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Home My WebLink About7898-z FO~M NO. 2 TO~VN 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? 7898 Z Permission is hereby granted to: T~,~, ..Fe~,k-.-Fene, e.- C ~...-~-~ .. .......... ~ %-~ .i.%.u~l~ ........................................ to ..e. Le..e. ~..~.....~. ~.n..~.a..~....t..e...n..c..~....a..~...~..e..=....~..~.~.~ 2..o.~....Ct~.o. ~.. ~.). ...................... at' premises located ot .....Tt~b];E[J;...].~]3.B. ............................................................................................ .............................................................. · ~.t,..~i.o~ ....................................................................... pursuant to epplicotion dated ........................~t.~t'. ...... ~ ............... 19.~.~.., ~nd ~pproved by the Building Inspector. Fee $..~.~.~ ........... Approved .............................. ..L ...... , TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. 19...~.?~Permit No .... ~...~...,~....~. ...... D~sapproved a/c ........ ¢,~ ............................ ._..... APPLICATION FOR BUILDING 'PERMIT INSTRUCTIONS a. This application must be completely filled ~n 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 premises or public streets or areas, and giwng a detaded description of layout of property must be drawn on the diagram which ~s part of th~s application. c. The work covered by th~s apphcation may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Budding Permit to the applicant. Such perm~i 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 the Building 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 described The applicant agrees to comply with all applicable 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) b u., .............. .......................... i~,~'~'~' ~ ~plicanf) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder ....... .............................................................................................................................................. Name of owner of prem,ses ..~-:....~../~..~...~.'~...~....?. ..... ..~.~.: ...... ~..~.~..~..~L ................................................................. If apphcant is a co,orate, s~gnature of duly authorized officer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's L,cense No ................................................. Electrician's License No ............................................ Other Trade's L~cense No ............................................... 1. Location of land on which proposed work wdl be done. Map No ................................. Lot No ....................... Street ond Number . .~....~....~...f~..~..~.......~......'~.'. ........................................................ ..~..~..'....~....~....~.../...~..~... ..................... Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction' 3 Nature of work (check which applicable) New Building ............. Addition ............... Alteration Repair ................. Removal ............... Demohhor ........... Other Work ...... ..~..~¢..:~.~ ......... ¢/' (Descript~/~) 4 Estimated Cost ............ /~../..~....~.. ................................ Fee ................ . ./...'.~....~....'~.. ................................................... (to be pa~d on fihng th~s apphcation) 5 If dwelling, number of dwelhng umts .......................... Number of dwelhng umts on each floor ....................... If garage, number of cars ............................................................................................................................. 6. If bus~ness, commercial or m~xed occupancy, specify nature and extent of each type of use ................ 7 Dimensions of ex~st~ng structures, if any. Front ........................ Rear ................................Depth ................... Height ........................ Number of Stones ....................................................................................................... D~mens~ons of same structure w,th alterations or addmons Front ................................... Rear .................... Depth ............................... Height .................... Number of Stones ............................. 8 D~mens~ons of entire new construchon: Front ................................. Rear ............................ Depth ................... Height .................. Number of Stones ....................................... :.; ......................................... ~ ........ S~ze of lot Front .......... ~. .................................. ear .......... ~. ........................ Depth ..... /. ................... Date of Purchase ................................................... Name of Former Owner ...................................................... Zone ar use district in which premises are situated ........................................................................................ Does proposed construchon wolate any zoning law, ordinance or regulation: ....................................................... W~II lot be regraded .......................... Will excess fill be removed from premises: ( ) Yes ( ) No Name of Owner of prem,ses ~..~...~...~..'~.....'/Z.......(.'..~...~...~..~....~?. .... Address ~.~i~l.!.Z...~....~. ..... Phone No. ~/..~.~.,.'T...~...:.~ ~', t~/-"~P- I 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 dimensions fror property hnes Gwe street and block number or description according to deed, and show street names and indicat 9 10 11. 12 13 14. whether interior or corner lot STATE OF NEW,~YOt~I<¢ z ~ c S COUNTY OF ~¢D/~.,.....,¢:~... .... f'~' ~..~...~../.~.:.....~..~..~...(-..:¢;/~.. 'bmng duly sworn, deposes and soys that he ,s the applicon (Name of individual s~gnmg contract') above named. He ,s the .................... .C'.'....~~..~~ ............................................................................................ (Contractor, agent, corporate officer, otc ) of sa~d owner or owners, and ~s duly authorized to perform or have performed the said work and to make and f~l this application, that all statements contained in th~s apphcahon are true to the best of his knowledge and behef; an, that the work wdl be performed in the manner set forth in the applkcation flied therewi,~. Sworn to before me this /l/I /7 // ............ ...~..' ... dczv of ........... ~'~//~...,1 ~ /~L/TL ~' ~'/~lgignoture of applicant) JUDITH T BOKEN Notar~ Pubhc, Stale oF New York No $2-0544963 Sufi'otk Count~ C~rnmlsslon Expires Morch 30,