HomeMy WebLinkAbout10348-z(THIS
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 10348 Z
Date AUGUST 7, 1979
Permission is hereby granted to:
ROBERT & MARTHA PRINCE
2575 SEAWOOD DRIVE
SOUTHOLD,NY 11971
for :
ERECT FENCE VOID C/O NO LONGER REQUIRED
at premises located at
County Tax Map No. 473889 Section 079
pursuant to application dated AUGUST
Building Inspector to expire on FEBRUARY
1785 SEAWOOD DR
SOUTHOLD
Block 0007 Lot No. 056
7, 1979 and approved by the
7, 1981.
Fee $ 0.00
Authorized Signature
COPY
Rev. 5/8/02
l~OE~ 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
COMPLETION OF THE WORK AUTHORIZED)
10348 Z
Permission is hereby granted to:
.......... Z/.x~.~.......~.~..,. ~c~ ..............
~.Z ~.'Z.~....,=~.~:4.~.~...,Z,.. 'x. ~2 ...........
to . . . .~.,~.~. ,,,:. ~.. ., c ,. . . . . . . . . .,~ ,;.c~ ~. ,~.~,,., ~. . ................................................
pursuon, ,o opp,,co,,on do,ed ......... ~.~.~..~.....~ ........... ,~...X..~o.d--~ opproYed by
the
Building Inspector.
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. 11971
TEL.: 765-1802
E×amined .... ,19 -- ^ppiicationNo. Z .. t2 ......
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
a. This application must' be completely filled in by typewriter or 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
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
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 applicant, or name, if a corporation)
......... (~l'ailing address of app' )
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder.
... p.v..,:,. ~ ....... .k'o,~.. ~.. ~..'~ lZ'~, .~...~. m..~.~ .......................
Name of owner of premises ~..7~...~..~. :~...O')..O.O.d... b..~.:...3t~.I,A-..~ 9. [¢. (..~..l~..~:. (as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
(Name and title of corporate officer)
Builder'~ License No .... $. , q~. .I. .&. ............
Plumber's License No .........................
Electrician's LicenseNo .....................
Other Trade's License No ......................
Location of land on which proposed work will be ~tone ................................................
House Number Street Hamlet
County Tax Map No. 1000 Section . .~..~..~ .......... Block .0.7 ............ Lot..0..~..~ ..........
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ..........
Repair .............. Removal ...... ~..:. .... Demolition .............. Other Work..~f~.~-MOF_.~_~ ....
4. Estimated Cost .......................... Fee ..............................
~ (to be paid on filing this application)
5. If dwelling, number of dwelling ~nits ............... Number of dwelling units on each floor ................
If garage, number of cars ..... i ..................................................................
6. If business, commercial or mixed: occupancy, specify nature and extent of each type of use .....................
7. Dimensions of existing stmcture~, if any: Front ............... Rear .............. Depth ...............
Height ............... Number of Stories ........................................................
Dimensions of same structure wi{h alterations or additions: Front ................. Rear ..................
Depth .................... :.. Height ...................... Number of Stories ......................
8. Dimensions of entire new construction: Front ..... ~ ......... Rear ............... Depth ...............
Height ............... Number of Stories ...............
9. Sizeoflot: Front ..[~..'...~.' ........... Rear..[{?..'..~..~..iiiiiiiii'~)~il~'iii~.~.'ii011111111111
10 Date of Purchase ' Name of Former Owner
1 1.. Zone or use district in which premises are situated .....................................................
12. Does proposed construction, v, iolOte any zoning law, ordinance or regulation: .................
13. Will lot be regraded ..... l[~J~O.,....~ ....~ ......... Will excess fill bes~r~emoyed frp~_pfemises: ..... ~;~ ' ' ' ~
14. Name of Owner of premises .~O.~..O~..7. (l.10~..~tl.OAddress ~-~.~.~-'. ~...l~-¢~..0.O.4 .[ll~ne No..7.&. &-~-. ! ~
Name of Architect ........................... Address ................... Phone No ................
Name of Contractor ......... . ................. Address ................... Phone No ................
PLOT DIAGRAM
Locate clearly and distinctly all Ibuildings, 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 or corner lot.
STATE OF NEW YORI(
COUNTY OF' _~
-.~
......... ~-'~~ ............ being duly sworn, deposes ~d says that he is the applicant
(Name of individual signing contract)
above named.
He is the ............ ...........................
(Contractor, agent, corporate officer, etc.)
of said owner ~r ownem, ~d is dul~ authorized to perform or have peffomed the said work and to m~e ~d file this
application; that all statements cont~ined ~ this application are true to the best of his ~owledge and belief; and that the
work will be perfomed in the manne? set forth in the application filed therewith.
Swam to be'fore me this '~ - "
, [ z umc ..... - .....................
~ E~ ~h (Signature of applic~t)