HomeMy WebLinkAbout14595-Z~'IELD INS[~ECTION
,'OUNDATION (1st)
DATE
~OUNDATION (2nd)
tOUGH FRAME &
PLUMBING
iNSULATION ?ER N. Y.
STATE ENERGY
CODE
FINAL
COMMENTS
ADDITIONAL COMMENTS:
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
:N.o 14595 Z
Permission is hereby/granted to:
.......
· .~.~./...~.-.~....~.~....~/.. ............................
.~~.....~..:.~.:.....!../...~.~..~ .........
at premises located at ...../~....~..~).~........~....~...~...~........~.~~ .......................
County Tax Map No. 1000 Section .... ..~...~......0.. ...... Block ...... ...~.....~ ....... Lot No ..... .~
Building Inspector.
Fee $ ........... : ............
approved by the
Building Inspector
Rev. 6/30/80
Examined..~...°~D~.....~ ..... 19~.G.
'FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
$OUTHOLD, N.Y. 11971
TEL.: 765-1802
Approved...~...~-:...., 19~..~. Permit No.! .~..~.~.~-..~.
Disapproved a/c .....................................
(Building Inspector)
APPLICATION FOR BUILDING PERMIT
BLDG. DEPT.
TOVVN OF SOUTHOLD
Received ........... ,19...
INSTRUCTIONS
a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli-
cation.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy
shall have been granted by the Building Inspector.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described.
admitThe applicantauthorizedagreeSinspect~l~g preeners ~a~uild.lma~Vs,t( CO~l[~ply with all applicable for°rdinanceS'necessary ~ns~ections.bUilding code, housing code, and regulations, and to
·
State ~p20~i~ci~'l~bvl~[]~e'~see, agent, architect, engineer, general contractor, electrician, plumber or builder. ·
........ ............ L ...... : .... ......... '"" lPPIlOYrl)', '8 .........
Name of °wn~r'l~'~r~,~,~rn~'"' .//7 ~/;'1 ~. g.'/~..~J~..~..~..~'.. :.. '.~...Dthe .h'..~.../~ o~) l~e s:t .~r~ F,0 '~'t~t'~'~(3 ' ' B'
~,'~, (as on tax roll deeul .
If applicant is a corporation,'~ signature of duly authorized officer. FFI:: -)- ~" ~ 8y~ /, ~,/-
NOTIFY B01ID!NG DEPARTMENT AT
766-1802 9 AM TO 4 PM POR
(Name and title of corporate office~. ,, ~OLt,OWING INSPECTIONS:
--~ I FOUNDA~'~ON Two r~EQUIRED
2 ROUG~ ~;~AMII%~ & PLUMBING
Plumber's License No ......................... 3. IK~: IL~ r , !
4 F!~Af ~: :~I~C~.,N MUST
~i~ ~..£.. · ,;far C O.
Electrician's License No. ALt ""'; "~ ~ '~
...................... ,.. ,'~ .... ~ON $~ALL MEET
THE ~L~LYW?~-~E~4T$ OF THE
Other Trade's License No ...................... STATE
(,or, s I ~;.. C r~c .N & ~NERGY
1. Location of land on which proposed work will be done.
....
.% ........... ................ T oi.U ......................
House Number Street Hamlet
County Tax Map No. 1000 Section 7.~..-./..'~..~. ...... Block .................. Lot
Subdivision ..................................... Filed Map No ............... Lot ...............
(Name)
State existing use and occupancy of premises and intended use and occupancy of proposed construction:
a. Existing use and occupancy ......... .O..A4'.~.=~... g~.~. ............................
b. Intended use and occupancy . .',~7~..".~..~. ~...4'?..~.C".~.~. ............................................
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