HomeMy WebLinkAbout23674-z rOR, Bf[ HO. J
TOWN 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.° 23674 Z
Permission is hereby gr~nted to:
...................
..............
,o ... ./. /z_/~.~... . ....... ~.. .......... ..~...~.~-~... .......... ~.~_.~~.......z~.., ...............
of premises located ~t
County Tax Map No. 1000 Section .... ./.~7~.. .......... Block ..... ~.Z .........Lot No ....... /..~... .........
pursuant to application dated .... ./'~tf~'.~/',Z..'~. ...... ~ ........... ,19..Z~ and approved by the
Building Inspector.
Rev, 6/30/80
FOEH HO.
'FOUN OF SOIJTIIOLD
IIUII,DIN~ I)1~. p A R'II~I|~ NT
'l'OgH
SOU'I'II(}LI), N.Y.
TEl,: 765-1802
^PPI.ICATION FOR BUll,DING PERNIT
IIOhl{I} {}F IIEAI,'rll ...............
3 SF, TS OF UI.AN$ ...............
SURVEY ........................
CIIECK .........................
SEPTIC FORH ...................
_ BLDG, DEPT.
[.~/N OF SOUTHOLD~ _
n~ t e..-7~..~: ffC-~-T.. 'Ti-:
a. 'lhie spplic~t|~ .,~nt be coql)lel, ely filled in by tyt~,~riler or i~ ink n~l md~,itt~l to the ~lilding hml~CLol
] ~ts of plan~, accurate plot pIm~ to ~ale. F~ accordit~ Lo sch~lule.
b. I'1o~ i)lnn ~il~ I(~nti(~ of Io1: n~KI of I~ihllt~s ~l prc~ni~s, relnl l(~mhip lo ml.ioinl.R prc~i~, or i~hlic
c. ~he ~rk c~r~ I~ this al~}licati(s~ p~ ~ I~ c{s~l lefore ismm~e o[ ~d]dlng
d. lllxx~ a~nl o[ this al~dicatlou, ll~e l~]ihl[nR h~l~ctor x.rill ism~ a l~dhllng Permi[ to the nl~llcant. ~ch
~xmi~ ~mll I~ kept ~ tl~ i~i~s available for in~l~¢~ti(~ Ihr(~tt lhe
e. ~} Ixdldh~ ~mll I~ ~oq~i~l or u~l in ~.~le or in l~rl: for any t~.~me ~mt~er tm¢[1 a C~rti[icate
A[~.I(~'I'I~ 15 1[1~1~ ~ to tl~ l~;ildll~ IMl~rt~l For the ismm~e of a l~;ilding l'e~ni~ pirm~nt
l~ildlz~ ?x]~ O~li~e of 1.1~ '1~ of ~ll~hl, ~tffolk {)~mty, ~ York, mxt other applicable l~s,
<~.cril~l. 'I1~ ~ppllc~t .gr~s [o co~l~ly with all .l~licnble I~s, orditm~es, I.dhlin~ c~le, I~slt~
re~lati~.~s, atxt to ~iult m~tl~ri~l jnSl~clors (~ pr~,nlses atxl in b~ihling for ~ces~ry
.....................
State wl~her nl~)licnnt |~ ~r, lefl,,,~, et~nl, nrchitect, enRir~r, Recital c~tr~ctor~ electrlcJm~, i)h~t~r or I~dhler.
.........~ ...................................................
' ' :'~' ~ AP~O~D AS NOrD
......................................................... ~y ~s .~ ~:
(~,~, md title o[ coH~rate o[ficer) NOTIFY BUILDING DEPART~ENT'A~
785-1802 9 AM TO 4 PM FOR ~E
~LLO~NG INSPE~ONS:
Ik~Jlders l.[ce~ ~) .......................... 1. FOUNDATION - ~0 REQUIRED
~R ~URED CONCR~E
['lt~t~rs l.icen~ ~ .......................... [ RO~H - FRAMING & PLUMBING
Elec[rJc]ans l.[cen~ ~ ...................... ~' INSU~TION
4. FINAL - CONSTRUCTION MUST
OU~r ~'s l.Jcen~ ~ ..................... ~E COMPL~E FOR C.O.
ALL CONSTRUCTION SHALL MEET
.................................................. ~~~az..~se~s~.~.
I~ ~i~r Strut ~ OR CONSTRUCTION ERRORS
~..,v ~'~ ~, ~,. ~x~ ~,,~,/.~L ..... ~ .~,.:k ...... ~ ......... ,~, ...~ ..........
(~.~)
6. If I~;~il~sn, t~xm~xctal or mi~d {x:CUlm{ry, Sl~cJf~ ~lhlre {.~1 extent ~)f e~t¢:l~ Lyf of use ......................