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Home My WebLink About23340-ZFORM NO,3 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALl. $OUTHOLD, N.Y. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNtiL FULL COMPLEtiON OF THE WORK AUTHORIZED) Date .................... ...~....~..~.. .............................. 23340 Z / Permission Is hereby granted to: ..~..~...~. ~,;~....,~.~.;:...... ~...~ ~/ ..~.-...~.,.../z~...i .............................................. ,o....~..~/.,.,..,,... ....... ~........:..~..,.>.,..~% ....... ~.~.~ ....... ~:_~ ....... . ~:. . . : ........ ~,:. .:~. . ~ ......... ~ ....... ~. . . . ~. ~. . . . . . . .,:. . .~./. . .~. . . . ~.,~., ~ ....... /..~........". ............................................... atpr~,~,,~ateda, ......... ~.~.~ ....... ~:~...~ ............................................................. CountyTax Map No. 1000 Section ......................... Block O-P~' LotNo. O/ pursuant to application dated ............... ~.,~... ............................ Building Inspector. F~ ~.../.../.Y...,..~ 19....~'~.. ..... and approved bythe Rev. 6/30/80 P'OIIH Nil. I 'I'OFIH (Ilr ~OIITIlOl,ll Illl I I.III fl(~ I)It.I~^II'I'FIIT HT TOltfl II^l.i. .~OIITllOl.I), It.¥. 11971 TEl..* I)i."a~lq. ove~l .lc .................................. IlOAlll) (Il; IIITAI.'III ............... 3 8E'1'80P' PI.AHS ............... 8iliIVEY ........................ CIlia. CF( ......................... 5F. PT1 C FOtIFI ................... NOT l F Y: CAI.I ................... FlAil. TO: .................... ^I'PI.IC^TION FOIl Illlll.I)IN(; I'EIIItI'I' I It.q'l'ItllCT ION.q n. 'lhi~ nlq)l|cntitx! .,Jill be el,~q)lelel¥ I-(llell J~ by I:ylX~lzll:or or in iff& taxi ~dx.tt:l~l to tim lh,ildl.~ b~l~Clor 3 r~t~ of plo,m, ncc~n-~te UIo~ Fin. to ~eole. Fee necordi.~ Io ~eh~Esle. b. Plot Illin, vJ~h~ l~fltl~] oF lot: m~l o[ Ixdhli[~n tm p[mfses. ,~lfltlonflhlp to ~ljoi.i.~ proul~e, or i~,blic d. IIl~xi .lq)~l of Ihig t]lq)llenl:[(~l, the I~)il(li.[l l.~lector ~dll iRm~ ~ I~,il(lit*~ I~mlt Io the .pi)liemfl:. I~lmlt f~i. II I~ ~el)~ ~t I1~ ly~lii~o flvfliloble for itml~(:~lcm thuxt~(~Jt Ihe ~rk. lt~il(IhT 1~ OnlhmT~e o[ 11~ '1~.~ o[ ~fll~l(J. ~][[(~lk ()~Jnly. ~ York, taxi oilier fll~licol)le I~, ordlt~,~en or ~l~,lnti(~o, for Lie ~.tT~ti~ o[ I~tiltli~o, ~llti~. or ~ltetoti~l., or for ~t[.ol or (b~litlo.~ Lottie Ambroski by .. ~. M~M~.,.. ~. ~f. ~.h~l~ ......... ~ ~ ([~ilhq~ ~he.u of al~dlcu.l:) ........... .A.g.e.n. ~. $.ox. ~b,~. ,~g.wu..of. ~.ou.bhold, ...................................................................... ~.~e of cx~er of pro,lr~o .. Lottie Ambroski (nn (xl the I.~Jx toll or InlenL deed) Il~ appllc~ml: ie ~s co~potnt|(w% ~|l~'~lme of (~lly mfll.)z|z~l officer. (l~,r~] .8.1 Ill leo[ CC. lXlral e officer) I. ll. ll.l~ iii: ~,~.~ (ll~l:l~ IJlllh .11~lll:.hh:): Ik~i Ik~thll.II . .. N~ltti~)ll .......... Allitllll i()u .......... Il. E.I ill~lie(I (~),~ . . ' ~e~ .............................................. '.i. Ii: ~llll~ll, ixill~r ()~ (~llil~ ..il. ............ Il.liar u~ i~lllllll Hilll. (Hi ~l.:h fl(x)r ................ ,.,,~,,..~,,, ,,~ ~.,:i,,~ ..,~.,,.. I~ ,,,,~, ,,,,~,,...~ ......... ,~,,,- . ..... ~ ,~,.,, ..~E .......... Ik~i~lE ......................... li,d~ .[; ~lml~..~ ................. ~. :;i~ ,,r I.~: i~.: ..~P ............... I~.~ ..~60 .............. I~m.* ....... 2~.0 ......... II. ~ I~r u~ lli,tril:[ lu ~Jlidl 1.~,1.~..l~ ,it~,~l(ed ...... ~T.~ .................................................. ITl. ~tlll 1411: I~ lelll'm~,l .................... I/ill e~l:e~i, fill I~ I'I,()T Izx:ille (:l~aily mid (li~t:li~:Lty llll I.IIl(til~, TJieii,e~ e.{ol ll~ ()r I)['()i*)..(I, APPRO~ AS N~ FEE: //~' ~ '~: NOTIFY BUiLDIN~ DEPAR~ENT AT 765-1802 g AM TO 4 PM FOR FOLLOWING INSPE~[ONB: 1. FOUNDATION ' ~O REOUIRED FOR ~URED CONCR~ 2. ROUGH - FRAMIN~ & PLUMBING 3. INSU~TION 4. FINAL - CONSTRUCTION MUST BE COMPLETE FOR ALL CONSTRUCTION SHALL MEET f~ ~:~C~:I~MENTS OF THE N.Y. ~: (~[4'.~T~LICT~ON & ENERGY "~1' RESPONSIBLE FOR / CLAIRE L. GLEW Notaw Public. State o! New York No. 4879505 Qualified in Suffolk County ~/ / C, ommission Expires Decernber 8, 19-TC~2 ( )ll~l~,ll~ll e (if Al)pi I(mit)