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Home My WebLink About9191-Z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTH-OLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 9191 Z ...../ , 19 7 Date ........ ............ Permission is hereby granted to: e�C o'/) ...........:� ................... .. ... ..........yl..........� 10J............f•................ .r ......f......�.� �......: CJ .............................lr!l!�-.....1. ' ......... ..........l.. .................... .....ell,.................. ........................ .... ... ..... ........................................ atpremises located at .........................................................✓ - .... ._ ..................... ................................................................................ .....:: -- �. .........�.....� .. ........................... ................................................................................................................................................................. pursuant to application dated .............. �12LY'..o.:...... 19..�... and approved by the Building Inspector. Fee $........................ f � j G Building Inspector -FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN.CLERIC'S OFFICE SOUTHOLD, N.-Y. Examined . ..... , 19 .l... Y Application No. � ............. Approved ............. ...............I/......, 19.,.,.... .Permit No. . ....... . .� ................. Disapproved .a/c. ................................................ . ........................................ ........................................................................... ....................... .................... .. .. .. ... ....../� �i............................ ' •t�(BtIiiing Inspector) r� _ c.. APPLICATION FOR BUILDING PERMIT Date'... a........... /P ... 7 (.LJ,. .. ., 19.7....... INSTRUCTIONS a. This application must-be completely filled in by typewriter or' in_ink and subm�tted in triplicate to the Building Inspector,�:with.3�,sets of•plans;accurate'01ot'plan to scale.'Fee according!to schedule b. Plot plan showing location of tOt`.aridPof 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 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 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 ems•. .e.. ` :,/ ........................:........:.i.:............................................... ' ,,(,mac J,o,C ,,�-s• —� 33-''�g 8 7 (Add r�e-ssofiaPp I icant'Sa-r�- F l./3 72 State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................... ....................... ...,�it�.................................................................... ............................................. Nameof owner of remises t p .............................................................................................. ....................................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of co orate officer) Builder's License No. .... .1 .. ....u...: �"� Plumber's License No. .........................................:. Electrician's License No. ............................................ OtherTrade's License No. .............................................. 1. Location of land on which proposed work willll,bg done. Map No.: ................................ ..._Lo a. Street and Number ............ ............. ..................... ..C ....... Municipality 2. State existing use and occupancy of premises.and intended use--an&dccupancy of proposed construction: a. Exisiting use and occupancy .......... ................................... ..................................................... .. .. . . b. . Intended use and occupancy ............. .... ....,. .......c�1 .......:......................................................... *~ 3. Nature of work (check which applicable): New Building...-.--.-' Addition .................. Alteration ............... Repair ------- Removal ------ Dan�o �bon°_-_--.. Other Work --.-.-----------.- '- ' ' (Description) �T ~l � -- 4. Estimated Cost -.'/�p-'J��'�'��. �................................. -..^�l.�.----_---^-----.-----_--'-------~_-. ' (to be paid on filing this application) 5. If dwelling, nun�berofd�eUing units --�7---.---��un�berofd*�|inQun�smnaoch�fkoor --.'.--_-.-- ` � Ifgarage, number of cars ........................... ..........................................................................''~--'-.'r------------'. . 6. If business, commercial or mixed occupancy, specify nature and extertofeach typo of use ....7=................. 7. Dimensions nf existing structures, if any: Front ..........................� Rear -,_''..~.^................. Depth ............... Height .................-.-' Number of Stories ........ ............................°............................................................................ Dimensions of some structure with alterations or additions: Front ...................................... Rear ............................ Depth Height � Number of -------'�'��-. t a . - r'' �r',. ................................ - �eor8. Dimensions of entire now construction:— o ---.. - � Deoth .-.��.^��.�_ Haight . ' ........... Number of Stores ...........`9`.� Size of lot: Front ----- �-------_-__ Rear ./_ /. .___.___._ Depth .1^92 }O.'. Date of Purchase `44C/' 4-.I f�96-_-.----..None ' of Former Owner �% -------- 11. Zone or use district in which- premises are situated ............................................`......................................................... i2. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ /~ ' 13. Will lot be regraded -..�4�1J............... Will excess fill be removed from m»no ( ) Yes ( � No ' /�' J��M / l�� Nonnmof��narofpranniyoa4��.''-.`.=,-..��-.. �ujdreos ��J�� PM�o��#��...-.., ' Name of Architect .............................................................. �uddrmss ....................,............. .Phone No. ..........,..... ' Nonne of Contractor ............................................................ Address ................................. Phone No. ...................... PLOT DIAGRAM . Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all sot-back dimensions from .property lines. Give street and block number or description according to deed, and show street oomoo and indicate whether interior orcorner lot. ` fit - ^=� ` ' STATE OF NEW ( 5� [C)UNT,/ OF -..�!��.-.--'} --..`r--.','. ��.-��j�J��J�--.-. ----- 8�rn, and says that he is the applicant (NPme bt'indkviduo| uigni `. � above named. /. Heis the ...................................................owner .",'(Contractor, agent, corporate afficer, etc.) of said owner or owners, and is a file this application; that all , thisto the best o�Hs knowledge and belief; and � % on filed therewith. thorthe work will be performed in the �G �dtk Swmmtobefore me this ^' " ............'8.th.- day of ---'Amur.i:I...................... l9...7*7 -.-^�..S�:��-~��-.-...,,.....-'.'.-.^-^~_--~-'----. -Notary ' (Signature of applicant) -_ ^f - V cuumETV owm mp/|uE / NOTARY PUBLIC, outem New York / ^ No. 52-81253 u. ou*v/k xoun��, lenn Expires 0hj�h 30. 18 '�^� FORK NO. Y r� 1 TOWN' OF SOUTHOLD BUILDING DEPARTMENT i n TOWN CLERK'S OFFICE 1. SOUTHOLD, N. Y. / Examined .... application No. . �: ..........\ Approved. ..........,.1.l..:...:...:...'�......, 19.11...... Permit No....r.. 1 /�.� .. ....... Disapproveda/c :..."........................ ........... ..::.. .................................. , .................................................. ........................,................... ............... .. 1 . ..................... EB rl ng Inspector) .APPLICATION FOR BUILDING PERMIT Date .. .........� ........... 19.......... Q` INSTRUCTIONS a. This'application must be completely filled in by typewriter or in ink''ond submitted in triplicate to the. BuildingIN 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 th'is 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 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. r- • G 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 tdX' admit authorized inspectors on premises and in buildings for necessary inspections. t � (Signature of applicant, or name, if a corporation) ..7...�..... i.... . ..... ..................................... f (Address of'opplicant) State whether applicant,is owner, lessee, agent, architect, engineer, general contractor, elect i ion�p`furr6er or builder. ............................................... .. ................................................................................................... ..... ................ Nameof owner of premises ..................................................................................................................................................... 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. ............................................ OtherTrade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: ..... �^....:............ Lo ,N Streetand Number ............ ...... ..... .... ...........................�/ �o / ..... Municipality -2. State existing use and occupancy of premises and intended usd and^occupancy of proposed construction: vs :-Q!4-r.` 4s a. Exisiting use and' occupancy ............ .... ......... .. .................................................. ...: �r ............................................ •................. b. Intended use and occupancy .. NJ �V 3. Notu're of work (chec`, which applicable): New Building...................... Addition ..... Alteration .............,.... Repair, .............!.... Removal .................. Demolition.. ................ Other Work ................................................ ..... (Description) 4. Estimat d Cost ....... ........Ig. ... Fee ..../.0.... ".J....... ......:..................................................... to be paid on filing ."this application) . 5. If.dwelling, number of dwelling units ... `"........ ...Number of dwelling units on each floor Ifgarage, 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 some structure with alterations or additions: Front .................................... Rear ............................ Depth ............................. Height ..... ;........ . ......Number.of,Storie.s ................................ •8. Dimensions of entire new construction Front ..... /2'. Re'r �a . ......... Depth G�.. Height .4 ......... Number of Stories ........................ ........................................................................................... 9. Size of lot: Front ............. . 0 C�. ........................... Rear ........../..C,/.Z�........................ Depth ...152. ... �-UX 101. Date of Purchase .. '9�r -01- 1014........................Name of Former Owner ...1<0,i�:,�,AN.:.cC�.................. . 11. 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:.,C ) Yes" ( ) No 14. Name of Owner of premis � ;�(d�:.�.�.. 9.t. �'/.� ... . Addres32 y aod:S.t1l. Phone,No. Name of Architect .............................................................. Address .............es.................... Phone,'No.. ...................... Name of Contractor ....... .......................................... ... Address ................................_ Phone"No. ...................... PLOT DIAGRAM Locate ,clearly and, distinctly all buildings, 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. `77 M STATE OF NEW YOR t COUNTY OF :....Su. Qlk.........jS.S .............................Denlas..A.:..De tzaak..........:.................being duly sworn, deposes and says that he is the applicant - (Name 'of individual signing contract') above named. Heis the ................................................:..OWner.....................:................,...................::...................................................... (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 all statements contained in this,application are true to the best of his knowledge and belief; and thar the work will be performed in the man'ne.ribt forth in'th'e'applieation filed therewith. Sworn to before me this .............Mth.. day of Apr a:.. ..............1 19. 77 2 �Iva-d NotaryPublic, .............................SAff.Q.IX...... County ...... .........................:.........................:..................................... (Signature of applicant) ELIZABETH ANN NEVILLE NOTARY PUBLIC, State of New yerk " No. 52-8125850, Stiffolk Coun fJQ[M EXpi[eS Marrh In ]rcH L Ae- '� TEL. 765-1802 TOWN OF SOUTHOLD � � r" N OFFICE OF BUILDING INSPECTOR ..z.s• TOWN HALL SOUTHOLD, N. Y. 11971 August 5, 1980 Denos A. Demitrack 33-28 84th Street Jackson Heights, T.Y. 11372 Dear Sir: . This is .to advise you that the job under Building Permit No. 9191Z issued to Owner , on, 1 " �— for storage s e - .appears to be - completed as of our last inspection. Before you can legally use or occupy this structure a Certificate of Occupancy must be issued. Please fill out the enclosed form and return same to the above office. There is a fee of $5.00 for a Certificate of Occupancy Thank you for your prompt attention. Very .truly yours, i GEORGE H. FISHER Sr. .Building Inspector - encl.