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Home My WebLink About9449-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) NO9449 Z Date ............................ <.)�i.......�,........., 19.�.�... Permission is hereby granted to: .......................... ti.p: ................................. ................................................................................ to}:...: .'....?�.�......'.�: �f.t»J.:..C:�::.1:�...i.L:. 1.�. .:..u�;�� 'f, ,mot �� e...,�.... _•`i,.... . s:^1. .. .awt.. 7reage .../ +�....f..........::::............... . ............ at premises located at ....... ........................................................... •4 , ..............................................( t;i c3,r .: ............ .... .......................................................... ......... ...................................... ........................................... .............................................................. . ...... pursuant to application dated ..............................:..i: :...:........, 19. ..., and approved by the Building Inspector. Fee .......... Ci...c� . .......... .. ............................................. ................... Building Inspector P C ■ 0 FORM NO. 1 TOWN OF i SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Examined ......... ...... ... ., 19.. Application Na. .................. ................ 7........, 19..7. Permit No. .:...�.r. .... Approved .............................. ..................... Disapproveda/c ........................ .................................. ....................... .......................................................................O(Building, ............ ......................... ...................... ............ :. ................ ... ................... !Inspector) APPLICATION FOR;BUILDING .PERMIT Date ................s?......................... .. 19.22. 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. Free 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 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. ..... f '` :.... ................. . . . ....... . . . ................................... (Signature of applicant, or name, if a corporation) 11.bK7..................................... (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. .................................................................. ............................................................ ............................. Name of owner of remises ..... „5........ /� p .. tQ. 0 l '.1.. -tct ... �.�� ........... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. ................ U :;:;1` �I Plumber's License No. ................................................ Electrician's License No. Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done.;;Map No.: .............. ..... t No. ... ............... Street and Number ......f:C V. ........ ......................:.................. . .......... Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy .....................................................................................................:.............................. b. Intended use and occupancy .O.Cc�'�,Il�1�,�,I�SC`5.....��....��.�,f��.......... �............................. i � -3. Nature of work (check which applicable): Naw`8ui|ding:.. ....'.....— Addition . .. / horotknn ............... � Repair .................. Removal ................... Demolition......... .......... Other Work ................................................ '_ <Deacri p tiun} 4. Estimated Cost —'' .�}.� �-----------...—Fee —~�-�-----_---__----_... .... ._ ..... _____� . ' (to be paid on filing this application) 5. If dwelling, number of dwelling units ............................Number ofdwelling units on each floor ............................ |fgarage, number ofcars ------.—_—..---'-----'---'-------,—.—,------.---------. 6` If business, commercial ur mixed occuponcoccupancy, speci nature and extent of each type of use ............................ 7. Dimensions uf existing structures, if any: Front -- �� . !.. -- --_--_ -- Rao, ��.-J / .. �aot� _ .� Haight ............. Number of Stories ....... ��>-.�...................................................................................... ...... Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Height ---------.Nunn6er of 3tnhos ................................ 8. Dimensions of entire new construction: Front .................................... Roor ----.----- Depth -------- HaiQht .. munbar of Stories ..........---_`'_----------------.------------- � Rea -- � ---- .. O Depth�9� Size of lot: Fro "—��.�� .-' ��& —----..n� �� '--- --------- � / 10 Date of Purchase -- " —.----.---. n n R. .----._— ll. Zone or use district in which premises are situated ........................................................ � 12. Does constructon vio|otm ony zoning |o�, o,Jinonce or regulation: —.^—°"��\ ........................................... .��w. 13. Will lot be regraded —.�r.��-----.. Will excess fill be removed from premises: ( ) Yes ( , .~. 14. Name of Owner ofpremises .'�� m�. ................. Address Aapt Phone No.� �None ofArchitect -------------------.—' Addraos .. . . ^ PhonmNo ...................... Nameof Contractor ............................................................ /\ddrono ................................ 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 o, description occnnding tddeed, and show street names and indicate whether interior o ner lot. � ......................................... .......................................................being duly sworn, deposes and says that he is the applicant (Name of individual signing cohtrod) above named. Heis the ........... ..'',.'^'''''''''''''^'^^''^''''''~''''''''.—'—''''.'--'^'''---~'----'--.'--''~''~---'''''''''''''..''.'.'.. (Contractor, agent, corporate officer, etc.) of soid'6wner or owners, and is duly authorized to perforrn or have performed the said work and to make and file ,his application; that all statements contained in this application are true to the best ofhis 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 d f .—.- ay o ��::��—..�.�, N -----' County .--�-^c_-----_---.-------^'-~-.---.--.-----_' -'—' (Signature of applicant) � New York � ^ mv."". ...~_ state-- of C^vP*� � FORK NO. I 1 ' TOWN OF'SOUTHOLD .. BUILDING DEPARTMENT TOWN CLERK'S OFFICE, SOUTHOLD, N. Y. Examined .......:( ..........1.... ., 192Z. Application No. .....1... ......... Approved ................................2.... .. 19... 7.. Permit No. �`.. ............. Disapproved a/c .... .......... ................... 'IV ............................ ............................. ....................... ............................ ................... n........;........ ......................... (Building, in APPLICATION FORS BUILDIN PERMIT R Date .................4.r............... .. 19...7 .. INSTRUCTIONS r a. This application must be completely filled in by typewriter oe 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 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 r sho'Il-have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for thel,ssuance 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, bui ing code, housing code, nd regulations, and tom admit authorized inspectors on premises and in buildings for necessa ections. �. .T........ (Signature of applicant, or name, if a corporation)...... . ........................:......................................................................... (Address of applicant) =State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ........................?.�.2............................................................. ...................................................................................... Name of owner of premises ....az4lk �` f�kV. .IC1'R � �5........... ..... .. ................................. . ...................... If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. ............ ....................................... SOD p Plumber's License No. Electrician's License No. ........................................... OtherTrade's License No. ............................................. V 1. Location of..land on which proposed w(� will �--.�!`,� e!{ ��..�.C.kE.O.G?...................�......... Lot;No. ........................ Street and Number . L ,.,,,, ......... . . .. .. ... .. . .... ................................. Municipality 2. State existing use and occupancy of premises and in±ended use and occupancy of proposed construction: a. Exisiting use and occupancy ................................!.................................................................:............................... b. Intended use and occupancy .. ? U:SCS.....!�1.......� ��. E:.................................... .... i Nature (check of work �ock which applicable): --�' applicable): New Building. ---- Addition ------ Alteration .................. . Repair ------ Ran`ovo| ------ Demolition Other \Ak�rk ................................................ .....(Description) � ,n� /l « �� 4 Eot n�otad Cost x�7��7/*| , ' --� Fee ,�[.�..=. . . . .----__-__-_--__-------__ ' -- ~~' -----' :''. ' '` ^ =� ��Uo be paid on filing this application) ^ 5. K dwelling, number of dwelling units -------..,—Nun`ber of dwelling units on each floor ............................ Ifgarage, numbmraf ozra ------.--------^—'--------------------~----------. 6. If business connn�arcio| or mixed occupancy, specify nature and extent of each type of use —_-------. ' / / ��^� ' �� '7 / 7. Dirnonsonsofeuidingstructures, if any: Front —..^--�---_.. Rea ----------_.- Depth r^� � � Height ��.+:/:---- Number of Stories .......... *._................................................................................................. Dimensions of some structure with alterations or additions: Front .................................... Rear ............................ Depth ................................ Haight ---------.Nunnbar of Stories ................................ O. Dimensions of entire new construction: Front ------,------ Rea r ............................ Depth -------- Haight .................... Number of as ------.-----'----------------------------. 4fs 9. Size of lot: Front ..........//�./�./----------.. Reor --. .r-----.. Depth —r�. /.............. 10. Date of Purchase --&--�-.30~-7.7........................Name of Former Owner —. .................... ll. Zone or use district in which premises are situated ....... ^ — —.------------' 12. Does proposed construction violate any zoning low, ordinance or regulation: ........................................................ �� 13. Will lot be regraded --�.�2.............. Will excusafiU ba narnovad from premises: ( > ~/as ( L�-No 14. Name of Owner of premises .3 1n� AA ------' Address P�mne�h�� Nome of Architect ............................................................... Address —.---'..—.'~........~ .Phone-No ...................... ` ' � Name of Contractor ------------------.—.. Address -.--'.-'...---.... Phone No .__—...--^ PLOT D|4GR/\N\ ' Locate clearly and distinctly all buildings, whether existing or proposed, and' indicate all set-6ack dimensions from property lines. Give street and block number or description according to deed, and show street nonnos and indicate whether interior orcorner |o*. ko .� _------.--------,--.—_-------------baing duly sworn' deposes and says that he /s the applicant (Name of individual signing contract) above named. He is the —.—.///�/.'.��`��--------.-------..-------~..—.-..--'......--.,...^----------' - �bn+r��o� ogent corpnm�e of�cor �rj of said owner or owners, and is duly ou"thorized to perform or have performed' the said work and to make and file this application; that all statements contained in this application one true to the best of his knowledge and belief; and thor the work will be performed in the et forth in the application filed therewith. h is '--''/^'~'^~—' ~~` ~' --` ''—`— v -^.^'~-'.'^.~ --.. ~^..Noto ' --..— County ».---.---------��n�u� of �p|ic��-_--.------. AR DAWSON ~—mv.. 52.46437xu » M/\f 01 14 CuQy E,1 } Na. W. SIMCHIK' CP ------- _ _� ' Cu r f�.55 52 30`E. 748,26 5CwFr tE cV In TN 1 j O ^�_. POST � Go . a Li F z SERVI AT;ALTH T•ryrynnAR ;,r.clvr f Vt+ii= I CES�f'Q�L.S SEP71C SANK '`t✓F Ll facl. ea and Water to- �1ATt0(+!.-. -- I Q — - 1G.✓� t _...� �} �r,Lk:lrNsrC t s -=�Ys ,ea:rvice�n •� es 0 XI L U<� s h lor F dc: 17 � i =ound. 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