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Home My WebLink About3226-Z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERIC'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FUL!"" J-`r COMPLETION OF THE WORK AUTHORIZED) `c\\ W? 3226 Z Date .......September 19.., 19....... Permission is hereby granted to: „Robb 1�r iGt A (! W11 Loh . .... .................................. Southold ................................................................................ ....................................:........................................... to ..Build„near„one family dwellin�................................................................................. ..... . .. ..... ....... ......... . .. .... ................................................................................................................................................................. at premises located at ..,'`T�S...��...xi �..$l 1 ..��r..t�.. .... bUn St............................................................ ........................ ng..Waers.y.....Poutho.ld.......................................................................... .. ............ ...... ................................................................................................................................................................ pursuant to application dated .................................. ep. `.......'1:9....., 19...(.6 and approved by the Building Inspector. Fee $........................ r 1 .l...e C. ...J�_ Building Inspector FORM NO. i TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE /; SOUTHOLD, N. Y. ExaminedI-S .., 19. Application No. � ............. pp ............................ Approved ........................................1 19........Permit No. ...... .. ... Disapproveda/c ................. ...................................................................... ........................... ... ............................... ............................... (Building Inspecta APPLICATION FOR BUILDING Date .......................... ...... 19.66...... INSTRUCTIONS a. This application. must be completely filled in by typewriter or in ink and submitted in duplicate to the Building I nspector. 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 propertymust 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 progress of 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 and regulations. Rob rt H a (Signature of applicant, or name, if a corporation). Sou; h,,1d ................................................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. C n' rac 1. .......................................................................................................:.......................................................................................... Name of owner of premises W....................................................L.hn If applicant is a corporate, signature of duly authorized officer. ................................................................................................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ........XX. ................ Lot No: XM............... Street and Number .............. g� Q' .�T.ate.x&................................................................ Municipality 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ....Vacant .lat....................................................................................................... b. Intended use and occupancy ............One..family...dwal1.ing................................' .......... 3. Nature of work (check which applicable): New Building ...N:6M..... Addition ................... Alteration .................. Repair .................... Removal .................... Demolition.................... Other Work (Describe) ...................................... 4. Estimated Cost ....a,7..'.5R0.........................................Fee ........10............................................................................. (to be paid on filing this application) 5. If dwelling, number of dwelling units .....or.e................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 same structure with .alterations or additions: Front ................................ Rear ................................ Depth .............................. Height ..............................Number of Stories ........................................ 8. Dimensions of entire new construction: Front ....:..32• ... Rear 32. ........ Depth 21 . Height ............................ Number of Stories ... W.Q.................. 9. Size of lot: Front .....7-7................... Rear ........78................ Depth ...�3p...g/.............. 10. Date of Purchase ........................................................Name of Former Owner ........................................................ 11. Zone or use district in which premises are situated..........!!A!!..dist.................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..........11Q....................................... 13. Name of Owner of premises Xr4..X4Q ......................Address ...u.Qldtho.la...................... Phone No. .................... Name of Architect ......................................................Address ...........................:................ Phone No. .................... Name of Contractor ......Rob t...liyatt......................Address ...S.Q11.thol.d...................... 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 numbers or description according to deed, and show stre t names and indicate whether interior or corner lot. . i STATE OF NEW YORK, - V � COUNTY -OF ...Suff.Qlk............ _S.S• l (�!a ......R a.•bext.••Hyatt............................................being duly sworn, deposes and says that he is the applicant (Name of individual signing application) abovenamed. He is the ..........Gontraotots.................................................... • - '", .................:....................... (Contractor, agen`t',-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 that the work will be performed in the manner set forth in the ication filed therewith. Sworn to before me this ...................1.9.. day of .................Se..telmb•er....... 1966... �r � l -, .. .. .. .................... ............ Notary Public, . at . �.,•e4rt�mukat (Signature of ag i9 nt) 1\10TA. P LIC. Suffolk 0 No. v 5 -06i8100 Commission Expires March 30. 19 f i C.o D-Aao Vo V Vie. 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLUG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLAC & CFIIMNEY REMARKS- Z4 Luca-C �tn�G�i�v,�/ DAME Ca INSPECTOR FORM NO: 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. Z Examined ...........:..... r........ .... 19::�.. Application Approved ......................................... 19........Permit No. ................................ Disapproved;a/c ............... ..................... ............................................................................%%...... �...--- ..........................l:". .......... ........... ............................. (Building Inspect ) APPLICATION FOR BUILDING PERMIT p t,em3ae�.. : 19.6 6:.._...:, Date ....... . .............. �:.. " INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in, duplicate to the Building Inspector. 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-propertymust 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 progress of 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 cerstruction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees';to.corhply�with all applicable laws, ordinances, building code and regulations. RQbext..M,yatt. ...................... ..... (Signature of applicant, or name, if a corporation) :. .:......+ Q � >?? ,d.. ....... ... ...... . ............................. . ........ .... . . (Address of. applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Contractor Name of owner of premises .9.11A : ...10A... ............................. ......................................:..................:.................... If applicant is a corporate, sigpature-of duly authorized officer. ................................................................................................. (Name and title of corporate officer) 1. Location of land on which proposed work will be done. Map No: ...... X.. No: ... ....... Lot XX................ Street and Number : ►Ae11aha,....D11V.d...............Lid.L1ghing...W&ters................................................................. Municipality 2." State existing use and occupancy,,of:premises, and intended use and occupancy of proposed construction: a. Existing use and occupancy ...Vaeamt..lof-..............: b. Intended use and occu anc .01M..f�.M7.1 ...&.10�1dng. ._ P Y ........... �t .... . _ _.�. ........... ....... 3. Nature of work (check which applicable): New Building ..... Addition .................. Alteration .................: Repair ................I... Removal .................... Demolition.................... Other Work (Describe) ...........................:.......... 4. Estimated Cost ....17 504 .10••••••.�.. .........................................Fee ....... ....................................................................... (to be paid on filing this application) 5. If dwelling, number of dwelling units .....011.0................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 i.' .............. Number of Stories Dimensions of, same structure with alterations or additions: Front ................................ Rear ................................ DepthHeight ..............................Number of Stories ......................................... 8. Dimensions of entire new construction: Front ........3,.2................ Rear ....32................... Depth .......24................. Height .........:...:.............. Number of Stories ...two•••••••••••••••••• 9. Size of lot: Front .....7.7..........:....... Rear ........ Depth ...��®...P/.............. 10. Date of Purchase ........................................................Name of Former. Owner ........................................................ . 11. Zone or. use district in which premises are situated..........Ukt.fl .t...............•. ................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation? ..........no ..........:............................. 13. Name of Owner of premises .eft-Lob1 f�.Ca1�.$31ta�,�1......................Address ... "...................... Rhone No. .................... Name of Archit`e4t ........:... ....Address ............... Phone No. Name of Contractor ......Plobt-Jly-.a:i�t:......................Address ...►Sou—tho•1 d..................... Phone No. .................... PLOT DIAGRAM Locate clearly dnd'j."distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block numbers or description according to deed, and show streIet names and indicate whether interior,or corer, lot. i STATE OF N W YORE;' ----- �____��._. , -.._.77__.. - 1 'COUNTY OF ..SV'41 k. ..........f S.S. �, Cb 1 ......•..................... ..............being duly sworn, deposes and says that he is the applicant (N, ritie of iiridi��idua signing application) 6 abovenam d. He is the d ®32$ a E33'..................... .......................................... .a........ ............................. � ' ' (Contractor, agent, corporate officer, etc.) In of said ow e or owners,Sand is duly authorized to perform or have performed the said work and to make and file6 this applw tion; that `all tstatements contained in this application are true to the best of his knowledge and belief; and that t e work will`bel,,performed in the manner set forth in the p�ication filed therewith. fore me this; Sworn to be Ld ....................ig... day of- �. �; ........ae ,e b n.... ., 1966... i s' " 1. N ........................... •:• B[IG'�SYa of.sf2�r•Yor�s� .........: ......... jri- n .a$... Sig ature ofa+� ' WILD Count Public � ' :RY.52-061800 Suffolk county,NOT '}I � } (;,(commi.ksion Expues Mich 30,'19 l