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Home My WebLink About23946-z I~OW'M NO. · TOWN OP SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 239t6 Z Permission is hereby granted to: .... ........................................ .... ...~. ~,~_.....~.../?Z~ .......... /.~....../.~......~........~....,~....~,~c.....~£......~..~.../.~,~......~,~ ........... ot premises located at .......... .,'~/~..~.~)....~~...../~.:. ................................................ pursuant to applicat'ion dated ........... ~--~.......~ ............. , J g..~..~,, and approved by the Building Inspector. Rev. 6/30/80 FO~4 lJo. I TOWN OF SOUTflOLD fiOUTIIOLD~ N.Y. 11971 TEL: 765-1802 Disapproved a/c .................................. BOARD OF IIEAI,Ttl ............... 3 SETS OF ~IA~S ............... SURVEY ........................ CIIECK ......................... SEPTIC FORH ................... NOTIFY: CAIA ................... HAIl. TO: .................. r~pector ) APPLICATION FOR BIIILDING PERHIT INSTRUCTIONS a. 'fids application mist be completely filled in by type~rlter or in ink a~l mll~itted to the Ikdldit~ Ins~ctor 3 ~s of plus, ~aCe plot pl~ to ~ale. F~ accordi~ to ' b. Plot pl~ J~i~ l~ati~ of lot 'struts or arem% ~ glvi~ a ~tail~ ~rlpti~ of la~t of pro~rty ~mt ~ dr~ ~ the di~ M~id~ is ~rt c tfiis a~flicati~. c. ~e ~rk c~ ~ this a~licati~ my ~t ~ ~ before isle of ~fildi~ Pemit. d. II~ a~al of tiffs a~lication, the ~ildi~ Ins~etor will is~ a ~ildlr~ Pemit to the a~flleant. ~g' ~mit Miall ~ ~pt on ~ ~i~s ~ilable fl)r ins~ti~ ti~mt the x~rk. e. ~ hsildi~ ~11 ~ ~pi~ or ~ ~all h~e ~n gr~t~ ~ ~ ~ilai~ In--tot. At~I~ IS 1~I~ ~ to tl~ ~ildi~ ~rt~nt [or the issue of a ~ildi~ Pemit ~a~nt to the ~ildi~ ~ O~i~e of tl~ '1~ of ~tl~ld, ~ffolk ~ky, ~ York, ~ other applicable l~s, Ordi~es or ~flati~, for t~ ~st~ti~ of ~ildi~s, ~iti~s or alterati~s, or for ~al or d~lition, as l~rein ¢~ri~. ~m a~licant ~r~s to c~ly m~lations, ~ to ~it ~l~ri~ i~tors ~ pr~i~s a~ in.~il~m~~i~ ~" ' '''"'"'"'" ' ''''''" '"'" (~ilir~ ~klress o[ a~licant') ~ ~' Sta~e ~tt~r at~lic~ is ~r, les~, ...................................................... .................................................. ~ of ~r off ~i~s ................................ ' .................................................. (~s ~ ~ ~ roll or latest d~) and title o[ corporate Boilders License bio .......................... Plant,ers License Ro .......................... Electricians License ~ ...................... Oflmr ~s Lice~ I. lmati~ of la~ ~ M~id~ pml~ ~ will be ~ ............................................................. ........ ........... C~mty Tax ~ aiflivisia~ ...................................... Fil~ ~ap ~ ................ l~t ............... 2. Scat'e ~isti~ u~ a~ ~ o[ prmi~s a~ inte~l u~ a~ ~m~y of ~ c~stmction: ........ .... ....................... b. lnte~l m~ ~ ~mlm~y .................. ~.~ ............................................. H;lll.e of ~>lk (d~_~:k ~|~:1~ al;plicahle): New I~dhling .......... ~kli~i~m ......... ~llerat?n .~ (l~:rl 0 Esl i.~a~l ~sl: .......... ~ .............. [~ .............................................. (Io I~ I~,ill ~m fi l in8 IIIJ~ ~1t~1 icat i~) l~plh .................... ILJ~ll .................... ~d~r of BlorJ~ ............... IJill 1ol I~ tel~r~l ..... ~ .......... ~ill em~es8 fill i~ r~l rrm ~t~s of (~r of l.'~ni~s ........................... ~klre~s Is (his prol~rLy vithin ~X) f~t of a ti&~l ~tla,~17 * ~LS .......... ~) ../ .... PI.OT DIM;RAH [~x:ate alertly ~i~l dlst:i~Lly nil Ix,ihli~s, ~elher exisl:in~ or protx~i, profoot? li~s. Oi~ st~t ar~l bilk ~,d~r or ~scripLi~ accordin~ to ~], a~*l d~ sLree~ ~m~ my1 i~licale APP, ROVED AS NOTED NOTIFY BUILDING DI=PARTfVlENT AT 765-1t~O2 g AM TO 4 PM FOR THE FOLLOWING INSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. ROUGH - FRAMING & PLUMBING 3. INSULATION 4. FINAL - CONS'f RUCTION 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 CONSTRUCTION ERRORS lhal the ~.k will I~ lmrForn~xl iu lho t~'..~r r~k For Ih in Ihe appli('al Jo. Fil~l Iber~Jlh. LL ( / JOYCEM. WiLKINS "-Notery Public, State of N.ew York No. ¢952246, Suffolk Coun.[y Term Expires June 12, 19-7-'~ /?£~, 01¢~ I/: I000 - I0 ~-01-00 4. I~ SEC. $1~Ddoo ~$0~ · · · · .,~.~ ~ ,- (~oo~ PLO ~ , ~ (~') ~'~8~ · ~ / ¢, // L6~~- ~'~ ~ SJ794G~OO"E /SO. O0~ ~ ~ ~ PORCD: /72 ~ ~ ~ ro f~ SrA~O~OS or f~6 su~oz~ COUNTr ~'"~- - OEPO T LANE URVEY OF PROPERTY 8ituqf~d qf Surveyed UUT CNO6U sMITH TOWN OF 80UTHOL D ,:: -6 --Fr6tc~ionol ~ SUFFOLK COUHTY NEW YORK ;an MEOFORO AVE. SCALE= I"'~0 ' PA TC HOOUE ~ N,~ Phone 475-3192 ~urvc~ CC~tiflCd to: Lot ~os. ~EOWN ~ g~ TO"MA~OF~O005 ~ u S A M ~HEP~E~D ~T Corcao6oE; c~c~ M4~C~ eJ, 1989 ~TEWART TITLE INSURANCE AGENCY C-C* FiLE B~Y L~ND TITLE ~EENCY~ INC.