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Home My WebLink About24083-zTOWN OF $O~THOLD BUILDING DEPARTMENT TOWN HALL $OUTHOI-D, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIl- FUl,l, COMPLETION OF THE WORK AUTHORIZED) N.°2~t083 Z ............ ~~ ~' Permission is hereby granted to:~'// /'~ / / ,/ · ...... ~...C,...C..~A~ ........... ..~ ~ ............... .~ ......... .... ~, ~,em,,.,,~,,,' ~, ..................................... ~ ~ ~..~-~ ...... ~~' ' ........................ co..~ ~ ~ ~o. ~o0~ Se~.o. ........ /~ .... ~ ........ Z .......... ~ot.o....~Z ............... Building Inspector. Fee $....~. .~:~~ ~,,~;--~ .......... ..... Rev. 6/30/80 BOARD OF HEALTH ....... .. · .. 3 SETS OF PLANS ............... SURVEY ........................ CI4~CK ......................... SEPTIC FORM ................... NOTIFY: - ~,, -- I~IL TO: .................... INSTRUCTIONS , a. ~his application mast be c~pletely filled ia by typewriter or in ink and submitted to the Building Inspector 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan ~owing location of lot and of buildings on pr~nis~s, relationshlp to adjoining pr~nise.q or l~bllc streets or areas, and giving a detailed description of layont of property must be drawn on the diagram which is part of this application. e. 3he work covered by this application may uot be corm~eced before issuance of Building Permit. d. UUon approval of this application, the Building, Inspector will issue a Building Pemuit to the applicant. Much pem~it shall he Pi~pt on tim premises available for inspection thret~g~at the work. e. No building shall be aceupled or used in whole or in part for any ptwpoae whatever tmtll a Certificate of Occopaacy ahell have been grunted by the hilding Itmpeetor. AP~ICATI~I IS Igi~Y ~ to the Building Departn~nt for the is.m~ce of a ~ilding Permit parstmnt to the Building Zone Ordinance of the Toan of So~thold, Suffolk County, New York, and other appllcable Laws, Ordinances or Regulations, for the constx~ction of beildings, additions or alterations, or for removal or d~m~litlon, as herein deserlbed. The applicant agrees to c~ply with all applleable 1.aws, ordinances, buildlng .cede, housing eode,~d regulations, and to admit authorized inspectors on premises and m build~r~-~-pr ~cessary i~t_ions. (Signature of applicant, or name, ~[ corparat'on) (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contrecto~R~l~er pr builder. · .................................................................... ........... ~ l)/~fE~: ,~/__~d~.._~... ~- o, o, .................................... .* ................ , ..... If ~li~t is a ~atlm, si¢m of ~ly ~ri~ officer. FOLLOWING / 2, ROUGH - FRAMING ~ / 3. ~h~SUI.,ATION . ~ ~ 4. FDIAL - CONSTRUCTION ~il~rs h~ ~...~ ........ ~ ......... 8ECO~PLETEFORC,O, ~rs Lic~ ~ ..... ~ .~ ............ ALL CO~STRU~O~ SHA~ . . ' ...... ~ .............. TME REOUJ~E~EN~ OF THR gl~tr~ci~s hre~ ~...~ ~ .............. S~AT~ CONST~U~ION & ~NEgGY , . ~ODES. N~ RESPONSIBLE FO~ I. ~tJm o[ [~ m ~Z~ ~ ~ ~[[ ~ ~.. ~.. -'~ ......... ~;~; ...................... ~ ~r ~tmt ~et ~ ~ m. ~ ~t~ .~5.~ ..... m~ ~.~:1.'~.. ~t ................ ~ivis~ ...................................... Fil~ ~ ~ ................1~t ............... .. ~ ~ ~ ~ ...~D!~.~J ....... , ............................................... b. ~t~ ~~ ................................. ' 3. Nz~lure of ~o[/k (cl~ck ~hich applicable): ~ I~ihli~ .......... Mklition .......... Alteration .......... , (to Im ~id ~ filing this a~lieati~) 6. If I~minesa, ~mrcial or mi~ ~, a~ct~ ~ture a~ ~tent of ea~ ty~ of u~... ~ .............. 7. I)in~nsJ~m of ~isting atnmtu~e$, If a~: l~(mt ......... ~ .... ~ar ............... ~pth ................. lhi~st ....................... ~. ~dmr off Stories ...................... llin~nai~s off s~ at~mt~e ~th alterations or ~litiona: Prat ............... ~ar ............... l~pth .................... Ibi~lt .................... K~tmr of Stories ............... lhi~st ....................... ~. K~tmr of 8torlea ..................... 9. of lot: · ~ ~0 ~ of C~tr~tor ........... , ..................... M~lress ........................ H~ ~ 15. la this p~rty within ~ f~t of a ti¢hl ~tlaM~ ~ W3 .......... ~ .... ~ .... PLOT I)ZAGRAH I~c. ate clearly and distinctly 411 buildings, ~lmther existing or proposed, and indicate aTl act-back diwensloos f-rc~ p~°Pert?/ lines. Give street ar~ block mntmr or description according to deed, and ahem street hanes and indicate xdmtlmr interior or cotter lot. ,____ z .' due · $'I'A'II'] (lit NLM Y(]i~K, I (~ of indlvid~l u~gmng con~ract) (C~tractor, agent, eor~rate officer, etc.) O[l)hcatt(n Lhnl ~l[ nLaL~}LS ccmtal~ m this nl~)l, tcatton are I:n~ to the Imal: ()[ hia kl~l~lge al~ Ix}J. lef; aiKI that the ~}[k ~ill I~ porfon~l in th~ t~m~c ~t fortl~ in the a~lication [~n~ to I~[ore ~ thia l - / 7 ~, ,/I ~ 7 THOMAS S. WHITEHEAD NOTARY PUBLIC, State of ~ew York No. 52-4604094, Suffolk CounA~z Term Expires March 30i 19 ._.._.~ (SIp, vual:t re of Appl ]cant)