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Home My WebLink About10155-z FOENI NO. 2 TOWN OE $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING DERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne 10155 Z at premises located at ................ /-./~..~ ...... j/./~.j.:...xr:.~,~.~.j./~ ........ .~./,:fff. ........................................ ............................................................................................ ~t,..~.v~.~.~ ............................................. doted ........................................ /¢I./~.A,...,2,,/19..~:~., and approved by the pursuant to application Building Inspector. Building Inspector TOWN OF SOUTHOLD OFFICE OF BUILD]lNG INSPECTOR TOWN HALL SOUTHOLD, N. Y. 11971 TEL. 765-1802 Twin Fork Fence Co. Route 27A Mattituck, N.Y. 11952 Dear Sir: This is to notify you that Building Permit No. 101~Z issued Apr_~l~q~ 197q ~o~ Mrs. David Morsan will expire on /O~/q/8~ If more time is required to complete the Job and obtain a Certificate of Occupancy, you may apply, ~y letter, for a six (6) month extension. If the work is not completed and the not issued after the six (6) month extension period, than required to apply for a new building permit. Very truly yours, GEORGE H. FISHER Sr. Building Inspector Certificate of Occupancy you are TOWN OF SOUTHOLD ~ ~/~ '~'*'/f ~ ~)''' ~,v? 7X BUILDING DEPARTMENT ~ ~7~ / ~ ,~/ TOWN CLERK'S OFFICE; . ~ ~ ~, e~ ~UTHOLD, N.Y. ~*'~ ~ ~ Examined ................. 7.?// .................. , 19 ........ , .;/; il Approved ................... ~L~..f ........... ./.., 19....../. Permit No ..................................... Disapproved a/c ............................................................................. (Building Inspector) Application APPLIGATION FOR BUILDING PERMIT Dote ...~?~,-.,~,g,~.,?.~ ......................... , 19...7.~..,i~, INSTRUCTIONS o. This application must be completely filled in by typewriter or~ in ink and submitted in triplicate to the BuiJdlng~ Inspector, with 3 sets of plans, accurate plat 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 o detailed description of layout of property 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 a Building Permit to the applicant. Such per, mit 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 Occupancyf~ shall have been granted by the Building Inspector. ~ ~J 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) ~oute 27& M~ttituok, ~..i,~', (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, eJectrscian, plumber or builder. ................................................. ................................... "'"J .......... ': ............ :'" "; ........................... Nameof ownerof premses ?~.;~ ~ .~.i~ ~/~Z',??.1% If applicant is o corporate, signature of duly outhorixed officer. .................... iS.... ~. k~.~'J, g 0).% ~. ..................................... (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, Map No.' ...................................... Lot No ......................... LIi r' Street and Numb/e~'~... ~.~A~o16~...I~¥~¥ g:Dj:-~.~.ii;....[~.'~W.-.'¥G';Z'k. ....................................... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: O Exisiting use and occupancy . one-£ami!2;' dwell,i.n~ ~ Intended use and occupancy ...:.PS~,~m...~'~iSTi;L,~ ...dtc(All~.l~kg .......... , ................................................................... 3. Nature of work (check which applicable): New Building'. ................. Addition .................. Alteration ............... Repair .................. Removal .................. Demolition .................... Other Work ..... ~.~tD,~lG~, ............................. (Description) 4. Estimated Cost ........f)Z~.~.f~.0. ................................... Fee .,..~:]?).~ ...................................................................... (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, commercial or mixed occupancy, specify nature and extent of each type of use ............................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Numbgr af Stories ................................................................................................................ Dimensions of same structure with alterations or additions: Front ....................................Rear .......................... Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Pear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot, Front ...... .I.~.D.~ ......................................... Rear ..... .l~):~).t. ............................ Depth .....~.~Q~/. .................. 10. Date of Purchase ........................................................ Name of Former Owner ........................................................ 1 ~. Zone or use district in which premises are situated ................................................................................................... 12. 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 .~i;L~Z..~)~...'~'~(~,~.'.;~,''. ................... Address ..~.~L'..%:X..;~.~....A.)...T, ..... Phone Name of Architect .............................................................. Address ................................ Phone No. ...................... Name of Contractor ............................................................ Address ................................ Phone No ....................... ~ ~' PLOT DIAGRAM ~' Locate clearly and d~stinct~y alI buildings, whetner existing or proposed, and red.cate all set-back d~menslons from pi'operty I nes. G ve street, and block number or description according to deed, and show street names and indicate whether interior or corner Io~ /) STATE OF NEW .¥. ,.O~J(,,, ! ¢ ¢ COUNTY OF ...:?~.O.&.~;~ ............ ................................................................................................ being duly sworn, deposes and soys that he is the appheam (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 to make and file this appllcation; that all statements contained in this application are true to the best of his knowledge and belief; an¢ that the work will be performed in ,the manner set fo~h in the application filed therewith. / Sworn to before me this /~ d / / / *~ ' ' ....:- / X/.3. %;'''''x' ' ~-r ~. ' , ~. / , ,.~ / : / (Signature of applicant) ELIZABETH A"~ N~JLLE NOTARY PLIBLI~, State at New Yot~ No 52-8125850, Suffolk County Term Expires March 3