The URL can be used to link to this page

Home My WebLink About23953-z FO~lg NO. II TOV~'N OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMDT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N.° 23953 Z Permission is hereby granted to: .... ~z~........~,,~....../J~.: ............................ .... ~.~..~.~...:...~/..,...../../.~ . ,o ..... ~.~ ...... ~.. ......... ~~ ............. ~..~/..~..~ ....... ~/z.., ................. Building Inspector. Rev. 6/30/80 FEB 0 FORH NO. I TO~4N OF ,qOUTtIOI.D BU I 1.DJHG DEPARTHENT TOWI'I I1AI,1, SOUTIlOLD, N.Y. 11971 TEl.: 765-1802 BOARD OF I1E^LTII ............... 3 sE'rs OF PI.ANS ............... SURVEY ........................ CttECK ......................... SEPTIC FORH ................... NAIl, TO: .................... APPI.IC^TTON FOR BUII,I}ING PERHIT INSTRUCTIONS ,, a. ~his application mst be completely filled in hy tyl~.rciter or in ink 3 ~ts of plus, ac~ate plot O~ to ~ale. F~ b. Plot plan ~ing l<ati~ of lot ~ o[ ~ilding. ~ ~i~s, ~lati~dp to ~jolni~ ~ima or ~.bllc ~r~ts or are~, ~ givi~ a cbta[l~ ~ripti~ of l~t of ~rty ~st Im dr~ ~ the di~ ~id~ is ~rt or e. ~ ~rk ~ ~ this ~llcati~ ~ ont Im ~l I~[ore i~m~e o[ ~ildlng Pemlt. d. ~ a~,~l o[ this ~lleati~, ttm ~ildlng In~ctor will is~'a ~ldi~ ~mlt to the ~li~nt. ~ch ~mlt ~mll ~ ~pt ~ tt~ ~i~u ~ilable for in~ti~ thro~t tim ~rk. e. ~ ~ildi~ ~mll ~ ~i~ or ~ ~mll h~ I~n ~t~ ~ tim ~dld[~ ~.l~'rl~ Is lns~.t~t ~ to t~ ~dld[~ ~rt~nt rot the in~e o[ a ~ildi~ ~mit p~rmmnt to tim · ~ildi~ l~m ~i~e o[ Om ~ o[ ~thold, ~fftolk C~mty, ~ York, aml other a~llcable I~, ~{m~en or ~dati~s, for tim ~t~ti~ oE ~ildit~s, (~ri~. ~m a~lic~t a~u to ~1~ with (Si~tu~ of~hcant, : .... (~ili~ ~kl~ss of ~lic~t) Stnte ~ether applicant is ouner, lessee, agent, architect, engineer, general contractor, eleetrlclsn, ph~ber or huilde 765-I~02 9 AM TO 4 PM FOR THE (~ ~] title of co~tate officer) FOLLOWING iNSPECTIONS: 1. FOUNDATION - TWO REQUIRED FOR POURED CONCRETE 2. RO~H - ~AMING & PLUMBING ~,Ht~rs Eice~ ~ .... ...................... 3. INSU~ON Fh~rs [,ic~ Ro .......................... 4. FINAL - CONS1RUCTION MUST BE COMP~ ~ ~ FOR C.O. El~trlci~s l,lc~ ~ ...................... ALL CONSTRUCTION SHALL MEET Otlmr ~'s [,[c~ ~..., .................. THE REQUIREMENTS OF THE N.Y. STATE CONS~UCTION & ENERGY' (~) '}. I%ttne o~ uo~k (cl~t:k ~t~id~ al~)licable): i't_-u lkHhlinl~ .......... &klition ...... ~.. Alteration .......... i~la~iv ............ ~al ............. l~t~/[tioa ............ Othe~ ;4~k ..~ .................... (lo I~ laid tm [ili~g this alglicari~) l~i~l[ ......................... ~t~tmv o~ 8co¢iea ...................... Il. ?~,m or t,~ district in ~,ia~ p,~,i~a are stt:~al ...~~~ ...................................... I]. gill lot 1~ PI.OT DIAGRAH [~ate clearly av.d dis£i~c£1y all I~aihli~gs, ~hether existing or proposed, a[~d iaxlicate all aet-I~ck dinensions ....... ./'~-.-.. [.. :.~g-~.~q ..... .,...r2.( ~ ............. la, in8 d,,l y ~,,,,, ,let,,~s a,.I says that be ia the ut,pi (~,te o~ iixlivith~d signi[tg i,, ........................ ........................................................... ((kal~racto~, age,t~, corlx~rate officer, etc.) said ~r or ~rs, m~l is d;~[y authoriz~l to I~rfo~m or h;~e t~rl'oHl~l tba said ~;~k a~l to nak~ a~l file Ihis appl ication; t.hal, al I ataLe~en~s cCmtai~l in this appl icat ion a~e tl~e to lhe I~sk of his k~lc~e md I~1 ief~ Ibat. the a~rk .iH I~ ler~on~l i. Ihe n;m~er ~t forth in the appl i~:al.[on fil~l CLAIRE L. G[.EW Notary Public, State of New York No 487Dbl)5 ., ,.;,.,.,.,.,.,.,.,~/' Qualified in Suffolk County ~ ~mmission E~res Decem,~er B, 19 ~