HomeMy WebLinkAbout9271-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(
FORrM 'NO.:i
TOWN OF SOU.THOLD
BUILDING DEPARTMENT ,A
TOWN CLERK'S OFFICE
SOUTHOLD; N. Y.
—3 f Application No. ... �'?Examined .. .. .,........, 19...,,.. J
....................Approved ...............�........... �. 192. Permit No. . .),7..1.. . .. _
Disapproved a/c ................ �
................................................................................::..: .....
..................... ......... ...........
...........................
(Building Inspector)
G
APPLICATION FOR BUILDING PERMIT
Date ......................May...3-10........... 19...7.7...... C
INSTRUCTIONS s
a. This application.musf be completely filled in by typewriter of 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 preises, relationship to adjoining premises or public streets or
areas, ond,giving;a detailed.desc.ription_of.layout.of pro perty.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.
,..TWN.URK„FENCE„C 0,,..�...INC.-...................................
(Signature of applicant, or name, if a corporation)
attituck N. Y. 119 2
(Address of applicant)
e
State whether applicant is owner, lessee, agent, architect, engineer, general ,contractor, electrician, plumber or builder.
..........................................Q QX1.tractor...............................,......................./..�................. ... ..........,.............................t.......
lTn ct
Name of owner of premises .P.eftQ.r..G .att.gL:.....................�C°eti?�Q...................R".?........................................................
If applicant is a corporate, signature of duly authorized officer.
S........................... . Perricone — �a......................................................
-(Name and title of corporate officer)
Builder's License No. .................................................... i
Plumber's License No. ...............................
Electrician's License No. ............................................
Other Trade's License No. .......................................:......
1. Location of land on which proposed.work will be done. Map No.: ................. .............. Lot No. ...............,........
Street and Number Ra1.nA d......SQ�a. t old..h1. .,X...7, ..9.7. ................................................. ..........................
Municipality
2. State existing use and occupancy of premises andIntended use and,occupancy of proposed construction:
a. Exisiting use and occupancy ..........pne.-rRmlly—dW.B.J.ling..........................................................................
b. Intended use and occupancy ...........one.mf amp ly_dwalling. ...................... .................. ...................
6.
3. Nature of work (check which applicable): New 8uUding .�.----- Addition ................... .-Alteration ............
. '
Repair _.,-_.-- Removal .................. 'Oenno|bipn—.—_.���-. Other Work ..�\QAQ�%l6�—.--------`,—
. (Description)
-OO � '
4` Estimated Cost --'���`V�.� ------_-���—. ........'..Fma .... -I
.................................-'--'. .............................
(to be paid on filing this application) �
5` /f dwelling, number of dwelling units ............................Number of dwelling units on each floor -- .......................
|f garage, number of cars --'----_--------------__-_-_----_-.-----'.-----_-_-----_.-'--..
8. If business, commercial or mixed occupancy, specify nature and extent of each type of use ............................
7. Dimensions of existing structures, if any: Front ........................ ... Rear ................................ Depth ....................
Height ........................ Number of Stories -_---.-------__-__------^---------------.--------
Oinnanoiono of same structure with alterations or additions: Front ....................................�Rear ............................
Depth ................................ Height ------.---Nunnber of Stories ................................. '
D. 'Dimensions of entire now construction: Front..................................... Rear ............................ Depth ----.----
Hoixht ..................... Number of Stories —_--_—.------_-___--------.----------_---_--
9. Size of lot: Front ......1.5�JX......................................... Rear ........1.5no......................... Depth .....3]j]1..................
lO. Oota of ............................................................Name of Former Owner ..........................................................
I Zone or use district in which premises are situated —.__--_-_----------.-_-..------_---------
12. Does proposed construction violate any zoning 'ovv ordinance or regulation: ........................................................
73. WiU .lot be_ regrodod',_--..----.-' \AUU m�caoa fill be removed from premises: ( ) ^�» ( �'��o
� �
��t �ttmzz '
14 Non�uof{�vnarofpran��os �]� ]�� �w�� ^ ��on� ��» Yb�
� °^^= ' =="'"`"----'--^ '�"" �X5f��tT��t�'^^~��^'^ -~ �^^~~^1�60
���^^^
Nomeof Architect .............................................................. Awjdrooa ..................................Phone No ......................
.` Nome 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 orcorner |o+
71
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|S|/\' OF NEWYORK, �
/COU OF --E.Uj�f 0]�C--'��'{�'� '
/
_—..+--_'�-...��.-P.e%��i����e........................................boing du|v.ywomn, deposes and soya that he is the applicant
(Name of individual signing controc�
above nomed '
He is the
��
--------..�---.—'cont�����---.—.—.—............. ...----..... ---..----_---___--.-----_.�
�ontroctor, a ont corpnrote officer etc.)
of said o�er � m�e� and isdu� mdhoriz� top r�nn or �� 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 ond belief; and
thor the work-will be performed in the manner set forth in the application filed therewith.
Sworn before hnethio
� �� � �� *� ��
--�=�.�.��-&-' day uf --� ��� ......' l9..�.*
Notary Public, --.—.—..^�`" .��[... County � . ' ........................
, 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