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Home My WebLink About24102-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PER~41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 24102 Z Permission is hereby grante/d~ ~ ./ ~.:~._.....~.......~/.Y..~ ................. .~ ..................... .... ................. at premises located at ~:.~..~..' .~..~ ~ ~.'~'.' ~~..'.' pursuont to opplicotion doted ............ ..~..~..' ..................... , 19~...~.., and approved by the Building Inspector. Rev. 6/30/80 FORH NO. I TO~/N OF SOUTIIOLD BUILDING DEPARTHENT TOi/N IIALL SOUTHOLD, N.Y. I 197 ! TEL: 765-1802' Disapproved aye ~. ......................... /~ ..... A~,ICATION FOR BOIl,DING PEIU~IT INSTRUCTIONS BOARD OF UEALTU ............... 3 SETS OF FLABS ............... SURVEY ........................ CHECK ......................... SEPTIC FORH ................... NOTIFY: CALL .................. HAIL TO: .................... a. 'Ibis application mast be oampletely filled in by typeariter or in ink end athnittM to the ~lilding 3 ~ts of plans, ~rata plot pl~ to ~ale. F~ ~i~ to ~h~ule. b. Plot pl~ fl~i~ l~ti~ of lot ~ o~ hfildi~s ~ ~d~s, relatio~fip to ~jolnlng prof.s or ~tblic struts or a~as, ~ givi~ a ~cail~ &~ripCi~ of l~t of pretty ~t ~ dr~ this a~li~ti~. c. ~m ~rk ~ ~ ~fis a~licati~ ~ mt ~ c~ ~fore isle of ~ildi~ Pemit. d. U~ a~al of cl~is ~licati~, t~ ~ildi~ lns~c~or will is~ a ~ildi~ ~miC ~mlt Mmll ~ ~pt ~ ~ ~i~s available for i~tim th~C t~ ~rk. e. ~ I~ildi~ Mtall ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~mt~er ~cil a ~rtificaCe ~c~ ~mll h~ ~n ~t~ I~ tim ~ildi~ Ins~tor. A~I~TI~ IS 1~ ~ to t~ ~ildi~ ~nt for ~e isle of a Mildi~ ~t ~ to the ~ildi~ ~ O~i~ of ~ ~ of ~tl~ld, ~f[olk ~, ~ Yo~, ~ other a~li~le ~, ~i~es or ~lati~s, for tl~ ~s~ti~ of I~itdi~, ~icia or Mterati~s, or for r~al or ~liti~, a ~reln &~ri~. lie ~plicat ~s to c~ly vith all a~li~ble l~a, o~i~nees, ~ildiu~ re.latins, ~ to alt ~g~ri~ ias~Cors ~ ~i~s a~ in Mildi~ for ~esa~ i~ti~s. (S~'' tu~of ~lic~C' (~ilit~ ~ress of a~licant) State ~mtl~er applicant is o~er, ldssee, agent, ard~itect, engineer, general c~tractor, electrici~, plier or I~ilder. If aR){ i~at is a co.ratio, si~cure o~ doly autl~rizal officer. ~O]'IFY BUILDING D~~ (Narae and title of corporate officer) Otlmr 'lYe's l.icen~ ~ ..................... 765:~802 9 AM TO ,4 PM FOR THE FOLLOWING INSPECTIONS: ~, FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING ~ PLUMBING S, ~NSULATION 4, FliP,AL CONSTRUCTION MUST ~ ~O~PLETE FOR C.O. ALL CONST~UC130~ SHAI,~, MEET 'T~qE ~?EQUI~EMENT$ OF THE N,Y, I. l~c~tlon of land on sdlidl proposed turk vii 1 be done ........................ .... ................ ........ t~ ~r St~t ~let ~ivisim ..... Film ~p ~ ............... l~t ............ (~) 2. State ~sti~ ~ ~ ~y of p~s a~ int~ ~ ~ ~ o~ ~ c~st=ti~: ..... .... ......................... b. ...... ..... .............. ]. l~;a.re af ~oll~ (c,l~ck d~icl~ al~Plicable)~ I~ I~ihling ~,. kh~ion .......... alteracio~ .......... t~. Esti,~lt~l (~t....,.....,..........,...' ' f~ ........... ... ~ .............................. 5. 1~ ~lli,g~ ~i~r of ~lli~ ~nits ............ ~d~r o~ (~11 lng t~dt'a tm each liter ................ 6. ]~ I~tail~sa~ t~rctal or mi~l ~c~qm~my, slmci~ ~t'ure m~l extenE o' each ty[~ o[ u~ ...................... 7. I)ineuai~m of ~isting st'n~tures~ if any: Fr(mt ................ I~ar .. ............. I~pth ................. 9. " ~ ~,~ ]e~:, ~,~,~ ...m~ ............ ~,~ ...~ ............ ~p~,', ..... ~ .......... I I. ~ or e~ (lt~t~ic~ in ~lidl pc~al~s are sit,mCat ...~..~ ......... , 13. ~[11 lot le regrahl .... ~0 ............ ~itl e~:esa fill Im ~m oi Ar(~lltecE ............ ~lre8~ ' 15. l~ ti&is pmimrLy vithin ~) ~eeC oi a tiihL x~tlm~l'l ~ ~1~ .......... ~) .......... hmate clearly md dlsti~tl~ all h~lldh~a, ~etlmr existing or protx)~l ~ther hderJi)r or conmr lot, ..................................... N:ing duly ~)ru, I~ ia the ................. ~.,,L~ .................................. ((kmtractor', aSent, corix)rate officer, etc.) of .aid (xamr er ~K4rs, taxi ia duly aulhorlzc~l to i~rl'oJm or have l~rfo[ntM Ilia IhaL the ~l[k ~it[ I~ I~rfonl~l in IJle JJ[lJJJ~[ ~[ J~rLJl ill th~ appl Jcal:io~l ........ · t~tl~eC~ In-Suffolk Countvl/__.~,~" ';me, mmslon- ~plres De~, 8, / ! [,