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Home My WebLink About10728-z FOI~M NO. 2 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHGLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PkEMISES UNTIL FULL COMPLETION OF THE WORK AUTHOP, IZED) N? 10728 Permission is hereby granted to: ....... ~.t.~/...L/z',~F,~, z'z...~.z~.~.~. ...... Z~.~-:~.~.:....~:..~: ...... z,r..?..g./ - to ..~7~c~. ....... .~........~.....:'. ....... .~.lz..?.~. ...... .C.~'.~.L~...~r.z~.&....CZ;~z.v.C= .. ..... . .~..~.: ,:r,,, .......... ~.o. .~ ~ r. o. ....... ..&. .~.~ Z l/ ~. c . J. crz.,. . : ............................................. at premises located at .~.~.~..~.. ....... pursuant to application dated .~-~.~.~*, ...... ~.- ....................... , 1~., and approved by the Building Inspector. Fee $.,~...~....~.. ......... , j/ FIELD INSPECTION COMMENTS FOUNDATION (Ist) FOUNDATION 2. ROUGH FRAME& PLUMBING (2nd) INSULATION PER N.Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: , ~C[~R RE$IDENTt[AL FENCES, CORP. Order Date Address Foreman Contact Mr,: Type Fence Fabric [---] K-Up I-'-[ T-U P Type Line Post [] H-Beam Height__ Gauge Size of Concrete Footings [---1 [] Pipe Mesh Fabric Toprail ~ SFP [] Schd 40 BW Arms F-"~ In Special Instructions: It/Z,' RESIDENTIAL FENCES CORP. ~ Commercial & industrial · P. O, Box 430 Route 25 ........ RIDGE, NEW YORK~ 11961 TO ,~/ (516) 924-3/011 .,' [] PLEASE REPLY [] NO REPLY NECESSARY ~ ~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined Z~/f, ,ff~. ,/..~. .... , 19 ~ ^pprovedZS,,V.~..../.: ..... , ~9~=, ~o. l(~ ~,,,~o~ .... ':.. .... :.' ........ .~, .... ...././ ,11 ~ ' ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT Application No. ~(f~. 7~..~. ...... 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 appli- cation. 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 promises 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 Sguthold, 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(inspe, gtjons. .. ~ ..... ........... (Signature of applicant, or name, if a corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. (as on the tax roll or latest deed) If applicant is a corporation, 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 .................................................. · .~t:? .... ~x.~.~.~.'/'x~'.., ............................. ~.x:..~ ......................... House Number Street Hamlet County Tax Map No. 1000 Section . .'~.,.~.. ............ Block . .~ ............... Lot..~?.~.~ ............ .... Subdivision .......... , .... Filed Map No. ~.~..~.5.2. ..... Lot..'.7. ........... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existinguseandoccupancy..~..V.~).~ I I"~"~'"~/~.ililJ '.~' .... ~'~x~'L .............................. b. Intended use and occupancy ~.. LK) .q / .~ .~-~ ~} ...... t ........................................ ' 3. Nature of Fork [~heck which applicable): New Building .......... Addition..~..,~ .... Alteration .......... Repair .............. Removal .............. Demolition ............. Oth~i Work ............... ' .~./..~.~ .~.. (Description) ~ (to be paid on filing this application) [.. 5. If dwelhng, number of dwelling u,,altS.. ;.2. \ ~,~ ?--... Number of dwelling units on each floor.. I...[\~e_.. If garage, number of cars .. I · · ~.0. O xcel ~ .... ~ ............................................... 7 ..... 6. If business, commercial or mixed occupifncy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structure~, if any: Front · / ~./ Rear Depth .~. ' Number of Stories Height ..................................................................... Dimensions of same structure with alterations or additions: Front ................. Rear .................. ' Hei t Number of Stories Depth ...................... gh ......... , ............ z~. 8. Dimension.spf entire new construction: Front . 13.~. .......... Rear . ,/.~.--~/ ........ Depth ./.../. ........ Height z-/ . . Number of Stories ......... 0 ........................... ~' ............... 9. Sizeofl;i"~;~nt'"l'~..~.' : Rear .[.3--. ............. Depth [~.~ 10. Date of Purchase ........... ~ .................. Name of Former Owner ............................. 11. Zone ok use district in which premises are situated ..................................................... · ' Iht g 1 12. Does proposed construction rio e any zonin aw, ordinance or regulation: ............................. 13. Will lot be regraded .2lJO... ~. i" .................. Will excess fill be removed from premises:., ~ Ye~, No 14. Name of Owner of premises /':.ltq~.~J'p. ~0 IJ~ t,/~,gg,.l~'~dress~0~o..~.giL b(q,.~.~..O¢~. Phone No..~.~... ,~/"~.~. . Name of Architect . .a-~.~, ~ .~. ~1~ .~.t~ ........ Address .~d.¢..~.-~... ~1'.~.{~ e .... Phone No...ff. ~...~..-.~.O.]. 1 · · Name of Contractor .~¢7x ~. d?.~V.{~.i 1..~...e~,-k... Address .1.~.~.~..~... I'{ Xc,[~.*... Phone No...~.~..~..~ PLOT DIAGRAM Locate clearly and distinctly alll 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. ,,<7 ' 0 STA~[E OF NEW Y RK, . .~../~./.~.~ .~.~.'~... ~..~.~4/?..z.4.°/'..~ ?../i ................being duly sworn, deposes and says that he is the applicant (Name of individual sighing contract) above named. He is the ......................................................................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is ddly 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 applic~ation filed therewith. Sworn to before me this ........... ........ day Of... (..j/~..//~-~< ......... 19 Qual?t~0~ ~, su,olk Coun¢ M (Signature of applic~t) Commission