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Home My WebLink About22854-zFOUNDAT ION ( I S'[') FIELD INSI'EGTIOH REPORT DATI~ COHHEN'I'S FOUNDATION (2ND) ROUGH FRAHF, & II It ........ Il- ADDITIONAl. GOI~HENTS: FOBM NG.$ TOWN OF SOUTHOLO BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLETION OF THE WORK AUTHORIZED) N_e 22854 Z Building Inspector. Rev. 6/30/80 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2NO [ ] FRAMING [ ] ROUGH PLBG. [ ] IN~TIoN [ ~FINAL [ ] FIREPLACE &~C~IMNEY jDATE INSPECTOR FORM NO. 1 TOWN OF $OUTIIOLD BUll. DING DEPARTMENT TOWN IIALL SOUTIIOLD, N.Y. 11971 Exa,,,h,cd .~....~...~..~.. ,l~ ~ TEL.: 765-1803. l....PermitNo ............ I)isalq)roved a/c ' ~ BLDG, DEPZ L~Q~N=OF SOUTH_~ ()¢~.~ INSTRUCTIONS (Building lnsl)eclor) / TION FOR BUILDING PERMIT /3 SETS OF PLA?iS , . .~ ...... /'SURVEY /CHECK ................... SEPTIC FORH CALL . . ..... HAIl. 'fO: Dale .......... -.. I a. This application must be coml)lelely filled in by lypewri/er or in ink and submilled to sols of phlns, accurate plot plan lo scale. Fee accordillg Io schedule. b. Plot plan showing 19cation of lot and o¢ buildings on premises, rehdionship to adjoining premises or public stieet or areas, and giving a detailed descriplioit of layout or properly must be draw i on II~e ditlgram which is pall of this appli cation. . c. The ~voik covered by lids application may not be commenced before issuance of Boiltling Permit. d. gpon approval of this application, the Building Inspector will igsued a Building Permit lo the applicant. Such portal shall be kept on Ihe p,elnises available fo~~~ the work. ' , e. No huihling shall be occupied or~]~V~r in )art for any )urpose w aleve't H a Certificate of Occupanc' shall rove )eon g~anted by tie Building Inspector. APPLICATION IS III]REBY MADE lo the lhdlding l)eparhnent for the issuance of a Building Permit pursuanl to Ih. Building Zone Ordinance of lbo Town of Soulll~ld, Suffolk Counly, New York, and other applicable Laws, Ordinances o Regulations, for Ibc construclion of buildings, additions or alte~afions, or for removal ~[ demolilion, as he~eifi described The applicant agrees Io comply with all applicable law,s, ordinances, buikling code, bousblgcode, and ~egulalkms, and admit aothorized insl)ectors on premises and in building for necessary'inspections. (Signahn9 of applicant, or name, if a corpoultion) .. ..... (Mailing address of applicant) al>plicant i~essee, 'agent, architect, engineer, gelleraJ contractor, electrician, pblml)er or builder SI}tlc whelher (as on. the lax roll or latest deed) II applJcanl is a COrl>o~a(ioq, signature o[duly authorized o[[icer. .......... · ............... Builder's LicL~.~ .................. l>lnml)er's License No ................... ...... I:lecl ~ct s I, :ense No ....................... Subdivision ' Filed Map No ............... Lot ............... (Name) , Slale exJslillg II.se alJ(J OCCtll)allcy of J)rel]lJses and ililellded JJse ailS OCCtlpallcy of proposed conslruclion: a. ....' ..... b. Inlcnded use and occupancy ~t.% .~, ~ ,~ ~, 9[JgU:~ V¢ihtO~ prolmrl.V lines. C3ive sh'eel and block interior m coFner lot. Repaii ............ Renloval .............. · I)eulolillon .: ~ .'~;;O...L.., ; ' I .~.. . . (l)escriplion) ,I. l,sllmnled Cost ....... . (to be paid on filing this a ~ fi'cahon) 5. lfdwelling, immber ofdwelhng [ nils ........... .,. Nm/iber of dwelling units on each floor ................ If gainge Iltllll b~f or ~flf$ i ........................... , ,. 6 If business cid or mixed occupancy specify nnhue ami exlenl of each type o~use DIIIIOIISlOlI~ el exlsllllg struch res f W' F'o t 'gl N ~1 ......... ~sear ............... Dcplh ............... fS h (' [11 Il I lilt :ton .............. mensimls of s ina SlnlChl ¢ w t n erahons or aC c Ollgl I I ...... ;~ ........ Rear .................. I) Ih j II tgi ' ~ 8 Di si f tlr h~l I1 Front R · men oils oeo e new coils c on: ............. ; ear 1) Il Ileight ............... Numbes of Stories 9. Size of l0t: Front ......... :d ........ '... Rear ........ ~ ......... ]... Depth ...................... 10. Date of Purchase ' ........... ; ......... ' ....... '.. Nnme of ];ol'llle~ Owner ............ I 1. Zone or use dlslHcl m wluch p~qmtses are s~h~aled ........ ~ .................. 12. Does proposed conslruclion violhle any zoning law, ordinance or regulal on: ....... ~v ~'~' '[ ', ............ 13. Will Io1 be regraded ....... '..i .....~ ....... .~ . . . Will excess lil?~e removed fro n premises: Ye~ Name of A~chilbct .......... i ................. Address ................... Phono Name of Contraclor ........................... Address ................... Phone No ................ 15. 1.8 thl.s prop~t'ty w[.thlll 300 feel of a t'l. cln[ Wotland? ~Yes ........ No...~... PI~OT DIAOI{AM Locale clearly and distinctly alllbuildings, Whelh~r existing or proposed, and, indlcale nil sol-back dimensions from number or description according lo deed, and show street names and indicate wlmlher .q' HOUT CERTIFICATE OF OCCUPANCy /}PPROVED AS NOTED .. FEE: ~ ' ' NOTIFY BUILDING ~ 765-'1802 9 AM TO ~t'A{IM..FOR~HE FOLLOWING INSPECTIONS: 1, FOUNDATIQN . TWO REQUIRED. FOR POURED CONCRETE I 2. ROUGH . FRAMING & PLUMBING 3. 'IhSULATION 4. FINAL CONSTRUCTION MUST BE COMPLETE FOR C.O. ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.~. STATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERROR8 ........ being duly sworn, deposes and sayslhatlle slheaplfltcan r (Conlraclor, age!it cor'porate officer elc ) el s:dd owner or owners, and is dul~ aulhodzed Io Ix~rform or have performed Ihe snid work alld lo Inake and file this iqqflicalion', thai all slalemenls conlaiJled {ji IIds'applicalioJ: are true 10 the besl of his knowl~clge and belief; lllld wolk will be performed in Ih~ mannei] s~t forlh io Ihe applicalioo filed lhetewith. Swoln Io before ine this .~ ~rm E~lrea ;May 31, 19~ P (Signature of applicanI) O'~'d E L "'IMMEDIATELY" F..I~ ~ TO CODE ~,lla(~,l ~MPLETION ~..F~F. "WATER" UND[l~ffl~rf~ ~ O6p:' ~ ?t · "' ;",' '?,. a c lc,'