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Home My WebLink About9271-z FOR~ NO. 2 TOWN 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? 9271 Z Permission is hereby gmnt~ed to: ~ ' ' ~In F'rk Fence O0 A/C Peter ~Jrattan ........ ~u~..~.x~. .......... ~g.X~ .................. -~; ~ . ~-~ ...;~.~.~ ................................ ~ ......... ~ ............................................................................................................ ~ .... N/S F~ain Road ~-.,-" ~'~ at premiss I~ated at -.-v ................ 3 ....................................................................................................... ~g:~:.r~:<~BUmuant to apphcahon dated , 8~ ~ . 19 ~?, and 088[ov~ by the Building Inspector( , FOV,~ NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. .............. :: ........... ....... , ,J.7.. ..... ..................... ..................... APPLICATION FOR BUILDING PERMIT Application No....?..~..Z.f ............. INSTRUCTIONS a Th~s application must be completely filled in by typewr.ter 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 Iocohon of lot and of buddings on premises, relationship to adjoining premises or public streets o areas, and gwing o detaded description of layout ofproperty must be drawn on the d~agram which ~s part of th~s application c. The work covered by this application may not be commenced before issuance of Building Permit. d Upon approval of this apphcation, the Budding Inspector wdl ~ssue o Budding Permit to the applicant. Such permi shall be kept on the premises avadable 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 Occuponc: shall have been granted by the Budding Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the issuance of a Budding Permit pursuant to Budding Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of buddings, addit~ons or alterations, or for removal or demolition, as herein described The applicant agrees to comply with oil opphcoble laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises and in buildings for necessary inspections. (Signature of applicant, or name, if o corporation) (Address of applicant) Slate whether apphcant ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder Name of owner of premises .?...~.~..e..~....~.~...~.~.~....~... ................................................................................................................ If apphcant Is a corporate, signature of duly authorized officer. (Name and t~tle of corporate officer) Bu,lder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... 1 Location of land on which proposed work will be done. M~p Nc ................................. Lot No Street and Number ..~..~...~.....R.~.~j...~..q~.~.~.O..~I,~....~.T.,....~.,...~,~.c).~.~, ........................................................................ Municipality 2. State ex~sting use and occupancy of premises and intended use and occupancy of proposed construction' a Exisiting use and occupancy .......... ~D~.'..~./~I~.~_~...~1~1~.~.~,~ ..................................................................... b. Intended use and occupancy .......... .Q~.-..~.~t'A;~....~'~.~,,~:T~ ....................................................................... 3. Nature of work (check which applicable)' New Building .................. Add,tion .................. Alterotion ............. Repair .................. Removal .................. Demohtion ................ Other Work ....~..fl.~. ~..~,.~.1~ ................................ (Description) 4. Estimated Cost ..... ~.~...0..~...,..0..?. ..................................... Fee .... ..1.~..~..0..0. ........................................................................ (to be prod on filing this apphcation) 5. If dwelling, number of dwelling units ........................... Number of dwelling umts on each floor .......................... If garage, number of cars ....................................................................................................................................... 6. If business, commercial or re,xed occupancy, specify nature and extent of each type of use ........................... 7. Dimensions of exmting structures, if any: Front .......................... Rear ................................ Depth .................. Height ........................ Number of Stories ............................................................................................................... Dimensions of same structure with alterations or additions. Front ' Rear ......................... Depth ................................ Height ....................... Number of Stones ................................ 8. D~mensions of entire new construction: Front .................................... Rear ................... ' ......... Depth ...................... Height ................... Number of Stories ......................................................................... . ...................................... 9. Size of lot' Front ...... .~.O..t ....................................... Rear ...... '..~.O..1 ......................... Depth ....~,~.0..t. ................ 10. Date of Purchase ........................................................ Name of Former Owner ...................................................... 11. Zone or use distract in which premises are situated ................................................................................................. 12 Does proposed construction violate any zoning law, ordinance or regulation: ...................................................... 13 Wdl lot be regraded ............................ Will excess fill be removed from premises: ( ) Yes ( ) No · ?e~. ~x, at;tan .................... 14 Name of Owner of premises .................................................... Address ~~.~J.i...~.~... Phone No. ?e~-zSe0 Name of Architect .................................................... Address ................................ Phone No ..................... Name of Contractor ................................................... Address ................................ Phone No ..................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether ex~sting or proposed, and md,cate oil set-back d,mens,ons fro, property lines. Give street and block number or descnpt~on according to deed, and show street names (:nd indicat whether interior or corner lot . . ~- ....... ~ STATE OF NEW,~'.(~J]~,~, t c S COUNTY OF ....~...~..z..~.~o.~..~. ............ f o ......................... ~.:....P..~...r'..~...i.~..o..D..e.. ....................................... bmng duly sworn, deposes and says that he ~s the applico (Name of individual signing contracf) above named. He ~s the ............................................................................................................................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and ~s duly authorized to perform or have performed the smd work and to make and f this application; that all statements contained m this apphcotion are true to the best of his knowledge and belief; a that the work will be performed in the manner set forth ~n the application filed therewith Swo~ ~o be.~e me th,s~' , ~.ta ry Public,. ................. ~,,.~..r~., ...,...= ..~. ,., ...... County .. NOTARY PUBIIC, State of New York N~ 52 8125B50. Sullolk iC~J~ Te~m E×a,~es ~oh 30