HomeMy WebLinkAbout23603-z FORM' NO. O
TOWN OF SOU'W34OLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. ¥.
BUILDING PERMIT
fTHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
N.° 23603 Z
Permission is hereby granted to:
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at premises located at .......... /./~....~... .......... ~,..~,~.,~,. ......... ~.~...', ............................................
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County Tax Map No. 1000 Section ...././..~.. ........... Block ........ Q...~...... Lot No ........ /~... .......
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Building Inspector.
Rev. 6/30/80
.~, ',: FOIIH rl()o I
,,~ ! TOI~/N OF SOUTIIOLD
,~[ ~ ~) I,,,;,, ~ ~ I~llll. I}lNC DI~PAR'fHENT
' E~ [ TO[~ IIALI.
~OUTIIOI,D, N,Y. 1197 I
B~G.~ TEl.: 765-180~
'~WN OF SOUTHOLD
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Di~al a/c ..................................
APPL}CATION FOR BUILD[NO I)ERH]'I'
BOAlll) OF IIEAI,'fll ...............
3 SETS OF PLANS ...............
SURVEY ........................
CI1ECK .........................
SEPTIC FORH
Date ................ ,I9 ....
l NS'I'RUCT [OHS
a. 'fids appllcfltioo namt Im c¢ol)letely filled in IJ¥ tylx.n.~riter or in ink a~xl mfl~nltt~l to the Ikdlding lns~ctor with
3 ~ts of plans, acne,rate plot plan to ~ale. F~ according to sd~kde.
b. Plot pisa ~l~ l~ti~ of lot a~ of Iadldi~s
str~s or areas, m~l 8ivi~ a ¢~ail~ t~scripti~ of la~t
this nl~J
c. the ~k c¢~r~] I~ this a~)l icati~ pay ~)l: Im co,~e~ tmfore ifl~l~e of lkdhling Permit.
d. II[~ fl~)r~al of this al~)t/catica,, tl~ l~dldi~ lns~ctor will iss~ a Ikdlding l~mi~ to the a~licant. ~lch
im~mlt ~m[l Im kept ~ tl~ p~d~s ~ail~le for ins~ti~ tlt~.x~t the ~rk.
e. ~ ladhll,g ~mll I~ ~cupi~l or u~l in ~mle or
~mqm~:y Mmll h~e I~n grant~l by tim I~dlding hm~tor.
AH~AC~TI~ IS I~BY t~ to tim I~ildi~ ~lmrtneot for the ismm~e of a ~fildi~ Pe~it ~ramnt to the
~fihlia~ ~m Onli~m~e of tim '1'~ o~ ~tl~ld, ~ffolk ~mty, ~e York, a~ o~her a~licalile l~s, Ordi~es or
l~latl~s, for tl~ ~s~n~tim of Ixdldi~s, ~kli~i~s or alterati~m, or for ~al or ¢~ml ilion, as Imrein
~scri~l. 'lira applicaa[ agr~h to c~ly with att al~licable l~s~ ordi~m~es, I~ilding
~Bnlati~m, taxi to ~nit aftl~riv~l ins~tors ~l p~d~s alxl in I~dldi~for ~cessa~ insets.
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~ ~ ~ t FEE. '
(fl~ ~1 Lira I:a~ ~ol[ of late~L d~) FO~O~NGINSPE~ONS:
If fll~licant is a corlx~rnticm, signatxwe of duly autlg)rized officer.
(lime m~l title of corl~rate officer)
Plmimra l.lcen~ ~ ..........................
El~[rlcians l.lcee~ ~ ......................
Otlmr 'IY~'a I.icen~ ~ .....................
1, FOUNDATION - TWO REQUIRED'
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
STATE CONSTRUCTION & ENERGY
CODES. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS
7. I)i.~nnit~m of exlsl:ing '
PI.OT
Nom~ Pub[~o, Sram d~ New York. No. 495130~ ~
Qualified in Suffol~ Coun~ ~
Commission Expires Ma~ 22, 19 ~