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Home My WebLink About24198-Z /~B~ NO. B TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 24198 Z DQte .... cou,,w To, Mop No. i00o Se,',,on ......... ~ ..... B.o,:k ......... ~ ...... Lo, No ..... ~; ............. Building Inspector. Fee ~ and approved by the Rev. 6/30/80 FORH NO. I TOWN (}F SO[JTIIOI,I) llU 11.1) 1NG I)I'~PAIgTHF, NT TOI/N IIAI,I, SOUTIIOI.I}, N.Y. 11971 TEl.: 765-1802 D i s~,~ a/c .................................. APP BU I I.D I NC, PF. RH I T I NS'I'IHKTI' 1 ()NS I~,OAItl) OF IIF. AI.TII ............... 3 S1'71'S OF PI.ANS ............... SURVEY ........................ CIIECK ......................... SEPTIC F'ORH ................... NOT 1 FY: CAI.I ................... HAl I. 1'O: .................... - ............. ..... SOUT Ot Date ................ ,19 .... a. 'lhis application mist Ix~ co~)letely filled in by type~-triter or in ink a~l ~l~itt~ to tim Adhling lns~ctor wit] 3 ~ts of pla,s, acetate plot plan to ~ale. 1~ accordir~ to sch~Mle. L. Plot I)la~ M~ing l~ati~ of lot a~xl of lx,ildings Cn~ prani~s, relaticamhip to ~tjoining pr~ni~s or l~blic si roets or arc, as, a~l givirg a ~tail~l dec. ripe ion of Iny(xst o[ i~o1~ ly .~mt I~ dt~ ~ the diagran Msicll is i~rt of lhis aloft icati~n~. c. 1tm ~rk c~r~ I~ this a~flicati~ my ~t ~ com~l I~fore isle of ~dlding Pe~it. d. Ill~X al~al of this a~licati~, the hfilding lnsl~ctor will issue a ~fihling Pe~it to the a~licant. I~mit shall I~ kept ~ tim ~i~s ~ailable for ins~cti~ thrc~,[O~t the ~rk. e. ~ Ixdldi~ M~al1 Im ~pi~ or u~ in M~le or i. fart for a~ ~r~ ~mt~er until a C~rtificate of ~.~y ~mll have I~n ~ant~ by tim hiilding ]ns~tor. g~l~ ICA'I'I(~t lS I~[~lff F~I~ lo tl~ l~ilding l~l~rln~nt lot Ihe iss~m~me of a hfihling Pemit ~r~t to the I~fildi.g 7xa~ O~lilm~e of tim T~ of ~xal~ld. ~ffo]k Cx~mty, ~* York. a~ other a~flicable I~s. Ordi~es or I~l~dati~s, for tim ~mt~ti~ of I~sildi~gs. ~kliti~s or alterations, or for r~al or ~lil:ion. as Imrein ~ril~l. 'lt~ a~licm~t a~s to c~91y ~ith all a~licable l~s. ordilm~es, l~ildi~c~, I~ming c~le, re. Harlem. a~xl to minit ~tl~riT~ insl~tors ~ p~o.i~s a~ in l~ihli~ for ~ces~ ins~cti~s. . ............. (~dl lng ~lress o[ al~licant) (as cc, tim tax roll or latest det~l) APPRO~/£O kS NOTED If applica,,t is a corl~rati~, sJ~t,sre of ~ly .,tl.,ri.~, officer. ~..~,~"" (~e a~xl title of corl~rate officer) ';;[FY BUILDING DEPOT AT ~ 5 ~gO~ 9 AM ~ 4 PM FOR ~IE ~:Cq LO~N~ ~HSPE~IONS: ~OR POURED CONCRETE l'l~l~rs l,icen~ ~ .......................... 2 ROUGN - ~RAM~NG & PLUMBING ~., F:~,AL ¢0~ 7RJC~ON MUST Other ~s Licen~ ~ ..................... ~F ~O~t;PLETE- V~R ,~[L CON :T~[ CT ON SHALL ..................... ' ,'~ '~ ~, k~E~ .... .................................... ......... Bl~k ...... ~ ....... l~t ...... ~. ........ (~) (Io I~ l~fid ~ fi I i.g this al)pi ical:i~n~) If ~lli~g, ~i~r of ~lli~g u~dl~ ............ l~l~r ~1~ ~lti~[; ~.dls ~ each fl~r ................ I)i][~tsi~Mm of exlst:i[ig ~trtttutes. if a]]y: Fr~M~t ................ I~ar ............... I~l)th ................. I~i1~l,t ......................... ~l[l~c o~ Slolie~ ...................... iEplh .............. '.' ..... IEi0tt .................... ~1~t~ o~ Storie~ I)i[tt~mi~M~s o1: elltire [~ ~XMIStiI~:I:itMI: Itrt~II: ................ lear ............... Ikl)lh .............. I~it~t: ......................... ~t~r of Stotie~ ..................... ~ize of IGC: PftMst .................... I~ac .................... l~l)lh 7zRe or u~ district i]~a,it~l p~o.i~s a~e stttu~te(I .............................................................. ~ill lot I~ ~egf~L~I .................... ~ill e~:e~ fill I~ r~n~c~l f~l ptts.i~a: ~I~S ~.~s of (~r of I ~s ............................ ~klre~a .............................. H~ ~ ............ ~ of Arddtect .................................... ~hhe~s .............................. l~n~ R) ............ ............................... ............ IS. la Ihi8 pn~l~rly ~ithi~ ~ f~l. of a riehl ~tlm~l'! ~ ~1~ .......... ~ ......... ~1l; ~1~, ~lllllll) '1~ '11~'1~;~ l~1~1'1' ~Y I~ I~11[~. I'I.OT l~x:al:e clearly a~l di~ti~l:ly all I~ihli~8. ~lher exial:it~g ~r prol~l, a~l i~licate all ~t-I~:k I:l~. pr~l~ty I h~a. Give atilt a,~l bl~:k ~t~r or ~s~:ript i~ accotdit~l~ I:o ~E~I. a~l ~ 81reeC ~u~ at~l i~licala II. I(}_ Il. 13. 14. ~.~ ................. y ~, delx~s ~t~l says th~C he i~ the ~q~pli~:a~l ,,, ................................................................................. Ih~ll Ihe ..k ~ill I~ I~rl:~n~ed h~ Ihe nil[~,~r ~1: I:o~lh itt Ihe appl icali(., I'il~l tl~r~ilh. JOYCE M. WILKINS Notary Public, State of New No. ~952246, Suffolk Counf~ Term Expires June 12, 1 ~