HomeMy WebLinkAbout24240-z FORM
TOWN OF $oUTHoLD
BUILDING DEPARTMENf
TOWN I.IALL
EOUTHOLD, N.Y.
24240 Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Date .....J~LY ............... il.j, ........................... 19,.9.7. ....
Permission Is hereby granted to:
....... ~.P,J~.NKL T.N.. A...JR.. SCHOLL .................................
....... 13.40...BI/NGAL01~.. LA~E ......................................
....... ~/AT. TI.T[/CE.. blY...11952., ................................. ~..
to .....I~E~T...A.. ,FENCK, ,%,~,..AI~.PZ,:f ~D.. F.0R ...................................................................................
at premises located at ................ 124~.....BgNC-,IALOI~..IA .....................................................................
Counly Tax Map No.....4,7.,,3889 ......Section ...l~iil ............. Block ....000.2 ......... Lot No. (11.7..,.00,2'. .....
pursuant to application dated ...JULY .................. 9, ......................... 19,....g'Z ...... and approved bythe
Building Inspector,
Fee $ ........ 85,.0,0 .....
Rev. 6/30/80
....................... ,.' ' I~()RH NO. I
TOWN lIMA,
~ ............... ~ : soIrrllOi,I), N.Y. 11971
BLDG. D ~PT.
hPPI.ICATIO~ FOR BUII.III~G PEI/HIT
INSTRUCTIOHS
BOAIH) ()F IIEAI,'rll ...............
3 SETS OF PL^NS ...............
fiURV[';¥ ........................
CIIIt. CK .........................
SEPTIC FORH ...................
a. 'lids apl)licatic~l rmst be cmq)letely filled in I)y typc~,lriter or in i.k taxi red,hilled to the lkdhling hml~ctor will
b. Plot plan Mg~ing l~ati~ of lot ar~l of I~dldings ~ pre~nises, relationship to ~ljoining pr~dses or l~fl~lic
si rc~ts or arena, arxl givir~ a ~tail~l <~s<:riptims of
this applieation.
c. 'lhe ~rk c~mr~l by this alSflication ,,~ly ,~l. Im cCmxn,~:~l I~fore issumme of l~Hlding Pemit.
d. IIlX~ n[~r{~al of this application, the lh~ilding lnsl~Cror will issue a lkdlding Penuit to Ihe applicant. ~ch
lx~rmit Mmll 1~ kept ~l tl~ prmd~s availahle for ins~eti¢., thr{x~(~lcx~t Ihe ~rk.
e. ~ Ixdhli~ lfllall I~ ~cupi~l or u~d in ~ole or in
(~X'Ul~l~K:y Mini I have I~n grant~l by tim I~Hhling lnsl~cl.or.
fiPPI.I(ZTI~ IS IEl]~lff }~ to It~ I~dlding l~lmrtn~nt for the issua~.:e of a ~dlding l'emit ~rs~mnt to Ihe
Ihfilding 2~ Ordi~m,x:n of the 'l'~m of ~,tl~hl, fi~fffolk Cz~mt-y, ~ York, a,~ other applicable I~, Ordinates or
I~gulnl liras, for Lie c~mt~eti~ of I~dhlir~a, ~kliti¢~m or alterations, or for r~al or ¢~litlon, as herein
~scril~M. '11~ applicant agr~s to cm~fly with all a~flicnble I~qs. ordl,m~a:es, I~Hldir~ c~ I~ming c~e,
~ignah,re of appi i~ ~r n~ if a (~orl~ral ion)
(~ili~ ~ldr~s of a~flicant)
State whet]let applicant is (x.~er, les~, agent, archil:ect, engineer, ge,~ral contractor, electrician, pltsd~r or I~dlder.
· ,,r ............. , ............... ....... . .
......................................................... 765-1~2 9 AM ~ 4 ~ ~R ~E
(~,,~ a,.l l irle of corlx)ral'e officer) FO~ING ~N$:
1 F~ND~ - ~ RE~ED
plu,i~r~ Licen~ flo .......................... . ~. FINAl. -
Elecrrlcbms Licen~ ~ ...................... A~ CON~TRU~ION
~TA~ ~TRU~I~ · ~R~Y
I. l~atk~, of lnr~l (., ~dch prolx~l ~rk will Im do,~ ....................... ~-~..R~~..~R ....
~d~livision ...................................... File~l ~q) ~:, ................ lx>t ...............
I
I'I.(:)T I) l A(}RAH
//
UNDA
~Ot~ Pit Publi~, State of
NO, ~4868259
Oualtfied in ~tftolk Co~ml~
(hlly t.'~)ll;, (h:.lXl!;(!, mM Fnlyt; thai: he i..; Ihe ,ppi h':inl
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