------ Den�oition---.---. Other \Akork ..l1' —_........ ` (Daucrh, k�n} �-�� '' 4. Estimated Cost _'--.--_---_-------._—�ee .~�.��.--.---.-----_-___----_----.---- Ho be paid on filing this application) 5. If dwelling, number of dwelling units ....../0.'_A.—_Number of dwelling undo on each floor --,.------- !f goroQa 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 —.------ Heioht .---------' Number of Stories -----_----.--_-------_-----_'-----_—.------ Din`ensnno of oonne structure with alterations or additions: Front .................................... Rear ............................ Depth ----------- Haight ---------..Num6er of Stories ................................ 8. Dimensions of entire new construction: Front ...................,................ Rea r ............................ Depth -------- Haight .................... Number of Stories ------_---.-----------------------.---.--- 9. Size of lot: Front ........................................................ Rear ..:------------- Depth ................................ 16. Date of Purchase ..................................................... ame of Former Owner .--_—__----'---- .................... premises � 11. Zone or use district /n which pre �sus ooe situotud .��—.—.�.��-�t=..8-�- _—.--.—.--.. .------.------. 12. Does proposed construction violate any zoning |o*\ ordinance or regulation: -- ��..��------~------. .. ) No)3. Will lot be regroded --- ranovedf &e ,.l4` NoneofOwnarofpren �es LAYM---� —. ��dress -' .No ,.._....~.-.-...� None of Architect ---' . . ------'---' Address ................................ .Phone No ...................... Non`e of Contractor .......... ............................. Address ................................. Phone No^ ...................... 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 nurnba, or description according to dead, and show street nornos and indicate whether interior orcorner lot. - STATE OF NEN06,Y OF SS / ------.--Afindividual -��_' --.boing duly sworn, deposes and ' that he is the applicant (No �gning controc�obova nonoad. He is the ----------- ...(Contractor, agent, ooqmvote officer, etc.) of said owner orowners, 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 thorthe work will be performed in the manner set forth in the application filed therewith. Sworn to before this Not—' Public, ' -�- .-- _ ... - -- <Siatu e f 6pp|ic ant 7 . . / . ' ,