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Home My WebLink About23274-Z FORM N0.3 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) Date ............. %'..l. ... ................. 19.9(P NG 23274 Z Permission Is hereby grant .................. ............ . ............ o.,.�Q..�......& ....... ............. Q ..�.....4 �s to ..... Z,'� ... ... . . .... ... .. .. ....-.................................................. tx�........... .................................................................................................................................................................. ....................................................... . ........................... ......... C/�1/1�/ .... .. ..!.............................. ...............................................G�.. �7......../�C. ...................................... County Tax Map No. 1000 Section .........a;Z...... Block .......43............. Lot No. C.d...3....... 8!l pursuant to application dated ................ ..... ISQ.........., 19.. �ci...., and approved by the Building Inspect Fee $. ... ........ . ..... ....... ....... .. . .. Building Inspector Rev. 6/30/80 PIIi LII IUSPI;r;:t 1.Utl IIF I'UltI UA 11; .._ Cut llif lll;i �z .,.,.__.__...._.. • I I p , _._ _._.. 1-I Fill llllln"I'IOil ( I;:'I ) I _ FOUNDA11011 --- --- -- I Itoll611 FIt AtIF 6 I - _ O 1S IS np - - -- - - - --------- _ I ___________ _ a c ate- I a n U) IIi511I.nt IUt1 I'I;R if. Y . S'1'A'1'li f.tll?IU:Y G CODIF �3 " --- :I ._.. - - -- --- --------- ------ ----____ ---------_---------- ---------------------____ nUU I'I'I011nl. CUHHI!NfS • __. An -- - ----- --- el AF 7177 � �J - -. )1- 4 - G r w Ncy NLAWFU FEE 3 p .n {•el•� - �",�vr � . ,id, � wNOTIF ♦ h♦ apt"> r ' �R �0g { 55-1802 9 AP R 1♦ �� . . �o �pgg gygr¢+�� y OLLOWING INS ` ' " \N11 �d 1.: FOUPIDATIO FOR POUREC \ i ,2 ROUGH — FI S INSULATION d,' FINAL -_. Cl o _ 'BE CONIPLET k - f" •� "Ya ' # ai x ALL CONSTRU e tt, I. �♦ �� THE REOUIREP STATE CONST! +.-ODES. NOT SIGN. OR CO � �V � T f Xn 1e• 'il x °r ' ,: h �i A sy i' i ♦ K. i .�t, 4 e1�4 5 F ok i IT A f � � FORM NO. 1 3 Si3TS OF PLANS . . . . . . . t . . . ` }7 TOWN OF SOUf110LD SURVEY � � . . . . : . . . . . . . . . : . . i P u BUILDING DEPARTMENT ClIECR �, �� . . . . . . Y T ...n*.v •-rarq . . . . . . . . . . TOWN IiALL 813PT1C FORH . . : : . . . . . . . . . . . . . . . FEB 16M SOUTII0I.T), N.Y. 1 197 TEL: 765-1802 NOTIFY: CALL 1?xamined. t 19 MAIL TO: . . . . . . . . . . . . . . . . . . . Apin oved...L 1,/ •/� 19 2,,6 Permit No.62.3� ... ................................... Disapproveda/c ....:.............................. ....4.............................. ...:.......................................... ..... ilding Inspector) ICATION FOR BUILDING PERMIT Date. . . . . . . . . . . . . . . . 19. . . . INSTRUCTIONS n. 71111; application mist be rmrletely filled in by typewriter or in ink and submitted to the Building Inspector wi 3 sets of plans, accurate plot plan to scale. Fee according to scliedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or lxd)li.c streets or areas, and giving a detailed description of layout of property mast be drawn vo the diagram which is hart of this application. c. Tire work covered by this application wary not be commenced before issuance of Building Permit. d. Upon approval of thin application, the iluilding Inspector will issue a Building Permit to the applicaoU Such permit shall be kept on the premises available far- inspection throughout Ure work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS ILREBY MWK to the Building Delxrrtment for the issuance of n Building Permit pursunnt to I_lie Building 7xxv Ordinance of the Tbwn of Southold, Suffolk County, New York, and other. applicable Laws, Ordinances-.vr Regulations, for lure construction of buildii,4;n, additicxra or alternticxrs, or for remount or demolition, as Herein described. lie applicant agrees to cxmrlq with all. applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary inspections. ..................................................... (Signature of applicant, or name, if a corpornti(rr) ................................................... (Bailing w1dress of applicant) State uiwtber applicant is owner, lessee` ager architect, engine r al autrcrlectrician, plunber or builder ..../6 �G'=4--L17.. ... i%a.. •;(•................................. Nave of owner of premises .... ..... /. . ............ .. .. . ........................ . 11(11as-ori the tax roll or latest deed) 'T�®/✓/ /. , If applicant is a co ation, signature of duly aiUrorizecl officer. . ................... . * (Name and'title•of corporate officer) ... ... p0 �1../Sao �/6 7 Builders License No. ........:7. .. ... P1urlrers License No. islectricians License No. ........ , .- .. OUrer Trade's License No. ........ :.... 1. iocation of land on wltidr proposed work will. be done.............................................................. ................................................................................i......... ........................... house Number Street hamlet Ccxmty Tax Map No. 1000 Section ..�1�1 ......... Block ... ........... Lot ...1&.3....... Stjbdivisiorr ...................................... Filed Map No: ............... Lot .... ........ (Name) 2. State existing use ant vccupnrcy of Premises aril intencle tti�se and occulkmocy of sect cOostmetiom a. Existing use and occupancy ......W,0—4A:sG.:7... ...f-4'1-,r ........ b. Intended use and occupmxy ...... Lam- Hature or work (d►eck rAlhidh applicable); Neu lkhilding .......... Add itior, Alteration .., Repair _.. Removal ...... IkOuolition . .... Other Work (Description) 4. Lstimated Cost .. �.•�O �..1.•.. fee .. ..................... (to be paid on filing this application) 5. It dwelling, muber of dwelling units ............ Umber of dwelling turits on each floor ................ If garage, rrnber of cars . ' ..'� ........................ b_ 7f Ixhsiness, causercial prmixedocrxrlhancy, specify rwture aril extent of each type of use*,/�wwuww, 7. Dimensions of existing structures, if any; Front................ Rear - , Depth ................. Iieig►ht ............... Umber of Stories .......... Dimensions of same atnrctiure +with alterations or additions: Front ............... Rear Depth .................... Ileil4ht .................... M,ylher Stories...........................�.. %, rDimensions of entire neW construction: Pliant , rt Rear ,1... . � .... �1 Depth wdolt ......................... Muller of Stories ..................... 9. Size of lot; Front ................ Rear .................... Deptlh .................. 10. hate of Purdhase ..,.,:.......,. Harv: of Fanner Owner .. . 11. 'Lone or true district in VJ►idk premises are situated .,.......... t ........................ 12, Does proposed coostnuction viol to any zoning law. ordinance or regulation: ........ 13. Will lot be regraded 1 ,,,,, 40 ... Will excess fill l 1 r be ra►ryved frau praid sea; YF.S 14. Naha s of Owner of premises , (E) ... ... Address ......... .. ............ . 1'Irone No, ...........y. Name of Architect ,.. .., . Address ...... •. ••,,• ,. 1'Irone No ......... Nauhe of Contractor ........................ ............... ......:.... Address .. ............Plhone No. .............. I5, is this property within 300feet of a tidal. wet larrrl? A, YE ... No ..... AN YIS, mnl"D IUM '110SIE S 11Vft4rr MAY ILL Rt1iUCt(RD. 1'1.0'1' DIAGRAM Locate clearly and diatinctly all buildings, uhedwr existing or proposed, and indicate all set-back dimensions frau property lines. Give street and block mxtber or description according to deed, wA show street names and indicate wlhether interior or corner lot, S'I'A't'L OF NI;W�RK SS COUNTY OF ` ---�C,L Ik , .•.•• •• •• t!t.l�} .5�.cui(,L) being duly sworn, deposes and says that lie is the spill icant (N-rue of individtual Pjanina c4h=r(ICt) alcove named, Ileis Ilre ................ .��.�.........•........ ... ... ....... ........ ., (Contract , agent corporateOfficer, etc.) of said otmer or owners, and is duly tauthorized to perform or dhave perfonued the said cork and to make and file tilts application; that all statements contained in this application are tare to the beat of his knowledge and belief; and that the work will be performed iq the manner set forth in the alil)lication filed tlrerewitl►. Sworn to before me tris ..: •1•�Q ► of .,. .......... . . Notary No.4879505 Qualified in Suffolk County Commission Expires December 8,1 ' ' ,65.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] I CATION [ ] FRAMING FINAL [ ] FIREPLACE & CHIMNEY REMARKS: � l DATE INSPECTO 70-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ INAL [ ] FIREPLACE 8 CHIMNEY REMARKS: e� L a� DATE INSPECTOR c� 765.1 QZ BUILDING D v 1 TION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION ( ] FRAMING I FINAL ( ] FIREPLACE 8 CHIMNEY c REMARKS: � 4;2Z zt- DATE � f INSPECTOR 70-1802 UILDING DE". ,/fNSPECTION [ ] FOUNDATION IST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY /*I') REMARKS: DATE `� INSPECTO