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Home My WebLink About17099-z =1ELD i.;S:'~~:iU;J ~~Dr;ic ~ ;;OMMf~NT° •v 1. FOUtJDATION + (1st) c~ FOUNDATIOtJ (2nd) 2. ~ z\ op ROUGH FRAME & Oy PLUMBING H 3. IIJSULATION PER N. Y. STATE ENERGY CODE y x > r 4 . FINAL 0 1 z ADDITI tJAL CO MEN x~ ' X ro H \ ~ H r'I~ O~tO~jWWq~\e MI'~1 ' x [*7 _ H x~ i d m 'v H POEM NO. D 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) No 017099 Z Date 19.8 Permission is hereby granted to: j~ , .~.G .J.. ~Ea . t ~ . . . to ...........................~.~Q................................................................................................... of premises located at ...~Q a~~.,~.,~ County Tox Map No. 1000 Section .......~.P~..2... Block .............L.... Lot No.........1..~:.... pursuant to application doted .......~1.~/ 19.t~.~ and approved by the Building Inspector. / Fee $..~Q ..i~.:l~ ilding actor Rev. 6/30/80 i _ THE NFW YORK BOARD OF FIRE UNDERWRITERS ~L:1~°~~ :t. ffllj's2r;a> BUREAU OF ELECTRICITY 95 JOHN STREET. NEW YORK, N€yY YQRK ]0038 ~LfieA :Sfl, ; <9`;Sl wti:'zkY 1}3ktJ;fB tY (4p~~'-;'!CS Date Applicatian No. an file ~ THIS CERTIFIES THAT `x"", only the electrical equipment as described 6elaw artd introduced by the opp(icaat named on the gbove application number in the premises of T)raY l,., 1_t1„`/t) 5.<)a4+J0 t1 _,''"t't`t`i IL'::, ya, Y. , ,t , in thefollou;inq (naati~pr•, i~ BpiaNe~ent ~ (st F!. ? 2nd FL Section B(xk Lot uos examined on and found to be in compliance with tha requirerneata of this 8onrd. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISH WASHERS EXHAUST FANS _ OUTLETS RECEPTACLES SWITCHES INCANDESCENT FLUORESCENT waGOaY PMT K W AMT K w AMT KW AMT K.W. PMi. H P DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI-OUTLET DIMMERS AML N. W. Oll H P GAS M. P AMT NO. A W. G. AML. AMP AMi. AMpS TRANS. AMi H. P SYSTEMS M'.r. WATTS NO.OF FEET SERVICE DISCONNECT NO.OF 5 E R V I C E METER NO OF CC. COND A. W. G. A W G. A. W G. AMi. AMP. TYPE EQUIF 1,e' 2W 1 ,9 3W ] A' 3W J,e' 4W pER % OF CC COND NO. Of MI-lEG Of H4lEG NO OF NEVTRAlS OF NEUTRAL OTHER APPARATUS: 1)i~i/I,`, ~ jl)s"%`) l1Vlt,V(% t;LfPt, Iq`tt'i`4'.'1'11{`~, NY, y l9'; GENERAL MANAGER ^ ~ i Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT. BE ALTERED IN ANY MANNER. BOARD OF HEALTH 3 SETS OF PLANS ' FORM N0. 1 SURVEY . 3 ~ ~ TOWN OFSOUTHOLD CHECK ~(.2`l.`f BUILDING DEPARTMENT SEPTIC FORM BLDG.DEP7. TOWN HALL F OUTHOLD SOUTHOLD, N.Y. 11971 NOTIFY y '7 TEL.: 765-1802 CALL o..... ~~yy MAIL T0: Examined • • . 19~ y~~ QQ ' Approved ^!~.3 lr,~.~ Pennit No Dsapproveda/c _ ..D (Buil and ector) ~ ~ ~~~t®~ APPLICATION FOR BUILDING PERMIT Date 19 . r7 I~egya INSTRUCTIONS g~ 1~ p:~i'.~F~'1~~~~ ~~S5Y4Y . .r}x.'..5.~+'f~e4hMa+~..'U~n~If'Ni r'~5,+~"' 05at Tlris ~p~iC"dtlon must be completely filled in by typewriter or in ink and submitte~hio t1xewi~rii~t ` ~ s c`~or, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. „ •Yi,i.iSas'3+.;vtt~"tY1 ~•¢n:'' b. Plot plan showing location of lot and of buildings on premises, relationship:~to°.a~~ADfti3ii~lp~"re~e~cfi~~~b~Jic streets or areas, and giving a detailed description of layout of property must be drawn ron the:dai#gt+afr3t'+thilif~ar4 ~t~'~his appli- c. The work covered by this application may not be commenced before issWance of Buildi•iao`Fdr'#A:~`Of'~ ~~{+e:~m d. Upon approval of this application, the Building Inspector wIll issued a Building6Rct~nlif<to the ap lic ,~~$ch permit shall be kept on the premises available for inspection throughout the work. ~ , c•. ' i.R4'6~1~i e. No building shall be occupied or used in whole or in part for any purpose a'wilt~ftl~#Gr`i1a~+~e ~~cupancy shall have been granted by the Building Inspector. A . mst"~'~i~`~"f t~>~ ~.5 APPLICATION IS HEREBY MADE to the Building Department for the isspaneg„gf B,uilditXg*P~RIi~~tfrsita~t to the Building Zone Ordinance of the Town of Southold, Suffolk County, New Yorks.anc~, aa~~Tp Rplicghlrs'~3~Y~~,~~nces or Regulations, for the construction of buildings, additions or alterations, or for rpzno~~l°or "moTiYsdn, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing,emde~n -rfitYtis;`and to admit authorized inspectors on premises and in building for necessary inspections:'` `t gy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (Signature of applicant,, or name, if a corporation) • (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises. c.,c:~.`G~°~`~"•••••••••••••••••••••"•••••••••••••••••••••••••••••• (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. A, S ~ 1!~'d1 (Name and title of corporate officer) ~ Builder's License No. .~.'~'r'`~""~f j Plumber's License No . ~ Electrician's License No. Other Trade's License No . . 1. Location of land on which proposed work will be done ~6 2 ~ ~ House Number Street HamlEt County Tax Map No. 1000 Section . ~ 2 Z............ Block Lot Z:'.......... . Subdivision Filed Map No. Lot............... (Name) 2. State existing use and occupancy of miser and intended use and occupancy of proposed construction: a. Existing use and occupancy... ~ . b. Intended use and occupancy ./r~~C 3. Nature of work (check which applicable): New Building , . Addition Alteration . Repair Removal Demolition Other Work . ~A (Description) 4. Estimated Cost ~G~. ` Fee . (to I,be paid on filing this application) 5. If dwelling, number of dwelling units Number of dwelling units on each floor , . If garage, number of cars . • P Y, P Y .i. 6. If business commercial or mixed occu anc s ecif nature and extent of each type of use . . 7, Dimensions of existing structures, tf any: Front Rear Depth • . Height ...............NumberafStories...................... Dimensions of same structure with alterations or additions: Front Rear . . . Depth ......................Height ......................Numbenof Stories . S Hem; Ysions of entire new c Numbenof •SFories , , , , • Rear : :::::.........Depth , , , , , , , , , g 9. Size of lot: Front Rear................... Depth 10. Date of Purchase 11. Zone or use district in which premises are situated , • .:Name of Former Owner 12. Does proposed construction violate any zoning law, ordinance or regulation: ' 13. Will lot be regraded Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ....................Address ......Phone No.......... , . Name of Architect ...........................Address Phone No............. . Name of Contractor . ..........Address . .Phone No........ . 15.Is this property located within 100 feet of a tidal ',wet'lanilT3*YES....NO.... *If yes, Southold Town Trustees Permit may be required. PLOT DIAGRAM Locate cleazly and distinctly all buildings, whether existing or proposed, and,'~indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. ~ • ~ i f ~ llv pOYE AS N01E0 KF~ DATE: ~d.R N 70 ~ oV'£-~,~-----' rt,~ p '~-~t~, ~-~.ET:I~ 8u Nf3 SCnE 76b•1802 8 AM 7b 1 !'M FOR Ti~IE , ~ X`f FOLLOWING INSPECT1pNg; „ ~ ~ ~ f 1, FOUNDATION TWb RE0UM1E0 FOR POURED COIVCIIETE 2. ROUI~N • !'4tAMINQ ~ hLUM91NQ 9 9.INSULjAT10N 4. FINAL - CONSTRUCTION MUST SE COMPLETE FOA C.O. ALL CONSTRUCTION SNAtJ. MEN' 1 THE REt,~U1REMENTB OF 111E N.Y. ~ V't, CODES. 'NOT RE SPON~IbLE FpR RRORS STATE OF NE1V YORK, S S COUNTY OF g y poses and says that he is the applicant (Name of individual signing contract) • ~ • ' ' ' • bein dul sworn de above named. , 13eisthe (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed thel said work and to make and file this application; that all statements contained in this application are true to the best of tiffs knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this I Nota Pub ic, (/s->r,,, , , , , , , , , , , , County ~+3s ~ HELEN K DE VOE ~ . h (Signature of applicant)