HomeMy WebLinkAbout30473-Z FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT r
Town Hall
Southold, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30473 Z Date JULY 9, 2004
Permission is hereby granted to:
ANN DOBSON CLEMENTS
345 W 13TH ST #3A
NEW YORK,NY 10014
for
CONSTRUCTION OF A DECK ADDITION TO AN EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR
at premises located at 560 RUCH LA GREENPORT
County Tax Map No. 473889 Section 052 Block 0002 Lot No. 025
pursuant to application dated JULY 7 , 2004 and approved by the
Building Inspector to expire on JANUARY 9, 2006 .
Fee $ 150 . 00
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Authorized Signature
ORIGINAL
Rev. 5/8/02
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GUARANTEES INDICATED HERE ON SHALL RUN
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ONLY TO THE PERSON FOR WHOM THE SURVEY
WTI PREPARED, AND ON HIS BEHALF THE ELEVATIONS SHOWN HEREON ARE
TITLE COMPANY, GOVERNMENTAL AGENCY, IN 1929 NGVD. `Y
LENDING SSIGNUPON, IF LISTED HEREON, AND
TJ THEASSIGNEESARES OF THE LENDING INSTITUTION.
GUARANTEES ARE NOT TRANSFERABLE
ADDITIONAL INSTITUTIONS OR SUBSEQUENN
T OWNERS
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UNAUTHORIZED ALTERATION OR ADDITION TO THIS
THESURVEYNEW
IS A VIOLATION U SECTION W. OF 7H (S SUR00 �}S 8CvfJ � (C 7ZJLCV
THE NEW YORK STATE EDUCATION LAW �./ / IT /w� /� /��{" (�
COPIES OF THIS SURVEY MAP NOT BEARING 6 Y Arnie 4 G H w� e/ Zt • 44 -" ")t c �- r
THE LAND SURVEYORS EMBOSSED SEAL SHALL 'r-O I NGf CA M P&4 Pa'G 0 000,� 07
NOT BE CONSIDERED TO BE A VALID TRUE / �T
COPY
SURVEYED: 17 AUGUST 2000
SURVEY OF
TkI# 1000-052-02-025 DESCRIBED PROPERTY SCALE 1 ' 30'
SITUATE AREA - 17,905.533 S.F.
ARSHAMOMOQUE (SOUTHOLD) D °R ACRES
TOWN OF SOUTHOLD
SUFFOLK COUNTY, N.Y.
SURVEYED BY
STANLEY J. ISAKSEN, JR.
SURVEYED FOR: ANN DOBSON CLEMENTS P.O. BOX 294
NEW SUFFOLK. N.Y. 11956
631 -73A-58,35
GUARANTEED TO:
ANN DOBSON CLEMENTSq—
FIDELITY
NATIONAL TITLE INS. CO. ENSE NYS Lic. No. R928
1. 10 SEP 03 ADD ELEVATIONS & CONTOURS.
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FIELD INSPECTION REPORT DATE COMMENTS
FOUNDATION(1ST)
y
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FOUNDATION(2ND) rn
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1 -
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ROUGH FRA1VMG&
PLUMBINGOil
y
INSULATION PER N.Y.
STATE ENERGY CODE y
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FINAL
ADDITIONAL COMWENTS
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TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
[ ] FOUNDATION IST [ ] ROUGH PLBG.
[ ] FOUNDATION 2ND [ ] INSULATION
[ ]
FRAMING / STRAPPING INAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
REMARKS: f!j
DATE INSPECTOR
,