HomeMy WebLinkAbout18517-z 11J y~' Li.. IJn1L ~I V:f'.'i f. it l.`..
ro
1. I a
-
FOU;IDATIO?I (1st)
. S
ti~
FOU'lDATI0;1 ( 2nd ) _
2.
zt
or
r
ROUGH FRAifE & t
PLUMBING
Cn~
3.
c~-
m
IIISUL„TIOPI PER N. Y. • •
S
STATE Ei1ERGY
CODS I '
~
4, m
c
F.;1AL
• I O
g
ADDITIOf1A COP?MEP]TS:
~_y x
IAlriti~ 4h{~JM-f~ 'Y1/7~_~j,It.L.~t~, •
.i^
.
' X
'O
N
77
9
H
H
O
m
a
' r
H
' ~ Z
r
• d
m
-v
H
!Yr -
roses xa ~
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)
N 0 ~ J ~ Z Date ..Q~..~~ 199
Permission is hereby granted to:
J~~l......O~i~TT.....ri;lr. r:..:.....//.9S/
....1~.
of premises located of ~.(.T... aGG~~?_/~~....... .~y..Z..~Sa.~.:~~f~~~~~~
County Tox Map No. T000 Section ...,,/~Q............ Block ........Q............ Lot No......3~
Q
pursuant to application dated ........;1..,({,1 19 and approved by the
Building Inspector.
Fee 3...c.'.~...,~•••..•..•.
. . i .....C,l~~/./1/~~
.
uil g for
i/
Rev. 6/30/80 ~ rj ~
_ _ _
l5 u ~ ~ ~ 11~~ BOARD OF HE~,LTH
~rglly 3 SETS OF PLANS
SGp ',~,;1 FORM N0.1 SURVEY Q•~;,.,
G O
t 5 TOWN OF SOUTHOLD CHECK • • • d=K• - • -
--~-°..-.-1 BUILDINGDEPARTMENT SEPTIC FORtt
7._v~Ca ..,~~T.
' m~.r.~.'n~••.~+''!10LD,,.,,,f,,a TOWN HALL NOTIFY
SOUTHOLD, N.Y. 11971
TEL.:7G5~1802 CALL
~J Q MAIL T0:
Examined ./.p~~ 191,.' pp /ryy y. ~J , r~~ 3
Approved 1~ Permit No..IO.~.I//.~ ~ • s-
Disapproved a/c .
FEE:
NOTIFI?~~~BUII.OINO FAT (B ildin Spector) . .
785-1802 9 AM i0 4 /MI FOR TNF
FOLLOWINGINSFECTICNS: APPLICATION FOR BUILDING PERMIT
1. FOUNDATION - T1M0 REdIUIRED
FORFOIIREDCONCRETE Date l~
2. ROUGH -FRAMING 3 PLUMBING
3. INSULATION INSTRUCTIONS
' 4. FINAL - COI~§TRUCTION MUST
a. $€11'dOA~11~E1Ei601M4zii.be completely filled in by typewriter or in ink and submitted to the Building Inspector, witi
. setse~CiPln(9N8fi~E1Qlhbty~1i011.tP MJ£lET Fee according to schedule.
1DHEPIRFlD111RE~ 106attblE opltOt and of buildings on premises, relationship to adjoining premises or public stre=
or al~l$ UC~'I~Ie6 dENIi4~6iibn of layout of property must be drawn on the diagram which is part of this ap
cati~ilDES. 118TR8 FOR
kxE„S'~t,@BztBd f C~LdiBEip~tion may not be commenced before issuance of Building Permit.
d. ` pon approva o is app tea ton, he Building Inspector will issued a Building Permit to the applicant. Such pen
shall bE9fi~egt-ox~th 91fs ,v~~i~htA v~~ Inspection throughout the work.
e. NRMtt7u~Q€Pi'~T~eQ~TotA~ised in whole or in part for any purpose whatever until a Certificate of Occupan
shall h3~e`t~rr`~rR~f ~ tA~'B'ttirrA~ rt~spector.
FOLLOWI G INSWE TtC'~~5:
APli?~ IIEW the Building Department for the issuance of a Building Permit pursuant to 9
Building ~AR~Ot11ifi0r[c~NaR$LETown of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulda.id~t9U(iId YH&i4AaldLidl1.W1618WI7Jings, additions or alterations, or for removal or demoiition, as herein describe
The app16tl9U1.l~MN9 to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit4uftllOAted-ins¢€lftl6~RE1C~K8Mhd.9$t71d in building for necessary in pe tions.
BE COMPLETE FOR C.O. /~~~Z~cru•~ _ ° ~~r~
ALL CONSTRUCTION SHALL MEET ' " " " " " " " " ' " " " '
THE REQUIREMENTS OF THE N.Y. (Signatttre of applicant, or name, if a corporation)
STATE CONSTRUCTION 8i ENERGY ~ q
CODES. NOT RESPONSIBLE FOR ' ' ' ~ ' ' ' ~ C ' ' ' !v'~'
DESIGN OR CONSTRUCTION ERRORS (Mailing address of applicant)
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or build
....~Jw !J.~2- .
Name of owner of premises (./1./.t.L•.(..-1.~.}'!')..... J-'. ~PP~~~~
{as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authorized officer.
QCCUPANCY 0R
(Name and title of corporate officer)
ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENS•
Builder's License No. P?~l~ , .
Plumber's License No . 1~ITH®UT CERTIFICATE
Electrician's License No . OCCUPANCY
O[Iter Trade's License No . .
I. Location of land on which proposed work will be done. ...T ~.5.~...~C~.~..:?~~.~1'x '~J. -
House Number Street QQ Hanilet
County Tax hfap No. 1000 Section .~l.d Block ..4~............... Lot . , , , , • , , , ; ;
Subdivision Filed Alap No. Lot
(Name)
2. State existing use and occupancy of pjr~emisers and intended use attd occupancy of proposed construction:
a. Existing use and occupancy .....i~. ~s~ ! , , ,~!~!~,ty,,.#s!~•~•~`
tis~cY ~.+e?t 4u a+wo2 ,o•I'
b. Intended use and occupancy ••••`~~•••••••••••-••••-•••••-••,.~,~:;.P:n,`a~*t~„
3. Nature of work (check which applicable): New Building Addition ~Uteraiion , , , ,
Repair . Removal Demolition Other 11'ork n.~~.G te- , , _
(Description)
4. Estimated Cost ~f6 0 Fee , .
' (to be paid on filing this application)
5, If dwelling, number of dwelling units . ~ Number of dwelling units on each Roor .
If garage, number of cars , . .
6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .
7. Dimensions of existing structures, if any: Front Rear Depth .
Hci~lit Number of Stories .
Dimensions of same structure with alterations or additions: Front . . Rear .
cpth
...........Height ......................Number of St°~~~~~ ~~t•~~p`a$'~'~1±...... .
8. Dimensions of entire new construction: Front Reat De th , ..,~4
Height Number of Stories ~
9. Size of lot: Front Rear
10. Date of Purchase ,Name of Former Owned+. TI'.'I:M':R'.~ '~~°1'` Il
11. Zone or use district in which premises are situated
12. Does proposed construction violate any zoning law, ordinance or regulation: . ;,,,.,,,.,ly,,.; ~,7.. . , v't'~ , .
13. will lot be regraded ............................will excess Fll be removed'fr"drr~pFeznLSe~: - ; Yas:,ya N.
14. Name of Owner of,premises ....................Address . ; L'hgne_No:,.: ~ ..::f•.++~~... .
Name of Architect ...........................Address ............:.".....Phone No...!.: a, .
Name of Contractor ..........................Address ..Phone No.........:.... .
15. Is this property located within 300 feet of a tidal wetland? *Yes No
*If yes, Southold Town Trustees Permit may be regu~ired.
PLOT DIAG1tAM ,
Locate clearly and distinctly all buildings, whether existing or proposed, and.indica~g_aU set-back dimensions from.
property lines. Give street and block number or description according to deed, and show steel name's and indicate whethe,
interior or corner lot.
nnn JJ~r
G~ ~tfl~ ~,r3~
,~po~•
-,Z> y~ ~
-fl
5~
~ ~}cc, CCA 5C~
/~!/[/ra~r~'ff~~4'•jpiY ctnrrciP T®®B/,$!
~ ~ ~zv~
STATE OF ?\E1' pR S
~Oii\TY OF . ~/~/11.!S. ~
~/.yllL (J 1,~.'f•6:+'i., ~-:a ~l~ q........ being duly sworn, deposes and says that he is the app]icant
('~amc of individual signing cantract~
Dove named.
icislhe ..................................~,t~.1~1~.~..........................................
(Contractor, agent, corporate officer, etc.)
f said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
oplication: that all statements contained in this application are true to the best of his knowledge and belief; and that the
ork wlll be performed in the manner set forth in the application filed therewith.
worn to before me this i~ ~n I
J
otary Public, ~ , , :L~. County ~
~r N~9s4~O NrWY~Mit ignature of applicant)
CdlMMpI011F)Nli?M ~0/pICiKI~. I L~