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Home My WebLink About23874-Z IeO~Bf NO. ! TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. N? BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 23874 Z D~,e ........ ~. .................................. /,,~ ~'~ ........... Permission is here~w gra_nt,e~l t,~ ~ ., / .~ . ,,q, ,~ . ~ / ~ ~Z"~" ~ ............. '"" ..... ' ' ................. ~..Z~., ................................... ........ .... ~...,~~.....~_..~...: .............. ;..-~ ................................................................ at p~mi~,~ I~t~d *t ....~.~.~.~.....~....~ ................................................................... ............................................... ~~~ ................................................................................ Building Inspector. and approved by the Rev. 6/30/80 FORH NO. TOI4N OF SOUTIIOLD BUILDING DEPARTHENT TOI.1N llALL SOUTllOLD, N.Y. TEL: 765-1802 / Di~pprov~l a/c .................................. BOARD OF I1EALTI ............... 3 SETS OF FLANS ............... SURVEY ........................ CBECK ......................... SEFTIC FORH ................... NOTIFY: I¢IAIL TO.' ....... . ............. APPLICATION FOR BUll,DING PERHIT INSTRUCTIONS a. This al~lieation mast be conpletely filled in by typewriter or in ink and sul~itted to tim Building In.~ector ~ith 3 ..~ets of plans, aeetrrate plot plan to ~eale. Fee ancording to ~le. b. Plot plan .~tx~ing location of lot and of buildings tm p,'~,ises, r~latlonshlp to adjoining pio,,ises or I~hlic streets or areas, and giving a detailed de~erlption of layout of proFerty ma~t be drmm on the dlagrara which is part of this app{ ication. c. alu va~rk co. red by this application v,~ry ant be coca. oecd before ismxanee of Building Permit. d. Upon ~pplo~al of this application, tbe Building In.,q~ctor will issue a Building Pemlt to tbs applicant. ~lch permit shall be kept on the premi.~s available for inspeetlan thronghont tbe work. e. No building ,~hall be occupied or u~d in whole or in part for any purpose ~.tmtever tnatlla Certificate of Occa,pancy Mmll ha~ been granted,Dy the Building In.~pector. APPLICATION IS IIMo'~mC ~ to tbs Building Uepartraent for the is.m~anee of a Building Permit puranant to tbs Building Zone Ordinance of the Toan of Sonthold, Soffolk County, N~ York, and other applicable l~,~m, Ordirkaness or P, egtllations, for tbs constroctian of Buildings, ack/itions or alteratians, or for r~aovs! or de~olitlon, as herein described, lhe applicant agrees to eonply with all applicable la~, ordinances, b~filding code, booaing code, and regulations, and to admit autt~clz~l in.~pectors on praises and in b~dldlng for necessary in,~peetions. (Signature of applicant, or name, if a coq~oration) (~iling a~lress o£ ~plicant) State ~d~etber app{icant is o~mer, lessee, agent, architect, engineer, general contractor, electrician, phsnber or lafi Ider. ....... C.o. ........................................................................................ ~ or ~r of p~i.~s . .'.0..~..B ..... ~.~-..% ........... .¢~o.~ .~.~..~. ................... (~s on the tax roll or latest deed) / If applicant is a corporation, siganturo of (k]ly anthorir~ed officer. (IS-sue and title of corporate officer) Builders License No .......................... Pl~l~rs License No .......................... Eleetrleians License No ...................... ..................... I. I~ti~ of 1~ ~ ~,id, ~ ~ ~11 ~ ~ ..... ~..9~.~.~ ..... .I. ~..~$. q~ ..... ~ ...... .. .... ...... 2 ........ ~l~ivlsi~ ...................................... Fil~ ~p ~ ................ l~t ............... State ~st~ um ~ ~ of ptu,ams a~ mte~ u~ ~1 ~ ofc~ c~stneti~: 2. a Exlsi'~ ' ' ' ~' 0 ~ . ~ .,,~ .~ ~ ~ ..... ~ ~. n.a..,..~.l ........ ~...~ ....... ~ ......................... b. ~nt~ u~ ~ ~ ................... ~..~ k ........... ~...$ ...... I~q~Hr . ........... I~al ............. I~1 ilion . ~... Olher l~)d( ....... .... ,,. ,~, ~,,,,~, ~ ..... [.O .ST~ .......... ~ .............. t. ~ ............................ l~q~lh .................... I~i~r .................... ~d~r o[ Stories ............... II. 7~ or u~ (lis[~ict in ~ict~ p~,i~e~ nrc ~[t~mt~l .............................................................. IL Uill I~)L I~ *el:rf~l ..... ~ r ......... Uill e~ceu5 fill Im 3~.. .... ~ .............. l~e ....... ........................................ ~ .................. i~ ~ ~ ............... 15. 1~ Ihi~ p~X~l~Cy ~iUdn ~ [~t o[ ~ tidM ~[lm~l~ * ~lL~ lq.OT DTAGllAH cleacly fl~d distinctly all I~dl(li~gs, ~hether exist;in§ or prol~s~l, tirol it~lic~Ce all aet-I~:k (lin~nsion. , ~,,~ .~..~.k.~ u~,, ¢..~ .,~,,,,,~,,,,,~ ,~,.,, ,,~,~,.~. ,,,,, ,,,,,. ,,,,,~,,~ ,,, .,,, ,,,,,,,,,:,,,,, ,,..~..,...,.,.,..~,.. .................................................................. N~R~ PUBLIC, State of Term E~ires May 31,