HomeMy WebLinkAbout23733-z I~OK~[ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PEI~v~IT MUST BE KEPT ON THE PREMISES UNTIL FULL
cOMPLETION OF THE WORK AUTHORIZED)
N.° 23733 Z
Permission is hereby granted to: , . ~
.... ........... · ............
.~2.P.. '~ ~..
,o...~~.~....~ ........ ~......~.....~~......~......~~
..~.~ ...... ~.....~......~.....~ ........ ~......~.....~ .......
Co,n,, To,, Mop No. ,000 Sect,on ....~ .......... ~,o,:,~ ...... ~/.. ........ Lot No ......... .0..~.. ......
pursuant to application doted .......... .~/~ .X?./..'~.'. ........ /.~- .............. 19- and approved by the
Building Inspector.
Fee $ ........................
Rev. 6/30/80
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BOAItl) OF IIF. AI.Tll ...............
SETS OF PI,ANS ...............
SIJRVI~Y ........................
CIIECK .........................
SI'] P'I'] C FORH ...................
HOT I FY:
C^LI ...................
H^ 1 L TO: ....................
APPI.ICATIOH FOR BtlII.DIHG PERHIT
INSTRIICT~ONS
a. 'lids applicati~ ITIIsL I~ co~tfletely filled in by tYl~riter or in ink a~l auhnitt~l to the Ikdlding InSl~CtOr wi
3 ~ks of plans, accurate plot plan to acme. Fee accordisg ~o sch~ule.
b. Plot' plao J~it~ l~aticnl of lot at~ of ladldis~s ~ pr~daes, relationddp to ~.ioining prmdsea or Ixdflic
str~ta or areas, a~l givi~ a ~tailc4 &scripti~ of la~l: DE pro{ratty ,mat I~ dr~m (m the diagrm~ ~ich is fart et:
this application.
c. 'lhe x~rk m~erc~l by this ai~flication ~,~y ~g~u I~ crane,s:ed I~ore issuance of Ikfilding Permit.
d. Illx~l appeal of this application, the Ih~ilding lnsl~cLor will issue a l~ildir~ Permit to Lhe applicank.
[~nnil: shall I~ kapt: ~l tim prani~s available for insI~ctk~ thrx~O~¢~t the
e. K~ Ixdlding eamll Im ~meupi~l or used in ~ole or in i~rt for any la,rinse Mmtever t~ltil a (~rtificat'e of
~xaqm~s:y ~mll have I~n grant~ by t'lm l~filding hm~ctor.
APPLI(ZTI(~ IS IEI~BY ~1~ Lo tim lkHldir~ Ikqm~tunnt k~r the isstmt~e of a lkdlding Permit D~rauant to the
Ikfilding 7zn~ Orxli~m~e of the 'l~a~ of ~thold, ~ffolk Cx~mty, ~ York, a~fl other applicable l~s, Orditmrmes or
l~gulati~s, for tim c~mtnmtion el: I~lildings, ~kllti¢~m or alterations, or for r~mvaI or d~olition, as herein
1~8c:rilmd. 'lhe applicant agree t'o co~lfl~ with all al~licable l~s, ordinm~es, I~ildia~c~le, tg~sing c~le,
regt,lari(ms, a,~l to ~ui~ a,,tl~ri~l ins~ctors t~l pr~nises a,~ io
(Sigr~tu~il~5 ~- na~e, if a covlx~raLion)
' (~lJng ~klress of applJcanr)
Ir al~,licam is a corlx, tati,m, air, lure o[ duly at,thoriz~t otfici~r. DA~: ~B.P.~
......................................................... NOTIFY BUILDING DEPARTMENT AT
(~ a~l title el: (:ox]~rate officer) 765-1802 9 AM TO 4 PM FOR THE
_ FOLLOWING INSPE~IONS:
1. FOUNDATION - ~0 REQUIRED
I~d hle~a Licea~ ~ .......................... FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
Phni~ra Lieen~ ~ .......................... ' 3. INSU~TION
Elecl:ri(:[ans License ~ ...................... 4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
Oiler 'IY~E~s LJ~en~ ~ ..................... ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
570 co s..or
.................................................. DESIGN- OR. CONST~CTIQN..ERRORS ....
(kxmly Tax ~11} ~. I(XD ~cl;i~l ................ Bltx:k / li)L
2, StaLe exi~l'Jng n~ ~xl ~mq~:y"of pr~nJse0 aid illEelglod use al~] (~Ctll~tK:y Of pro~)~ construction:
E~d i.~,ted (~mi .......... ~ ...... Fee ..............................................
I (h~ Im Imid oH IllinB thl. nlq~lic.tqon)
(( HB,,, '
CLAIRE L, GLEW i
Notary Public, State of New York
No, 4EI79505 I
Qualified in Suffolk County
Commission Expires December [8, 19
....................................... t .................. I~HTU~ duly
((xn~t, t~r, n(V.,I, (:O~lX,.le oFFicer,