Loading...
HomeMy WebLinkAbout23449-z ' � volt '�' ��S�|�, i�)�i��[[�y\| T V^ |[ � [ � id .......... ------- -------------- STA IT Lop _---_--.~ , -_--_ z-� �i --'- r� --- U ~~ -_-_ 4s, - --------_---__--_--_-------'--'- _.~` _-'---..............----_--___---_--'___-__-----____---_ -------------------_'---'___ ____ u ---__'-_-_----'---_-'----'----'_-- � __ _ - --'---'----'----'------'----'---- 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) N23449 Z Date ...� ......................................... 19. ... ..... ep Permission Is hereby granted to; �� .... C� .s...... ............... /��1���� c .........................�...../1, 1� �� to ... ?-!-444.............. . ........: .. ...........��.... ............... .... iJ!jrr?/ iy. ......... 5.v......... l�l ...., -a �......................................................... .................................................................................................................................................................. .................... ..... . ...................................................... ................. ............................................ at premises located at..............ow...../. ✓..!9/�f.....1"A.A .................................... ............ ............................................. i 7/7 1�............................. ............ /OlfCountyTaxMapNo. 1000 Section .. ........ Block......0_::2............ Lot No. ... ..1.... / /JT /�pursuant to application dated ......... ..... ... .... ......... ...................... 19.... .... ...., and approved by the Building Inspector. Fee $...12............... ...... . - . N ).•' ....I......................... uilding Inspector Rev. 6/30/80 i i i 1 r 1 i f E f L f F HOARD OF Nf:,Al:l'N . 1101t11 NO. 1 _l SE?'I'S OF PLANS . . . . . . . . . . . . . TJ l 1,014N OF SOUTHOLD SURVEY �1 BUILDING UI?1'AR'1"tlliN'I' CIIECR TOWN HALL SEIPTIC; FORK . . . . . . . . . . . . . . . . . . . SOlITHOLD, N.Y. 1 197 1 ZBI��Lo J, 'flit.: 765- 11107_ 110TIFY: ` cnt.l. . . . . . . . . . . . . . . . . . . 1lATI, TO: . . . . . . . . . . . . . . . . . . . . AI>pumed.........✓/..� .., 19%fP Permit No. . .... .. .......................... ... ... .... Disalnwaved a/c .................................. .................................................... .. L5o :.... . ii ldiol; nr -:c:to I AI'I'I,ICA"PION FOR II1111.I11NC PIiI1M1'I' I , Date. . . b. . . . . . . , 19 OF SOUTHOLD INSTRUCTIONS a. 'This alrlAicatioo must be ccarplet.ely filled in by tylxx•rriter or in ink aril s(drtnitt.ed Co Lhe Wilding Inspector" will) 7 sel:s of plans, accurate plot pl.all Lo scale. Fee according to sclleclule. b. 1'lOt plan SIxYwi(lg 1(x:000xl Of lot: arrd of Ixrildings ou premises, relationship to adjoining pronl ses or lx(blie. sl:reets or areas, aril giving a detailed description of: layout: of properLy mist: be dmnm on [lie diagram which is part Of tl Ls application. c. Ihe work covered by this ahlilicali(xl nvey rxlt he ccvix-xed Ile fore issuance_ Of lkli1ding Vennit. d_ Illxm algrraval. of this a1q)l icaLion, the Ikri Iding Insp ec-Lor (•ri I l issue a Ikri(ding Perrni t to Lhe applicant. Sw..•h permit shall be kept: o(1 Llre premises available for inslmcfim thrcxrghrxrt the work. e. No building shall be occupied or used in 01ole or in pall: for any Ixn-Ix-me wllaLever until a Certificate of Occ:ulkmw:y shall have been prmlte<I Iry the Ikril(ling Insl)ecfor, AI'PI.I(INFION IS I11KI(EEIY KU11. to Lhe Ikrilding DepartrrrnL for the issuance of a lkrildinl; Permit lrrirsuanl: to t.be Wilding Zcxre Ordirkarrce of the Tum of `"ithol(I, S(lffolk C(xmll:y, M-w York, a10 Other applicable Laws, Ordinmlces or Regulations, for Lhe C(xlstutict'i(H) of Imildings, a(klitims or alterations, or for rerl(Nal or dernolit.ion, as herein described. 'Ihe applicant agrees to comply with all. applicable laws, Ordinarx:es, building uxle, housing axle, nod regulaUcAls, arxl to a(lait: alll.lxrrized inslx-,ctors Oil lrrernises alxl in building for,{mcessary inspections. l 'i gma ure of 1jppl icarlt, or name, if a corlxwr itjon) (KI I ink; address of: appl icairt) SlaLe r4(ether applicant .is (xarrer", lessee, agent, nrchilect, engineer, general contractor, electrician, liluriler or Imilder. .....©. na != t. ............ ...................... .................... ...... ......APQRQVED ASAOT9.E2D........ Ntr,nca of cxaler of premises .. 61ATE: B.P.# :1f� i (as (xl the Lax vol l or latest deed) NOTIFY BUILDING DEPAR MENT AT If: alrtrl icant is a corixmiLioo, sigr><alure of: (hlly nnl.lxrrived officer. 766-1802 8 AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: ............ ................. ..... ...... .. ..... .... i. FOUNDATION - TWO REQUIRED (Name n(xl Little of corlwace officer) FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION Ikrilders License N). 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR C.O. t'ludrers license No. ......................... ALL CONSTRUCTION SHALL MEET 1?lectricians I,icense No. ...... ........__...__ THE REQUEREMv_NTS OF THE N.Y. 011rer Trade's License tJo. ........, STATE CONSTRUC:1'jON & lr cNERGY CODES. NOT RESPONSIBLE FOR I. I ccaLioo of larxi Oil wllidi prolxrsed work wi 1.1 Ire done.....u�G�..�. ,�,,,,_T�RSIGFg(W�C� 7 i v y„ 1� o... ..................... �!3. /7 's..L ...................... . . . .. ..................�................'...�.�� IkAme Uirdwr Street IlatileL 0xlnty Tax Hap No. IO(X) 8(eeaiexl .../D.9........ 1)l(xk ...o.3.. ..... I.Ot S(llxlivisiorl . ............................... ...... Fi Ied Kip Pkl. .... ........... Lot ............... Mine) 2. State existing use arxl tx:c.uparx:y of: premises aril interxled use argil Occupancy of lrroposed consLnlclion: n. Hxisling use aril occuparx:y ..-�`rO,R C?L 02..1�. IT. ... �.�./#.T�.�J�................... b. 1nL(:trx1,ed ore aril (xruluuxry .......... ..... .................................... 1. R-1111ie of crank Gikecl( c.Alicat aii,lirnhlc): Pk�a Klildinl,. . . . . . .. . . . AM!I.ion . .. . . .. . . . Alteration . . . ... Ilf!iN1I f . ... .__ . ... . IWIKN:11 . .. . ..... . . . . Dcllx)l 11.ioil . . .. . . . .. . . . Ol,her 1'loi k .I: .�s.r.►.N�. . n (Ik:ncrlpl:icxl) �l E's 1.iuifil L41 (k)sl: 4�00 ..W. . . ... .. . . fec: _. . . ../.. .. .. . . .. .. . .. .... ... ... ....... ...... (to Ix, paid oil fil inl; Illin appl ical:icxl) (kx!I I inil, (i(,Ill)er of: tkael l iol; units . . . ... ___._. Iknl)er of Awal I ing ulli Ls oil each fl(x)r . .. . . . ... . . . . . 1 I' [vu III;e, Ixlllx:r of cal ff ..._.I. . .. . . ... .. .. .. . . . . . . . . . .... . .. . O. If IKlniDef)fi, (xanllerc:lal or mixed (x:cutull)cy, nlu_(:Ify 11"Wre I'M exCenC of each type of use..... .. . . . _. . . . . . . . . . . I � 1 7. IIhllensi(xls of exist'In(; slrluauren, if: Illy: I?r(x11 ._ .114. . .. . .. .. . Ilenr __f'4. ... . .. .. . Iklplh ..�. ... . .. . . . . .. t ..... . .. ........ . Rx►bm- of Slovien . . . . .. . . . . . . .. . . . . . .. . 1)inx!oni(x)s of s(nie sl.rtuaure with alt-eralicxls or ixldiL'loor•,: Front! .. . . . . . . .. . . . .. Rear .... . ... . ... .. . DOI)lII I010iL tkoi6ar of Blorien .. . .... ... . .. .. 1{_ 1)lllx!linioils of (2111.111! Ix'_(J coIInl:I(WA.1otI. FI()ill He'll. Dept11 . . . . . .. ..... . . Ik!i1011. 9. ._. .. ... .. .... .. .. .. . . .. Reiher of lilnrieil ; ize of IoC: IrcxlC .. ... 7J .. ._ M. . .. . .. .. . . . . - . .. .. . . p . . . . . ..... _. . . . .... 10. NILe of flu chase . .. ....... .. . .•. .__. _ Niux! of Fol ux!r (k'dmer L I I. 1.(x)e or use Mist.►icL in c.Alich piemisen ale situated 12. Ikmn proIX)eed r,Enislrix:lloo violate any z(Kllni; Ilia, ordina)lc:e or- rel;ulal.icxl: 17. IJt I I Iol Ixe r ellrimled .._N... . .. .. .. . .... Will excess fill lie re5lx'rved fr(Xl% pfUlll ffes: Yi:S IX) 11711c:s of (kaller of preluie;es SOL. �� .•. ..... Afklress :sl1�r')1u:.lki.a7y��9 UJ,.. . .,...... . Ilinx! of Arcal l le(:L ... ... .... .... . .. ...... .. .... . . . . . .. . . . . . . : . .. . . ... .. l ll�ix: 1k). :I. . . . . . . . . N:rlx! of (kx)l racCor ...... . ... . . . . ... . .... ...... ... . .•. NMI ess •. . . . . . . . .. l_lLo('e tk)_- I:i. III (Iris prr)lx!rl.y within :3(X) feet- of a l:I(Ial lxlLlfilxlf a-ot: Alf YES, t)O1f UND •11AA4 'Ilt1);i111;;i lli14-11.1- MAY I11s 111?d�llNu?I)- PLOT I)TAGIIAII Imille clearly nlid disLi(xaly fill Ixlildiril;f), l.Alelher exislAill; or prolx)sed, nIWI ilxlicaCe fill seL-I)n(--l( dimensions frill) prolx!rly l ilvan. Give .9cm:t: 111xI I)I(x:I( IxKli)er or (k!sc:ril)l io" according I'o (teed, alxl fa►(xa sCreeL nir)len and iodir_nll! 'AmAher interior or c:oviklr lot:. � l y3 a f r r (l am m0 J!� fig-owl tra .j-. 4 . SS`(XAII(IY ( �'l . . .. . . . . . g2- �`l�m ?•• . . . . . .. . .. . . . . . . . .. . . .. . .Ixlinll duly f(x)nl, (letxmes nixl says that: he is ill(! opplicanl (N:nx! of ilxllvid,Ill r•,il;lllnl; (:oral inl;l ) ills'V`Q li:rlxld .,,.. . 71 -••• ... .. .. . . .... . . .. .. . .. ... .. . . . . . ... . . .. . .. .. . . . . . . .. . . .. ...... . .. . ... .. ... .. .. .. ((:(xllraclor,, nllenC, corixmit a of fir:er, of id (nxxlr of. oulx:rf:, 1110 in duly authorized to ixlrfulnl or have iK!rfonlxld (he saki wilt mill Lo make find file Illin :1i)iltl(:IIt-IOIlj thnl. all. slnlmielllfl coillnllxlll ill this ilpillll;(11'lull nre tl"lK! to the I)eal: of his I(Ix)wIe..(Ihe i11K1 Ixtllclf, alxl that. the (d)rl( wit lx! perfotllxld ill ttl(! llvllllK',t' Set: foilll ill (lie ili)pl I(1f11:1(111 Filed therf-milll. !;vx)In to IK!fore fir! this �./�1'^ r . . . _. . .�!. . . ......day f . .. .. . ... 1) �. . . _ r AIM LAURIEE.GRAEB l;nnLuYofppl icool.) r'rmm Notary Public,State of New s No.4821818,Suffolk County/� f mmission Expires Sept.30,19%6