HomeMy WebLinkAbout30169-Z~a~~~ ~
TOWN OF SOUTHOLD BUILDING DEPT.
765.1802
INSPECTION
[ ]FOUNDATION 1ST [ ]ROUGH PLBG.
[ ]FOUNDATION 2ND [ ]INSULATION
[ ]FRAMING /STRAPPING [ ]FINAL
[ ]FIREPLACE 8~ CHIMNEY [ ]FIRE SAFETY INSPECTION
[ ]FIRE RESISTANT CONSTRUCTION [ ]FIRE RESISTANT PENETRATION
REMARKS:
DATE S- ~ ~ - ~ ~ INSPECTOR " ~'"~~~•l~
FORM NO. 3
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
~~~~.
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(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
PERMIT NO. 30169 Z Date MARCH 17, 2004
Permission is hereby granted to:
SUSAN ULRICH
2345 MILL CREEK DR
SOUTHOLD.NY 11971
for
ADDITION TO AN EXISTING SINGLE FAMILY DWELLING AS APPLIED FOR, TO
THE CONDITIONS OF THE ZBA #5460
at premises located at 2345 MILL CREEK DR
SOUTHOLD
County Tax Map No. 473889 Section 051 Block 0006 Lot No. 039
pursuant to application dated FEBRUARY 3, 2004 and approved by the
Building Inspector to expire on SEPTEMBER 17, 2005.
Fee $
150.00
Rev. 5/8/02
Authorized Signature
ORIGINAL