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Home My WebLink About9604-z IPO~-M NO, 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~OUTHOLD, N. Y. Examined ,~- ;h ~ ~9... Approved ................... '.~ ........ ~..~....., 19..~..~, Permit No...~....: ........ ,; ................ Disapproved a/c ................ ~. ........................................................ ~.~ ................................................................... ......... ..................... ......... (Bud ~ insp,c~) '-" i'll'in-'''---- ''''' ' ........................ APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No..,.~.,~i,.~../. ............. ~ ~-O 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 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~ admit authorized inspectors on premises and in buildings for necessary inspections. ..... ~z__...,~, (Signature of applicant, or name, if a corporation) ....... ~.q~.,..L..~. ........... ::..,....kc,~.,..F...!~,..J,L..L.....L.L)...'....~..., ....... (Add'ess of applicant) arch'tect en meer eneral contractor ele tr an I '" State whether applicant i~lessee, agent, , g' , g , c ici , p umber or builder. Nome of owner of premises ..::~ffh'.~, .c~4.. :.....~ ....................................................................................... If applicant is a corporate, signature of duly authorized officer. .~t' (Name and title of corporate officer) Builder's License No ..............~..~.('.;Y.?.;.~Z'::::'Z.~.'-].:~ .......... Plumber's License No .................. Electrician's License No. Other Trade's License No ............................................... . .~,..--~ /, I. Location of land on which proposed work. will be done. Map No.: ..~..~.~..~:.~........~:.-.TZ~.'-Lo~ No ...... Street and Number ........... ~.....~d....~.....O.~ ....................................................................................... Municipali~ 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ......... J~ ......................................................................................................... b, Intended use and occupancy ........... '~]~.~..~.-:~.'E~;'.~;?.~.~.~'[~.'.~T ............................................................ sOUTH'OLD, N. y. BUILDING PERMIT (THIS PERM~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 9604 Z Permission is hereby granted to: ........ p..~z..~.?...i":. .............. ./..~.~ ............... Building Inspector. December 13~ I 97? hain ~to~d ~£~ve received your application for i~uilding Permit to move L~i~ting ~arn and renovate same on Lot 1 of ~?ouv minor sub-division. Also ~L ha~(~ i~: i]ealth Depnrtment apprevs, l ,for well We now need (3) three Floor Plans with window loestions g si~e$~ door location & size~ etc. as you propo~e ~,o re~:~k~ tbi~ building, ~ours t~ly~ APPEALS BOARD MEMBERS GERARD P. GOEHRINGER, CHAIRMAN CHARLES GRIGONIS, .JR. SERGE DOYEN, JR. ROBERT J. DOUGLASS JOSEPH H, SAWICKI MAIN ~r'IAD- ~TATE ROAD ~-5 SOUTHOLD, L.I., N.Y. 119'71 TELEPHONE (516) 765-1809 PUBLIC NOTICE PLEASE TAKE NOTICE, that all new applications to the Board of Appeals should be filed n.~ later than Wednesday, March 17, 1982 in order for the applications to be processed in time for the next regular meeting of the board (which presumably will be on or about April 8, 1982). 3/5/82 ~( 3. Nature of work (check which applicable): New Buik. hng.. ................. Addition ....... v. ....... :.. A teration,4:,~..~.~,~4~ Repair ................. Removal .................. Demolitior'. ....................Other Work .................................................... (Description) 4. Estimated Cost ................................................................................................................................................. ' (to be paid on filing this application) 5. If dwelling, number o~ dwelling units ........ ./. .............. Nt~'rnber of dwelling units on each floor ..... , ...................... If garage, numbe~ of cc, S ......... ~...~ .................................................................................................. 6. If business, cornmercJal or mixed a~uupun%,, spu~.~i'y nai't4re arid extent of eack~_type of use ................... ~_~ ..... 7. Dimensions of exisling structures, if any: hold ........ ,M..~... ._ Rear .....~1..~. ............. Depth .... ,-,~. . Height ........................ Number of Stones ....... ~ .............................................................................................. Dimensions of same structure wilb olie~atJons o.' o~t c ~: kmnt ................................... Rear ............................ Depth ...... ' .......................... }teight ..........................Flu,~nh~ of Stories ................................ 8. Dirnensions of entire new construction: Fronl ..................... Rear. ........................... Depth ........................ Height .................... Numbe~ of Stories .............................................................................................. 9. Size of lot: Front ................................................. I~e,x ............... .......................... Depth .................: .............. 10. Date of Purchase ................................................. N:me al Former Owner ........................................................ 1 1. Zone or use district in which premises are situeted ......... ,/~-,¢~~ .............................................................. 12. Does proposed construction violate any zoning Iow, ordinance or regulation: ............ '~.c-.2...: ................................ 13. Will lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes Name of Architect .................................................. Address ................................ Phone No ....................... Nome of Contractor .................................................... Address ................................ Phone No ....................... Pl_O-I DIA(.~RAM Locate clearly and distinctly all buildings, whether existiag 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~'~I~ /,J..~ I ~ ~ COUN'r,v. oF ...... r ..................... ~ ................. :,,~ ................. ;,: .................... hcu~j duh/ sworn, deposes and says that he is the applican~ (Nome of individual signing conlracO above named. ~kle is the ~ ~ N-I- , ............................................................................................ (Conlractar, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or haw~ 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 tha~ the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this .................... ....... ........ No 52-g125850, Suffolk Ct)BB Term Expires ~arc~ 80, 19 ~u~P co :H~ALTH APP~0V^L H.S. NO. ~ . ~ ~ , ~ LAND SUgV~YOR'S IN[<LD SCAL OR I ~TAMP O~'F ROO~CK VAN' TUYL. P. C. SUI=~'F. CO. Ri[PT. OF HIiCAL'rH, t~i[RVI~ ~ ~ .... ( , b'~A"[P~M E OF IN'lENT ' 4" FOR APPROVAL OF CONS~U~ION ONLY ~ WA~ ~UPPLY AND C/o¥ ' DE~CE WILL CONFORM ~ THE ,, , , ~ ApPLICA~