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Home My WebLink About24163-z241~5 ~ FO~M NO,$ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN ~ $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date .....d.U~E .................. 5 ............................ 19.,9.7. ..... Permission Is hereby granted to: ....... C fi-I~'.~ ,T. ~,, .&...WE..',., F.. I ~NE~ ...................................... ....... B~ I .'~,S.E.~I I.. ~W~ ..................................................... ....... SDU.T. HDLD.,. fi, kY...1.£ .~.7.. 1., ....................................... to .... E~RE~C.T... ~.,E, ENC ~,. mS...AP.RL, I ED.,..~. QE~ .................................................................................... at premises located at ............... 2~.ZO..... J~ClI. S,SE,~U...~.V..E ................................... .~O~I.T. ~OL, D ............ County Tax Map No......~.Z~.I~.I~.~. ...... Section ..Q. 5.5 .............. Block ....O.O.QJ~ .........Lot No. 0.3,1 ................ pursuant to application dated ...~.~1~ .................. ,~.~. ......................... 19......c/.Z ...... and approved bythe Building Insl~eotor, Fee $ .......~D,.~.QP. ..... Rev, 6/30/80 FOEM NO. 1 TOI~I OF SOUTttOLO BUILDING DEPARTMENT TOWN HALL SOU~OLD, N.Y. ]1971 TEL: 7~5- i80~ .... .... .... (~ld~ In--tot) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS HOARD OF HEALTII ............... 3 SETS OF PLANS ............... SURVEY ........................ CHECK ......................... SEPTIC FORM ................... CALL .................. MAIL TO: .................... a. This application must be c~pletely filled in by typewriter or in ink and sul~itted to the Building Inspector with 3 sets of plans, accurate plot plato to scale. Fee according to sched~fle. b. Plot plan showing location of lot and of b~ildings on pr~dses, relationship to adjoining premises or p~blic streets or areas, ami giving a detailed description of layout of property ~mist be dr~n on the diagram wi]ich is part of this application. c. The work covered by this application ~ay ant be c~r~enced before issuance of P~ilding Permit. d. Upon approval of this application, the ltuilding Inspector will issue a ]~ailding Permit to the applic~t. Such permit shall be kept on the premises available for inspection thronghont the work. e. No building shall he occupied or used in whole or in part for any l~rpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATI(lq IS l~Rgll¥ HMlt to tlm Building Depar~t for the ismmoce of a Building Permit p~rs~ant to the Building ~Z~ Ordinance of the Town of Sonthold, Suffolk C~mty, New York, aad other applicable Imws, Ordinances or Regulations, for the construction of b~ildings, additions or alteratlcms, or for removal or d~molition, as herein deser~bed. The applicant agrees to comply with all applicable laws, ordinances, building code, ho~slng code, and regulations, and to admit authorized inspectors on premises and in building for necess~y inspections. (Sigr~mre of applicant, or ~, if a corporation) (Mailing address of applicant) (Name and title of corporate offi~or) Builders License No ........................ · . Plt~bers License No ......................... . Electricians LiceeseNo...;' ................... State wbe~z{ applicant is omer, lessee, agent, architect, eng, r~er,~ gemral contractor, ~3~i~S~_~_ ~°r M~lder. ........ .................... ................ · .................. (~ m ~ t~ mi1 or latest d~) If ~li~t is a ~ratim, siam of ~ly ~t~ri~ officer. .., FOLLOWING ~NSPECRONS: 2, ROUGH - F~AM~NG & PLI,iMG~NG 4, F~[~AL COnSTRUCTiON MUST BE COMPLETa FOR C.O, ALL CON$TRUCTIOM SHALL MaET TNE REQUIREMEN~ OF THE N.~ STATE CON~TRU~ION & ENERGY CODES. MOT ~ESPONSI~ FOR O~r ~'s I.icen~ ~ ..................... . ~ DESIGN GM CO~RUCT~N ~RORS ...... ......... .......................... ~ ~.~. ~ ~i~ ...~ ........ ~ ...~ .......... ~ ..LI ........... ~Mivisim Fil~ ~p ~ .............. ~t . . (~) 2. State ~sti~ ~ ~ ~ of ~i~s ~ inte~ ~ ~1 ~ of ~ c~stmcti~: a. ~isti~ um ~ ~ ............................................................................· 3. Nah]te of ~o~k (clmck ~[id~ aPPlicable): ~ Iklilding .......... /kklition ..... Alteratlen 4. Estimt~l C~st: ~ ~[[ 5. I~ &~tling, ~ndmr of &~lli~ oalts ............ ta~d~r of kk~lling uni~s t~l each ~r ................ ] f garage, ~amlmr of cars .... ~ ................................. 6. lP lami~mss, ~nmrcial or mi~l ~qmt~, a~ci~ tultttte a~l e~tent off each ty~ of use ...................... 7. I)mens~m of extstmg stn~tu~ex, if any: Frtmt ................ l~ar ............... [~pfll ................. I)in~nai~m o~ sm~ stnmture w~th alteratitms or ;~klitioas: Front ............... l~l)th ... .................. [~i~tC .................... ~dmr oF Stories ................ 9. Siz~ of lot: Fr~t .......... ~ ......... I~ar .................... ~pth [O. lk~le of l~]rcha~ .............. ~ ....... gm~ of Fotu~-~r C~mr ........................................ ~m or u~ district in xd~id~ ~t'~ni~a are s~t~ .............................................................. 12. I~s pro~s~l omstn~ti~ vlo~ate mW ~]ing l~, onlirm[~e or regulat:i~: ........................ 16. ~es of ~mr of p~ni~s .... ] ......., ................ &klress .............................. ~me oP Ardfiteet ............. : ....................... ~lress .............................. 1t~ ~ ............... · ~e of C~t:ractor ............ I ....................... &klress ............................... H~ ~ ............... 15. ls tiffs pm~rt~ within ~l f~t o~ a tidal ~tlm~l? * ~kq .......... ~ .......... [ PI,OT I)IAGRA~ l~×:at.e clearly taxi distinct:IS, ~il Dailflings, ~mtlmr existing or propel, arxl it~lica~e all se~-I~k di~nsiona f~t pro[~rty li~s. Gi~ st~t' m~ bilk a~dmr or ~scripti~ accerding to ~1, taxi M~ street ~s taxi i~lica~'e xdmtlm~ interior or co~r lot. I~e is the ................... ~..~4..~...' ............................................... (Contractor, ageat:, t~orlx rate of fleer, etc.) cfi said (~mr or acrs, at~l is duly &~thoriz~l to l~rfone or h;me l~rfon~ the said ~tk a~l to rake a~l file tl~is appl leak ion; that all stat~mnts C(mt~iT.~l in this al~)lication are the to Ihe Imst tff hi~ ki.~l~lge a~gl Imlief; a,xl [hal the ~)rk will Im [~rl:onl~l Ju til~ II~llll~l' 8e(~ forth i. Lhe appl it:at, ion ftl(~l ther~D:h. (Sig.al-ure of ^pplit,ant)