HomeMy WebLinkAbout24853-zFORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
(THIS
BUILDING PERMIT
PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO.
24853 Z Date APRIL 30, 1998
Permission
is hereby granted to:
DEBORAH PENNEY
PO BOX 470
MATTITUCK~NY 11952
for :
ENCLOSING AN EXISTING ROOFED AREA FOR STORAGE AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 144 Block
pursuant to application dated APRIL 7 1998
Building Inspector.
160 SAILORS NEEDLE RD
MATTITUCK
0005 Lot No. 026
and approved by the
Fee $ 75.00
Building Inspec or
ORIGINAL
Rev. 2/19/98
FOUNDATION (1st)
FOUNDATION (2nd)
ROUGH FRAME
.PLUMBING
INSULATION PER N.
STATE ENERGY
CODE
FINAL
ADDITIONAL COMMENTS:
FORH HO. I
TO~dN OF SOUTIIOI,D
IIUILU1NG DEPARTHENT
TO~N [IAI,I,
SOUTIIOLI), N.Y. 1197 I
TEL: 765-11102
BOARD OF-HEALTII ...............
3 SETS OF PLANS ...............
SURVEY ........................
CIIECK .........................
SEPTTC FORN ...................
CALl ...................
HAIT. TO: ....................
APPLICATION FOR BUILDING PERHIT
' Date 19
INSTRUCTIONS
a. '~his appltcatio~ nttst be ~letely filled in by ty~riter or in i~ and ~d~itt~ to
3 ~Cs oF pla~, at,rate plot plan to ~ale. F~ according to sd~hde.
b. Plo~ plan M~t~ l~ttm o~ lot aM of ~tldh~s ~ ~i~a, relatton~dp~to ~jotnlng
struts or areas, a~ 8lvi~ a ~btall~l ~:rlpti~ of layout off pro~rty mint I~ dr~ ~ the dia~an ddch is l~rt of
this appl icati~.
c. 'lhe ~ c~r~ I~ this a~llcati~ my ~t I~ ~1 tmfore is~a~e of ~dldi~ Pemit.
d. tl~ a~al off ~ds a~llcatla~, tl~ Iklildi~ Ins~ctor will is~ a ~ildlng Pemit to the applicant. ~ch
~mlt Mmall ~ kep~ ~ U~ ~{~s avall~le for {ns~ti~ th~t tim ~rk.
e. ~ ~iidi~ ~mll ~ ~pi~l or ~ in ~le or in ~rt for a~ ~ ~mt~er ~til a C~rtificate of
~y ~,alt h~e I~a gr~tM by He ~dldi~ Ins~tor.
~HACA'rI~ I9 IE~ ~ to tie Ik, ildi~ ~Dart~nt for the issue of a ~ildlng Pemit F,r~nt to the
I~ilding ~ ~im~ sE t~ 1~ off ~tl~ld, ~ffolk ~n~, ~ York, ~ slier a~licable las, ~i~mes or
~lati~s, for tie ~st~ti~ of hdldi~s, ~iti~s or alterati~, or for r~al or ~ltti~, as lerein
~kscril~. ~e appltc~C ~s to c~ly vlth all a~licable l~s, ordim,~es, ~ilding c~, I~ing c~, ami
re~daCi~s,~and to ~ic ~ri~ ins~tors ~ prmi~s aM in ' ' '
'
SLate d~etJ~r applicant ia os~er, lessee, agent, architect, enSineer,'ge~eral c~trector, electrician, plt~nber or Iafilde~
Nave of o~mer of premises ............ .~...~.~=.~7.~..Y~...O-~....~..~X.~ .........................................
(as o~ the tax roll or latest deed)
If applicant is a corporatloa, slgnata)re of duly aul:l,)rlz~t~l oEficer.
(lime and title of corporate oEficer)
l~dlders '
l.tcettse ~ ..........................
Plt~bers Licen~ lqo ..........................
Electricians License No ......................
Otl r So ..................... l,
l~¢atloo of land c~n ~ddch propo~l ~ork will I~ ......................................... '
Ilouse lx~i~er Street L~-/~q
~aty Tax ~p ~. I~ ~ti~ ................ Bilk ................ T~L ................
~l~ivlsi~ ...................................... Fil~ ~p ~ .......... ~ ..... l~t ...............
(~)
2. State existing u~ a~ ~y of l~ni~s
.......................
a. F~st ~ a~ ~i~y ..................................................
........ ....
3. ~nm'e of ~rk (clmck,~liich applicabte)~ ~ lhilding .......... ~kJiri~ .......... Alteration .... ~ ....
f~fmJr ............ ~1 ............. I~1 t~f~J. ........... O~her
~i,,~ ~ ..~/.~.~.~!~po,~ ~ . .......................................... ...
If g~ruge, ~mtmr oe care .......... ~ ......
~ ......................... ~imr of 8torlea ........ ~ ............
Ilt,,~n~i~m o~ m,m .trimLy,re .lth alreratl,mu or ~ittons= Front .
I~pth ....~.~ .......... I~i$,t .... ~.-.. }.~ ....... ~,amr of 8torie~ ..... ~ ......... "
~.si~ ,,~ ~o~, ~=,~ ...2.B,.~O ....... ~ ...}!~:.e.9. ....... ~,,~, .~.~.~:.Z~. ......
m. ~..~ o~ ~,.~,~ .O~.~3. g. ....... ~ o~ Fo.,~ ~.~ ..~.iA~kO.m.~~.~...
12. ~ prolm~l m~attmti~ ~lol~ta a~ ~flng I~. ordi~me or regulatl~ .... ~O ................
13. ~ill lot Im regr~hl ~ ..... ~. .......... ~ill ~eaa fill Im rm~
,,,.
", ~'" ~Oc ,~ ..............
' ' ........................................... B~m ~ ..............
}5. Is Ibis p~rty within ~ i~t. ot a ti~l *mtla~l · ~ ...~ .... ~ ..........
PI.OT IIIAO, RAH ·
locate clearly and dlatincrly all Imildinga, tl~etlmr exiettn§ or proposal, and indicate all ~e£-Imck dirmnaiona
prolmrty li~es. Give etreet m~l block r~imr or description accordtn§ to deed. and ~hoa ~treet re, nee a[~l tvalicate
~d~etlmr interior or corner lot.
is the ........... ~ .................................................................................
(O~tractor, nge.t r corlx)rate officer, etc.)
.aid i~mr or ~mr~, m~l ia duly ~thori~l to [mrfonu or h;me lmrfor,~l the .aid ~rk m~l to n~ke m~l file Lhi.
appl lcatinn; thet ail atatomnt, c~mtai~l in this nl~)licati~m are trim to the Im~t of his kill.ge and Imliefi
thak th~ ~k ~itl Im ~rfon~l in the ,~m~mr ~t forth in the application fil~l
~)rn LO tmfore n~ thia
......
' CAROL A, SEARS (SiRlml:m'e ()f Appl leant)
~TARY PUBLIC, SteLe of New York
No. 4~84~ Suffolk County.
lmm Expire~ June 29, 1~ ~
duly s~)rn, (lelx)Be8 alxl mqy8 Lhnt lie |. LITe
~LE
DATE ~ SEPT, 2~', i980-
~U
EiANK Et TRUST CO. ' '