HomeMy WebLinkAbout23597-z · OR~ NO. ~
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
~T.o
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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,o
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,,t pre,,se', I,~ated ot ........... ~././....'~.... ........ ~Z'.Z/.~.~.~......~ ......................................
................................................................. ~....~..~....../...%~ ..........................................
¢o~ To~ Mop No. ~000 Sec.on ..../~..~.. ......... ~o~k ..... ~ ...... Lot No....~. .......
1
Building Inspector.
Fee $ ........................
/~l.¢l~g Inspector
Rev. 6/30/80
'h f&~ht~e o{: wodc (check ~ddch nl~dicable)~ I'k.a~ l~:ildin8 .......... &klition .......... Alteration ..........
6 Eat in~t~l (~st' ~ ' "
.......................... fee ...............................................
(lo Im fid {~; filing lhi~ applicati{~0
5. If (k~llins, ~lll~r Of tk~lli~ unit~ ............ Ikn/~r of {k~llin8 tndla ~ each fl¢x)r ................
7. I}i,~n~li~m of exinling ali~turna, if any: I~rg~sl ................ I~a~' . .............. I~pLh .................
I~i~l: ......................... Kid~r of 81Drier ......................
,,,. ~,~ o,: a.~ o~ ,,~,~~-.~r~.v. ~T~.L~T~¢~ ~ ~/.~¢r~,~ .~~7..~Y ........
15. 'Is this [)aq~Ly ~Jtilin ~KJ feel of a ti~bl ~etls~l? ~ ~I~S .......... ~ /
PI.OT D IAGllAH
NOTIFY BUILDING DEPAR*MENT AT
786-1802 9 AM TO 4 PM FOR THE
FOLLOWING INSPE~ONS:
1. FOUNDATION - ~O REQUIRED
FOR POURED CONCR~,
a. rO~H - FRAM NO
4. Final - ¢OnSTaUC;10n
Be COMPL~E FORC.O.
ALL CONSTRUCTION SHALL ME~
TNE REOUI.EMENTS OF
STATE CONSTRUCTION
CODES. NOT RESP~~R
DESIGN OR CONSTRUCTION ERRS8
(~.t~ of i,~livldual s' ~ igni,}8 c(ml,acL)
t~r-n, delx)se8 m~l f;ay~; that lie i,~ the appl J(:~nll
Ik,. i,; u,e .................... .C~.**~Z. ~.e.(. ................................................................
{(k:,)Lra(:tor. clj[o.i)l~. COrIX)I'iI[e officer,
of ~Jai(l (~r or (~ra, taxi ia duly authorl~ad to inrfo,,, or- have Ix~rl'onled the tmJd ~)[k taxi to n~d~e mai file Illi~
alq)l [cnLion; thaL al I 8LaIai~iiI. i; concai,~M in this ;]piH i(:at.i(m are I~t~ to Ihe IK~t;I: of his ktR~l~lge taxi Is~l iefj alxl
,~)rn Lo I~fore ll~ Ihi:l
...... ....... .....
N~aw Public, State of Ecw York
No. 52-8125850, Suffolk CounW.
Term ~ires O~o~r 31, 19~
($il~-e of ^l,lC/-ica. t)
FORH ltO. I
'l'O{N OF SOUTIIOLD
BUI 1,1)IHG DEPARTHENT
TO{Iq IIAI,L
SOUI'HOLD, N.Y. 1197 I
TEL: 765- 10(}2
APPLICATION FOR BU]I.DIN~ PERHIT
a. 'lhis appllcatlo~
3 sets of plans, accurate plot plan
b. Plot: plm~
I~()ARI) OF IlI~AI,'I'II ...............
3 SETS OF PLANS ...............
SURVEY ........................
CI1ECK .........................
SEPT'lC FORH ....................
NOTIFY:
CALl ...................
HAil. 'FO: ....................
INSTRUCTIONS
' l)ate ................ , 19 ....
,letely [illcd ie by tyl~riter or in hdc m~l sut~uittc4 to the Building lnsF~ckor wltb
scale. Fee accordi~g to schc~lule.
lot and o1~ buildings c~ pronlsea, relat:icamhip to adjoining premises or la~blic
streets or areas, and giving, a del:ailc4 description of layout o1~ l~COperl:y ,a~st be drmm m the dla~an ¢lldl is Imrt off
Ihis a~filcaticm.
c. 'lhe ~rk c~r~ I~ this aH~ icati¢m ray ~x~t: I~ cod~e~l I~fore isstmt~e of ~ilding Peunit. ..,
d. I1~ a~al of this al~flle;~tlon, tim ~dlding lnsl~el:or will ismm a Mildi~ Pe~mlt to the n~llcanl:.
I~nnit shall I~ I~pt cs~ 1.1~ p~onises ,~vailable For insl~cti~ fhrc~t the
e. ~ txdlding ~mll Im ~piel or u~d in ~le or in lmrt for m~ ~se ~mt~er ~mEil a C~rtlflcate
(~oq~q[~y Mmll. h~ l~en g~ant~l I~ lm ~dldlag lnsl~ctor.
AI~q,If~TI~ IS lEggY ~g t~ ~t~ ~dlding l~rtneat: For the is~:e of a Ikdlding Permit ~rmmnE
Ikdhli~ Fxx~ O~limmw~ of the To~ o~ ~tl~ld, ~fffolk (~mty, ~ Yeti% and other applicable l~s, O~li~es
I~gula~iam, for tlm ~mkx~i~ o~ ladldi~s, mkliti~s or alteraCltms, or for r~a[ or ~li~io~, as lmrein
ages to c~ly with all a~licable ~s, ordinates, ls~lldi~ c~, I~si~ cnde,
llm
ret~flatiCxm, and to &it a~fl~rlz~l ns~ctors em lw~i~s and~ln Isdtdlrq} for ~cesea~
State ~letler a~licant is ~er, les m, a~nt, architect, engi~mr, gererat contractor, eleetrlcimb plmt~r qr Ixfilder.
* Y ' . ..............
~e oP ~r of p~i~s ........ 7'; ......................... ~"'"' ~ .........................
(aa s~ the tax nflI or l~tesk de~l)
~,uo,~ ~.~ ~ ...... :./~.~..
l~lect:r tells Lieen ,
Otler 'lY~*s Licen~ ~ ....... ..............
.................................. ' ' ' ................. ' ' / ...................................................
~lJ~JvJsJal .................... j .................. FJl~] ~ll~ ~) ................ l~t ...............
(~) ,
2. 8tat'e exiati~ u~ aJ~ ~:LXII~IK:yj Of prenJ~s mKI Jntendal use and ~cu~q~y of p~l camttuctiom
a. Exlsking u~ and ~o~Da~y . 'I .......... ~ ~ ............................ ' ...................
,,
b, lnLmx~d u~ and ~:~..,...,...: .. ~ ..........................................