HomeMy WebLinkAbout23458-zFOIJM NO.$
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y.
N£ 23458,Z
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
Permission Is hereby granted to:
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Building Inspector.
~ee ~ .,~...'..~ .......
Rev. 6/30/80
/// B,,,d,ng,,spec,or
l;O^lll) OF IIF. M.TII ...............
3 ,ql~,'l'8 OF l'l,AH,q ...............
SURVEY ........................
GIIF. CK .........................
SEPTIC FORtt ...................
(i~i I/n8/l ssi>eclat )
APPI.1CATIOF1 FOil BUI1.DIN~ FEIIHIT
I NS TIIIJCTJ 1[)1518
a. 'Ibis al~dicaticm s,st be ~ospletety filled in by tylx~.~riter or in lek taxi md~nittcM'to the ~ildiug los~ctor with
3 sets o~ plans, ~marate plot plan to scale. Fee accordi~ to schedole.
str~tn or areas, a~l givh~ a ~tallal (~scriptla~ off logit al prolerty ,amt t~ dram a~ the dlagr~ ~ich is l~art of
this al~licati~.
c. 'I1~ ~rk c~r~l I~ this al~lleatit~ p~ ~x~t I~ ccm~:~l I~Pore ismm~:e off ~ildlng Pe~it.
d. UlXn~ n~nl cE this aH~licatica~, the lhHl¢lislg lnsleCtor will iaaa a l~Hlding l'e~it to the al~pllcant. ~ch
e. ~ Ixdhli~ ~mll Im ~¢a~l)i~l or o~l in ~ole or in l~rt for any ~]r~)se ~ml~er tmtil a ~rtlficate of
fil~A(~'l'l~ 18 l~t~l~ ~II; to tl~ IhHldi~ l~l~rt~nt For the ismm~e of a ~Hhling Pennlt ~rm~,k to the
Ik~Idi~ ~ O~1[~¢ off tl~ '1'~ o~ ~tl~)Id, ~lfrolk (~mty, ~ Yorl% m~l other applicable I~, O~i~es or
~gulati~m, for tl~ ~mknetia~ of Ixdldlngs, mklltia~s or alterations, or for ~x~a[ or d~l ition, as herein
¢~scril~l. lie applicant agrees to tacitly with all al~licable l~s, call,amies, Imildln8 c~, I~slng c~le, ar~l
re~daticms, a,~ to ~iait m~tl~ri~l iOSl~ctora ¢n~ proalses a,~ hi la~ildlog for ~cesc~ry hm~cti~s.
State ;d~ther al~dicant is o~ver, lessee, ago,,t, architect, eugleeer, ge,~rat contracto~D~,~r or Is, ihler.
........... g .................................................................. ~i"'~69',~.~ .... f.~.CF~ ....
(aa ~ tI~ tax ~ol 1- or latest de~l) ' ~6fi¢9' ~'0fCOla~ 'OE~AR~ENT'AT" '
II al~dicmtt is a corporaticm, ~ipff~0tore of. duly at!tl,)vLz~l.offlcer.
· .... ....
(~ m~ t~tle ~ ~orl~rate officer) '
I~[Iders IAces~ ~) ........ ,.., .............
OU~r ~s l,lcm~ ~ .....................
765-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSP~ECTIONS:
1. FOUNDATION = TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSUlaTION
4. FINAL - CONSTRUCTION MUST
BE C,OMPLETE, FOR C.O.
'ALL CONSTRuctioN .~HAI~L MEET
THE REQUIREMdNTS OF THE N.Y.
S~ATE CONSTRUCTION & ENERGY
CODES. NOT RESPON~tlBLE FOR
DESIGN OR CONSTRUCTIObJ ERRORS
I. Docaticm el~ land on ~hid~ proFo,,~d work will I~ ~k~oe ..............................................................
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~ R~t~r 8tr~t lbnl et
c.~,ty T. ~, ~. ,xx~ ~ti~ ..~9.~,~ .... ~,,~, .... 0~0. .... ~t ..P~.,.q.e ....
~lxlivlsi~ ...................................... Fi l~l ~p R~ ................ lot ...............
2. State existing u~ taxi (~cnl~q~K:y O~ p~d~s atxl inte~x~l use taxi t~l~y of ptoff~ c~struction:
a. Existhll u~ a~ ~Ca,l~a,~y ...~.. ~g~ .........................................................
EuL i.~sted (~)~1: ......................... fee ......................... i .....................
If Iamheua~ cxm~ercXal or mi.ed tx:cu m~y. al~cif~ luJt.u[e taxi eatenk of euch t~l~ off use ......................
~. ~,~ ,,~ ,,,,.: ,,,,,, ....--. ............ ,~ .... .,.,. ............ ,~,,,,, ...=~.~.., .........
~ll, 2z~ or u~e diutrlct in s]~ich i.~.[~ are ~ib~ated ........................... [ ...................................
PI.OT I) I A(;IIAH
lL~)rl~ lo I~fme .~! Ih|n .4 'i
UNDA R KOWALSKI
Notety Publlo, b~tate of NewYork ,
No. 62-4624771 r ~ /
Ouallfled In Suffolk County ~
Comml~lon Expires Nov. 30, 1 ~ ,,,C. ~-
^ppi
i~1: iJnhl (~r (~r (~r~, taxi J~ duly m,tllorlz~l to i~l film or I.~ve ix~rforu~d Ihe m~hl ~)tk taxi LO lmke taxi file IhJll
.ppi ic:n~io, q thul: .11. tJtnl~m, to. talcuM in Lhi. nlqd,Je4~t 19. ~re t.~ to Ihe Imtll;~ of hi. kl~lmll~e m~l I~l. iefj
IhnL lile ~itk ~iil I~ I~rl'om~l iii iJI~ ii~iiiig~F flat' I'oltII ill l~e nlqd. imd:lou 'lied tharwiLh.