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HomeMy WebLinkAbout32626-Z FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No: Z-32644 Date: 10/02/07 THIS CERTIFIES that the building ACCESSORY GARAGE Location of Property: 1705 (HOUSE NO.) County Tax Map No. 473889 Section 114 NEW SUFFOLK AVE (STREET) Block 11 MATTITUCK (HAMLET) Lot 30 subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated DECEMBER 26, 2006 pursuant to which Building Permit No. 32626-Z dated JANUARY 8, 2007 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is INSTALLATION OF A PRE-BUILT ACCESSORY GARAGE & RELOCATE AN EXISTING STORAGE SHED IN THE REQUIRED REAR YARD AS APPLIED FOR. The certificate is issued to JAMES H PIM (OWNER) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A ELECTRICAL CERTIFICATE NO. 3047218 09/28/07 PLUMBERS CERTIFICATION DATED N/A ~"~ Rev. 1/81 ~-,..-"\ Form No.6 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-1802 - \ \)\1 .J / APPLICATION FOR CERTIFICATE OF OCCUPANCY.. This application mnst be filled in by typewrIter or ink and submitted to the Building Department wlttr1h~ following: A. For new building or new use: I. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal (S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/1 0 of] % lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: I. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is denied; the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees I. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00, Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $]00.00 3. Copy of Certificate of Occupancy - $.25 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date. / t) / I / D 7 I New Construction: Location of Property: 7.sD House No. Old or Pre-existing Building: f?ce:ve.. Ave:.- Street p~ ......... (check one) M CL ZZ 17:..., c..k.. Hamlet Owner or Owners of Property: ~ I CJ n7':= ... J.J- , J 4 Block iI , Lot ..<<;b Suffolk County Tax Map No 1000, Section Subdivision Filed Map. Lot: Health Dept. Approval: Planning Board Approval: Date of PerInit. Applicant: --..I4-~ 1-J. P, ~ .,..__ Underwriters Approval: '1,/:7: "'/177 Pennit No. __ .:s 2. (,. Z. (p Request for: Temporary Certificate Final Certificate: ;/ (check one) F b d $ ...., --~ ee Su mitte : .c.. ;:L , 6(~ .7'3/7fo CO ~ :?J.G tftf pplicant Signature FORM NO. 3 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) PERMIT NO. 32626 Z Date JANUARY 8, 2007 permission is hereby granted to: JAMES H PIM RT 2 750 REEVE AVE MATTITUCK,NY 11952 for : INSTALL PRE-BUILT ACCESSORY GARAGE & RELOCATE AN EXISTING STORAGE SHED IN REQUIRED REAR YARD OF SINGLE FAMILY DWELLING. REPLACES BP# 23269 at premises located at 1705 NEW SUFFOLK AVE MATTI TUCK County Tax Map No. 473889 Section 114 Block 0011 Lot No. 030 pursuant to application dated DECEMBER 26, 2006 and approved by the Building Inspector to expire on JULY 8, 2008. Fee $ 75.00 A~.~ i Authorized Signature ORIGINAL Rev. 5/8/02 l!l.l!l I BY THIS CERTIFICATE OF COMPLIANCE THE I ~ NEW YORK BOARD OF FIRE UNDERWRITERS ~ ~ BUREAU OF ELECTRICITY ~ ~ 40 FULTON STREET - NEW YORK, NY 1 0038 ~ ~ CERTIFIES THAT ~ ~ ~ ~ Upon the application of upon premises owned by ~ ~ ~ ~ JAMES PIM JAMES PIM ~ ~ 750 REEVE AVE. 750 REEVE AVE. ~ I MA TTITUCK, NY 11952 MA TTITUCK, NY 11952 I ~ Located at 750 REEVE AVE. MA TTITUCK, NY 11952 ~ ~ ~ ~ Application Number: 3047218 Certificate Number: 3047218 ~ ~ Section: Block: Lot: Building Permit: 32626 BDC: n511 ~ ~ ~ ~ Described as a occupancy, wherein the premises electrical system consisting of ~ ~ electrical devices and wiring, described below, located in/on the premises at: ~ ~ . First Floor, Second Floor, garage only, Detached Garage, Outside, ~ ~ A visual inspection of the premises electrical system, limited to electrical devices and wiring to the extent detailed ~ ~ herein, was conducted in accordance with the requirements of the applicable code and/or standard ~ ~ promulgated by the State of New York, Department of State Code Enforcement and Administration, or other ~ ~ authority having jurisdiction, and found to be in compliance therewith on the 25th Day of September, 2007. ~ ~ Name OTY Rate Ratin. Circuit Im ~ ~ Miscellaneous ~ ~ as built-2002 ~ ~ Panels I 30 6 ~ ~~~~ ~ ~ Outlet 10 0 Fixture ~ ~ Fixture 6 0 Incandescent ~ ~ Fixture 4 0 Flourescent ~ ~ Outlet II 0 General Purpose ~ ~ Receptacle 11 0 General Purpose ~ ~ Switch 4 0 General Purpose ~ ~ Receptacle I 0 GFCI ~ ~ An as built inspection. of the delineated electrical installation, determined that an obvious hazard is not present and the installation is believed to ~ ~ be in comformance with the applicable reference standard for the estimated period of construction of the premises wiring system. ~ ~ ~ ~ seal ~ ~ ~ ~ 1 of I ~ ~ ~ I This certificate may not be altered in any way and is validated only by the presence of a raised seal at the location indicated. I 1iI.l!l 'i!ii\!jj.:ntlHi BRDOkLYN DIOCESE W ~ j/Jfl ~ (fJ 120.37 g; ~ u.I :> .:l.. :--- -~---; 't ~:-3<)--' \ 2 I ?iT ST'OR.y' 0 ,J ,... ':;; \ [5Tb~ i!s ;,J > uJ \JJ d +. C! "5 o o If) w J1 170.1E> ----- C o'/',q';,o'" ./ "';.0 ;. 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'o'.~ __\<< \~:' ;;~-~:-.... ..:. .be COf<lik\cji'::.f ~ ~ iil VIIUd'" coPf. _~_.:,.);..l ('.:;-;;. . tor whOfTl ~~ ':.1;,. , L~.:~"~=:...*m::~'~~.~.~ J ,j ,.Y.!'lRY.fC.W""'--. ~'~'\."!.;!lt!~ ~h:"7>1..< .c":,~~1I"'1;A1 i:'.. . ~ ~ _,".'.1 .'. . .' . ,.~_~;J;~J{J. GU;':~ANTf:ED TO THE nn [~A;Al.iANT[F TO' Tl1fFi\U(''1lJ.>.51-10ME.. :\Dl'-<'lr~'1-5'(RAfi; AS surGvEYE.[; - ..---.-....--'--- -----.-----'jlJf-iE \;:~\!'~ TUYL,'l50N ----.--. ....- ----- {\ rz. . V <>----'l"~~t/~ t:iCLNSf;[)l:A."li5.WP_v'FyO~:- -iqp'EEW?Q~.i N.'(. _.._..._______.____....:.:-1-. - .-- 3~~"7--- TOWN OF SOUTH OLD BUILDING DEPT. 765.1802 INSPECTION [ ] FOUNDATION 1ST [ ] FOUNDATION 2ND [ ] FRAMING I STRAPPING [ ] FIREPLACE & CHIMNEY [ ] FIRE RESISTANT CONSTRUCTION REMARKS: [ ] ROUGH PLBG. [ ] INSULATION ~FINAL [ ] FIRE SAFETY INSPECTION [ ] FIRE RESISTANT PENETRAnON F~~, ~ok, c:~ ~~ ~cf. ' ~) DATE I"'~-O 7 INSPECTOR ~.~ OJ C~~l..!IIE!Jl:.!_ ---~--===_= .)0 - ~~.==~=~~=--- It' ~ t~' 111,1.1) IW:~!;!.:1~!!~!=~!;~!!!!L_if'.;~~"'m"';;,7'Z:3.?-.:" w<- u .,.';;:1::;;:.; ~ ....,.... . 1-1. I/V-./"''''.- V' . -"~7--~ _ t~__ ~ ____~ _ 'I II _ _ ~~ I~;T) 1111______n_I~~--- _ __ c:~, ~ ''''''''''.' '"" '1 _ . . " - -I (III (lNIl) m ~~~~=~~!~lll ~=_==..====_===_==_==_=_========__==_====_==__======_===~ I'UlIlllM !__============= =======--- ------11 -----.-. 1 ________II.m___~~~=:_:_----- 1 :===~--= ~ -_==:-- ______ -11- ---~=~=~===-=============== ===_=__===__=__=_____=__=_=, ,;,===:==== 11'1 ===-=~ ==============-====~==-== -------11 'n_ !I_ I:: I: _. .. ... ........ -;. ""'___ 1__________._ ~ __ n__ ___________ =_==========_===_=_____=__=__===_===_=_ ==========--=---=-=----== '=-'-~j-:~f'----?.~ -~.. -~-r-~ /'r___I_________ _ I _ ~ - -- - ~ --- D ~_ __~_ _~ ______ ---- ~------- ----~----_________n_ 'I ____~_ I ~~----- -- 1,--------- _ --------i-u-------- __ I II ----- - =___==___=~ ----- - -- ---1---------- __=___=__==_==____====_=_________=____ -A_======_ ==__< -==-- 'WfS' ___=_= =====--===--=--======---- ==- AllI) IT I OIlAL C~~~~=_;,.:.__===__=____=_ ===---======-===-==--==--=---=------==========--===-==-=== - ---- HOIIl:II FHMm ~ I'I.IIHI\IIH: 5~ \:) 'w ~ Vl ~ ~tl" t~ 'I \. ~ INSIII.ATIOll I'EIl 1I_ STAnc IWlmr;y y - COlli, ~ ,5 , ''i H I'II'AI. ~ ~.. ~ "~ ~ , ~:K..\ ~ H," .....". ~~ ~~'l' ~I . "_n_" "._n____._..__ f,l ~ > " ~I CJ ~ ~I 'u >-I J FORK NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN BALL SOUTHOLD, N.Y. 11971 TEL: 765-1802 r-3 SETS OF PLANS ..........1.... rsURVEY ...... ~ , .. .. ;, .. . ;. .. .. .. . .. .. .. . .. .. .. .. .. /CHECK " ....... ........... ...... SEPTIC FORM................... F3ani~'#'kt 19~... AwrtNed..q!4&l:., 19.... Di""JlllTUV"<! alc ....:........................ Pennit to.Cd.8..~ f.f NOTIFY: ~ CJ ~ - a;L/ 0 CALL .............:1... HAIL TO:.................... ...................................... ............................................ .................................... ICATION FOR BUILDING PERMIT "Date. .f':-v.:/-. .1.4-....., 19.'1.~ INSTRUCTIONS a. Thia application 1IlllIt be .".,.,letely filled in by typewriter or in ink and subnitted to the D..ilding Inapector with 3 seta of ploos, accurate plot ploo to acale. Fee according to schedule. b. Plot pIon sbwing location of lot and of buildinga on pranisea, relationahip to adjoining pmnisea or public streets or areas, and giving a detailed description of layout of property 1IlllIt be dr....... on the diagrail ""iet. is part of this applicatioo. c. The work ctJvered by thia application IIIIy not be eu..."".ced before issuance of Building Pennit. d. Upon ..w.vy.,J of thia application, the Building Jnapector will is""" a Building Pennit to the applicant. ~ permit shall be kept 00 the pmnisea available for ioapection througl1OlJt the work. . e. to building shall be occupied or used in .mole or in part for any plIJlOse ""atever until a Certificate of, Occupmx:y shall have been granted by the Building Inapector. . APl'LICl\TIIlf IS IERI'JlY !WE to the Building Di!parbJl'!nt Cur the iS9\J8l1Ce of a Building Pennit purllU80t to the Building 7noe Ordinance of the Town of Southold, !W'folk County, New York, and other appltcable LawlI, Ordinances',or Regulationa, for the construction of buildinga, additions or alterations, or for rmoval or derolition, as herein described. The applicant &greea to .".,.,ly with all applicable I......, ordinances, building code, housing code, and regulations, and to lIlioit authorized inapectors on pmnises and in bui!-~ for necedj'/'i~iona. .~~:.;.;ii;;;~;;';;;;';;;;i;;j ...7..:5:. R. .12t:e.ti.?-. .4<-&> ~. !{~<<;.~ Ny (Hailins address of applicant) J I CJ 5 z... State whether applicant is """"r, l..ssee, agent, architect, engineer, general contractor, electrician, plumer or builder. ... .00-dn .e.!::"...................................................................................................... Name of """"r of pmnisea .~~~~~....~....~.~......................,..................................... (as on the tax roll or latest deed) (Name and title of co.~...te officer) ',::--) (fi' - ~ Q \ Ii , r .---. f~~~ Fi 5 If applicant is a ""'I",...tion, signatore of duly authorized officer. ELC'G. :;':'..~ Tf'\^'~\:.Qt~Sl'.' " Builders License to. Plumers License to. 2. Electricians License No. ..................... Other Trade's License to. .................... ) I. llJcatioo of land on ""ich proposed work will be done..~.JZ~(:..'-!f';-..I:.;j~I::.-5.k1.#~!i../..~d.fH~c... .....7. SO...... ./.2.f<t:-.v.f..-.1.... A~ 1...... . M.q.ti.;.t.<UR-k. ........................................ IInuse Ibtber Street lImilet County Tax Mop to. IIXXJ Section ....1.1..4....... Block .....//........ lot ..30......... Subdiviaion ...................................... Filed Mop to. ............... lot ............... (Name) State existing use and occupmx:y of pmnisel' and intended lL"" and occupmx:y of I'.uvu-d construction, a. Existins use ~ occupmx:y ...;;v.Q.FJJ.c...*a.m.'./1"..c.~sl.Cl.r?-Y.7.C<L..:....7fr!~..;.;. b. Intended use and occupmx:y ..SJ.r7J.!e-..J'.4.m'{!1.Y.:&<;;./.dC<!J.Co;Cr,,:-,'!JfU::0;-v.; e.... .,' 3. Nature of work (d>eck ...Id. applicable), NeIIlluildina.. .~.... Addition ..~.. Alte~lon .......... Repair ..........,; lIa10tal ............. JlenDlition ............ Odler >>'nk #e.1Z'.;.;;~~.... . ""; 71 r>n-,-, 00 Esttlllilted Cost . '" ....,..t. .v.Y./.<. ........ fee .. ... .35~...... ... .... ......... .......... (to be paid on flllna this application) If cb!llina. rudler of cb!lling units ............ lb.iler of lk"'lllna units on esd. floor ................ If ~r88e. RuDer of cars ........~.......................... If business. lXJDrercial (>r mixed occupancy. specify nsture and extent of esd, type of use...................... . If" 'f /:</0" /"//1" '1/ .....-// Omens ons 0 e>:tsttna structures. I any: F.-ont..........~..... Rear ..., .-f-. .:v.... Deptb .. ( ..:-'........ ,-,,' Q ,- I lIel81.t ..!....J.~..-(.............. lUtLer of Stories ......,............... . ) 01 1ft h._ 'tl I t' ^.,"t'. ~ '~ . . ~"D^ 36 -0 - noms ons 0 ...... s ruc.~e VI . a tera Ions or ......1 Ions. uont.. ...;~..~~.... .~ar ............... ..., A. ' " "J /'> / // I-*' Depth .....+.,..,;0....., lIei81.t ...._..~tR...... tto.ber of Stories ... ..:k-....... O. . f . . ~ / 0 ' "F ! c/ /, ..., A ' ^ '/ 1"""",lons 0 entire new COOBtructlon' uont ......"'..:v.... Rear ,.. .o.~D..... Depth ..""".T.:.V.... . /) r'> I. " .}; lIel81.t .. r.-....-;...4.............. ttuDer of Stones .. ..I.. 'h-.-........... '. . /o;Z.y-q/ 0.0-."",1 /,;;2. I~ Sue of lot. F.-oot.. .D.....>..<...... Resr .../.""""..~-'..... Depd, .. ...0............. Date ofPurd....... .:7.j;2, 1-.,1..7.:?..,.. Nime of Fonner OoIner ..M.... b{;.Vt?:-I! (:1............... Zone or use district in ....icto pr...lses are si~ted \.,..........................,................................ \Joea proposed <XlIlStructlOO violate any 200lna 1..... ordinance or regulation, ....N(7................ Will lot be regraded ,... Ni{........... Will ellC.eas fill be rfl1O\/ed fran I,ranlsea; YES m Nalres of OoIner of 1'r6lllses .J.amfl;.$../Ih0.., Address .7;~---:O'.I.~t1-!~A~.. Phone lb. ;;2..9i?;.CjAR~ 4. 5. 6. 7. 8. 9. 10. II. 12. 13. 14. 15. tJiJJe of Ardlitect 1 ~.w .,.,.~~, '0. .~.. .~... .......o....... Mlre68 ........ e............... .~.... ..... ..~... Plsone Ml. ................ Nime of Contractor .QCl/.lI.S..t3r.~.i......,.. ..... Address 30..&.r.-Lt'U<.rl3l.lU<P.tiPlIDOO lb. 2Z?~.:sa(1) ,Is this property within 300 feet of a tidal wetland? * YES .......... m ..K...... ,oIF YES. InJIIDD 'Jl:m 'I1lUSI1!I!S 1'IlItfn' tfAY llI! IlFlpIRIID. . PLOT OIAGRAM l.ocate clearly and distinctly all buildlnas. Wledler existing or proposed. and indicate !Ill set-back dimensions fran property lines. Give street and block RDber or description acCOrdlna to deed. and show atreet oanes and Indicate tAletller interior or coner lot. I J7e /A A ",/'..-<1- E.><ISTIN<1 5+-1ED fl. tt-Lr< Z I" < (j) .c 1\ 11 o r r- f rn i3 '911'-OPoek.- ]::> WA.R-AC.IE. '1' 5] E.)<,I~TING, R6'S\t::.E.-MC.;;;' 7!'5Cl l2.l;;.~v"" Av>z. ~-\ '" -.() _R!:.-i.:...vp A.v~. STATE OF NEil Y9RK'J f}. A L SS COllNTYOF "~" .. J fjj:1~:;,.. ~.. PI./:1............ ......,. lleina duly sworn. deposes and says that 'le is the applicant (N",,,, of indlvidJal ~Ignina COIltTllCt) a1lO\/e naned, . lie is tile .... ..Q.w.N,~;:"',...................................................................................... (Contractor. agent, corporate officer, etc.) of said owner or owners. and ia ....ly. i1udlOrized t(> perfolJD or have perfomed tile aaid work and to mal<e snd file tllis application; that all stst.......ts cootsloed in dlis application are tme to tile best of his knowledge and belief; and that tile work vi11 be perfumed il> tile IIIilJlner set ford. in die application filed tber...ld,. !Mlm to before me this -....p 'A_..LAAllIA .........................}.2".,,,. day of dJ~~-::.AJ.. ...... 19, ;(~,.... . =~~= . ~. ......-..'i~..~..-;tt, / ,COMM\!lSIl)'H^',,"" 4-if-1(' "p~ "';:'~ /i~...~. .......................... 'Jf..(~;"""'''.,. "F """li".",,\ w 1000 ~ / - 11- 30 OWNER '- .;' it!. ~. FORMER OWNER t\*~o wok. lli"'W :;:L ?'d-Lo-~-c F SOUTHOLD PROPERTY RECORD CARD 05 /'IEvr ~uffoL II' AI/I! N VILLAGE /)1Ajbl:tA.-~, ~ K'-4e tLrt.. .c. 5 ew S:fj'1J/1( VL. , v FARM COMM. U .~l..t.Q CB. MICS. DIST. SUB. 9 ACR.; TYPE OF BUILDING Mkt. Value LAND IMP. 000 ~()d AGE NEW FARM Tillable Woodland Meadowland House €.!st Total NORMAL Acre TOTAL DATE BUILDING CONDITION BELOW ABOVE Value Per Acre Value '"""'~ FRONTAGE ON WATER FRONTAGE ON ROAD DEPTH BULKHEAD DOCK I ll'~ De..sc-\ ...J ).-J -:l- Cj I \ , , LOT "'" _ , "O'-'T' r;.. ': S... 7 I OJ ;( e.~/rc(-( /i 1'r; TO ~'_, ; ,.. {(,'"", v t' II... ( I .. , 's r'~1 <:9-"00 ~ r./"fI,r/V//1'" (1-- I()Vo c( (. 2 t' l I \i... - - - \ I \ I I , I I , I ,. ~--'--- .. ~ .... ~- - --- -- - - - \ c ~ ~ ---. 1-- - -- - - i :1'- ~ " \ j . , ~I U In - ;; l<t i -- ,.,. ." ~ ~t:~;;:;:~i ?<~::;- ::~ '::- l:.r~::::~:.:~;:~::;;;:~~7;(~~'~f , ''''''',~~'' 1\ I ..(:'J.:.,- I ({'hr,' ".-, ., t~ · . \" 1 'W~:1> . ,/ --- . ~ .~ , - -- -- \ .- I '1 1 . 1-' - - . _,'.e.:i i ~ SO 't, '<1 "- .... . . M. Bldg, J'f X. 30 "- 7.?-O 5:<> 0 3 ? 00 :; Extension ,x:J,v,J7 ~ .~-91 t7 ? ? J 00 Extension 171fi'';: SOe, 1.2 .2 00 ~ Extension Foundation Both Dinette Porch Basement Floors K, Porch . Ext, Walls Interior Finish LR, Breezeway Fire Place Heat DR, Garage Type Roof Rooms 1st Floor BR. Patio Recreation Room Rooms 2nd Floor FIN. B 0, B. (& I) L sHElJ iX.5 Dormer Driveway Total 6()/Cf . D ~rffb' ' l-itii;, . COLOR WH ,-r C TRIM wH, rE i , , II I , ~ , , ! ; 1 I , I ~ ,r 'jfPtSf/ j""l ') . ;'~ Town Hall. 53095 Main Road P.O. Box 1179 Southold. New York 11971-0959 ~;/;7/:""77;':<<:;,":>-<,- .0 c sa ~ f~~ \If Uli;;' ~')..~.~""."\ \. ~ ~ ~! !~ " ~.. f!f ^., . -'a ~ ..I/ .., 'rPr> ,,<;,'I>..1i "<.~17UN1'l, '~ij' . /)-:r/-;[/"):-rO Fax (631) 765-9502 Telephone (631) 765-1802 BUILDING DEPARTMENT TOWN OF SOUTHOLD December 7th, 2006 James H. Pim 750 Reeve Avenue Mattituck, N.Y. 11952 RE: 750 Reeve Avenue (accessory garage) SCTM# 114 11 30 Dear Mr. Pim, Please be advised that your Building Permit #23269 issued February 29th, 1996 has expired. According to the Code of the Town of South old, a Certificate of Occupancy must be issued prior to use of the structure. To renew your Building Permit, please submit a fee of$75.00. At that time we can schedule an inspection by one of our Building Inspector's. If you have any questions, please call us at 631-765-1802. Respectfully, SOUTHOLD TOWN BUILDING DEPT. FORM NO.3 ~ if)~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HAll SOUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Date............~.....&................. 19..9..~ N~ 23269 Z Permission Is hereby granted to: ;:::;.. ...~<P$.............d.........~.#......................... ........... Za-o..... .tf.'i?<?.k(.~....... A:-.I!..~..:.......... n ~ ....../?2~.~~...IY:y;...II..tf5~ to.~att....h::......d.(!..~..a~~~..~~; ~.JJda.r;:,.~...~..~...~~.~..... ~..~....~.......... ...~ ......~.#~~....~........ ......~~..~.......... .....s/..~.~r~r- ~;~;~~I~~~';:~;:'~;.'.'.'.'.'.'.'.'.'.'.'.'.'.'z~~'.'...........~.......h.......~............;............................................................................... ........................................................../?2,,4~Lu..c/2...................................................... CounlyTax Map No. 1000 Secfton ..........jl.'/.. Block ......./1..,,""""" Lot No. ,;3.Q""""....""" pursuant to application dated ..........d..d.......I..C....... 19...9~.... and approved by the Building Inspect~ Fee S....i7.?............ (j/ Rev. 6/30/80 ...........~~~m