HomeMy WebLinkAbout23455-zFOI~M Ne.3
TOWN OF BOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y.
N~
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
' ~/..
Date ............... ~ .................................. lg....~...~..
23455 Z
Permission Is hereby granted to:
...... ~.~.~.~....~/.~ ..........................
-- ~, ..~'~'~"~'""~¢":'"'"'/"/'~'"'~"~ .....
to ...... ~...~.~......~ ......... ~~...Z.......~..~.....~-~.~ ........ ~ ................
Coun~yTaxMap No. 1000 Sectlon.....,~....~.,. ......... Block .......... ..~.,. .......... LotNo ...... ~,~.,. ............
pursuant to application dated ....¢~,-~.....~.~ ............................. lg....,~...~....., and approved bythe
Building Inspector.
Fee ~...~..~..,.~ .......
Rev. 6/30/80
L"--'~DBLDG. DEPT. D
lfisab~ ~c~l a/e . ·
FORH NO.
TOIJN OF SOUTHOLI)
BUILDING DEPARTHENT
TO~IN DALL
BOUTI1OLD, N.Y. 1197 I
TEl,: 765-1802
BOARD OF IIEALTll ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK : ........................
gEPTIC PORN ...................
NOTIFY:
CA~.L .. ?.~.¥.'=&.?Z(...
HAIl. TO: ....................
APPLICATION FOR BUILDING PERHIT
1 NSTEUCTIONS
Date..: ..
a. 'lhia eq~)llcstion mast Im ccsnpletely filled in Ir/ typ~.miter or in ink m~l md~itt~ to Um ~dldi~ Ins~etor ~lih
~ts of plans, ~Jrnte plot pl~ to ~ale. F~ accouling to sd~de.
atr~ts or areas, ~1 81vi~ a ~htail~l ~acrlpti~ of l~lt of ~rty ~t ~ dr~ ~ O,e dia~.~dd~ is ~art of
this a~licati~.
~mlt ~a[1 ~ kept ~ tl~ ~i~s mailM~le for ins~cti~ that tim
~ildhg 7~ ~i~e of tl~ 'r~ of ~ltl~ld, ~fffolk ~mty, ~a York, a~ other a~licable l~s, ~i*b~es or
~lati~s, for t~ ~st~ti~ of ~fildings, amities ~ alterati~s, or for ~al or ~llti~, as ~{n
(gl~atu~ of n~llc~t, or ~, if a
State ~t.l~r a~tie~t is ~r,' les~, a~nt, archlt~t, et~h~r~ ~ral ~traetor, eleetrlei~n~ pt~r or
If a~licaat is a ~rati~, si~tu~ of ~ly ~fl~rir~l officer. 765-1802 9 AM TO 4 PM FOR THE
FOLLO~NG INSPECTIONS:
1, FOUNDATION - TWO REQUIRED
............................ ~ ........................ FOR POURED CONCRETE
(~ mfl title of'~ote o ricer)' 2. ROUGH - FRAMING & PLUMBING
3. INSU~TION
'4. FINAL - CONSTRUCTION MUST
~fi[<brs Licen~ ~ .......................... BECOMPLETE FOR C.O. '
Pl~mrs Lic~m Eo ..................... '- .... ALL CONSTRUCTION SHALL
THE REQUIREMENTS OF T~E f~Y.
Otlmr ~*s Li~n~ ~ ..................... CODES. NOT RES, Oh~.,IL,
DESIGN OR CONSTRUCTION
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lbq~ir ............ I~al .~ ........... I~x)liL[~ ............ Other I~)lk ./~.~..~.~.
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lg hmim~a, ~lm~reial or mi~d m:eUl~y, ~l'meif~ ~flure m~l
~:r~x~[ .... ~ .......l~ar . I~pth .................
~i~,~ . ...... /.E..'. ......... '...,,~ ,)~ ~.)rl~ ....... / ............' " /
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~,,~ ,,~ ~,,-,:h~'....~'... LT~ / ~,,~ 0~ ~,,,,,,~ ~,~ ...~. ~.a.~... ~... ~u ........
l~ or ua dJs~rJcL iii OHd,jl.'a.t~a a~ S[ti~t~l ..~(~.L~ .................................. ' ...
~lll Io~ Im retrial ...~.~ ........... ~ill e~:efis fill I~
~]~ of ~rdHLec~ .................................... ~klre~ .............................. l~m~ ~) .............
· ,~ or C~tra~m' ....... ~.. 7~ .................... ~khe~ ............................... l~m[~ ~ .............
PI.OT Ill ACllAH
tgmtl~r interior or co~r Io~. ~
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(~AJNi'/ (X'~ .............
.... ~ .... :..:.:..., .......................
(l~ix. of ]xhvldt~fl Sll;llil,l~ eonlrm:t)
.............. Ix!inli d. ly ~,~)r,), (letxme~; alxl 8ayfl flint: lie i~ tim al)plit:mil.
(Si ~, I:ule ()[: Al~plical)l )
Ik.~: 'i tim
(Co:tL tact. or ~
()~ ~;ai(I (~t~l- or
al)iff Jo:aL iou; thai:
IluiL tile ~)Jk ,il I I~ j~rl:olll~l Je jibe ii[Jlll~U ~[ [ofLil ill the el)iii iafll~Joll filed II~r¢~iLh.