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Home My WebLink About7886-zTOWN 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? 7886 Z Date ......................... .La.y ..... .~ ................ ,19.:J.,~..~' ~' Permission is hereby granted to: .. 5,~. ~.~ ~.) ... ~ ~,s ~,~.~ ............................................ ............ 2,....e:....-.ic~:L?.,..~.~5.-~.f~ .............................. ............................... ~a.tt.~.~.~k, ...................... to ~a:r~c~`.a~T.~.~.~.~£~.c.~.n.g~.i.n~.r.~a...r~.~.~.a..r.~.a. .......................................... at premises located at ,,;/~.~ ,).~ T'n'tp D'r' ............................................................ ~a.~.i.tu~k.....~[.~*~.* ............... '. ................................................ pursuant to application dated .........................~'~.~.~...2LI, ............ 19.~1..~.., and approved by the Building Inspector. Fee $..:~.~,(}0 .......... Building nl'~spector TOWN OF $OUTHOLD '~ / ~ Examined BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. D,sapproved a/c ..... '"' '"7 ................................ A~I. ICA. TION FOR BUILDING PERMIT o Th~s application must be completely filled in by typewr, ter 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 locahon of lot and of buildings on premises, relahonsh~p to odjmmng premises or public streets or areas, and g~ving a detailed description of layout of property must be drawn on the diagram which is part of th~s application c. The work covered by th~s application may not be commenced before ~ssuance of Budding Permit. d. Upon approval of this application, the Building Inspector wdl issue a Budding Permit to the applicant. Such permu shall be kept on the premises available for inspection throughout the work. e No building shall be occupied or used ~n 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 buddings, additions or alterahons, or for removal or demolition, as herein described The apphcant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and t, admit authorized inspectors on premises and in. buildings for necessary inspections. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's bcense No ................................................. Electrician's License No ............................................ OtHer Zrade's L,cense No ............................................... n ~ N Lot No .~..~.. 1 Location of land on which pro£os,~.d work w)flj)be done/~ p IN~ ........ .~/~.~,./ ....................... Street and Number ........... .~.~...~_~ ....... ~..~,,~Z~. I 1~.~......... /~~ ..................... 2 State existing use and occupancy of premises and int,~fded use and occupancy of proposed construction: a Ex,siting use and occupancy ....................... .~.~..~';'/"~' _.../...../' ........................................................... / b Intended use and occupancy..................... Z .............//J J~J' I J(~ t~'~ ................................................. Repair ................ Removal ................ Demoht~or, ........ Other Work ..~.~s.~c. .... .~r~..~ ............... ' (Description) 4 Estimated Cost ..................... .I7_,z~.. ~. ~. .................... Fee ................................................................................ (to be pa~d on filing th~s apphcabon) 5 If dwelling, number of dwelling units ............ ~ ............ Number of dwelhng units on each floor .......................... If garage, number of cars .......................... ~... 6. If business, commercial or mixed occupancy, specify nacre a~ extent of each ~pe of use .................. 7 Dimens,ons of exmtmg structures, ~f any Front~.f.~t~ .~....~ R~.~.~ ................... Depth .................. Height ........................ Number of Stones .................................................................................................... D~mens~ons of same structure w~th alterahons or addthons: Front ................................... Rear .................. Depth ............................... Height .......................... Number of Stones ............................ 8 Dimenstons of enhre new construchon Front .................. · ............Rear ............................ Depth .................. Height ................... Number of Stones ............................................................................................................ 9 S,ze of lot Front ~f~.~.~.. ~ ....~h~.~(~.~.~... Rear .................................... Depth .............................. 10 Date of Purchase ...~E ....... [.~.~.~ .................... N~me of Former Owner .~...~7.~C~f~.t~ ................. 1 I. Zone or use d,strict in which premises are situated . ~L~E.~.~I.~ ..................................................... 12 Does proposed construcbon wolate any zoning law, ordinance or regulation ...~. ........................................... 13 Wdl lot be regraded ....... ~. ............... Wdl excess fill be removed from premises' ( ) Yes ( ~ No , .......... .......... 14 h~ame of ?wrier of prem,ses ...~X~, .2 Addre~ .............. Phone Name o~' Architect .................... h ........................ Address ................................Phone No ...................... Name of Contractor ....................................... A~ress ................................ Phone No ...................... PLOT DIAG~M Locate dearly and dishnctly ail buddings, whether exmting or proposed, and mdmate all set-~ck dimensions fron prope~y hnes Gwe street and block number or descnphon according to deed, and show street names and ind~cat~ whether inter,or or corner lot ~[~ ? ~[ ~. C_TATE OF NEW Y.OR_K, [ S S COUNTY O.F ..... ~(.~.:.~,1.~'. ......... ............ ~...~.C.~..~'..¥......~.~.¢Z-(.~.~../'/..~./,~). ......................... be,ng duly sworn, deposes and says that he is the (Name oFmd~wduarsigning contracO above named. i ,r He ,s the .......... ~.~.e~...Z~.~.I.~.C~ .......................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duty authorized to perform or have performed the said work and to make and fil~ th~s application; that all statements contained ~n th~s apphcat~on are true to the best of h~s knowledge and behef; ant tha~ the work will be performed ~n the manner set fo~h m the apphcation filed therewith Sworn to before me this ...... ...... ..... ................ ~oto~ Pubhc .... Coun~~n~ture~of ~o