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Home My WebLink About9356-z FO~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL CQMPLETION OF THE WORK AUTHORIZED) 9356 Z Permission is hereby grant, ed to: to .it~'eet.. and ..naif, at ~ ..f~e ~,8.. a~:~z.~p~~n..~ ............................ at pr~mims Imat~ at.. ~,.~;~ -. 8-.~ ...................... , ............................... ; ....... ............................................,~ ,, ~ , ........ ~o~....~ '~ ...................... ~ ~ ~ ~ ....................................................... .~ : ~.'~/~ . ,~:-~-~ , :~.~.~ pu~uant to application dat~ ........................... ~...~ ...... ,,..., 19..:.~ and a~oroved by the TOWN OF SOUTNOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Disapproved a/c .......... ~ ........~ ................................... ~ APPLICATION FOR BUILDING PERJ~IT Date July ? 19,?.?. ..... INSTRUCTIONS a. This application must be completely filled ,n by typewriter or in ink and s.,ubmitted in triplicate to the Buildir 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 ofproperty must be drawn on the diagram which is part of this applicatio~ 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 perm shall be kept on the premises available for inspection throughout the work. I e. No building shall be occupied or used in whole or in part for any purpose what,ever until a Certificate of Occupam shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Budding Department for the ~ssuance of a Budd,ng Permit pursuant to tr Building Zone Ordinance of the Town of Southold, Suffolk County, New York, andiother applicable Laws, Ordinances. Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, os herein describe, The applicant agrees to comply with all applicable laws, ordinances, building code, §ousing code, and regulations, and ~ admit authorized inspectors on premises and in bulldlngs for necessary inspections.~ 2n6 Streetx New Suffolk, New Yo~k (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contraqtor, electrician, plumber or builde Owl~e3~ Name of owner of premises John Malinowski If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ............~.;;;, ............. Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's License No ............................................... Location of land on which proposed work will be done. Mop No.: - Lot No..,; ................... Street and Number ..... ~.~9~'~u..~.''~.~)~.~-..~.~'.a~.~8:~t~..~.u'..ff~.h..~'.~.~t~.N~e.~R~ .................................. ~. ...................... Municipality State existing use and occupancy of premises and in:ended use and occupan(y of proposed construction: o Exisiting use and occupancy ........... Busines8 ................................................................. b. Intended use and occupancy .................................................................................................................. 3 Nature of work (check which applicable}. New Building.. ................ Addition .................. Alteration ............ Repair ................. Removal .................. Demolition ................... Other Work Fenoe £net~l~.tion (Description) ts00.00 , Z? ................................................................ 4 Estimated Cost ........................................................... roe ................... (to be paid 'on filing this application) 5 If dwelling, number of dwelling units ........................ Numbcr of dwelling umts on each floor ...................... If garage, number of cars ............................................................................................................................... 6 If business, commercial or m~xed occupancy, specify nature and extent of each type of use ...................... 7 Dimensions of existing structures, if any: Front ......................... Rear ................................Depth .................. Height ........................ Number of Stories ....................................................................................................... D~mensions of same structure with allerat~ons or addmons: Front ................................. Rear ...................... Depth ............................. Height ........................ Number of Storms ................................ 8,. D~mensions of entire new construction' Front ................................... Rear ............................ Depth .................. Height ................... Number of Storms ............................................................................................................. 9. Size of lot: Front 902' . . ReQr ~..~..~.~ ................... Depth 10. Date of Purchase September 24, 1973 Nome of Former Owner Flora. F. Lesser 11. Zone or use district in which premises are s,tuated ........... :~.-.~:~...-....C..e..z?.e...~...1...~..u.s...i..~.@..~..s. .................................. 12 Does proposed construction violate any zoning law, ordinance or regulati6n: ....... .~,9. ...................................... 13. W~II lot be regraded ........ .~..o. ............... Will excess fill be removed from premises: ( ) Yes (~) No 14. Name of Owner of premises ..... ~.o.~....~..~.o.~]~.~. ................. Address ..,~.e.~..~9...~.. ....... Phone No. Name of Architect ................................................. Address ................................Phone No ................. Iqome of Contractor ....................................................... Address ................................Phone No ................. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, ond indicate oil set-back dimensions property lines. Gwe street and block number or description according to deed, and show street names and indi whether interior or corner lot. " ~ '~ z - /v~ '~ , STATE OF NEW YORK, COUNTY OF .~IJ~.OLK. ................ ~S.S ...................... .J..o..h..n.....M~..~.~..o..~..s..k..t. ....................................... being duly sworn, ,Jeposes and soys that he i~"the ap~ (Nome of individual signing contrQct) ,' above named, i He is the ............................................ (Contractor, agent, corporate officer, et ~t~cl~x~'x~¢ and is duly authorized to perform or have performed the said work and to make a, this application; that all statements contained in this application are true to Ithe best of his knowledge and beli: that the work will be performed m the manner set forth in the opphcation filed therewith. Sworn to before me this 7th Pubhc, . ................... ' -5.??. .~. ........................ day of .......... ~.]'.~..~ ......... '..., 17-7.? Notary No. 52-0376625, Suffolk ~un~ ~/ - ~ - Te~m ~p~res ~ir.¢h 30, 1979 ,~