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Home My WebLink About9380-z'SOUTH'OLD, N, Y. ~I~A~TMENT t~'S O'FFICE !i ~ BUILDI~IG PERMIT (THIS PERM ~T MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 9380 Z Permission is hereby granted to: Por~ o~' E $ ,ente.r.p.~ses pursuont to opp~icotion dated ....................... ,~.1~.. ....... ~.~ ........... , 19.-~.~..,'~and approved by the Building Inspector. Fee $.. FOlr;~ NO, 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE ~ , SOUTHOLD, N, Y. · p/: . ~ppraved ......... ~ ..~.,Z.%:.-(.~: ....19.6%,.t( Permit No ..................................... ' PP / ....... 7~' ............. '3 ............. APPLIGATION FOR BUILDING PERMIT Date ..3.u.t.y...2, fl.,...&9.7.2 .............. , 19 ........... INSTRUCTIONS a. This application must be completely filled in by typewriter o¢ 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 giving a detailed description of layout ofproperty 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 Irispector"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 hove 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 oil applicable laws, ordinances, building code, housing code, and regulations, and to~ admit authorized inspectors on premises and in buildings for necessary inspections. Port of Egypt Ent. Inc, (Signature of applicant, or name, if o corporation} .~.~..~.n....B..ct ,...8.~ ^...~.5.......¢i.o..u.~b.~ &ci.,...FJ.,.~.~3, B.2,~ ........ (Address of applicant) Store whether oppliccnt is owner, lessee, ogent, architect, engineer, generol contractor, electricion~ plumber or builder. Name ~f_p~,pe,_r. of premises .-P.o~'.~,...e¢...E.gy.F~...E.~a~,.,....T. na., .......................................................................................... Builder's Lic~se No ............................................... / 0o~ ~ L6~ ~ ~:~ Plumber's ~icense No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... /} ]. Location of land on which proposed work. w,~ll be done, Map ~No.: ...,.c'../..~.~.~.//~-~' ~ ....... l/~,,~,,...~.,~Lot No ......................... Street ond Number ........ ~ , .~ .~..~.. .... ~--.~..~.~,,,,!M~,.~., ....... .C~J¢~,,.fl-~. ,, ../?..;.~ ............ ..C~..~..u..*.:::T:~.~7..T. ............................ Municipality 2. State existing use and occupancy of promises and intended u_se and occupancy of proposed construction: o. ~x s tng use aha occupancy ........ ~ .................... t ................................................................................................... b. Intended use and occupancy ....¢.elq4~a ................................................................................................................ Nome of Contractor .~t~.r.A...o.f...~..§-y.p.f,..~..n.f,-~..-[t~..m.,.. Address PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or propos~ property lines. Give street and block number or description according whether interior or corner Iol. STATE OF NEW YORK, COUNTY OF ................................ 3. Nature of work (check which applicable): New Building. ................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ....~.O~.fl ................................ . .... (Description) 4. Estimated Cost ...~.2.~O...O~ ........................................ Fee ........ l~.l.,5,.gl] .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ...i~ ..................... If garage, number of cars na 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ....n.~ ..................... 7. Dimensions of existing structures, if any: Front ....0..a. ................... Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front .,.~q~ ............................ Rear ............................ Depth ................................ Height; ...... ~ ............... =...Number of Stories ................................ 8. Dimensions of entire new construction: Front ...... .5.6.0 ....................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ...m.a ................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner '. ....................................................... 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ...~ ................................................ 13. Will lot be regroded ..... ..n..o. .................. Will excess fill be removed from premises: ( ) Yes (X) No · Por~ of Egypt Ent. In Main Rd. Sout 765-3918 ]4. Name of Owner of prem,ses .................................................... ~k~dress ................................ ~J~o!nC~ No ....................... Name of Architect .....n.a. ...................................................... Address ................................ Phone No ....................... t~L.~..R.~¥...~.~u.tlRba~r~ No...96.~-.~g.~.8. and indicate all set-back dimensions frorn deed, and show street names and indicate ................................................................................................ being duly sworn, deposes and says that he is the applicon~ (Name of individual signing contract) 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 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 tk, aT the work will be perform,m in the manner set forth in the applicatio~therewith. .............. of. ...... .... Notary Public, . ................. ~ i ......