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Home My WebLink About9835-z FORM 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? 9835 Z ,JO~ Y ~ Z~ Dote ........................................................ , 1c) ........ Permission is hereby granted to: ................................................................................... /~.,r...~,.....:.~..~.a.~a..t ~ .~: ............. . ......... opproved by the pursuant to application dated .............................. .'.-/'.~,....-'.~'...,..Z-~.., Building Inspector. Fee $..../~.~ .............. ~ i~uildirig iffSpector TOWN OF SOUTHOLD BUILDING ~ DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined Approved .............. .~/~A~../..~..., 19.~..L.. Permit No ..................................... (Building Inspector) Application No ................................. APPLICATION FOR BUILDING PERMIT ................ , a. This ~pplication must be completely filled in by typewrit~/io~iin ink and Submitted in ~ripllcate to the Building Inspector, with 3 set~ of plans, accurate plot plan to scale. Fee akordmg'to schedule. ~ b. Plot plan showing location of lot and of buildings on premises, rel0tionship to ad~qining premis~es ar p~bliq areas, and giving a detailed description of layout ofproperty must be drawn 6n the d 'agrE~n which is p6rt ~ tl~is opj~ ~atio~ c. The work covered by this applic(~tion may not be commenced before issuance of Building Permit, d. Upon dpproval 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 a~terations, or for removal or demolition, a~ herein described. The applicant agrees to comply with all[applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on pret~ise~ and in build~3~[~rh~ry inspections. ~ ,. ..... (/ (Address of applicant) v ~ State whether applicant is owner, lessee, agent, a~hitect, engineer, general contractor, electrician, plumber or builder. ........................ ..................... ............... .................................................................................................. ~ame of owner of premises,,--__--~.~..~.~.~ .......... ~~ ............................................................................... If applicant is a corporal, signature of duly puthorized officer, ..... ....... (~me ~nd tit e o co~oroto o fic~r) ~ - Builder's License No ..................................................... Plumber's License No ................................................. Electrician's License No ................................. ..~..~... Other Trade's License No .................... ~.~... .......... Location of land on W~icb propp~d work wil! be.done. N~ap I~..' .~.. .................. ~ ................. _Lot No ......................... Street and Number '"~'~~~i'~'~''~''~''''~'~''~'1`~' ~'~i~i~Ji~ ........ State existing use and occupancy of premises and intended use and occupancy of proposed construction: b.a' Exisitinglntended USeuse andand occupanCYoccupancy ii~i i i i ii i iii i i 3. Nature of work (check which applicable): New Building.. ........ ......... Addition ..... ~'Z Alteration ................ Repair .................. Removal .................. Demolition .................... Other Work ......'ZT~~ ........................ (Description) 4. Estimated Cost ...... .~.~....~.~..D ........................... Fee'. ............. i..~. ...... .~.Z~. .................................................. (to he-paid on fi'ling this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................. 6. 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 ................................................................................................................. Dimensions of same structure with alterations or additions: Front .................................... ~ear ............................ Depth ................................Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ...~.~. ............................ ,.~ .........Rear ...~.~ ................... , ........ De~h ..-.~Z.~.~.....,....-, 10. gate of Purchase ....~.~.~...~..../~..~.Z ......... Na~ of ~ormer O~ner 11. Zone or use district in whi~premises'" are dtuated ....... ~e.~Z~~Z....~7 .......................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~.~..~ ...................................... 13. Will lot be regraded ....~.~ ............. Will excess fill be remo~d frqm pre~ise~:,( ~Y~ ,, ( 14. Name of Owner of premises .VZ~.~~ ......... A~S~~.~..,. Phone No~...~ Name o~ Architec?~~~ .............................................................. Address ............... ~lZ'~" Phone No ....................... Name of Contractor~~.~~ .............. Address ..JZ~l.~.. Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buiJdJngs, whet~er existing or proposed, and indicate all set-~ck dimensions frem prope;ty lines. Give street and blocl< number or description according to deed, and show street names and indicate whether interior or corner Iol. %. STATE oF NEW s /~~ ................................................. being sworn, ~~;ontracf) duly deposes ond says that he is the opplicon, ~ve flamed. He is the (Contractor, agent, corporate officer, etc.) of sdd owner or owners, and is duly authorized to perform or have performed the said work ~nd to make and fil~ this application; that aH statements ~ontained in this applicoHo~ are true to the best of h~s knowledge and bdief; and tho~ the work will be performed in the manner set fo~h in the ~pHcation filed therewith. Sworn to ~ me this ....... ............. ........ .... ................... SURVEY FOR · VINCENT 8 JOYCE TESE ~ ,IT NEW SUFFOLI(, TOW~ ~IEFERENCE ~