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Home My WebLink About16738-z?O~H OF $O~T~OL~ BUILDING DEPARTM£NT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PEP, b~IT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) NO_ 1673~8 Z Permission is hereby granted to; 4 /, /~ / ~ , ~......z..~~ ....... .~/~.;~.~ .............. ..(./.;..z~?.......~:........~.. ............. · , ........... ~..../,,~..,...~:.~.-.. ................ ~...,, ,, ,o.~~~~.......-,,:~...~~.....,~.~.'...~:~ ..... at premises located at ..........~.4/...~'...~..~). ..g~..~...~::~' .. · ~-:.Z/"_'"~"' ~/4'"'~..~: ........................................ ................................................. ...<-/~_.~~r ...~'/.x../. .................................................... County Tax Map No. 1000 Section .... .//....~.. ...... Block ...... .//. ........... Lot No....../...~.:. ~'~... ........ pursuant to application dated ............. 2/~....~ ....................... , 19..~..~, and approved by the Building Inspector. V Rev. 6/30/80 FOUNDATION (1st) FOUNDATION ( 2nd ) ROUGH FRAME & .PLUMBING INSULATION PER N. Y. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: 7-/ [ TOWN OF SOUTHOLD Examined . ~,/,/ .......... 19.07.~ BOARD OF HEALTH ...... 3 SETS OF PLANS ....... 'FORM NO, 1 SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTMENT SEPTIC FORM ............. TOWN HALL NOTIFY $OUTHOLD, N,Y. 11971 TEL.: 765-1802 CALL ................ MAIL TO: Approved....'~./d~// ........ 19 . .~. Permit No....~.~...7~. $ Z Disapproved a/c ..................................... // APPLICATION FOR BUILDING PERMIT Date ................... 19... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- cation, o. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the 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 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit auth°rized inspect°rs °n premises and in building f°r neces~ns" 0/t:~,' ~~li~c '~f a corporation) · (Mailing address of ~applicAn, t) ~. / State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or §uilder. ............ ....................................................................... Name of owner of premises ~..~. ~.~:..0~../ ~ If applicant is a corporation, signature of duly auth~ed officer. (Name and title of corporate officer) ALL CON, TRACTOR'S MUST ~ ~'BE SU~'FOLK COUNTY Builder s License No.. -- ;../~.~..~ ........... . Plumber s License N~ ............ LICENSED Electrician's License No ....................... Other Trade's License No ...................... l. Location of land on which proposed work will be done .................................................. ..... ....... House Number Street Hamlet County Tax Map No. 1000 Section ...l..[.¢. ........ Block ...t.t ............ Lot .... /...~'~ ..... Subdivision ..................................... Filed Map No ............... Lot ............... (Name) 2. State existing use and occupancy of 2[emises and intended use and occupancy of proposed construction: a. Existing use and occupancy .. K~,. ......... _' ............ ,.. ;.,~ ......................... b. Intended use and occupancy... ,~,~. 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