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Home My WebLink About9561-z(THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9561 Z Permission is hereby granted to: ~).~:...J. ohn...A.....~.'z..c h ........................................... .......... E ~.t.h..~,4oa~ ............ G.I~.~.~o ~,:l; ............ to .~Er~.t~.a~.~z~t~£~z...~e~c:£ng...a.z...p~:..~p`p~.i.~a.t~. n..~.~.1.$/~3~.?.~. .................... at premises located at ...?.~.,g.~...~.,.~.,.~.'~.---.~.~ie>~,~.~'~...~,oad:') ................................................................ ................................................ ~1~.~-~ ~:u~.c~.~ ....... ~..~ ................................ ~ ......................................... pursuant to application dated ........................... ~[0...'¢..~ ....... , 19...~.~., and approved by the Building Inspector. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, No Y. ×am,ned ............ '922. ....................................... , 1~ .. Permit No...~.:z..~.....~...T:S ......... Disapproved a/c .-._~_ ,~, . . INSTRUCTIONS 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 o detailed description of layout of property must be drawn on the diagram which is port 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 Yojlk, and other app cable Laws, Ordnances or Regulations, for the construction of buildings, additions or alterations, or ~ removal or demolition, as here n descr bed.~4 The applicant agrees to comply with all applicable laws, ordinances, bui~igrg code, housing code, and regular ohs, and to admit authorized inspectors on premises and in buildings for n~es~ iR~ections. (Signature of app~nome, if a corporation) (Address of applicant) ~I / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) -7-r'~ - /Z~ Builder's License No .......... ~,~,..~.'.~,.'t.'..':.2~/.:::T.~ ......... Plumber's License No ................................................. /O ¢o rP ~- 5'~'- ~2.- ~// Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed wor~ will b~e, df~e. Map No.:.~.: ................. ~;; ........ Lot No. ':'"l .................. ...........,r/ ............ ............................................. Street and Number Municipality State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy b. Intended use and occupancy .......... ~.~....,.~..~.~-~.~. / 3~ Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ................ ' P, epair ................ ../~,emoval .................. Demolition .................... Other We r ~. :2~'..~... ..................... .... ,,~ ,-- d--~3 (Description) 4. Fstimated Cost L..~.~.~...~..: ....................................... Fee ..~.. ..................................................................................... / (to be paid on filing this application) / 5. If dwelling, number of dwelling units ....~ ................. Number of dwelling units on each floor .....,..."-'~. .................. If garage, number of cars ............................................................................................................................................. 6. If business, commercial or mixed occupancy, specif~v nature and extent of each type of use 7. Dimensions of existing structures, if any: Front .~.~.'~..~..~. ............. i .,~..~..../. .................. '"~.'i:..~.iii ...... Height ~..~...../. ............ Number of Stories ......... ~.~..~' ............. R.~..,l~,/~.~..r .,~,.~,¢. ...................... Dap. th ~,~.~[~. ........... Dimensions of same structure with alterations or additions: ~o~.~.~,.~'~R~~...~. Depth ................................ Height ............................ Number%f Stories 8, Dimensioas of entire new construction: Front ................... , ............... Rear ............................ Dept~ ....... ../ .......... Height .................... Number of Stories ..~..~/~*....~.-..~...~.~.-..~.~...~...,/ 9. Size of lot: Front ..... Z~ ...................................... Rear ........ ~.~ .............ff....... ~pth~.~..~ ,0. ................................. o, ...... ................................................ 11. Zone or us~ district i~which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...... ~.~....~ ....................... 13. Will lot be regraded ...~ ................. WHI excess fill be removed from premises: 14. Name of Owner of premises .~*.~(.~.~ ...... Addr~.~ ................... Phone No.~~~ Name of Architect ....... ~'~'""~ ........................................ Ad~.~ .......... Phone No Name 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 number or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW Y~)_P-.L~..-_. ,., I c S COLfl'~.kry 0 F ~.%~. _ .¢~...I"~...."'Z~... ~... ~'~' ........ ..).~,.~..l~......~...*......f~..'~.~...~... ............................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contract) above named. He is the ...... ~.~.~.~ ............................................................................................................................................... (Contractor, agent, corporate officer, ~tc.) ~~_~ and is duly authorized to perform o~ have per~ed the sai~ work 9d,to m~ky ~n~ file this appl cation; that aH statements ~ontained in this appiicahon are tr~Fo the best or h~s ~¢nowleage aha Deuet; and 'hat the work will be perform~ in the manner set fo~h in the applicati~/fi~e~here~ ;war, to before me this .... . -- ................................... Term Expires March 30, I~