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HomeMy WebLinkAbout26052-Z I:DIIH NO. I 'J'O~JN OF ,qou'J'IIDLD BUII, I) I tt(~ IJEP^RTHENT TOWN IIAI,I, SOUTIIOI.D, N.Y. 11971 TEl,: 765-1802 y PI,ICA'FION FOR IIUII.DING PERMIT I N~'FRUCT i .3 SETS OF PLANS ............... SURVEY ..... : , ................. CIIECK ......................... SEPTIC FORH ................... ' l)nte ......... , 19 .... n. 'Illin npplicnti~ ~nmt be co.pletely f~lled in Ivy typewr|ter or Jn i.k mxl .ul~[tt~l to tl~ ~Hl. dJng In.~ct:or with :etm oF plmm, nco~rnte plot plnn to ecnle. Fee ncco~llng t:o nch~l~.de. h. Plot pln. d~b,g h~nti~ oE lot m~l o[ l~dtdl.gn ~ pronleen, ~el~titmsl,lp to ~jolnl.g p~ine~ or ~,bl lc -eet..r nrenn, mxl glvi~ n ~t~tl~l ~Cr~l)ti~ oE l~t of ~rl:y mint I~ drm.) m the dl~n ~Jcl, ~n l~nrl: o[ d. Ui~ al~n~ol off this n~llcntlm, the l~H.d[ng hm~ctor w[l~l, i~m~ n ~ltdlng ~mtt to the al~l. lcant. Such .,,it: ~lmll I~ kept ~ tl~ ~,,l~n nvnilnble For i-Sl~cti~ th~t the ~rk. e. ~ I~Hlding ~nll I~ ~o~l~l or u~l I. ~ie or in ~nrt [or ~ ~ne ~s~t~r tmtll n C~rt~flc~te o[ ihli.g 7x~ Ordhw,,~e 0[ the 'Ik~ of ~thold, ~[Folk {kx,nty, ~ York, o,~1 other nl~llc~ble I~, Ordl.m~en or ncril~l. 'll~ nM)l icm,t o~ to c~)l.y with ~ll ni~)l.~cnbl.e i~n, omll,~r~en, I~HI.d[ng ~, I~st.g c~le, n,~l (Slgrmt~re oE n~llcnnt, or ~*m, if n ~ f~ ' ..~ ............. ,.: ...... ~.. ale whether nppl. ic~nL in ~er, lennee., n~.t, nrcl :~c:, ehgb~er, ge~ernl c~tr~ctor, electrlclnn, ph~r or I~,ild~r. ............ ........................... ....................... (os ~ tl~ trix toll or l~l:ent: d~l) ... ~ ~~ ......... ,~I'A'II~ (X" I,l'.~I :;:; ( 1 ~.11'1 i'/ (Ii" ....................... .... ~.-~/..././.:~-~.~./:. ....... ,~:~,,,, ,,,,,~ ,,~,,,,. (llml; ~)l: i~,lJvJllulJl IlJlllijly.j I:oill:rlll:t) ,,, ,,,,: ((~xlLl'lll:LCJf, lllJl]llJ:~ I:¢~l-i~jr~le ufl~i,:~r, lJl~jll i~'~l i~lj Ih.I. iii I ~JlII~iRii~ ~JlJl'aJ~l ill IIIJtl .ppi il:hi Joll ale I IJllll II~e ~J~l~ will ~ i~l~m.~l ill IIl~ Imul~' Ile~ J'l)[lll ill II~e ill~lllJl:lll:i~ fih~d ..... /~ ...... ,,,~ ,,~ ..~ ..... ~...~.. LIND^ J. COOPER Notary Public, State of Naw ¥orh No. ~,8225(~3 Suffolk County