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HomeMy WebLinkAbout23355-z i� FORM NO.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......... ... ................ NE 23355 Z Permission Is hereby granted to: �-... ... .... ....... ` ........... ....1. o���.a� � .. �........................ .............. ....................... to . . .... ..�.�....`. ..... l ........................ .... .. ....... .. ......... ....�...•.••.... .i�'T..tS/.'"K"tv"E'�...+�................ ............-6.... . .. .. ... ..... ..... .. .. ..... .................................... .................................................................................................................................................................. at premises located at.............mno....... i..:..... ............................................. ....................... .............................. //�a .. ..... ....................................................... County Tax Map No. 1000 Section ......Z Block......./.............. Lot No. o..................... pursuant to application dated .........W..ae.. ... ......... 19..(. .... and approved bythe Building Inspector. Fee$.. .��............. ............ ................... . . .. ..... ............ Building Inspector Rev. 6/30/80 BOARD OF IIF.AI T11 . . . . . . . . . . . . . . . 1701m N0. 1 3 SHTS OF PLANS . . . . . . . . . . . . . . . TOWN OF SOUTHOLD SURVEY . . . . . . . . . . . . . . . . . . . . . . . . BUILDING IMPARTtIgH 1' C1117CK . . . . . . . . . . . . . . . . . . . . . . . . . TOWN iiALL SEPTIC Roil" . . . . . . . . . . . . . . . . . . . S0UT1101.0, N.Y. 11971 7 6 5- 1 110 2 NOTIFY: 4, -4 19�_ �Approved. . Cl... 19 I'ermil: No. ...........uw ©..... . 0isal>Imrov ..................... ?1.1A*1rA0H ...........n l 1.��.t:� �`'•�- ...................................... ... �..... . ...... ...... ... ... ng 1nrix-ctor) A FOR 01111,I)iNG PERMIT : nate. .�.CDYC/7 a. . 19.g1P 0 I HSTRUCT I ONS a. 'Ihia nppl icalimt mijst be cunpletely filled in by t:ylwwriter or in hik mtd milmmoltted to the Wilding lrrspeclor with 3 sets of plums, accurate plot plait to scale. Fee accordhig to schechmle. b. Plot plan slmowing locntimt of lot arxl of: ixmildingn on premnises, relationship to odjoining prernisen or Ixiblic streeLs or arena, awl giving a detailed descripticxm of: lnymmt of property must be drmnt ott the dingran wlmich is part of this applicatlon. . c. 'lhe vmr.k kwered by this applicaticxm rcty mxmt be caanetx:ed before insculme of Ikmildiog Permit. if. Ulm nitprovni. of this upplicaticxt, the Ikrildinll lnsixaclor will issue a iktilding Penny to Lhe applicant. Such peimit nlurll be kepL- cxm Live premises available for inspecticm lhtrxmgltmtt the work. e. No building shall he occupied or used in tAmole or is part for nrty lxrrpose Nlmatever »ntil a Certificate of: OCCUpalWy shall. have been granted by time Wilding ltmspeclor. AITIACA'FION IS II3Rl,11Y HNI13 to the lktildiog Department for the issuamx:e of a iktllding Permit lxmrsuant to Lhe Wilding 7cxme Orditwrx:e of the fount of: Smtllmold, Suffolk Cmmt:y, New Yorl,, arxl other applicable laws'. Ordimmes or Regulalimm, for the c:cxmstntclimm of: Ixmildings, mkikimms or alL'eratlotma, or for remxrval or denmolitim, as lwrein describeil. 'Ilene spplicaol' ngreen to code ly with all applicable laws, ordinammces, building ccxle, hmtsing code, mxl regulnticxms, nix] to rxbmit mitlxorized inspectors mm prvinisea nmxl in Ixmilding I-or necessary hmpections. : .................. (Signature of ap pt i aril', or mate, i f a corporation) �� �� �s Aiy ................y..........,............. .. (mailing rxklress of applicant) 9So13/054 !',Late wlmelher applicant is owner, lessee, agent, ardtit:ect, engineer, general ccxttroctor, electrician, plumber or- builder. 2�c v h.e r......................................... ........................................................ ...... Pk>tne of anmer of premises ..!C1. 4� lcurc�e;�l.�:.6ric.......................................... ..... (as mm I.he tax roll or Intent: deed) If allil icant is a corpxrratimt, sigrwlure of duly rxmUxtrize(i officer. L u I L (PL-me amxl title of corpxmral.e officer) i MAR 2 9 1996 Iktilders License W. ......................... Plutimers i.icense No. ......................... - �Tft.rf�0---63'T-HOLD i 1slectric:ians Licermse No. ..................... Outer Trmle's License No. .................... 1. ImnLicxm of: lnrxl mt witidm prop used work wi 11. be clone.. /.... �D..... ............. .�Ct...... ....................................................................................................................... Ikxmse Ribber Street llanlet Uxnml:y Tax PL-mp No. 10(X) Sectimm ....aa....... illock ....../......... Lot ...� ...�' .9kiWivispc4m ....................................... Filed Kip lki. ........... .... lot' ............... (1lrrrme) 2. Stale existing tire and occulwaxy of premises nrxl inLerxled tense nix) mcupwrx_y of proposed cmmnlnmction: :t. l?.xistirtg use atxl o<: up>cmtxy ............................................................................. lt. 'Itttewled one arxi oc:copmx:y .................................... ................... •e3� D ;,,.7ti;:.i'`'t 1, R11111a oI` wolk (chuck IAlicll ulgllicuille): lk,e Ik111diug ... ...... . tukiicioo _..._.....'Al I oral.iull ..... . MINI i I. ............ Itelllyvil I ' I .......... ... Ik�elr►I Il:lon ....... ..... Other Fknlc .�e��ll.Z ... ........ .. .. .... ... (Ikasci7lll:lcxl) 6. Isal.iuulted Conl: .l-?Y(jT................. fee (to IK! paid oil flllnll [Ilia npplicildol) 5. If ckxlllinit, IK,111er of t1welllull uuila . ....... ... . Relber of AAIIIfill, unica on enc:ll floof. . .. . . ......... .. It llclrclite, Ixill/er of c:nr-a ......... ............ ......... ....... . h. If Imuln!sn, coin11ercial or Mixed ex:c111HIMy, apealfy nnlure nlul extent: of: enc11 type of title...... . ..... .... .. .... 1. DIIlleurli/xllr of exisl:inil stnlcLuren, if any: Frcxll:.. .. . ... .. ... .. . Iteur (k pill _ . . ..... .. ....... Ik:illlt: ......................... Ikvll>ev of Sl.orie:l . .. ... . .. ... .......... U1111ens10ls of amle sl.rticlure with mlleratima or lul(Ill:iona: I'ronL ..... . ..... .... Itenr ..... .... ...... Ik:11111 ...... .............. Ilei0ic ................. . . . Ik,11,er.of St'oricl:l .. .. ........... Q. Ilinlenslona of entire llew ("ISLnxa:1011: Fr(xll Itatir ... . ... .. .. .... Ik:plll . . . .. ... Ik:ll)it: ......................... 1•kidmr of :itorieu . ......... . ... .. .... . 'J_ Mize of lot:: 1rofIu .................... hear ..... ...... ... . ..... DU1)111 .... . .......... .... . Ill. Mile of (111-c:llnlle lltilll! of For111er (X4iilr ... .. .. .... . ..... ................ 11. Moe or title eliscrlet: In wlll(a► proillaen lire tlictiaced . .... .......... ... .. .... ... . ... . .. .. . .. .. ... .. .. ...... . ...,.. .. 12. Ikx prulxwed ceKulLrlu:Llon vlolure lily itKlinll llfw,.ordllllllK:e or relttilol.lon: .. ........... ...... ..... I:1. "Ill lot Ile regrlrlred .................... Will excesa fill be rmoved froln prc-3niaes: YEN NO Ill Mullett of Owixlr of pr(anlses ........................... NMIena .......... .... .. .... . .. ...... . 111o1u! Ik). ... . .. . .. ..... Milk! of Architect: .................. ... ........ . ...... Acl(iretln .. ....... .. . ...... .... ........ 11101u: 1Jo. .............. li:nle of ConCracl'or ... Aeklrana ............. . .................11K111e lk). ....... . ..... 15. Is Illia prnparcy within Peel' of n Lldnl IxlLlmul? * YES NO .......... *lr' YES, f)UIIIKMI) '11XAI '11MI611013 11iltl-11.1- NAY M I11upilarl). I'I.OI' DIAGItAIr llK:nce clearly n1Yl distinctly till Ixllldinitu, rAlelller exlsl:Ing or proposed. mill hullenLe till aec-bock itlllr:nuIonll f-veYu prolierty lilies. Give street ncxl block rrr11Klr or dencripLion sccor(llnll to deed, 111x1 IJICw acreel' Onven alxl ilulicnre 1AKllllec- iol'erlor or comer lot. APPROVED AS WOTCD FEE: NOTIFY SUILDIN DEPARTMENT AT EB5-fS®2 S AMTO a PM FOR THE FOLLOWING INSPECTIONS: 1• FOUN1.?ATdO'V - FrWo REQUIRED FOR POURED CONCRETE 2. ROUC-H - FRAMING 8t PLUMBING 3. INSULATj()N 4. FINAL - CONSTRUCTION MUST,@E COMPLETE FOR(,.0. ALL CONSTRUCTION ,SHALL MEET TIME REQUIREMENTS OF THE N.Y STAVE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR (Mr IEW Y(XtK, ®ESIGIY OR C0NSTRUCTi0N1 ERRORS (lIXIIIIY (X, ..... - ...... ... . ..... . . ..IK:init duly clw<nn, delx>retl nlKl mays dint' lie in [lie nppllcnllt. (Now of inklivicllrnl, nignitill conl:ract sllxve 1111111c:d, Ike i,: till! ... .... .... ..... .....:. ..... . �W. . .. . .... ((:cnWruclor, nitc:nc, corlxnul.e officer, etc.) of raid ennK!I- or 1/411K:ru, 1110 In duly nu111or1z.(:d to lx!rfona or have 1K:r1fon111:d Ilm mild work 111KI to 111alu., lied Illu 111111 nppl k"Lion; 111ut: till, atalenlellcu concjiflKA in Illin nppl icol ioo jive t111e to (lie 11emt: of Iris lux)wle(Ille mKl lxil ief; nlKI Hint. ilia rnlllc will Ix: llerfornled lu Ilia immier tleL for111 ill ilia mllplictlHon 1-11ed tllerewill1. !kr(1111 to IK'.fore IIr! thin ..... ..... ......(Illy o .v... . . 19.� ... Ik)tclry 1'lllll is ........... . �c-e-,✓ �j t (Silpnnl:tire of Appl 'ciml) ROBERT I. Sc ,.JR. NOTARY PUBLIC,✓ fate of N.Y. No.4725089,Suffolk County. Term Expires May 31. 19p d, . -420 1 HDGLE �t 76 U AD E` . . .,G.'L/tf.oM1U.'_�J..' SHED lip. 'it IOICE 410f "�SHED 1 t_pt.IC2.(.OVEQ i� •1\ \ s. 5.-74 fig=' 4o8.8t Z Ln --------------_.. --FbST age,N ~ SoUtiJD 5 p��50,50"W. 227.57 S.7S 8 50 MAP CF PROPERTY t. 9L9W.EYED F08 .. PAUL MAUREEN M. GF2I PPA - - AT MATTiTUCY- TOWW'OF' SOUTHOLD. M.Y. L..i:,_::.n•,!af.irraa.:`?c' i ILL 48vcwv c-py. : ^ SUFF � _ MAR .29 Inc