HomeMy WebLinkAbout23694-z FO~e NO. ·
TOWN OF $OUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTNOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Dat. ..... : ...... ~. ................ , ~.~
23694
Z
grant t: .
· ..r~7....].--/.-..[ ............................ :~ ....... ~ ...........
.Z~.....~...,..~../../..?~.Z.. .............
ot .re./.. ,o~a,~ at~.....~' ............... ~..~..~....,~~.~.~,..:...............~' ...............
pursuant to application dated ............. ~..~.. ........... , 19...~...~., and approved by the
Building Inspector.
Fee $,.,....~...~....~~
Rev. 6/30/80
SEP $1 8 '
FORH NO. I
TOWN OF ~OUTIIOI.I)
BtJ] I.DTN(: DI: PA R'l'tJl,', NT
TOT~N I1ALI.
fk ..... ~ I ,~OU'I'IIOI.I), H.¥. 11911
BLDG EPT. : .,, .
~._..~TOW~ O OtJTHOLD l El.. 765- 1802
BOARD ()F IIF, AI,TII ...............
3 !;ETS OF Pi,AMS ...............
,qlIRVI~,Y ........................
CIII~CK .........................
!;F. PT 1C FOIIFI ...................
HOT I FY:
H^ 1 I, TO: ....................
DnLe ................ ,19 ....
n. 'lhi.,; nl~pllcal j(~l u~mt be c~1flelely I-|lletl in by lyl~4rih~r or in inl~ m~l mfixnittecl
'1 ~;~lln oF i)lmm, accurate plot l)lnn (o mtnle. Fee ~mcordinB lo m:h~Mle.
IMihling Zx~ Ordism~me of the ~?~t of ~ll,)ld, P~fffolk (k~mty, t~ York, arm oilier applicnl~lo I,~,
I~gulnl J(~, for tl~ ~tn~ti~m of I~dhli~, mMiti~ms or nllernL~on~, or for rm~al or doral il ion, as hereh~
~k,m:til~nl. 'lbo ~ppllcm~t ng~s ~o c~ly wilh nil nl~fllcnble I~, ordhmt~:e~, I~dJdJn~
..... .....
1~( ~'"/~ in ~l~~-'JItlih~ oJ' duly null~ri?x~d ol'flcor.
(N:s~.! ;lcd l il h? o1' corlx~r;lle oFFicer)
.<"alii. J~
F, lec! riclmm I,ic~n,~ 1'~. .. ;..././. {,~, ........
!
Other 'l*~ml~ I,iceus~ No .... J .... ' ............
I. Ixxml i(~ or lmm c~l ~dc;h pn~lx)s~l ~nk will I~ do~s~ ..............................................................
............................. ........ ...................... ................
I~ ~s;e ~d~r fitreeL I
~)lJ~lJv{~J(~l ...................................... FJl~I ~lp lk~ ................ I~t ...............
b. Inl~l u.~ m~l (gx:ul~ng:y ............. ~~ ................ ~?~e..~... ~.-~ ....................
.5 / /.
~P. PROVED AS NOTED
PEE. B
765-1802 9 AM ~ 4 ~OR ~E
FO~O~NG INSPE~ONS:
I. FOUNDATION - ~0 REQUIRED
FOR POURED CONCR~E
2. ROUGH - F~MING & PLUMBING
3~ INSU~ON
4. FINAL CONS~U~ON MUST
BE COMP~ ~R C.O.
ALL CON~RUC~ON SHA~ ME~
THE REQUIR~E~S OF ~E N,~
STATE CONS~UC~ON & ENERGY
CODES. N~ RESPONSIB~ ~R
DESIGN OR CONSTR~ON ERRORS
CAROL A. BOHN
NOTARY PUBUC, STATE OF NY
NO. 01B05064109
QUAUFIED iN SUFFOLK cOUNTY
COMMISSION EXPIRES AUG. 5, 1998