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Home My WebLink About10599-z FORM NO. 2 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE pREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 10599 Z Date .h/A/l.cl.,/.......Z.ttT'........,..., 19;0. Permission is hereby granted to: /._ ...4tt!."-I.c.......6/A:5.H.4C,J.;...., . . . #..57(;J......Sf/.'C.t:1....ST:......,..,...., ...., , I .A./.;:.W... (;;<FFQ.t..t;...-;:-./.J...,!:....... to 8r'.E.c.T.......t!/:.:..~.a::....#t7.f./.' " c'7ct...a.~....Fs;,lwlCc:."...."..".. .."... . ~.:.~~~~;~.~~.;~~~;~~..~:~;;7.;::::.i:;z:~S;.2..z~;;;;:::7~;;;;~;;:...'. ........................................................................ .... ..,..Ne:w...~.;.!FQ~.....,../J.,.,y..... , ' .......................................................................... .,. ....... ", ................................................................... pursuant to application dated j?(~C#.,..../.5....., ..........,.., 19;:b.., and approved by the Building Inspector. Fee $15:.~...... . .......... ..... . ..................................... Building Inspector "j ..~ . i ! :0'I<<ET....JD ..J::'1SP ~ccllION i! DATE 1\ CCJl!~~1~1:,2\!TS ;i, I - , ~ -- ~,. 1'1 - - - - '-' 1. 2!~ ~I 1-____." ______~__. ___---------. ""N FOUNDATION (1st) z:K ___'___"- 0 . to- I r!i\ FOUNDATION (2nd) ~ ~ I rrt 2. ROUGH FRAME & ~ ~ . PLUMBING N I~ v , ~ ~ (J)f:} 3. q~ _ ro~\ (]) " INSULATION PER N. Y . IT ~ 1: STATE ENERGY ~ CODE ~ ~ :I: I'll p>e 4 . P<..-. _ ro P I IT~ 0- FINAL E ~ ~ (])~ ADDITIONAL COMMENTS: \ 'i!:,\ ~ - ~ , , I~ t'd~ 1-""'-. 'i('J ~"1 1-'." g~ t :I: '. ~ ~ , t::I ~ , IT I ,_,,,. j ,t . ",' ~., :riil, "_,,- ,kif: .0' I _ .::tI=: ." FORM NO.1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 , AA~c4 Z.s- !8 TEL.: 765-1802 Application No. /.o:r:19. . . . . . . Exammed . . . . , .. .,..,.." 19 . . . Approved M;((l1. . '?:; , 19f!iJ. Permit Nol9.t;.-r:e.;; Disapproved a/ c . ........ ii" .... . . -.... '. ................ ....... ~ .....~.., ....,............ . (Buildmg Inspector) APPLICATION FOR BUILDING PERMIT I Date~ B..........., 19.f.b' 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 Buildmg 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 mspection throughout the work. e. No building shall be occupied or used m 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 Ordmance of the Town of South old, 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 mspectors on premises and in bUIldings for necessary inspections. ...~e.-:. (Si,..."", of "",ij~'f.~' ...m,. ";:P~ , ,~./~..~~~ ..... '. (Mailing address of applicant) State whether applicant IS owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ~~~'~;~~~~r ~~p~'el:,~~e~' '{j~~:: &~:::::::::::::::::::::::::::::::::::::: (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){.if~!,J. /('./",!,!!:;:K'tl::'6. //</(;' /'I?1i.////..."j J},17 / '> ,j}7 JE<<tcN<J TI"/<:'~- 57 ..JJ;';:4 AI 7: Plumber's License No, "... . . . . . . . . . . . . . . . . . . /-/..:;,1;:0 :;'I?v!':o Electrician's License No, '.:.g:..../j >5"".".'... (z6r. //<'/5) Other Trade's License No. #' _ /.0. 6~. . . . . . L '"~'(o' off"''' o. wWon ,m,=" w~' dO"'~~"" ~ErI*~' . St~" ..,..,....... ... Ha~let County Tax Map No. JOOOSection "./1.7..,..". Block ,..~.i,.....,... Lot..,.c;q.c:t........ Subdivision. . . , . . , . . . . . , , , ' , , , , . . . . . . . . Filed Map No. .... . . . , . .. .. Lot...,.......... . (Name) 2. State existmg use and occupancy o~ and intended use and occupancy of prontruction: a.Existinguseandoccupancy,., ., .~..~t,.............. ............ b. Intended use and occupancy . ,.........J.).. .~.~. . -:,(-!--:q. ~'. ~'L .. . .. , .,L ~ .ii., , ;! ",.... 3. Nature of work (check which applicable): New Building. . . . . . . . . . Addition. . . . . . . . .. Alterati~... 7:' . . . Repair .......~.... ~~~val .. " . . .. . ... .. Demolition . 'g.' .... . . . Ot:~or~ 4. Estimated Cost .. .~~... .t. rJ?Q.................... Fee....../. ~.~.................. i (to be paid on filing this application) 5. If dwelling, number of dwelling pnits . . . . . . . . . . . ... " Number of dwelling units on each floor. . . . . . . . . . . . . . . . 6. ~~ ~:~~:~~uc~~%~:c~~r~r '~jx'e~' ~;~p'a~'c~: ~~~;~~ ~~~~r~'~~d ~~;e~~ '~f'e'a~h't~~~' ~i ~~e' A~ 7. Dimensions ofexistingstructunjs, if any: Front... .:-:--......... Rear.............. Depth .~'............. Height....~.... Number of Stories ....... ............................................ Dimensions of same structure with alterations or additions: Front .... .--: . . . . . . . . . .. Rear . . . . . . . . . . . . . . . . . . Depth. . . . . . . . . . . . . . . . . . . .j. . Height. . . . . . . . . . . . 'h' . . . . . Number of ~ries . . . . . . . . . . . . . . 'r-' . . . . 8. Dimensions of entire new consttiuction: Front. . , /. ~!:? .:.bE)k;ar . . ./..k7?/:-~c. . Depth (7..>.-:-: rE.6.-.;:r Height ..... ..-f'. . . . . . . . NUllfber of Stories. . . . . . ~. . . . . . . .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9. Size of lot: Front. . . . . . .~ . . .: . . . ....... . . . .. Rear......... S. . . . . . . . . :.. Depth ...!.................. 10. Date ofPurch~se. . '.' . . '.' . . . .;. '.' . . .).. : . . . . . . . . . Name of Former O))')..1rtf' . . . . .\. . . . . . . . . . . . . . . . . . . . . . . II. Zone or use dlstnct In w~lch ~remlses are sl~uated . . . . : . . . . . . . . .'. . . : . . . . . :..: . . . . . . . . . ~ . /. . . . . . . . . . . . . . . . 12. Does proposed constructIOn vIOlate any zonIn law, ordInance or regulatIOn: ........... .NI;?. . . . . . . . . . . . . . . 13. WilIlotbe regraded . <,... .i,..... .. . ... " ill exces~~e r~rom premises: _.. Ye< <f, J~ 14. Name of Owner of premises .... . . ddress ..;::l...~ .......PhoneNo.7!...;;>.~......'#' Name of Architect .,...,.....: n .'" T/I. . . . . . . . . . .. ddress. 't7 .~. . . . . . . Phone No. . . . . . . . . . . " . . . Name of Contractor ,~. . . . . . . AddressA4,.-. . .~... Phone NoO/."~ .#. #'~ , PLOT DIAGRAM Locate clearly and distinctly alIi buildings, whether existing or proposed, and, indicate all set-back dimensions from property li1\es. Give street and block ):1, umber or escription aCrordi to deed, and show :tr~ names and indicate whether interior or corner ot. !3D){Jl1l? /hilt? / j/ / C!- r . . O~ ~ FF"c'T '/ /~ ~ ~ ~ -\ /~ g,! /P~ ) ~b / ~ ~ ~ L ~.L- ~ y- /....rcJ /' ~-= ./ ;:r-;,C K..flO/l1 8' / STATE OF NEW YORK, SS COUNTYOF'~'5"';r;;.4!<:.... ,. .W~ .~. . . .. O~. . . . . . . . . . . . . " being duly sworn, deposes and says that he is the applicant (Name of individual~n~-c'o~tract) above name(l. ' He is 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 cont~ined 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 therewith. Sworn to before me this ......It!: ..T:'........ .dayofo../lJ/I./!"c;:.tI..........., 19B:q Notary Publie, ..f".II.r:-f'ff-}!'.......!................ County ~ 1f/..4A? d, 11..... Y.!uI- ' \ . NOTAR~Af,1~~l SVt,^tN VflENCK .. .. ...~ ..................... N I eo ('wYorlt To "2:'1526203, Suffolk CO'!l~Iy,u fly (Signature of applieant) Ei'rm Expires March 3Dt 19.:U