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Home My WebLink About19925-zFOUNDATION ( 2nd ) 2. ROUGH FRAME & -PLUMBING 3. INSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: vu ~ · ]I;OB.M bO. et TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Ne- 19925 Z Permission is hereby granted to: ...... ~....~.~ ........... ~ ....... ~.~..~.~. ....... ~ ,o ~~ ~ .................................... Coun~ Tox ~p ~o. I000 S~cfion ........ ~l..Q ......... 81~k ...... .~..~ ....... lot ~o...~ ............... pumuont ~o oppllc~tlon d~t~ ............ ~ .......................... , Rev. 6/30/80 r 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL REMARKS: / -~ DATE //~///~/ INSPECTOR ~/"-,~ :' TC,',"/! ~ OF %'gU'~'!,.'OLO xamined ................ , 19... .......... ................... (Bui~Inspector) ' APPLIOATION FOR BUILDING PERMIT FO~9~ ~0. I TOWN OF SOUTHOLD : ~IJILDING DEPARTMENT TOWN HALL SOUTHOLD, N,Y. 11971 TEL.; 765-]802 BOA~.D OF HKALTII ......... 3 SETS SURVEY ................... ClI~cK ............... TO: , INSTRUCTIONS a. Tlds application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 s if plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan shosving location of lot and of buildings on premises, relationship to adjoining premises or public streets areas, and ,,iv' o o mo a detailed description of layout of property must be drawn on the diagram which is part of tiffs appl/- c. The work covered by tiffs application may not be c'bmmenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 11 be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose wliatever until a Certificate of Occupancy ll have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department ~r the issuance of a Building Permit pursuant to the lding Zone Ordinance of the Town of Southold, Suffolk County, r~ew York, and other appUcable Laws, Ordinances or :ulations, for the construction of bu;idings, additions or alterations, or for removal or demolition, as herein described. : applicant agree~, to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to fit authorized inspectors on premises and in building for necessary inspections. Date.. ..U .... 19.f./ (Signature of applicant: or name, if a corporation) (Mailing address of applicant) :e whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. . - f. (as on the tqX roll or latest deed) ~plicant is a corporation, s~n~ture of duly authorized officer. ..... ... (Name and title of corporate officer) Builder's License No .......................... Plumber's License No ........... : ............. Electrician's License No ....................... Olher Trade's License No ...................... .ocation of land on which proposed work will be done. ~ ./.~Z.-~a,,,/~,~,~_ /00 ~ .......... ~o~ ~v~ do~c~a ~../. ~ ouse Number Street Hamlet ...... ~tmtyTax MapNo. 1000 Section /~ .... ff.~ ..... Block ....... ~ ..... Lot Z :bdiWsion ..................................... Filed M p No (Name) .............. Lot ............... ate existing use and occupancy of premises and intended use and occupancy of proposed construction: Existing use and occupancy . ~ ~.~. · ~ ~ ~ . ..................... ?r~'~ ......... 'L%a;" ....... ' ........ ' 3. N et'work (check which applicable): New Budding . ....... ' ........ Addition .......... ,\lteratmn Repair ....... RemovaI .............. Demolition .......... i , ' ............. Other Work ............... ,I. Estimated Cost ........ ~q, o~ (Dcscnptmn) " (to be paid on filing this applicatmn) 5. If dwelling, hum her o f dwellhw ,,.., / Nu . If garage, number of cars ...~,ms ............... /hoer of dwelling umts on each 6. If business, commercial or mzxe~,occnpancy, specify nature and extent of each type of 7. Dimensionsofex~tingstmcture~ if any, Fro t Hei,, ir /~ ., , .............. ' .................... ............ u , . · Rear .............. Depth ........ ~. , , ..lw ml?orolStones ...[ ......... . ...... ~cnmons o~samc structure wi~h alterations or additions: Front .................................... · . . .;, c Lht ......... · ........... 9. "'~'n~";'/'''&~'~L"'~undJcr°fgt°fies. ., Z ... ~car...v~ ........ Depth ..V.~f.. ... o~zc o~ 1o~: Pron[ k~ ............... '"' 0. o aorm ,= ........ ........... ' ...... ............ . . ' .......... ~ z~./..] ~ ~ ,,~ ~ - - I. ' ...... Name o~ FOrmer Owner .~ ............... ') ~ ' ~'~3~ PLOT DIAG RAM Locate clearly and distinctl- all '--~ "~' - ' ' ' · . ~, uulmmgs, whether existing or re osed . · :operty lines. Give street and block number or % . .. , . P P , and. indicate all set-back dim · .tenor or conler lot. ct scnprlon according to deed, and show street names and lndi;~°wn;ef~l~ Zone or use district in xvhich prcniises are situated... - Does proposed construction viol,; .... ' ......... · ............. · ,~ a.y zoning law, Ordinance or Will otberegraded ...,4(.a ' ~,..ato : ..Z..'.. '' , .............. N~e of Owner of premises~/~~/~ ' Wdl e~css till be removed fro~prem scs' Name of Architect ~ ~ ~=~),~.~,~r~/zx:.: .... Address/'~ ~t ........ ,o~,r~-~.~o~4~.~ . .. '. · · · · -2~',.~,~ Is thins proper~y wi ~hin 30b~'~' ~' ~' ~'5' ~mares~i-5~¢~¢ff~ ,~&~ff~Z. p lone No 'Z~"-~25~ ..... s Permzt may be requxred. ''' 'rE OF NEXV ~:I:YI~K~C~ / ! _ , NT¥ OF .... h¢/4." s,s ...... ~'(' ~ ' ~ · ·. being duly sworn, deposes and says that ho Js tile applicant (Name of individual signing core, tract) e named. ' the ......................... ,..~ ...... ' dc°a a g nt e ;}rind ............................ :d OWner or owners, and is dty aut m~o~r~ ' ' , P n or have performed the sam work and to make and file this :alien; that all statements contained ht this application are lmm to the best of his will be performed in the manner set forth in the application filed d~erewith, knowledge aod belief; anti that the to before me this,