The URL can be used to link to this page

Home My WebLink About23526-z FOBM NO. ~ TOWN O~ $OUT~OLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) .................. /.~ ,,.~.~ N.° 23526 Z Date~ ..................... , Permission is hereby granted tg;,~' ..... ........ ~.3...~.~......C'.;~.,......~./...._~ pursuant to application dated ............. ~..~......~... ........... , 19.,~./~:~, and approved by the Building Inspector. ~/ Building Inspector / FORH NO. I TONN OF SOOTItOLD BUILDING DEPARTHENT TOI4N IIALL $OUT}IOLD, N.Y. TEl,: 765~ 1802 11971 BO^RD OF IlE6LTH ............... 3 SETS OF PLANS ............... SURVEY ........................ CIIECK . SEPTIC FOR}4 ................... NOTIFY: Disapproved a/c ...................................................................... INSTRUCTIONS a. 'lhia application mint be completely filled in I~' typewriter or in ink and aul~nitted to the hdldi~ Ins~ctor will 3 ~ts of plaas, ~ate plot plan to ~ale. F~ acco~i~ to ~ule. ~ b. Plot plan ~i~ l~ati~ of lot ~ of ~ildl~s ~ ~i~8, relation~ip to ~joining pr~i~s or ~)lic struts or areas, ~ glvitg a &tail~ ~ri~i~ of l~mt of ~r~ ~mt ~ dr~ ~ the diem ~i~ is ~rt of this a~lication. c. ~e {~rk e~ ~ this a~llcati~ ~ ~t ~ co]~ ~fore isle of ~ildi~ Pemit. d. U~ a~al of this a~licati~, tl~ ~ilding Ins~ctor ~*ill is~ a ~ildi~ Pemit to the ~)licant. ~mit ~mll ~ ~pt ~ ~ ~fi~s ~ailable for ins~cti~ thr~t Om x~rk. e. ~ {~ildi~ gmll ~ ~pi~ ~ ~ in ~mle or in ~rt for ~ pm~ ~mt~er ~}cil a ~rtificate of ~.I~ IS l~ ~E to t~ lkdldi~ ~ramnt for ~e issue of a ~ildi~ Pe~t ~m~t to the ~ildi~ ~ Ordi~e of tim T~ of ~tlmld, ~fffolk ~t~, ~ York, a~ oUmr aH)li~)le I~s, O~i~es or ~lati~a, for t~ ~atueti~ of ~ildi~s, ~iti~s or alterati~s, or for ~al or ~lition, as ~rein ~ri~. ~ ~liant ~s to ~ly ~ith all a~licable l~s, ordi~es, ~ildi~ (~ I~i~ c~e, ~lati~s, ~ to ~it ~fl~riM in--tots ~ ~i~a ~ in [~ilding for ~ea~ ~:, ~ (~'ili~ '~rOss of.0~lican~) electrxclan, plier I~ilder. State x~tlmr a~licant is ~r, les~, ~nt, a~it~t, engi~r, ~lmral 'c~tra~tor, ' ' or O . ' ' ., . . ................. ~ o~ ~r of ~i~s .......... ~----~. 5.. ~. ~. {.~ ~ ................................. (as m tim t~ mi1 or latest d~) ~ : .. If a~llcant is a ~rati~, si~m of ~ly ~tt~ri~ officer (~ and title of ~rate officer) "'~ '" ~ Builders License No .......................... PiLing)ers License Ro .......................... Electricians I.icen~e No. . Other .ale's License No ..................... ~...~.. ?'(~' ~ . Dacati~ of lam ~x~ ~{ich ptncgo~ ~o~ will be d~ ......................................... % Fnha'(~ of (~)Ht (clmck MH(:h applic~ hie): ~ I~lihling .......... ~klition ..... ~.. alleruLi~ ......... 7. I)inensi~m of existing ~tn~:tt~t'e~, ~ig m~y~ Fr~mt ................ l~ar ............... l~pth ................. l)inen~h~m oE m~ ~tttr:ture ~ilh 0heratiim~ or ~Mition.: Front ............... l~ar ............... IEFLh .................... Ihil~*t ~ .................... ~dmr o~ Stories ............... B. l)ilmnsi(~m iff entire ~ c(.mtn~: 'j~* Fr~t ................ I~mr ............... l~pth .............. 10. l~lte of [5~rehase .............. i. 12. [lin8 prOln~l ~mtn~:ti(~ vlolot~ oay z~du~ I~, o~lilm~me or reguloti(m: ........................ ~ og Architect ................................... ~klrefl~ .............................. l~m ~ ............... ~ FI,OT l~at.e clearly m~ dlsti~ly all I~ hln~s, ~mlher ex s :rog or prol~, taxi h*llcate all set-I~k dhmaslons ~ros Frolmrl-y 1hms. Oi~ st~t ~1 I~l~k ~dmr or ~scriptloa ncconllng to ~ed, a~ d~ sLreeL ~s taxi J~lleate xSmllmr inter/or or col~mr lot. ~u~O~NG INSPE~ON~: 3. I~SU~oN 4. FINAL - CONSTR~ION MUST BE COMPL~E FOR C~O. ALL CONSTRU~ION THE REQUIREME~s OF ~E N.~ STATE CONSTRUCTtON~ & ENERGY CODES, N~ RESPONSIBLE FOR ~(~IGN OR CONSTR~TION ERRORS ....... Dxlividtml signing co. tr~mt .................... Ix:hq; duly ~'~)r~, (lelxmea atxl nayn that he is lhe (Cx~tr~etor, al;eat, ~:orlx~rnte officer, elc.) of ~ald (~n~r or ~mr., ..KI i. duly {n~thorlzc~ Lo Ix~rfoim or have i~rfor.~d I.he .aid ~rk taxi Lo n~lke orx] file thin Ihat th~ ~tk ~ill lm l~rfotu~l itt th~ t~asmr ucc forth i. the ~ppl. Jc~l:io~ flied tlmr~tth. ROBERT~'I. ~T. No. 4)2~8~, Suffolk Cou~ Term E~ir~s May 31, 19~