The URL can be used to link to this page

Home My WebLink About7950-z FO~ NO. 2 TOWN O~ $O~THOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL CO~MPLETION OF THE WORK AUTHORIZED) N? 7950 Z Permissic~ is hereby granted to: · .Oeo~g~. ~.. ~t~/~a.~.d .~.. ~leh~b .............. ................ .3eut~3~4 ........................................... to ..eme.~..J~exm~g..u..~er...al~p~.:[c~.~o~ .......................................................................... at premises located at ..~.;~I~..~Iu~]L,~Qa~- ........................................................................................ .................................................... 8oat]~o:Ld ...................................................................................... pursuant Budding Inspector. Fee $....~,~eDO. ......... · f - Building Inspector t TOWN o:: SOU'r.O,D ©1~ ' ~/~,~ ~ · ow.omc. ~UTHOLD,N.Y. Examined ........... ~~....~..~;~~ 19.~..~ Application No. ~ ............ ..................................... ...... D~sapproved a/c ..................................................................... APPLICATION FOR BUILDING PERMIT ....... ..... .......... INSTRUCTIONS a. Th~s apphcation must be completely fdled in by typewriter or in ink and submitted in triplicate to the Buildi~ Inspector, w~th 3 sere of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buddings on premises, relahonsbp to adjoining premises or public streets areas, and giving 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 application may not be commenced before ,ssuance of Budding Permit. d. Upon approval of this apphcation, the Building Inspector will issue a Building Permit to the apphcant. Such pern 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 Occupan. shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Building Permit pursuant to tl Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and ir~ buildings for necessary inspections. ................. of app icant, or name, if a 9prporation) .... State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budd: Name of owner of premises~...f~......~..~. '.~......~....~...~. '.~'.7'~. ].., ............... If apphcant ~s a corporate, s~gnature of duly authorized officer. (Name and t~tle of corporate officer) Builder's License No ....... .~.?...~,~.~i..] ................ Plumber's License No ................................................. Electrician's License No ............................................ Other Trade's License No ............................................... ~ ......... A...L. ~ Location of land on wh,ch pr~aose~d work ~,ill be.done /¢~p No. ^. ......... ot~No ............... Street and Number .......... ~...~.....L(..~...C...~.........i..~.f~... ~ ~t ................. ~...~ ......................... Municipality State existing use and occupancy of premises and ~mended use and occupancy of proposed construction' a Exisiting use and occupancy/~x ~~[~<~k,k_kjL]4 ~.~ ~ 3. Nature of work (check which applicable). New Budding .............. Addition ...... :,~t" Alteration Repair ................. Removal ................. Demolit~or. .................... Other Work ...... ~,~....It ............... (Description) .................. ..~...~,...O.....~... ........................ Fee .~.~ i~ 4. Estimated Cost ..... /' ii~"~"~i~i"~'~"~'i'li'~"['~'~"~'~¢i~;i~i .......... 5 If dwelling, number of dwelling units ......... ~ ...... Number of dwelhng umts on each f~oor .... , ..................... 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~st~ng structures, if any. Front ......................... Rear ................................Depth .................... Height ........................ Number of Stones ............................................................................................................ D~mensions of same structure with alterations or additions Front .................................... Rear ..................... Depth ............................... Height ....................... Number of Stones ............................... 8 D~mensions of entire new construction: Front ................. , ............... Rear ............................ Depth ..................... Hmght ................ Number of Stories ................................................................................................... 9. S,ze of lot' Front ........ I~ ..~...' ....................................... Rear ......................................... Depth ~ .................... 10 Date of Purchase .................................................... ~N~o ~e~ of.l~ormer,,j~)wner ...................................................... 11. Zone or use d~stnct in which premises are situated . .~. ......... 12 Does proposed construction violate any zoning law, ordinance or regulation' . ...... ./~...i.~.. ...................................... 13 WJll lot be regraded .......................... W~II excess fill be removed from prer~_es: ( ) Yes ( ) No 14. Name of Owner of premmses .....~....~..~..~ ....... Address ..~ ....... Phone No ...................... Nome of Architect ............. ..~ ................... Address ................................Phone No ...................... Name of Contractor ................. '"~"~'~"..'~<..:..-.. ~- ................... Address ................................Phone No ...................... PLOT DIAGRAM koco~e clearly and d~stinctly all buildings, whether ex~st~ng or proposed, and indicate all set-back d~menslons fret property hnes G~ve street and block number or descnphon according to deed, and show street names and indicat whether interior or corner lot STATE OF NLC~f~Y~.,~/~ ~ ~ S COUNTY OF ~ ............ (Narrlle of mdwldual signing contracfl above named, He is the ...................................................................................................................................................................... (Contractor, agent, corporate officer, etc ) of said owner or owners, and is duly authorized to perform or have performed the so~d work and to make and f this application; that oll statements contained m th~s apphcat,on ore true to the best of his knowledge and behef, that the work w~ll be performed in the manner set forth in the opphcotion filed therewith. NO ,~'//' / (Signature of applicant)