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Home My WebLink About9753-z FORM NO. 2 TOWN OF SOUTHOLD BUiLDiNG DEPARTMENT TOWN CLERK'S OFIqCE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE P~,EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) No. 9753 Z Permission is hereby granted to: ................... .C...a..r...o..1....~,.ey..e...r.....&.....J..o.~,,a...A.~.?..e. rger Build a fence at premises located ct ......... 26.Q25. ...... ~4..~i~..~o.a~ ......................................................................... Orient, New York pursuant to application dated May 11 19...'~, end approved by the Building Inspector. Fee $....J. 5.,.~..0. ........ 1000- fl 8-3-22 Building Inspector FO~ NO. I TOWN OF SOUTHOLD BUILDING D£PARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Yo E×ornined May 26 19...~. ~proved ...... ~ ....... ~.~ .............. , 19...Z.~ Permit No ......... ~7.~ ................ Disapproved a/c ............................................................................................ Application NO ...... ~ ................. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date .......... ~.....~,. ,.. ~ INSTRUCTIONS a. This application must be completely filled in by typewriter ox in ink and submitted in triplicate ?o 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 premises, relationship to adjoining premises or public streets o: areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this opplication~ 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. (Signature of~pplicont, or name, if a corporation) (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber al builder. · . ........ Nome of owner of premises ...... .~.:~.O..~.....j~.~..~..~.....~......~..O.~..~..~.~......[.~.~.~?..~....~ ........................................................ 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 ............................................... ~)t$~_jC~; i;~r~ ~'~c:Z/~,~ ~ J~' ' ' ' k dl'edone Ma No Lot No ~ 1. Location of land on which proposea war w' b ' P '~ ................................................................ Street and Number ............................ ~f~!~/~.~¢/}~.~`~f~a~`~.~c~.~.~`~&./U`¢~ ............... MuC~ipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: Exisiting use and occupancy ................................................................................................................................ ......................... Intended use and occupancy ..... .~.,'.~................. ~ ........ ~ J J J '~ 'il ; 'J~'~ ~ J J' J 3. Nature of work (check which applicable): New Buil&ng'. ................. Addition ...~:~ ..... ion ................. Repair .................. Removal .................. Demolitior. .................... Other Work ................................................. 0 ~ ~-- ~ (Description) 4. Estimated Cost .... .~['.I.....C). ............. 1~.{..?...~.. .................. Fee ....~.t~..~ ...................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ....... ~. ............... Number of dwelling units on each floor ............................ Jf garage, number of cars ............................................................................................................................................. ,6. If business, commercial or mixed occupancy, specify nature and extent of each ~pe 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 ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new~onstructi~n: Front ....................................Rear ............................ Depth ........ y .............. Size of lot: Front ....... 1.0~ .......................................... Rear ....... ].~.J ............................ Depth ...~.~....~.~: ..... Date of Purchase .... ---- -'~.~.[~1...~:'~'~. ................... Name of Former Owner ..~.~.~.~....~.....'~. ........... Zone or use district in which premises are situated ..................................................................................................... Does proposed construction violate any zoning law, ordinance or regulation: ..g~.~ ................................ Will lot be regraded ..~.~ .................... Will excess fill be removed from premises: (~) Yes ( ) No Name of Owner of premises ~L ~ ~E~ ~ddress ~.~.~f.~l.~.~...,.. Phone No ~.z.~]... ................................ ~ ~ lo~ Name of Architece .............................................................. Address ................................ Phon~ No ....................... Name of Contractor ............................................................ Address ................................ Phone No ....................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-~ck dimensions from prope~y lines.~Give street and block number or description according to deed, and show street names and indicate whether interior or corner Io1. u ~10. 11. 12, 13. STATE OF NEW YORK, . ~ ,, ~cc COUNTY OF ..... ~...N..C1.. f~'~ ...... .~..~..~......~-.¢;-~......~.¥.~.~. .................. being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. He is the UCL~I~/...~ ............. . ................................................... " (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 oil statements contained in this application are true to the best of his knowledge and belief; and thor the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this Notory Public, . .............................. [..~ ...... County ...................... AAARCIA PRYLU_ CK(_.J Notary Public, State of New York No, 24-8450900 Kings County Certificate fffed in New York County