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Home My WebLink About11355-z _NSPECTION ATE COMMENTS w. 1 �. _. FOUNDATION ( 1 s.t )..._..� w_... .�._._ ,.._.,� . c FOUNDATION ( 2nd ) — - mX a � 2 . CD ROUGH FRAME & _ - PLUMBING _.. M. u INSULATION PER N . Y . STATE ENERGY CODE ... , FINAL ADDITIONAL COMMENTS : _ w .° H y J' ya !a f' d rr+ ry yW) y FIELD ~NSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (~nd) 2. ROUGH FRAME & ?LUMBING INSULATION FER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: N°. P~ermissiori TOWN ~0 BUILDIN~ TOWN HALL sOUTHOLD, N~. ~Y. BUILDING PER~iT (THIS PERMIT MUST BE KEPT ON -FH,E PI~EMIS~S UNTIL F]ULL cOMPLETION OF THE WORK AuTHORIzED) ' ~1355 Z is hereby granted to: / , . ........ ~,:.~.....~;. ....... ~m..~...../../.~/..~m~..~.;.~ ........ ,o ..:....~z~.....~......~~..~.....~.~...~r.~, ............ :.~.c~ .... ., ~ ,,,.~ ................................ ...~ ..................................... ~, ~ ~,~,,o~..~ ...... ~ ................ .~....~ .... :v~ ...... , ........................ ~.. ~, ...... ~ ............... ~....: ................ ~ ~¢~.~-~....~.~.~../ ~~.~...L&.~...~ ....... ~.~..~.~;~....~. ........ ~..,...~ ........................................ co~.w ,~ ~op ~o. ~ooo so~t~o~ ,:..~...; ....... :. ~k :,.~Z.~ ....... :~ot ~o.....~.~ ....... Building m6spector.. Rev. 6/3C 180 FORM NO. 1 TOWN OF SOUTHOLD BUILD~NG DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-180:3 Examined ~<f ~-<J~' ,196~z/ -- Disapproved a/c ....... :~'~";'~.-T ':". .................. ' APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No.../[.~..~..".~. i ..... a. This application must be completely filled iu 'by typewriter or in ink and submitted in triplicate to the Buildi Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according tc schedule. b, Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public stre~ or areas, and giving a detailed description of layout of property must be drawn on the diagam which is part of this apF 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 issoe a Building Permit to the applicant. Such porn shall be kept on the premises available for inspection tb, roughout the work, e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupan shall have been granted by the Building Inspector. APPLICATION 1S HEREBY blADE to the Building Department for the issuance of a Building Permit pursuant to t Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describe The applicant agrees to comply witk ali applicable laws, ordinances, building code, housing code, and regulations, and admit authorized inspectors on premises'"' and in buildings for necessary inspe¢,~i~ns. .._~/~ / , (Signature of applicant, or name, if a corporation) (Mailing address of appiicant) //~-~ 7 State whether applicant is owner, lessee, agent, architect, engineer, generaI contractor, electrician, plumber or build, Nmncofownerofpremises .~.OCa~ ~ d ,~.~9/,..t/,<~ 17:;d).z./~ff-~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate o/f~cer)~ Plumber's License No ......................... Electrician's License No ..... qa.<',-M.-<--,. :L ........ Other Trade's License No ...................... Location of land on which proposed work will be done ................................................ (3' O o ....... House Number Street .Hamiet County Tax Map No. i000 Section lO,A-- Block ]0 Lot <~0 '~ Subdivision .~/.~,¢,L).'~.T',..(-./,..O. ~,..~y~'~. ~-~.~. Filed Map No .... ~..~.G? ....... Lot .. ia,C.-o. ....... (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .......... .~. ~--'~, .i.i?.~.k~. ~.~ ........................................ b. Intended use and occupancy ............................ Nature of work (check which applicable) Repair .............. Removal ... Estimated Cost ...... . .~, .~..'4...~.2.~.. Ne~v Building .......... Addition ........ Alteration .......... .......... Demolition .............. Other Work ............... (Description) .................. Fee.. ? ...................... - ........... (to be paid on filing this application) ;. If dwelling, number of dwelling units If garage, number of cars ....... ~ ............................................................... ;. If business, commercial or mixed occupa tcy, specify hature and extent of each type of use ...~ ................. t. Dimensions of existing structures, if any Front ..... ~.(~.'. ..... Rear ....~..(o. [ ...... Depth . ./2,~,' ......... Height ............... Number orS ~ries ~ ............ D mens OhS of same structure with alter~ ohs or additions: Front ,,. ,~(o. ......... Rear .. ~.. ~°/. :':(o... Dept ~ . .'~. ............. Heigll(t ...... G-.. ~_ ........... Number of Stories ....... I .............. ~. Dm~ensmns ot ,~nt~rc new construction: ~ront .... ~,-.¢. ....... Rear . .1.~'. ........... Depth . .Z...'~. ......... Haig it . . ..(~..: ...... Nnnlber of S[ones ......... ~. ....................................... . ...... .).Does proposed construction violate any :;oning law, ordinance or regulation: .... "~.~. 2 ............ ~ ...... L Will lot be r~graded .~...,~C~ ..... ~ ............ Will excess fill be removed from premises: (Yes] No t. Name of Or, nar ofpr~inis~s~,~., ..~ Name of Architect Address Phone No Name of Contractor Address Phone No Locate clearly, and, distinctly all buildint roperty lines. Gix u street and block hum. bar terior or corner lot. YATE OF NEW YORK, on . ......... rove named. S.S PLOT DIAGRAM s, whether existing or proposed, and, indicate all set-back dimensions fi'om )r description according to deed, and show street names and indicate whether ........... being duly sworn, deposes and says that he is the applicant e is the ....................... agent, corporate officer etc) f said owner or owners, and is duly autho to perform or have performed the said work and to make and file this ~plJcatJon; that all statements contained in this application are true to tbs best of his knowledge and belief; and that the in the application filed therewith. 'ork will be performed in the manner set for worn to before me this ....................... day of .... otary Publk NOTARY PUBLIC, State of New YoI~ No, 52'4524771, .... ~-/ ..... 4~., ./~. · ,, .......... :, ~ualified.~ Su~fo~ Co~n[y ' ' "' ' Commission ~xp/res March 30, 19&~" (S~gnature of applicant) L r C@ I , i k r ,IL r T7=^"roc Pin�iuso Nla,?,:r� yyr 'rt Lu �'ni - .+..$ 191...►4Q � "y L "�" .T :; ._,..,.-, - � e 4 3" „ at � �- - -a -" c rG i .m^r r..�.„ r+.in---"-• �jiy 'tl. + ' ' @mho-•�"�41 ',T,'" I'��„'`." ,P1 _ 3 a d ^ 'Q }� r trl IIs . f 7 �7 Ml 1 1 Z 4 aw 1 � R 7 1 5t4 I II I �Y �5l3a