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Home My WebLink About18852-zFOUNDATION 2. ROUGH FRA~-IE & .FLUMBING iNSULATION FER.N. STATE E}IERGY CODE FINAL ADDITIONAL COMMEHTS: !/ox: ~. TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, Iq. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~_ 18852 Z Permission is hereby g~nt~ .~~ ....... ~.._~_~~.~ ........................... ......... .._:~~~...~...L~.....: ....... ................................................................. I..Z...~. ~.~ .................... ~.... ........................... ~,~ ~ ~ ~o. ,000 ~,,o. ~Z...~..~... ~,=~ ....... Z ............ ~o, ~o....~..~. ....... ~u~., ,o ~,,~,,o. ~,~ .~......Z.~ ..................... Building Insp~tor. Building In.q>ector Rev. 6130/80 ! BEFORE .....,'~::' ',':':, ;~. ~ I~ UNLA, .Vt!RJL , ,,~ . :t *": :" !;" 7l~1~ / g , ~ ~OUGH · RAMIN_ · : '. ' ...... '= ; . *~- ;*~. -**~ 4 -FINAL - CONSTR~CT!ON '~ '~'~ ~' ' ' ~ ~,(~' THE REQUIREMENT~ OF THE"NY :J"i', :1"' ~?. ~i. ~ .... STATE CONSkRUCT~N[& ENERGY ~ -~ .*.,;,~-~.~---l..* ..; C~ES. ,N~..,RESFO~SIBLE FOR , I *'." ..... ~ --~'~'"'~'~1"' DESIGN O~'CONSTR~ON ERRORS O®o °®o °©o " .t FIRE INSPECTION, REQUIREB BEFORE OPENING 3EPA~TMENT ~T"' imm FOR THE T:V~,'O REQUIRE[': & PLUMBING LIST SHALL MEET ' '.i':: :,i o~ ~'HE Nv. : \ o ' i . ' II , ~ & ENERGY :" .~:. '. .,'.1 [::' .,.~ ~SPO~!~.L~ FD~ '....' ... ' ~ I I ...., { ,;.1..' .' . . [ ; . ~d_,_.~,,~,~ .... E~__,..l ..... U~ Ig. UNLAW~Ill ' : ~:'=' ~ ~'t' ~OUTI ~ t I WI,, ':::t.~ ' ' ~'i".~ [~ ~11 ,OF~CCU~ANCY~ :, - FORM NO. 1 TOWN OF SOUTHOLD EIU ILO1NG DEPARTMENT TOWN HALL $OUTHOLD. N.Y. 11971 TEL.: 765-1802 BOARD OF REALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC FORM ................ NOTIFY; CALL ..................... MAIL TO: Examined ................ , 19... ' (Building 'APPLICATION FOR BUILDING PERI,lIT Date .... ~... .......... INSTRUCTIONS a. Tkis application must be completely filled in by Wpexwiter or in ink and submitted to thc Buildin~ l~ector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premise~ or phblic streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is pa.q of this appll- 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 issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. c. No building shall be occupied or used in whole or in part for agy purpose whatever until a Certifim~,- of Occupancy shall have been granted by thc Building Inspector. APPLICATION IS HEREBY MADE to thc Building Department for the issuance of a Building Permit Immuant to the Building Zone Ordinance of thc Town of Southotd, Suffolk County, New York, and other applicablc l.a*~, Ordinances or P, egulations, for the construction of buildings, additions or alterations, or for/-emoval or demolition, a~ heroin described. The applicant agrees to comply with all app icab~e aws, ordinances, building code, housin~ code, and reg'a/a~inns, and to admi£ authorized inspectors on premises and in buildL,~g for neceaxaly in;pections. · . (Signature (err hpplicant, o; ~;r~e, if'a'dfrt~arlt'~gn')' ' ' (Mailing addre.ss of appticzmt) 'grate wh~ther applicant is owner, tqess~ agent, architect, engineer, general contractor, electrician, plumber or builder. ,~ame of owner ofprcmises ...................................· . - -- (as on tko tax roil or latest deed) f :ppli~ c~rpo~4ion, sigpatur$.of duly authorized officer. .d. . ~ ' (Name and title of corporate officer) . Builder's Liccnse No .................... Plumber's License No. .......'. ............. .. . Electrician's License No Other Tradc's License No County Tax Map No, I000 Section .., ./~,. , i .....~ Block ......... Lot ~ ' Subdivision F, iled Map No Lot ' Nature o£work (Lk~(~cb~ck which applicable): New Iluilding .......... Addition .......... ~(cra[i~ .~ .... Repot .. . R~mova[ ...... Demolition ...... Swimming pool ..... Tennis Court~ ...... Accessory Building .......... Fen~ ....... Other Work~ ........ (to be paid on fi~ing ~hi~ If dwciHng, number of dwelling uni~ ............... Mumbcr of dwelling units on each ~oor ................ If. bu~i~, commcrcia[ o~ mixed oc~up~n,~y, ~-~ture and extent of each type of u~e .~~~ ~ .. D~mcn~on~ of ~xi~King sK~cturcs, if any:~ F~K~, ~.~. ~ ......... Rear ............... Depth ............... ............ Number of Sto~ .... t ~ ~ .......................... ............... ~t ....... 'c~ ............. Num bet of Sto~e~ Dimemion~ of entire new con~tmction: Front ... ~T .......... Rear ............... De~th Height ............... ~um~er of Stohe~... ~... ~x. ...... ; ......................................... Size of lot: Front ...................... Re~ ...................... De~th ...................... Date of Purch~e ............................. Name of Former Owner ................... : .......... Zone or use d~thct in which premi~ are xituated ..................................................... Doe~ pro¢o~cd constmct[oa ~io[ate an~ ~oning taw, ordinance or regulation: W~I I? be regmded .... ~ ....................... Will cx~ Fffi be removal from pr~mise~: Ye~ ... ~o. N~= of Architect ........................... Addre~ ................... N~= of Cont~ctor ................. i ........ Add~ .......... ......... P~on~ No ..... n..~ .... i .... 5.Is this property located uithin ~00 feet of a tidal uetlaad~ *IgS...;]0 .... *If yes, Southold Town Trustees Permit may be required. PLOT DIAG~M Loc=re cl~ly md dis~ctly ~I bu~d~, whether existing or proposed, md. indicat~ ~1 ~t-back ~en~ion~ from rope~y Hnes. Giw sneer ~d block number or descNption a~aord~g to deed, ~d show steer n~ ~d ~i~t~ wh~ther %te~or or comer lot. ;TATE O F NEW <YONif~ /f ~ ~~.~.~d_,. /~ .... being duly swom. deposes =d says that he ~ lhe applicant . '.~(~am= of individual signing contras0 bore nam~ . (Contractor, agent, corporate officer, etc.) }f xafd owner or owners, ~d i~ duly authorized to perform or have perfo~ed the said work and to m~e and file this pplication: that all ~tatcmcnts contained in Ihi~ application are true to the best of his knowledge and belief; and that the ~ork will bc perfonned in the m~ner set forth in the application filed therewith. ' .............