The URL can be used to link to this page

Home My WebLink About23738-Z A dam 7"-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: DATE 1` IO V' INSPECTOR -E u�nii�u U. 11�.�\1,111 . . . . . . . . . . . . . . . •. r - FORM NO. 1 3 SETS Or PLANS . . . . . . . . . . . . . . . TOWN Or SOUT11O1.1) SURVEY . . . . . . . . . . . . . . . . . . . . . . . . RIMMING nRPARTMEINT CHECK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN iIALI, SEPTi.0 FORM . . . . . . . . . . . . . . . . . . . 5O117•11O1.11, .N.Y. 1 197 1 TiiT.: 765- 1807 NOT1 FY: CAi.1. . . . . . . . . . . . . . . . . . . l.w�nined..../..0 ..., 19./.. 54 j 2 MnTMAILTO: . . . . . . . . . . . . . . . . . . . . Airin cnrnol..��••��...., 19. Y Permit No. J�✓� ... ............................. ....... nisniproveda/c ................................ .. ............................... ..... ...................................................... (Illli I�.1 �, it•>ix�ctor) APPi.ICATION FOR ROflnING PrRMI'T nate. . . . . . . . . . . . . . , 19CW�. i NSTR11C'T T ONS a. 'illis ai►i►licatior► mlrst he cuTplet.ely filled ill by (yl".Iriter or in ink arxl milwniLted to the 1luilding inspector wit 3 sets of plans, accurate plot: plan to scale. Fee accordinp., to schedule. b. Plot plan r6owiog location of lot aryl of Imildings on premises, relationship to adjoining premises or po►bl is streets or areas, aril giving a detniled clescripLim of IayrT,►L of property gust, be drm,7n on the diagram which is ivgrl: of this npplication. c. 'ibe work cmered by this ai►plicaticn nrry o0t be conrnerx-ecl Ix-fore issmw-e of Njilding Permit. d. Olxm approval of this al►plicatioo, the %jilding Insi►ector vii II issr►e a Wilding Permit to the appiicant. Snob permit shall i►e kept on tl►e premises available for insl►ectim thrcxlgl►crlt the work. e. No NdId.ing shall 1►e occupied or 11sed in whole or in iknrt for ally ixrri►ose whaLever until a Certificate of lkcrrlkroxy shall have leen grmlted by ll►e njilding -Inspector. Al'Pl.l(;Nriom 1S Ill'sltl;my mur to Ow lilrilding Dei-mbner►t for the isslnr►ce of a i didinl; Permit: plrrslnnt to the ik►ildiog 7boe Ovilirkam-e of the Towrr of SmLllold, Suffolk CrT<►nty, New York, aril ol_her applicable laws, Ordinrm►ces or Reinrlaliox►s, for the coostructioxr of: Imildings, mklitims or alterations, or for reimval, or deml itim, as I►erein described. The applicant agrees to comply with all. al►l►l icable laws, ordinances, 1xii 1ding tale, lxxrsing code, nrxl regulations, arxl to admiL aotl►ori7ry.1 inrl►eclors on irrernises arxl in imildir► for r►ecessar inspectiox►s. (Sigmuire of -,, iia _, or r>afrle, f a corl►rnatirnl) (Mai I ing acklress of ai►pl knot) State x-Awtl►er applicant is ►er, lessee, agent, architect, eogiryer, gerx-ral contractor, electrician, pltml►er or Ixlilder Nallle of owf►er of premises ......� Pi .............................................................. . (as on the tax mll or i,)test dml) if applicant is a corporation, sigrnture of duly mrdx►rized officer. (N Tr arxl title of corporate offi(-er) ih►ilclers License No. ................ lIhv&,.rs License No. .... ............... riectrlclnflR license No. ........ O1_Iler Trade's i.icense No. 141A............. 1. 1oxatiox► of iaryl on wmlich proposed work will be ckxm......�c7�l�5..�S.I a�............................... N. ....................... /IN ......................................� 54rplk ................ ikxl:.e Maber Street1L-rnlet 0Xnty Tax Map No. 10()0 Sectioxl .. ........ Block ......J 22......../.. lot ...�........ Srflxiivisicxl ........ A...................... riled Map No. �`.� ...... 1,0L ...N,/T� .... (1 uX.) 7. State existhip, use arxl occtrpmx-y of i►remrses arxl intemled use arxl a-crri►.aryy of proposed cooslructimi: a. R , ..................................................................rfciax h. ]nterxlecl use aril o►rmparx-y VOLQ! 1. Rilore ill; tA)ik ((:Iwt:k likidi "14)"t:iIh1e)- R-'%j lklildill),- ..".. ... . . tPuklitioll .. .. . ... . . Al I MiUl i r .. ... ....... Ila,luval .... ... . . . ... 1)0110 1 i 1-i CM .... . . . .. ... Other %&ilk (DescriplAoi)) Esciimtetl (asst:-6 Zff) ....... ...... .. (to Ile paid on filing; this appl icat ioo) i. If; AOL,I I i III,. I ILI lber of: tk,,c I I i Ilg tit 1 5 of I Ig twits 8 (X I each I Floor . .. .. . ... It gatijiw, otsiber of cart; .....0/ liosilv2sa, cilluel-cial or Illixittl ix:culialk.y. specify nature will extEnic of each type of use—OA. . .. .. . . . .. . .. 1. D illy-9 I.-JOil'i of existing tit-It k(Atocti. if any: Ffot it . . .3 . .. . .. . hear C,.*.. .. . .... . Depth . . .N-0. .. .. ..... ....... Riiber of Slot ics . . . . Diltielksioils Of; sisife tittimAtire will) alletal.iotis or ati(litiolls: Froill. I)cIall ... . ........... ..... IL-il)IL ..... . .. ... . . .. . ... . RJANX:!r of Stories .. .... .... .... . 11. Di1IK!o.ii0o.-i of CIJL ile oeW C(XISt Itm'.j joij. 1�1()111 Ovl;�..... ... .. Rear /A. ..... I lept I I . N^._. .. . . lleij�ll .....t")/)I......... ..... 141111kir Of: 'jjoj-ie.1j . . . 9. Size 0 f I o J:: 1"tool 1A Rear .. .. . .. . .. . .. .. . .. . . I)LI)III .. ..... . . .. . . .. ... . 10. IL-11L tit' lklicial.-w of PoIllel ()t4Ik!r If. Z-Ooe or illie Ilibl.riCL ill %AiitJl pruidtics are situated . ..r--.^ 12. lbes proilottied conal lfocti(MI Violiffe ally WAX1418 11M, ofifillaoCe or I-ej) ... ...... ... . .... H. Will 10C lk-1 regCakle(l ... ..1" Will excess fill, be Itsimed froill Inalkises.. YES M. M-111ILS of 06jour of presiliaes Aililresu Mou Ave A(W.I.Cr. ... li C),tu a). 1a.,:nrlik u 61 Naas! of Afdiitect-l�kwi -.9 .. ..... 11Knte N, 3tnti5 M-MIK! of .......... Ai*v. ... .... . . . ........... ........ ... IS Illis 1)1()Ix--Irty within '0) feet of it t-itlal %4ef:1jjIjKj? 'kil'. ws. 'X1111111) 'ItAm -l1d18117---S HAY M. ldq8111 l). PLOT DIAGRAM 1<x--ate clearly aid distinctly all Wildings, %Jiellier exislAtig or profioseti, mul indicate all set-liack dillemsions l'itxkl property lilies. Give street: aril block iiisiber or (LiscripLion iiccoitling ro ik-ed, awl ,J1(x4 street: oilleS all(l joilif.-jite %Akutliev int(nior or coriw!r loc. y l � �� 1644 /7tt5 Cowl A f 4*-z* 5 61 LO(A-;1111 I K-el I 5142 plow, 41 Plao.5 f�ez*,Ov-, s -z- Deff', INAII (W III-V SS OXINFY M -a . . ..... ..... ... ... .I.... . .. 'I.o. .. ... .�. .... . .. ..IX!ilkl,- (]illy fmorn, dejX)ses altil says that: lie is the ill)l)l icallt (Mitile of iixiividtial Sifoilli,1 totraCL) aix)ve 1141med, Ik! i.,; (he (G)l1tractor, i1j),01C, C0rlXMk1A2- OCHCCI-, of: said (MIK.-l- 01 ilixl is duly all(borized to liel4olill or have liel 1,011lied the said 1,A)1k Will to Illilke illkl file 111i.1; i1pplicaLitio; Ilial. all tstateiielktti contained in Ibis applicilt ion it'e t,tK-1 to the bent. of: Ili.; kiltowledge .1111.1 lXjjiC!f$ jillil 11ml the %A)lk will be jlerfotlllud in the luminer tiet: I:ottlk in the applicalJoll 1:ile(l Illerewitil. :k,),11 to l)e[oIL(! ill,! 111i., . ... .... .. . ..clay of U)Ialy hiblic . . ... .... .�.�. . . ...... .... . .. . . . . . . ....C—(2 SUSAN J.NAG (Silpial.twe of: Apljli(:aoj )L lilfty Public,State of New.York No.4896735 MOW in&MA wApy ftn*Am&Om Mw 26,k2'7