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HomeMy WebLinkAbout15617-z I~OB,B~ NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PEI?,.MIT (THIS PERMIT MUST BE KEPT ON THE PP~MISES UNTIL FULL COMPLETION OF THE WORK AUTHORI7-./L~D) NO 15617 Z /~e ........ 1.~ ........... , ~...~..~ / Permission is hereby grante~ to: ,/ ~.~...~...~.~.....~.~~ /..~..=.I,~.. .........~ ~..~ ........ ~ ~, ~.~...~.~.~* ...... ............ · .~. ""~'-?"~",~':;'"' ........... '~' ..... :'":'":"'_'"":: ...... '"';'"::'" ....... :'~ ..... c~ ~ ~-";~ .... at prem,se, located at ...~ ........... ~-..~..ek~. .................................. .~l~r.,......~ ..... ~- ..... County Tax Map No. 1000 Section ....... /./..~.. ......... Block ..... ..~...."/. ......... Lot No ..... ..'~......~:,. .......... pursuant to application dated ......~..~.~....~3 .............. , 19~..~.., and approved by the / ~J Building In ~spector. Rev. 6/30/80 OUNDATION ( 1 st) OUNDATIOI~ ( 2nd ) OUGH FRAME & PLUMBING NSULATiON FERN. Y. STATE ENERGY CODE FINAL ADDITIO~AL COMMENTS: THE NEW YORK BOARD OF FIRE UNDERWRITERS 1000091 BUREAU OF ELECTRICITY ~-- k.h 85 JOHN STREET NEW YORK, NEW YORK 10038 TNI~ CE~IFIE~ TNAT Vino ~aCe~ll~, 11~ ~CO~ S~., ~ Suffolk, N.Y. $ E 1 X 1 A W G NO O~c Hi LEG A W O }NO OF NEUTRALS A W G OF CC COND Of: HI LEG ~F NEUTRAL 310 1 310 Peter Bogovtc h. ~ayvi~,~ Rd. Southold, 11971 lic.#137-E GENE~tAL MANAGE~ Th~s ce~hf~cate must not be altered ~n any manner, return to the off~ce of the Board If incorrect Inspectors may be ~denhf~ed by their credenha~s COPY FOR BUILDING DEPARTMEHT THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. FORM {~O. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SODTHOLD, N.Y. 11971 TEL.. 76{5-1802 Disapproved a/c ................................ (Building Inspector) APPLICATION FOR BUILDING PERMIT 6 1987 l~ecezved ........... ,19. Date INSTRUCTIONS a Tlus application must beI completely filled in by typewriter or m ink and submitted to the Building Inspector, wit sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showmg locatibn of lot and of buildh~gs on premises, relatmnship to adjolmng premises or public strc or areas, and g~vmg a detailed descnptlon of layout of property must be drawn on the dmgmm which is part of this ap cation, i c. The work covered by ti'ns application may not be commenced before msuance of Building Permit. d. Upon approval of this applicahon, the Building Inspector will issued a Building Permit to the apphcant Such pet shall be kept on the premises available for inspection throughout the work. e. No budding shall be occupied or used m whole or ~n part for any purpose whatever unhl a Certificate of Occupm shall have been granted by the Building Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Braiding Permit pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordmancet Regulations, for the construction of buildings, addihons or alterations, or for removal or demolition, as herein descnb The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and admit authorized mspectors on premises and h~ building for necessary~~._.~.~ ~ .mspect~°ns' - t~,~'. . .. ' (S~gnature of apphcant, or name, ff a corporahon) ............. (mailing address of applicant) State ~vhether apphcant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build NameofownerofpremIses ll~.~'l~ ~/l~t~.~)~l~''/~lL'4C .... (as on the tax roll or latest deed) If apphcant Is a corporation, mgnature of duly authorized officer (Name and title of corporate officer) Budder's License No ............ Plumber's License No .. Electncian'sLlcenseNo ............ Other Trade's License No. Locatmn of land on which proposed work will be done louse Number Street Hamlet County Tax Map No I000 Section Block .'~ .. Lot ~ Subdlvm~on ' ' ' (Name) Fded Map No Lot Stat,: exmhng use and occupancy of ~m~and occupancy of proposed construction a. Exmtmg use and occupancy .... ~.~..,'~ .I ~ ~ ~. ................ b. Intended use and occup .... ~..~T~.i.I>.Et-~. ca~. ................ 3. Nature of work (check which apphcable), New Building ........ Addition . ~ ..... Alteration ~ ..... , Relator ,. . ~. /,~.~. . Removal ............ Demolition ............. Other Work ........... I (Description) 4. £stunated Cost..ff...~cO0.O~ ..................... Fee .................................... , (to be paid on f'ding this application) 5. If dwelling, number of dwelling units .. ~ ~.~-- ..... Number of dwelling units on each floor ............ If garage, number of cars ................................................................... 6. If business, commercial or m~xed occupancy, specify nature and extent of eac..h~ type of use ................... 7. D~menmons ofexmtmg structures, if any' Front.. ~'~.~'..~.~ ...... Rear . 1,.~.-..~'. ....... Depth .~,~.~.-~..~. Height .~.~? ...... Number of StonesO'~;~...O. ........................................ · ~4~.' .~' .......... Rear .~.tr.' .'~. ........ DLmenmons of same structure with alterations or ad.d]tions: Front ' " Depth ...'~'O~ .~''. ............ Height ... :~ .~' ............. Number of Stories .'TI4X. O ............. 8. Dimensions of entire new construction: Front .. ~a,...~! ~. ..... Rear .. ~ g~4,L~ ...... Depth ~r~*.'~?. .... Iteight . '~.~* ..... Number of Stones . .~ ..... .. ..................................... 9. Size of lot Front .... ~'~.'. Rear .&o .. Depth . .l.{~./¢~..~ 10. Date of Purchase .......................... Name of Former Owner ........................ 1 1 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 ..... /,dO ............. Will excess fill be removed from premises: 14 Name of Owner of vremisesV, ~l..~.'T['.l.I,.~.c~.... Address 1~..°.'i[~..~... N~.'~:... Phone No ......... Name o f ~~/~,~'t~1-F~-,47.4~ ~ ~,.. Address gOZ,.~ ,.i~C' It.~..~.'~ Phone No. ?.Z~ ~,~.?.. Name of Contractor .......................... Address .................. Phone No ............. 15. Is thzs property located withinl00 feet of a tidal wetland? * Yes ..... No ~'... · If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and dlshnctly all bmldmgs, whether existing or proposed, and. indicate all set-back dimensions fr~ property lines. Give street and block number or description accordmg to deed, and show street names and indicate whett interior or corner lot. STATE OF NEW YORK, COUNTY OF .~) ~¢Ot-~1~ . . S S ..... ~lS.~J>O}O. ~, .~.t4 ~ , ~ ~ .... bexng duly sworn, deposes ~d says that he is the apphc (Name of individual signing con}ract) above named. He ~s the .~.~ ........ (Contractor, agent, corporate officer, etc ) of sa~d owner or owne~, ~d ~s duly authorized to perform or have perfomed the said work and to m~e and apphcanon; that ali statements contained ~ thru apphcatton are tree to the best of his ~owledge and behef; and that work will be perfo~ed in the m~ner set forth in the applicatmn filed therewith. Sworn to before me thru ....... .... ........ lef?a ~xpe~s Mamh ~, 1 ~ County (Signature of applic, -9 N Offi~ Of G,~r4o~ K. Ahlers, P. K. ,.~ed f~t. ~GI ~' of drawing. ]ha~j~, al~.railoe~ er I ~ © ® 1 I It I0" ,' I ~:~: 4" If copper tubing II for water distributing It/item; piping ahall be of typel K or L only PLUMBER CERTIFICA T/ON ON LEAD CONTENT BEFORE CERTIFICATE OF OCCUPANCY SOLDER USED IN WATER SUPPLY SYSTEM CANNOT EXCEED 2/10 ~t 19~ lEAD. WITHOUT CERTIFICATE II -q i! 0 lice Of ~c~on K, Ahlers, P. E, P