HomeMy WebLinkAbout23267-zFORM NO.3
TOWN OF sOUTHOLD
BUILDING DEPARTMENT
TOWN HAIL
SOUTHOLD, N.Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNIIL FULL
COMPLETION OF THE WORK AUTHORIZED)
~,.-:,..~~......:....~ ...................... ~.~
N~ 23267 Z
Permission Is hereby grant dto~:, ~' ~
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at premises located at ................ ..~...~....~..~ ............ , ,~..~.~..~'~n:~,~,..... ~ .........................
CounNTaxMapNo. 1000 Section ........ .~,,./..,.,,~.,.,, Block ............. ././~.. ....... Lot No. ... ...~..., .................
pursuant to application dated ....................................................... 19 ............... and approved bythe
Fee $,.,.~..~,,,,,~
Rev. 6/30/80
MAIN
Cl~'l
BLDG. DEPT.
'TOWN OF SOUTHOLD
.
....
I~ ale ..................................
.......................................
BOARD OF IIF.^I.Ttl ' ' 'k' '~' ' ~ ......
3 SIS'rs OF PI,hitS ...............
SURVEY ........................
CIII~CK .........................
SRPTIC FORH ...................
[~STRUCTIOBS
a. 'lhis appl. ication n~kt ~ completely filled ia IW type~mlter or in ink taxi ~ul~ittt4 to the ~fildi~ Ins~ctor
3 ~ts of plans, accurate plot pl~ to ~ale. 1~ according to ~d~de.
b. Plot ptm~ ~i~g l~tlm of lot aM of kdldlngs m w~i~s, ~latimship to ~jolning pr~isea or. ~dAic
str~ts or areas, ~1 glvi~ a ¢~tail~ &~rlptim of last of l~rty m~st ~ drmm m O~e dlagrm ~dd~ is l~rt
this a~llcatlm.
c. alto ~rk ~ 1~ Ods a~lieatim ~ ~t 1~ come~ I~fore isle of hdlding Pe~it.
d. ~ a~al of fids a~llca:~m, tl~ lkfilditg ~ns~ctor will isme a ~ildlng Pe~t to the ~llcm~t.
~mit flmll ~ kept m tim ~s ~ailable for ius~tlm three,mt the
e. ~ ~ildi~ ~mll I~ ~i~ or u~ in ~mle or in lmrt for ~ I~$~ ~mt~r ~til a ~rtlflcate of
~ flmtl h~ I~n ~ted 1~ Om ~ildi~ Ins~tor.
M~H,1I~FI~ IS I~l~ ~ to tim ~ildh~ I~rt~nt for the ia~e of a ~ildi~ Pemit ~r~nt to the
~ildi~ ~ O~i~e of t~ T~ of ~tl~ld, ~ffolk ~tT, ~ York, a~ o~er a~licable I~a, ~i~a or
~lati~s, f~ 6~ ~st~ti~ of ~ildi~a, ~iti~s or alterati~a, or for ~al or ~litlon, as Imrein
~ril~. 'I1~ a~lic~t a~s to c~ly with a11 ~li~ble 1.~, o~i~es, ~ilding ~, l~aing c~, a~
~lati~, ~ to ~it ~fi~rir~ in--tots ~ ~i~a a~ in ces~
.... '~ ( ~eof ~l. , if a c~ratx~)
.... '~': (~ilJ~g ~aa of a~lic~t)
' ' n I~ild~
State ~tl~r a~Ai~t ia ~r, les~, a~nt, ardHt~t, e~x~r, gears1 c~tractor, electr~caa , plier or
~ De ~ De ~ ....... ~.~:~.~.,-. ..... : ....... ;"7' :"~ ............ g'V~6~L~ ~$ ~ .... ~' Z'c. '
~as ~ t~ tax ~ll or lauese ~l~ ~ '-~7 ~2 ~/y
(~ aM txtle of ~raLe offxcer) FOLLOWING INSPE~ONS:
1. FouNDATION ' ~0 REQUIRED
FOR ~URED CONCRETE
~il~rs Licen~ ~ .......................... 2~ ROUGH ' FRAMING & PLUMBING
Pl~rs ~ic~ RD .......................... 3. INSU~ON
,~ .' 4. FINAL - CONSTRUCTION MUST
gl~trlci~s Licen~ ~ ..................... BE CoMPL~ FOR C.O.
ALt CONSTRBCTION SHALL MEET
' CODES. NOT RESPONSIBLE ~
....... ' ............. , .......................................... ~ .... nestG~.qP. ~n~np~mN Enno~ ........
.... ;~ ~- s~ / 1 ~ ,
," . ~ n~. /~ ~t Y'. .........
C~y Tax ~p ~. I~ ~[x~ ..... ~-.~ .............. - ............
· · · Fil~ ~ap 4~ ............... l~t ...............
(~)
2. State ~ist~tg u~ a~ ~ o~ ~i~s md ln~ use ~1 ~ o~ p~
~ff~ 77N. Y~.~ ~ ......... - ..........
a. F~isti~ ~ ~ ~t~ ...... ' .....................
l/
b. Inte~ u~ ~1 ~ ...............................................
(la Im ~Hd on filing Ibis applica~i~)
If 8ar~ge. i~xImx' of cars ......................................
I)i.~nsiam of ~[sElng ~tr~Lures. if any: Fr~z~ ................ I~ar ............... ~pth .................
I'I.OT I)]AGRAH
Icc. aLe clearly ~n(I dJel:lnc~:ly all I~ildh~s, ~mtl~r exts~ing or prol~l, mgl it~licace all ~-I~k dinensions
.~u proi~rl'y lb~. Give ~r~C a~l bl~k ~=fl~r or ~scril)ti~ accordin~ ro iMed, a~ ~l(~ atree~ m~a ar~l b~lica~e
:liar Jlltei'Jo¢ or corlmr ]OR.
q~ of i~xlivi<lua[ nlgni.g contract) ~
i~ tl~e .............. ' .... ......... ....................................
(C~m~rac[or, agenl:, ~orl~ra~e o[flcer,
j)l iCa~lOIl; Lllal: ;il [ 8~atol~llEB c(~lt'aJ~K.l in I.h[s al)pi icat ion are trim
,;Il. tho ~)lk ~i [J I~ Imrfon~d in IJto II~llJl~ ~ fortJI in llie al)piical:ioll fi i~l