HomeMy WebLinkAbout24135-z FOI~.M NO. ~
TOW'N 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)
N.° 2~t135 Z
Permission is hereby granted to: -- -- ~ ,
....
,.~ .., ....... ~; ............................. .~ .......... ~;~: ............ ~
,o ....:..~, ....................... ~...;~.~.~.~ ........... :, ........ ~.:...-~.:...~. ......... ~ ...... .: ...............
...........
a' remises located at ~ ~ Z~ ~z?~_ ~ ~ ~ ~
r p ............................ ..."~:...r,~9~./ .............. ;7 ....................................... 7' .............. ~' ....
County Tox Map No. 1000 Section .... Z...~....~... ...... Block .....~ ...........Lot No ......................
pursuant to application dated ..... ~..,.,,,~.,.,,~,, ................ , 19. ,~,.,~, and approved by the
Building Inspector.
Fee $....~..: .q..~...
Rev. 6/30/80
RESIDENTIAL FENCES CORR
1760 Route 25, Rd. Box 430. Ridge, New York 11961
PHONE (516) 924-3011 FAX (516) 924-3275
Address: ~'~0 ~ ~ .................
City/State/ZIP: ~E.~-~........................... Installation Date To Be
Res. Phone: ( . .) ................... Bus, Phone: ( ...... ) ................ on Or About .......
Erect At: Weather Permiffing
Purchaser: Date: Contract Total $
RFC Representative: ~_._~_ _~ _~_6_~ Deposit
- Setting of Post
RFC Officer: On Completion
RESIDENTIAL FENCES CORR SHALL NOT BE LIABLE FOR ANY UNDERGROUND LINES (ELECTRICAL, SPRINKLER, WATER, FUEL, SEWAGE,
TELEPHONE, CABLE, ETC,) ALL PROPERTY I INEt. FENCE HEIGHTS AND LOCATIONS ARE THE RESPONSIBILITY OF THE CUSTOMEF~ RESIDENTIAL
FENCES CORR WILL NOT BE RESPONSIBLE FOR FENCES DAMAGED DO TO HIGH WINDS OR AC"I'~ OF GOD. THE FENCE MATERIAL SHALL REMAIN
THE PROPERT? OF THE SELLER UNTIL IT IS PAID FOR IN PULL, NO MATTER HOW IT IS AFFIXED TO THE PROPERT'L
THE ABOVE PRICES ARE BASED ON FOOTAGE WRITTEN ON THIS CONTRAC]; ANY CHANGES OR ADDITIONAL FOOTAGE TO BE CHARGED AT UNIT
PRIDES CONDITION PRINTED ON THE REVERSE SIDE OF THIS CONTRACT ARE MUTUALLY UNDERSTOOD TO FORM A PART HEREOF YOU. THE
BUYER. MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS
TRANSACTION
INITALS
FORN NO. I
TOWN OF SOUTIIOLD
BUILDING DEPARTNENT
TOWN I1ALL
SOUTI1OLD, N.Y. [ ]97 ]
TEl,: 765-1802
APPLICATION FOR BUILDING PEP. HIT
]NSTRDCTIONS
IIOARD OF IIEA1,TE ...............
3 SETS OF PLANS ...............
SURVEY ........................
CltECK .........................
SEPTIC FORN ... ................
NOTIFY:
CALL ...J'.?C:.
NAIl. TO: ....................
a. ~his application immt be eonpletely filled in by typewriter or in ink aed mff~nitted to the P~lilding Inspector with
3 sets of plans, accurate plot plan to scale. Fee according to admdule.
b. Plot plan ~t~wing location of lot and of buildings on premises, relationship to edjoinlng premirms or pabllc
streets or areas, and givi[~ a detailed description of layout of property mst be drawn on the diagran which is pert of
this application.
e. ~lm work covered by this application my not be eommeneed hefore issuance of B~ilding Permit.
d. Up~ approval of this application, tim Building Inspector will issue a Building Permit to the applicant. Snch
permit abalI be lmpt on tim premises available for inspection throughant tim work.
e. No building aball be occxq}ied or used in danle or in pert for any purpose ~hatever until a Certificate of
Occupancy shall hav~ been granted by tim Building Inspector.
API~I.ICATIflq IS I~REBY NME to the Building Departnmnt for tim issuance of a Building Permit puranant to the
Euildi~lg Zone Ordinance of the Tixm of $onthold, S~lffolk Couno7, New York, ami otimr appIicable Laws, Ordi~mnees or
P~gulations, for the construction of imildinga, edditi~na or alterations, or for rem ml or demolition, as herein
described. Tee applicant agrees to c~mply witi~ all applicable laws, ordinances,
regulations, ~ to a~it ~ati~)rized inspectors on pr~nises and in L~fil~g for [mc(
(Signature of aPO
· (Mailing address of applicant)
in§ c~., .l~using code, a~,l
ry inspect ~ons.
leant, or name, if a corporation)
.....
State ~tmtlmr applicant is omer, lessee, agent, architect, engxeeer, general eontrae~pi~l~4o~aJ~OT~.~r or I~a, lder.
................
......
....................................... ....
(~ ~ fl~ t~ ~11 or latest ~) 765-1802 9 ~ TO 4 PM FOR THE
If a~li~nt is a co~tl~, si~ of &]y ~t~riz~ officer. FOLLOWING INSPE~ONS:
1. FOUNDATION - ~0 REQUIRED
(Nane and title of corporate officer)
Builders License No ..........................
Plt~i)ers License No ..........................
Electricians l,ieense No ......................
Otber 'lYade's License No .....................
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCHON ERRORS
I. l~cation of lat~l on ~Idch lXopesed work will be done ..............................................................
No. EInc ..... ........ .... ........
Sulxlivision ..................................... . Fil~ mp ~:~... l~t ...............
(~)
2. SLate ~st~ ~ ~ ~my of pr~s ~ inte~ n~ aed ~ of ~ c~st~ti~:
a. Exlsti~ u~ ~~. , ................. ~, ........................................................... ,j
h. Int'ea~ u~ mfl <m~q ................................................ ~-$~(~ .... ~ ...........
~;ll. ttre of x~.k (check xddd~ applicable): ~ I~ihling .......... ~klitioa .... Alteration
(lo I~ ~id ~m filth8 thia al~licati~O
If garage, tildes (}[ ¢a~ ...... ~ ...............................
If I~iail~as, ~m~rcial or mi~lJ~:inqmt~y, SlmCi~ ~l:ur~ at~l e~tenr of each ty~ o~ u~ ................
J)h~n~J~ o~ existing stn~blre~, tf any: Pr~lL ................ I~ar ............... I~pth .................
loL:
........ ~ ..................... ~lre~ ........................... ,... I~ ~ ...............
l~¢al.e clearly and d|atiocttly all
fr~u plroperl-y lines. Give ~l:reeL and
x,4~ti:er i.lerlor or con~.~r lot,
I'I.OT I)IAGllAtl
I~lihlings, ~ether existing or proposed, and indicate all ~et-lx~ck di,~ensions
lock r.,i~er or descriptic~l according to de~l, and ~how ~treel: iw~n~s s,xl hxlicate '
~ ............... I~:{ng duly m~xlrn, delxl.~,es and ~ay, thsr lie is the .ppl
oF .aid {x.a~r or (m~l-s, i.,~1 iv duly m(lhorlzed Icl Ix~rfom or h.vL: p(!rf'o~tl~! the nnld we,ok alii Lo mnke .nd file. I. his
vet Forth in the al~l. icatlou filed tl~re~ith.
,k
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