HomeMy WebLinkAbout25387-zFORM 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. 25387 Z
Date DECEMBER 8 98
Permission is hereby granted to:
ROBERT FRENTZEL
PO BOX 363
EAST MARION,NY 11939
for :
CONSTRUCTION OF A FENCE IN THE REAR YARD AS APPLIED FOR.
at premises located at 1900
County Tax Map No. 473889 Section 037
pursuant to application dated OCTOBER
Building Inspector.
OLD ORCHARD RD EAST MARION
Block 0002 Lot No. 009.001
8 98 and approved by the
Fee $ 35.00
Rev. 2/19/98
ORIGINAL
FORM NO. 1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N.Y. !1971
TEL: 765-1802
SURVEY ........................
CHECK .........................
SEPTIC FOP~ ...................
NOTIFY:
CALL ..................
MAIL TO: ....................
a. 'Ibis application ntmt be conpletely filled in by typewriter or in ink and sutxnitted to the Building Inspector
3 sets of plans, accurate plot plas to scale. Fee according to schedule.
'b. Plot plan showing location of lot and of buildings on pr~m{ses, relationship to adjoining pr~nises or public
streets or areas, and giving a detailed description of layout of property ~t be drawn on the diagram which is port of
this application.
c. 'lhe work covered by this application my not be commnced before issuance of Building Pemit.
d. Upon approval of this application, the Iluilding Inspector ~11 issue a Building Permit to the applicant. Such
pemit ~hall be.kept on ~ premises available for inspection thronghont the work.
e. No building mhall be occupied or used in qaole or in port for any pmrpose whatever until a Certificate of
OcCupancy shall have been granted by the Boilding Inspector.
APPLICATI(I~ IS ~ MA~E to the 11oilding Deportnmat for the issuance of a Building Permit pursuant to the
Boilding Zone Ordinance of the Tc~ of Sonthold, S~ffolk County, New York, and other applicable Laws, Ordinaries'or
Regulations, for the construction of buildings, ~44itions or alterations, or for r~mval or ~lition, as herein
described. ~be applicant agrees to conply with all applicable laws, ordinances, building code, housing code, and
regulations, and to ~mlt anthorized inspectors on pr~mlses and in boil]ing for necessary, inspections.
.......... : ..............
(Signature oft/''-~_pplic~ or. n~nm, if a corporation)
(Mailing addre-~s o.f applicant) _~ ~, .
State wbether applicant is ~er, lessee, agent, architect, engineer,' general' contractor, electrician, plumber or builde~
.......................... : ......... ..:.: ...... ~ ..... ;...'~'....i.': ........ : ...............................................
(as on the tax roi1 Or latest deed) ' /:' AP~V£~ AS
If applicant is a corporation, si~naL~Ire of dui, anthori'/~t officer. ~
......................................................... . . BY- ·
(Nmr, e d title of corporate officer) NOTIFY' BUILDING DEPARTMENT AT
7~$d802 S ~M TO 4 PM ~O~
FOLLOWING INSP£C]]ON$:
B~ilders License No .......................... ]. FOUNDATION - TWO R[QUIRED
PON POURMD CONC~
Plt~abers License No .......................... 2, ROUGH - ~PJ~MING & PLUMBING
Electricians Licease No ...................... 3, INSULA~ON
4, FINAL - CONSTRUCTION MOST
Other Tr~l~'s License No ..................... BE COMPLETE FOR C.O,
....... ALL CONSTRUCTION SHALL
I. Ix)cation of land on which propose(l worx wlt.~ ~e ~m~e. 7... .............. . .... ~.~.~. ~..~;.: :,.~-~- ~. ¥~- ~ ~, .....
........................................................................... c~D~$2' NOT' ~P'd~'gF~EE' 'gb'~ .....
House Nearer Stree~t ~_ DESIGNH~ONSTRUCTION ERRORS
Subdivision ...................................... Filed Map No ................ Lot ...............
(~)
2. State ~w~st~ng use and occupancy of pr~m~ses and intended use and occupancy of proposed construction:
a. Existing use ~ occupancy ................................................. ~ ....... ~ ...................
gat,re of ~ork (check ~hid~ applicable): Ne~ Building .......... Mdition ...~ ...... Al~,ration ..........
Estimated Cost ........... fee ....................
(to be paid on filing this application)
If d~elling, r~ber of &lling units . .~ ....... tl, nber of &*elling units on each floor ................
If garage, surer of ears ......................................
If business, eommrcial or mixed occupancy, si~cify nature ami extent of each type of use ......................
Dimensions of existing structures, if any'- Front ................ Rear ............... Depth .................
tleight ......................... l~nber of Stories ......................
Dimensions of sam structure with alteratloos or additions: Front ............... Rear
Depth .................... tlelghr .................... Number of Stories ...............
Dimensions of entire new construction: Front ................ Rear .............. ~ Depth ..............
}leight ......................... IIJat~er of Stories .....................
Size of lot: Front .................... Rear .................... Depth ....................
Date of h~rdmse ..................... Nane of Former Owner
Zone or use district in ~hich pr~nises are situated ..............................................................
Does proposed comtruetion violate any zoning la~t~ ordinance or regulation: ........................
Will lot be regraded .................... Will excess fill be r~oved from promises: YES NO
Nares of Ommr of premises ........................... Address ......... Foone NO ........ : .....
Nam of Arddtoct .................................... &tdress .............................. Pbene NO.
Nam of Contractor ................................... /~tdress ............................... ~one No.
Is this property within 300 feet of a tidal rutland? * YFS .......... NO ..........
PLOT DIAGRAH
It>cate clearly and distinctly all buildings, ~heflmr existing or proposed, and indicate all set-back dimensions
from property lines. Give street and block nmt~er or description according to deed, and ~ street nares ami indicate
whether interior or corner lot.
· qFA'IE 0F ~';W YCh'IK, : :
SS
C(IJ~IY OF .................. .....
(Name of ~Mivi~ si~it,g emtract)
a~e ~,
(~tractor, a~.t, cor~rate officer, etc.)
>f ~id ~mr or ~rs, a~ is ~ly ~thori~ to ~rfom or h~e i~rfo~ ~e ~id ~ mgl to rake a~ file this
a~licatim~; that all statmnts cmta[~ in fl~is a~].ieation are t~ to tim ~st of his k~l~ and ~l. ief~ a~
that ~e ~rk will ~ ~rfo~l in the ~mm~r ~t forth in fl~e a~licatlm fil~ t~r~fl~.
~m to ~[ore.m this - . '
· ............................
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