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Home My WebLink About24131-Z FOi~M NO. ! TO~'N 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.° 24131 Z Permission is hereby grant~ to: .~ ~.~ ~ , ...................... .................. . .'", '~~7/,;;~ ....... ...... pursuant to application dated .......... ~...~T.~... ............ , 19~..., and approved by the Building Inspector. Fee $...7...~... · g....~. Rev. 6/30/80 Al'lr SCALE: I = ~0 PJA e FORN NO. I TOWN OF SOUTIIOLD BUILDING DEPAR]~ENT TOWN IIALI. SOUTIlOLD. N.Y. 1197 I " TC ,V~ ~ ~ ' , ~. _, _....~: ~..~ ~ TEl.: 765-1802 INSTRUCTIONS BOARD OF IIE^I,TII ............... 3 SETS OF PLANS ............... SURVEY ........................ CIIECK ......................... SEPTIC FORN ................... NOTIFY: CALL ...~. ?.& .~.~..~.(.... NAIL TO: .................... a. This applicatlo~ nt~t he conpletely filled in b~ typewriter or in i~ ~ ~itt~ to t~ Adldi~ Ins~tor with 3 ~ts of pl~s, ~ate plot pl~ to ~ale. F~ ~co~i~ to ~le. b. Plot pl~ ~i~ l~ti~ DE lot ~ o~ ~ildi~s ~ ~m*i~s, ~lation~dp to ~joining pr~i~s or ~llc str~ts or areas, ~ givi~ a ~tail~ ~ripti~ of l~t of p~rty this a~l icati~. c. ~ ~ ~ ~ tiffs a~licati~ ~ ~t ~ ~ ~fore isle of ~ildi~ Pe~t. d. ~ ,w~al of this ~li~tim, t~ ~ildi~ Ins~ctor will is~ a ~ildi~ Pemit to tl~ ~li~t. ~mit ~all ~ ~pt m t~ ~i~s ~ail~le for i~tim theft t~ ~rk. e. ~ ~ildi~ Mmll ~ ~a~i~ or ~ in ~le or in ~rt for ~ ~ ~mll ~ ~n ~t~ I~ fl~ ~ildi~ In~tor. ~J~H~ IS ~ ~ to t~ ~ildi~ ~nt for fl~ ism~e of a ~ildi~ I~ildi~ ~ ~i~ of ~ T~ of ~flmld, ~ffolk ~m~, ~ Yo~, ~ otlmr a~li~le ~ O~i~es or ~lati~a, for ~ ~t~ti~ of ~ildi~s, ~iti~s or alterati~s, or for ~al or ~liti~, ~ ~rein lh~ri~. ~ ~lic~t ~s to ~ly ~ith all a~licable 1~, o~i~es, ~ildi~ ~, ~i~ ~, aM r~lati~s, ~ to ~it ~ri~ ins~tors ~ ~i~s a~ in ~ildi~ for ~es~ in~ti~s. .. ......... (Si~tum (~ili~ State ~hether applicant is o~ner, les~, agent, ard~itect, engineer, general contractor, electrician, plunher or I~il(~r. .. ~~... ~mtD.~ ................ .............................................................. .... .................................... (~ ~ t~ tax ~11 DE latest ~) ' J APPROVED AS rIOTED If a~l,~nt ,s a m~rat,~, s,~t~ of ~ly ~t~ri~ officer. D.-~E:. ~7 8.R ': .......: .... :'"; ...................................... - ..... t,~o'n~w BUILDING DE~M~ AT ' ' UPANCY OR ~.>~so~ ~ AM ~ 4~o~ USE IS ffNLAWFUL~ot.ww~ O~ FRAMING .liners Licen. ~ .......................... OCCUPANCY :;, ,~ :N~;ULATION gl~trici~s l,icen~ ~ ...................... 4, n~ m.~. CONSTRUC~ON Other ~Y~'~ Lice~ ~ ..................... FU- ~;O~f~.ET~ FOR C.O. A~L CONSTRUCTION SHA~, ,~ ,~ ~ ,~. ~ ~,T~ IC(~TRI~N & ENERGY ~.=~ ~ ~ ~. ~ ~=~. ..... ~L~. ..... ~ .... L~ ........ ~= ............... ~ivlsi~ ...................................... F~ ~p ~ ................ l~t ............... (~) 2. SLate ~sti~ ~ ~ ~y o[ pr~s ~ in~e[~ ~ ~ ~ o~ ptu~ a. ~ist~ u~ ~ ~ ..~~ ............................................................. h. ~.t~ .~ ~ ~ ... tDG ....... %~.~ ............................ 'l. )&'llme o~ w~[A (d~eck ~,idl ~qq~licable): NL~ IAdidh,g .......... ~klition .......... Al[etatlon .......... If garage, st~;i~r of cars ...................................... If I~si~ss, ~rcial or mi~l ~O~lm~, slmci~ ~mture and extent of each ty~ of u~ ...................... I~i~r ......................... ~dmr of Stories ...................... Di,,e,~si{s,s of entire ~ ~srn~ri~;: Fr~t ................ I~ar ............... l~pth .............. Sir~ of lot: F~¢s,r .................... ~ar .................... I~pth .................... Ik~s prolg}~l ~s~s~n~t[~ violate any z~s~ing h~, orditN~e or regulati~: .~ ................... ~ill lot v~ - ' · · ~ of Arddt~r .................................... ~klress .............................. ~ ~ ............... ~e of {~lractor ................................... ~kiress ............................... l~>ne ~ ............... PI.OT I)IAGRAH 1,)cate clearly and distinctly all btlihlings, ~et. mr existing or propost~l, and i~licate all set-back dlme~ sions fr~lu iffoperty lines. Gi~ street and bl~k ~stt~r or ~hscripti~ acco~ing to ~, a~ ~ street m~ms alii indicate and .~tys ti,at I~e is the alq)l ic~mt -~k-~ b; the .............. ~.~L~.~. ......................................................................... of said ~r or ~r,. m~l is duly ~lhoriz~l to I~rfenn or h~ve l~rl:o~.~ Ihe ~id ~tk arm to n~ke a~l file this applicatio.; Ihat all ,talo~nts (x,;lait~l in Ihi~ alq}licat i~m me tr~ to the I~nt: o[ hi, klx~l~lge and Ix~lief~ snd Ihat the ~k will Im imrfont~l Ju I1~ .~,,~r ~t Forth in the al~licaui~,~ fi lml tl~r~iOt. TOWN OF SOUTHOLD PROPERTY RECORD CARD ./[:.,:: . / / :'.. ,/./_ ~0 OWNER STREET .~'/ '/) V,LU',GE D~ST. SUB. LOT / FORMER OWNE~ N E ACR. LAND I~P. TOTAL DATE RE~ARKS FARM Acre Volue Per Volue Tilloble 2 Tilloble 3 Swampland FRONTAGE ON WATER Brushlond FRONTAGE ON ROAD House Plot DEPTH ~ ~ BULKHEAD Total DOCK COLOR Porch Foundation ension ,~'~2 y z Basement Extension Ext. Walls Extension Fire Place Breezeway Garage Patio Total II Room Bath ,~. Floors 0 ~ A' Interior Finish ~-"~, /Ooc' ,t Heat Rooms 1st Floor inette IR, BR. Rooms 2nd Floor FIN. B. Dormer