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Home My WebLink About9179-z ti-;r,: }.c�ya;ryz•.,�'»"�•' �<y: r --�+-:.raryi.; ., - _ ______ -- -__—_ -., -_ .t - .—�- 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 FULL COMPLETION OF THE WORK AUTHORIZED) N? 9179 Z Date ..............................lti!{vu.......It., 19...12 . Permission is hereby granted to: v y D .....�a1t�x..Co................................................ tts.,3r �,1 �jct.�` ........................... Southold ............................................................................... t0 ..;:S�i .. ' ..f�s.�.G'.�r.►"7�`, 1�ri.1:...v n. }.�ti .....................................I................................................. ......................................................................................... ............................................................. .... at premises located at .Y:°t............LE!sy* rd...1�C !................;........................................................... 11+?3 l e*wv Td Drive swttMid ` ................................................................................................................................................................ ..........1................................................................................................................................................... pumpdnt to application dated ........................RpriZ................. 19.1Z., and approved by the Fee ?0, 4............ .Lya2 Y ............... .. e.M.................................. .. ......... ......... ............. Building Inspector FIELD INSPECTION REPORT DATE COMMENTS • � b FOUNDATION(1ST) y --------------------------------- FOUNDATION (2ND) tsi z 4 . LA ROUGH FRAMING& y PLUMBING INSULATION PER N.Y-. H STATE ENERGY CODE r FINAL ADDITIONAL COMMENTS c. t st fi �r'IS ?D a Am/94"iA Am/94" y o o 6- :* �� y O z d b H ` baa SOUryo TOWN OF SOUTHOLD BUILDING- DEPT. 765-1802 INSPECTION " - I FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING /STRAPPING [ ] FINAL [ ] FIREPLACE & CHIMNEY [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION [ ] ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL) REMARKS: ®: go,"twayq fiac 0, 4ll'(. DATE Z � INSPECTOR �� FOUL -• 34 j SATE_ 00T 2 2_15z I-I, U. REP'a ; J" �l ! ;a r 5.T. � ,gam - R•� The sewage disposal IIl,ci ura2er SAT'•p�y ' facilities for t_ ,s ?c, baelljD Pected b 'L''iS dGi:at ii:'i found' •,r:i~`r-'r-. F� _-- " -- tis - - , 1 to be satisfacte,r _ •,�/�*� - -- : chief of -General E igineerinj% 'P , -_-- �� - ?_ ~• Services 13 ;r3"+ r,`; '°4� _ • _ - - �m.,e�.� �$pyo ,may �, ' _ �'7 :-',_•,�4;.•d - � ' R1`�;.'� .A- ;, • �. .,°y� J�wpJ� �L.� �9 ®W, �° .- "`d Mr:t�.`gyp" 8 _ _ _ _ , • .. i5-_ i T' UD� `\ 4 Ono , TL o . ';=;�,+'�:- tis^_>- �::- 6�`:'II�. _ •. _, ._ - _ - _ - - - -' - - - .- -- ' 1 _ ,. - 2�,=_ " - I"S•�'a+r �*', ^"B rpt _-_ _ ,,. ;- riy,`. d - -- ' - - - _.•, - z"S-��h:- 't �• ';�` ''r,a- =s:5: -_' f - . �v!')'tial J.3a 1 .. .}��}' • UNAUTHORIZED ALTERATION OR ADDITION s', 4;•5,'1- _ •ej .•'�i . TO THIS SURVEY - . Y;',..":'.•,,'p_�, �'s "{`� - - `I _ SFCTIOr' i:RV CFSTA VIOLATION OF !. -,, „ a - - ,EDUCATION L HL NEW YORK_STATE .... - �p.=t�t'' - ra - _•a�.',.. -u� _ - - < ~� '� •� !�. C: A W -r--to• A. M e ,�_`^-t-_'. ', .4 - p - ,.OF THIS SUPVCY MAP NO EA 92,1� Tf LAI"Awl .' TB RI p~ r .}t_ c�.wa.r y�'�e�8 - �E D SU-•iEYOR'S.INKCD SCA N - , . ,L. ,+wS `irai• 's,4,�.`�.r+" „M1��ra7t -� EMBOSSED EA! - OR _ v ��•''F S��hL ., _ �a ,TO BE A VALID !RL' .•7:L't CONSIDERED, ,' �greAi '.".T'��.+ a-�'a.x'^a!': t t-�n;•"- `.�t :'• _»,t '•' _ _ E CUPY. .q} - y y - i.. s�_ per'_ _ _ _ _ GUARANTEE - >'Lt7` - L,, uC. '. ?a-S _, �,..a� r', - ii is'•t�' ' '3 `:.65�+'..�„- - ` , , - S I,VD!CATED N,rREON 5N 1 '�'�- �+�. rr,• "';�-$�` ,'r Ofu4Y TCS TY-_P-014 - 'lois RV4 - '• Ott,,, .@p _u ,des_- t •, ,' - ef'`� _ ;4r,> At,:Sy Fa:' ,� "T _ 'i,.da_+�.tP."},e Al iia._;� �;:t�_�•Rir�t�?4T Ii'4''R&-F%iO TMA ' `_r, _Wit- - I;�IPIZE ZO T�$P'`'y-�ti 5`• � 'aa•• _ _.•r t x - - _ r ,,4,r - _ k g __ _ _ A3.'7, �,_ _..':/sEN7Lti - _ _ - `•.� -'c..•= Tn . _ -- 6s�0 '., .�1Lvl� •..R' e -a\�-' "0'_!O �YEd _ - LE3F. L ST,Yuu:: _ST J'� � r4*,..� i!ed 3 - '_'-' ;;"."�e.'�,,'•�:'',N .1�-'.:r- -_ - i � 1,.(r,: ,! _ cn� V , ED�fdcB A{,,A _ .�•* - - - -'�'' r -- - � .,7.9% t �t �` /��y �+�•q47", t�/' y� ,j p/ 'Of-ib�. r (/4 [ �¢J<.. v_��^-w fw _ PU?FLYAL SijPAR/yt,j{g5 ADIIt�Cr'IMS3sY.Y .g„j.'1a9tirw C�.P'V,ed •9 .:r.r" Y -aP yiP �•'.�T ''f - _ __ ,r - -rtt,-x�j,-• Y `si'Y'"� rs'�a �'+'i"i ri F�'+ +."��.`e r_�:,' - i 70 AMntCjgAj .dt A t•,UfgFEQxy.F� ,k' '- _ `i.y,;_-.,,.x_w,. _ - , _ _ .. = dCV7.iS[t� `'` •5;ri 3 lt5S�S26G�lt!-' � � �•'''." .q�a�M i��'• "-"r3xr':arL.d' " _;: _ �n -- '_"�P- '� _ Lj CSD (� / H y q E Gt/ 1�� I ✓� �3 7 a c��P�t c `� �P / �_ / F _3". 5-12 f4 3 So - r3S t " 17 �-77 /7-71 / CX f FORK NO. I TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERKS OFFICE SOUTHOLD, N. Y. Examined Application No. Approved .............................f'.... ., 19 2:.. Permit No. ..� ..�4... ....... Disapproveda/c ............ ........ ............... ...... .............. �� .......................................................................................... ....................... ........ .................... .Building ........... ................. Inspector) APPLICATION FOR BUILDING PERMIT Date ! t,� INSTRUCTIONS m 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 application. c. The work covered by this application may not be commenced before issuance of Building Permjt. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit c shall be kept on the premises available for inspection throughout the work. r� 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. d 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. Ie .................................................................................................. (Signature of applicant, or name, if a corporation) -RC1 v T^11�7r) ( l-) .................................................................................................. (Address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................. �. .�.�C'.Cl�� -- ........................................................... Name of owner of premises ... .i,N.i .. ..... !f.:................................................................................ If applicant is a corporate, signature of duly authorized officer. ........................................................................................ (Name and title of corporate officer) Builder's License No. .................................................... l/�'7 /-*� Plumbers License No. ................................................ " 79- 7 - ZI--Q Electrician's License No. ...........K............................ Other Trade's License No. .............................................. �a�cl 1. Location of land on which proposed work will be done. Map No.: �.....e '.. Lot No. ................ Street and Number f—.........Zeef........................ .. .......... ............. .... .t9- ............. .......... Municipality 2. State existing use and occupancy oZpises an� intended use and occupancy of proposed construction: a. Exisiting use and occupancy ............................... ................. ..................................................�.�.... ....................... b. Intended use and occupancy ....................... ................ ... ... , ..................... 3. Nature of work (check which applicable): New Building" .....6........ Addition .................. Alteration .............. . Repair . Removal Demolition .... Other Work ................................................ ... /D (Description) 4. Estimated Cost ............................................................Fee ......................................................................................... (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 Stories ................................ 8. Dimensions of entire new construction: Front ...................I................ Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ 10. Date of Purchase ........................................................Narpeo For r Owner ........................................................ 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. ........../Vv... . . . W'� excel fill be removed fro premi (�) Yes (X, No 14. Name of Owner of premises ....................................... ......• Address .. ..r/...... Phone No. ...................... t� Name of Architect .................... ........................... Address ................................ 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 scorn .att----. �- r STATE PFOi S COUNTYVF ............f - ............... ........ ............. .................................................. being duly sworn, deposes and Boys that he is the applicarn (Name f individual signing contracts above named. / Heis 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 application; that all statements contained in this application are true to the'best o is knowledge and belief; and thar the work will be performed in the manner set forth in the applicatio filed therew1 Sworn to b7ef7e me this ........................ day of ......... 19........ Notary Public. .......... ....... .. ........ .. .....:........... County .........c......... .......... ... (Signature of applicant FORK X0. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE 77 SOUTHOLD, N. Y. 9 Examined .......... ....11... .., 19.7.7 Application No. Approved .............................k.1......, 19.77. Permit No. . t7f Z, ................................ Disapproved a/c ............. ...... ................ ........................................................................................... ................... .. (Building Inspector) APPLICATION FOR BUILDING PERMIT Date ................... ....../.... 19...... 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 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. AMI-Z(;p— Co ciCry.............................................. .. . ........................................ (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. ........................................................... .. ...................... ......... Name of owner of premises .....�/ ra.11e^'..... d...................................... ........................................... 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. ............. ........................... Other Trade's License No. .............................................. 1. Location of land on which proposed work will be done. Map No.: .... Lot No, .............. Street and Number ... ........... -r !�-.......... .. Municipality 2. State existing use and occupancy of pr ises and intended use and occupancy of proposed construction: a. Exisiting use and occupancy ... ............................ ............... ........................................... .. . ................................ b. Intended use and occupancy ......................�.�................... ........................ ........ ••. ..................... ti 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration .............. . . Repair .................. Removal .................. Demolition.................... Other Work ................................................ ..... (Description) EstimatedCost ............................................................Fee .... .:... ......�-................................................................. (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 same structure with alterations or additions Front .................................... Rear .....I...................... Depth ................................ Height ............................Number of Stories ................................ 8. Dimensions of entire new construction: Front .................................... Rear ............................ Depth ........................ Height .................... Number of Stories ..................................................................................................................... 9. Size of lot: Front ........................................................ Rear .......................................... Depth ................................ N ofFormer Owner ........................................................ 10. Date of Purchase ........................................................ ame o 11. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ........................................................ 13. e s regraded .....I... premises: ( ) Yes (x) No 14. Name otfbOwner opremises ....................................................Will excess fill be removed ess from semis Phone No. ...................... Name of Architect ............................................................... Address ................................ 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. i . 1 I I I i I ,( 1 1 J f j STATE OF Nil.YqRK, I S.S COUNTY OF,......::..:.....................f ...............................,r.................................................................,being duly sworn, deposes olid says that he is the applicam (Name of individual signing contract) above named. 1` Heis 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 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 application filed there Sworn lto ore me this �� i ...................... day of ............... .. .......................... 19........ NotaPublic . d••.................. County ..... .......1 .^„.r1�................` ��......... ... ..... ...:............. (Signature of applico t)