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Home My WebLink About9808-z l~O~ NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PI~EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9808 Z Permission is hereby granted to: x'/ // ............ ~~ ........ ...,..z~:~....~.~:..~..~.~.~./,';~-~ ,o ...... .~_~.~.z:......-.../.....:..~. ....... ~/~.~...... ~?...~...;..... ~;~...~~ .......... .......... c.~~.:~ , ~c ~ ..~~ ~ ~ ~ ~~ '""'~'~ ........................ 7 .................. ......... ~ ................. ~ ................................. ,. ....... ~ .......... ~~ ~ ~ ~x~ . ~z. . ~ ~ ~ .~, ~'~' ............................. ~/ ~ Buildin~ Inspoctor. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE -C-...... SOUTHOLD, N. Y. Exam,ned .7 .......... . ,9.Z ............ Approved .......................... , I9 ,/ Permit No...Z.d/-.~..~o,~ ° Disapproved o/c ............................................................................ F .............. (Buildirfg Inspector) ............ .,,z/...i.. INSTRUCTIONS Date a. This application must be completely filled in by typewriter o~ 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 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 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 o 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 port 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, ar for removal or demolition, as herein described. The applicant agree~ ta comply with a appl cab eaws, ord nonces, bud ng code, hous ng code, and ragu arians, and to admit 6uthorized inspectors on premises and ir~ buildings for necessary inspections. oq (Signature of applicant, or name, if o corporation) .... (Address of applicant) / State whether qpplicant is owneh lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................. 0....~:.. ~ £ ...¢~... ............................................................................................................................................................... Name of owner of premi,es ..~,,.~:ffC....L:...°.,,..~Y~..~...L-...~..-~..°..,~ ............................................................................................. If applicant is a corporate, signature of duly authorized officer. (Name and title of corporate officer) Builder's License Ho ..................................................... Plumber's License No ................................................. Electrician's License No ............................................. Other Trade's Lice,se Nr~ ............................................... ~ *.) /~. ,¢¢ ,/¢~ 1. Location of Jo,,d o~ ~hich ~,~e~ ~ork ~Jll ~ ~,e. Map No.~~./~. Lot No...~ ............ ..... ......... 2. State existin~ ~se and occ~¢y of premises an~ ime~ded use and ~cu~ncy of pr~osed co,struction: a. Exisiting ~se ~ ~cu~ ..... :..~.~r~f~.: .................................................................... ~~ b. Intended use ~nd ~c~y .... ~ ................ ~.~. .. 3. Nature of work (check which applicable): New Buifding,.~ ................ Addition .................. Alteration ................ Repair Removal .................. Demolitior ..................... Other Work /z? ,,~,.~z~ ~ k,,,,~., r (Description) 4. Estimated Cost .................. ~ ..................................... roe .......................................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................ Number of dwelling units on each floor ............................ If garage, number of cars ............................................................................................................................................ 6. If business, commerciaJ or mixed occupancy, specify nature and exten~ of each type of use ....................... 7. Dimensions of existing structures, ff 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 construction: Front ......... :.:,. .............. Rear ............................ Depth ........................ Height .................... Number of Stories ..............: ...................................................................................................... 9. Size of lot: Front ........................................................ }~ear. ......................................... Depth ................................ 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ ] 1. Zone or use district in which premises are situated ..................................................................................................... ]2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. Will .lot be regraded ................ ,,...: ....... Will excess fill be removed from premises: ( ) Yes ( ) No 14. Name of Owner of premises ...... ................. ............................. Address ....................... ;,.,.,.., Phone No ....................... Name of Architect ............................................................. Address ................................ Phone No ................... , .... Nome of Contractor ' ~dd'[ess .................. ' .............. Phone No ....................... RLOT DIAbRAM . Locate clearly and distinctly all buildings, whether existing 0r ~roposed, and J~dicate all set-~ck dlme'nsions from property lines· Give street and block number or description according tO deed,'and show street names and indi6ate STATE OF NEW YORK, lc c COUNTY OF ..... . .......................... f~.~ ~: I ,~:> ~ ,\~ t ,., ',. ,~,1·'~,~, L ,C"7-~,,' !~ , , ~ ............... q ............................................... ~ ................................ being duly sworn, deposes and says that he is the applican~ (Name of individual signing contract) .... ' above named. '". He is the ................................................................ : ................................................................................................. '. .......' ....... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and t~ make 'and file this application; that all statements contained Jn this application are true to the best of his knowledge and belief; and tha~ the work will be performed in the manner set fo~h in the application filed therewith. ,, ,~ ~ d Sworn.¢~ ~ef~r~,me this .~. , , .,: .... ............... da of ..Z.;(: ........ ::. .......... qr ......... ~.. ...... x ' ? ~, ~ -/ ~ ~ Notary Pub c, .; ...... [ ........................ [ ......... ;'~ ...... Coun~ ...... T .................. :.: ..................................................................... (Signature of applicant)