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Home My WebLink About24601-zFORM NO.3 TOWN OF $OUTHOLO BUILDING DEPARTMENT TOWN H~LL SOUTHOLD, N.Y. 24&01 Z BUILDING PERMIT (THIS PEr, MIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) Permission Is hereby granted to: ....... .q.~.[~...~I...~...INF.....~.I~.Q K~.I~ ...................................... ....... P..O...i~P.~.,.~2,~ .......................................................... ....... ~U.T.~ W.O~.U F~ ,, bi .Y.... J, ~-..~ 5 ...................................... to .....ERECT...A...E E. INC.E...~ S...~..P.P..L.LE D... E.OI~ ................................................................................... at premises located at ................ ;L.2~.O......C.~SE~E~...L..~ ............................................. CLt.T.~;HEIE~LIE: ......... Coun~yTax Map No......~.7..~EtEL~. ..... Section ...1.0.9. ............. Block .....OQQ.5. ........ Lot No..Q:L~ ............... pursuant to application dated ....DE.C:.E.iTIBE. FI.......~D......i ................ ,. 19......9..7. ..... and approved bythe Building Inspector. Fee $ ........ ~J3... O.O ..... ' ' B~ll~l~ Inspect;; ....... ~ ...... Rev. 6/30/80 FOP~ NO. ! TOI~N OF SOUT~OLD BUILDING DNPARTNENT TOI~N HALL SOUTHOLD, N.Y. 11971 T~L: 765- 1802 ', Pemit No ................. Disapproved a/c ........................... BOARD OF HEALTH ............... 3 SETS OF PLANS ............... Cl~CK ......................... SEPTIC FOlfl~[ NOTIFY: I~IL TO: .................... APPLICATION FOR BUILDING PEP. HIT INSTRUCTIONS " a. 1his appllcatlou m~st be cmpletely fillat in by typewriter or in i~ ~ ~tt~ to ~ ~ildi~ In~tor ~ 3 ~ts of plus, ~ate plot pl~ to ~le. F~ ~c~i~ to b. ~ot pl~ ~ l~ti~ of lot ~ of ~ildi~ ~ ~s, ~lati~ip to ~joini~ ~s or ~llc st~ts or a~, ~ glvi~ a ~tail~ &~rlpti~ of l~t of ~ ~t ~ ~ ~ ~e di~ ~i~ is ~ of this ~licati~. 'c. ~ ~ ~rd ~ ~is ~li~ti~ ~ mt ~ c~ ~fm isle of ~ildi~ Pe~t. 'd. ~ ~al of ~is ~li~ti~, t~ ~ildi~ Iu~ctor ~fill is~ a ~ildi~ Pe~t to t~ ~li~t. ~t ~all ~ ~t ~ ~ ~s ~ilable f~ in~ti~ ~t ae ~rk. ~. ~ ~ildi~ ~11 ~ ~i~ ~ ~ in ~le ~ in ~ for ~ ~ ~at~r ~til a ~rtificate of ~ ~1 h~ ~ ~t~ ~ ~ ~ildi~ I~tor. ~I~ IS ~i ~ to ~ ~ildi~ ~t for ~ isle of a ~ildi~ Pe~t ~t to ~e ~ildi~ ~ ~i~ of ~ ~ of ~ld, ~ffolk ~, ~ ~, ~ ot~r ~li~ble ~, ~i~es ~ ~lati~s, f~ t~ ~st~ti~ of ~ildi~s, ~iti~s ~ alterati~s, or for ~al or ~liti~, ~ ~rein ~i~. ~ a~li~t ~s to ~ly ~th ~1 ~li~ble 1~, o~i~es, ~ildi~ ~, ~i~ ~, ~ r~ati~, .............................. ............. ........... (~ ~ t~ll orlatest ~)~ l~~ffi ~ ~ I FOUmWION. TWO ntoMmto I. I.)UeN. FIIMMIe A Iq.UMnING 4. FINAl. - CONSMIUCTION MUST BE COMPt.ETE FOR C.O. ALL CONSTRUCTION SHALl. MEET THE REQUIREMENTS OF THE N.Y. ~TATE CONSTRUCTION & ENERGY CODES. NOT RESPONSIBLE FOR DF.61GN OR CONSTRUCTION ERRORS 5o 15. Pnlure o£ uork (deck ~dlidl sl~licable): Nos l~lilding .......... ~ici~ ....... ~. M~eration .......... l~l~,ir ............ ~at ..; .......... l~l iEi~ .......... ~~..~ ........ ~ ~ .............. (~ripti~) Est i,~t~l ~st ~' ~ / [ (to ~ Did ~ filing this a~li~atJ~) ~lli~-- units ..~... ~d~r of ~]ling traits ~n enO~ fl~r ................ ~lli~, I~ ~roge, ~r of earn .... t ................................. If I~mi~ss~ ~mreial or mi~ moz~, s~elf~ ~ture a~ ~tent si each ty~ of u~ ................ ...... I)in~nsi~s of ~lStmg stnm~es, if any; ~t ................ , · .................. ~. ~t~r of Stories ...................... Din~nsiom o~ so~ stn~re v~th alterati~m or ~itioos: Front ............... ~ar ............... l~pth .................... lht~t .................... ~mi~r of ~tortes .............. D u~nsl~ of entire ~ ~st tjx; I~t ................ ~ar ............... th .............. I~i~nt ....................... ~. ~t~r of Stories ..................... Si~ of lot; [~t ................... ~ar .................... ~pth ............. ~ ..... I~te of ~lrdm~ .................... ~ si Forn~r ~r ........................................ k or u~ district tn ~id~ ,rmi~s ~ si~t~ ............................................................... ~s propel ~mt~ti~ vie ate any ~li~ 1~, o~[~e or re~l~tJ~; ...... ~. .......... ~ilt lot ~ ~r~ ..,~.~ .......... ~ill ~ss fill Im r~ ~s of ~r of ~ui~s .... { ...................... ~lress .............................. 1~ ~ ............... ....................... ~ress .............................. ~ ~ ........ > ...... ~ress Nme of Ardtltect ............ 1~ of C~tr~ctor ........... Is this property within 300 Ic~ate clearly and distinctly froot property lines. Gi~e street a~ ~ther interior or co. nar lot, ,t of a t~dal x~etlm~l? YF~ .......... NO .......... sr~s m~rr mv m~ m~n~). PI.OT D[AGRAH 'il buildings, d~etlmr existing or proposed, and i~x{icate all set-ba~k dimensions block r~,lmr or description according to deed. and shc~ street rk~s arm i~ticate o[ 8a~d ~r o~r~l 18 duly ~lhorJ~ ~o i~rfonn or halo i~r[orn~ tho ~t{I ~[k m~l to n~ke ~l f~le thi~ applicati{m; lhat all statmnts cont+i~ in this alq)licati~; are the to Oxe Imst of his kl~l~&m timt the ~)rk will I~ ~rfont~l in th9 ,mmmr ~t forth in Ute appl.lcati~ fil~ ~rn to Imfore mm this ~ [ ~ ~ I · ' ' ............ .................. being duly s~x)m, delx)ses at~l s,~ys lhat he is Lite appl leant ARE. A: 'U T~5~zv o[= ~OOT~OL, O, b~.'~. 0 ,.T.~..~J~- ,SI. IFF. co. DEPT. OF HEALTH SERVICES ' ' ' ~'~A'~EMENT OF INT£~,IT .......... FOR APPROVAL OF' C,0NSTRUCTION ONLY '. THE WATER SUPPly AND SEWAGE DATE: ; DISPOSAL SYSTEMS FOR THIS DENCE WILL CONFORM TO THE H. S* REP, NO.: STANDA~IDS OF SUFFOLK CO, DEPT. OF H~LTH. APPROVED~ ___ , j