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Home My WebLink About25016-ZTOT~N OF SOUTIIOI.D BUILDING DEPARTHEltT TOIJN IIALL SO01'I1OLO, N.Y. 1197 I TEl.-' 76!5-1802 Penni t No ................. BOARD OF HEAI,~! ............... /3 SETS oF/PLANS ............... SURVEY" ........................ CllECKJt: ........................ SEPTIC FORH ................... NOTIFY: C^LC~(~'.: ~.).1 ......... HAil, TO: .................... I NS'rRUCTTONS n. 'lhis applicotlon mint be co,pletely filled 3 ~ts o[ p~, ~co~te plot p~nn to ~ale. b. Plot plan ¢~l~ l~ttm of lot struts or areas, ~1 glvi~ a ~ta[l~l ~rtptt~ of la, it o[ pro~rty ~mt I~ dr~ ~ tim dia~an d~lch in ~qrt of this n[~)l icntt~. d. U~ a~l of ~lis a~lScati~, ti~ l~ihli~ lng~ctor ~dl[ lamma ~ilding ~mit to d~e appilcont. ~:h l~mlt emil ~ ~pt ~ O~ ~[~8 ~allnble for tns~tt~ th~t tim ~rk. e. ~ ~tidi~ ~mll ~ ~t~! ~ ~1 in ~le or in ~rt ~r m~ p)~ ~mt~r tmtil a C~rtlflcnte of ~.l~'r1~ 1~ t~ ~ to tim Ikdlding ~rtmnt for ttm ism o[ a ~ild[~ ~mit ~lrmmnt to the l~ildi~ ~ ~im~ of t~ ~ o[ ~tl~ld, ~[folk ~ ~ Yo~, ~ otlmr a~li~ble l~s, ~i~es or ~lati~, ~or tim mtmtt~ o[ ~dldt~s, m~iti~s or alte~ti~s, or ~r ~al or ~liti~, as I~retn ~ri~. ~ a~limt ~k'~ to ~,vly wt~ all a~lt~ble l~,,o~lm~s, ~ildi~ ~, ming ~e, and ..... ............ (S~tur~o[ a~ltcsnt, or (~ilt~ ~mss of a~licant) State ~tl~r a~li~nt is ~r, ies~, ~nt, arddt~t, engt~r,' ge~ral ~tr~tor, el~trict~n, pl~r or ..CL~a~t ................................. ~ ....................................................................... ~ o~ ~ o~ ~,~... ~Zaa~.../~itt, k.a~/~.; ....................................................... (ss ~ tl~ ~ax mil or lo~es~ d~) If a~)tlcant is a ~atim, st~ of &il? ~tl~)ri~ officer. (Hame and title of corporate officer) Plumbers License No .......................... Electricians License No ...................... O0~r Trade's Ltc~se No ..................... '~.~ ~ af~.C-- ' ' ~/~ l(,-'~l/--~j/~~ ~ ,. ,~.,~ o~ ,.~ ~ ~,,~, ~, ~-n, ,~ ,~...~w.~...:.~'~ ........................................................... ,Y.~.~Z~. ~,..~.- ....... ' ............. I~ ~r gt~t i~leC ~,~ T~ ~ ~. ~ ~i~, ..... ~.t ....... m.~ ...... ~ ......... x~ .... /.~.,.L.~.. ~l~ivisi~ . ~.Ol'J. 6~, ~.~ .4/){~ .~.~.e~ ~1~ ~p ~... ~.~.~J .... I~t .... ~ ~ ..... 2. State existi~ ~ a~ ~ Of ~i~s a~ iatem~ ~ a]~ ~ of p~ crest=tim: a. F~isti~ ,~ ~ ~ ..... -- --~.~--. ~'~-~ ................................................. b. ~,t,~ ~ ~ ~ ..... ~.~-~--i~!:'~a Z.~: ................................................ PI.OT I~caCe clearly and dieClnccly all building, ~lmtlmr exlecin8 or proposed, mzl indic, aCe alt sec-back dimensions fr(]u properry lines. (~ive aCs-eeC and block r~mi)er or descrlptioo according to deed, and ~ho~ **treeC n~nes arxl indicate ~d~etlv~r interior or corner ,~I'A'IE (Ili` M~M ,~ ~ ~,~ ..... ~.~.~ ............................................................................... o~ ~i(I (~r or ~'~r~: n(xl l~ duly ~l~r]~ to i~rfonn alq)l iCll~i(Xl; tirol oil 8~aL~li~8 c,x~t:al~l In tlm~ th~ ~)rk ~itl I~ ~rFon~l hi I.Im i~nt~r ~L EorOt itl Lhe flppl, icnLi~ ~it~ tlmr~l~,.