HomeMy WebLinkAbout25289-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. 25289 Z
Date OCTOBER 28, 1998
Permission is hereby granted to:
LOUIS LESSARD
715 LEGION AVE
MATTITUCK~NY 11952
for :
ERECTION OF A 42" PICKET FENCE AS APPLIED FOR "AS BUILT."
at premises located at 715 LEGION AVE MATTITUCK
County Tax Map No. 473889 Section 142 Block 0002 Lot No. 004
pursuant to application dated SEPTEMBER 14 1998 and approved by the
Building Inspector.
Fee $ 35.00
ORIGINAL
Rev. 2/19/98
~ORH~O. I
TO~I OF SOUTHOLD
BUILDING DEPARTH~T
TONN HALL
SOUTHOLD, ~.Y. 11971
TEL: 765-1802
Disapproved a/c ............................. .. . . .
APPLICATIOH FOR ItlllLDINC PERHIT
I~STRUCTIONS
HOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY
CI~CK .........................
SEPTIC FORH ...................
NOTIFY:
cA-- :?.
HAIL TO: ....................
a. 'Ibis application muat be eanpletely filled in by ~iter or in i~ ~ mitt~ to ~e hfildi~ I~tor
3 ~ts of pl~, ~ate plot pl~ to ~ale. F~ ~o~i~ to ~le.
b. Plot pl~ ~ l~tim of lot ~ of ~ildi~ ~ ~s, ~lati~ip to ~joini~ pr~s or ~lic
struts or ~e~, ~ givi~ a ~tail~ ~ripti~ of layer of pm~ ~t ~ ~ ~ ~ di~ ~i~ is ~rt of
this a~li~ti~.
c. '~m ~ ~M by ~is a~li~ti~ my ~t ~ ~ ~fore isle of Mildi~ PeMt.
d. Ui~ a~l of ~is ~li~ti~, t~ ~ildi~ l~ctor ~11 is~ a ~ildi~ Pe~t to the ~li~t.
~t ~11 ~ ~pt ~ ~ ~s a~il~le for i~ti~ thr~t ~e ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~at~er ~til a ~rtlficate of
~ ~11 ~e ~n ~t~ ~ ~ ~ildi~
~l~I~ IS ~t ~ ~ t~ ~ildi~ ~nt for ~e isle of a ~ildi~ Pe~t ~t to the
~ildi~ ~ ~di~ of ~ T~ of ~ld, ~ffolk ~ ~ Yo~, ~ o~er a~li~le ~s, ~i~s or
~lati~, for ~ ~t~ti~ of ~ildi~, ~iti~ or alterati~, or for r~al or ~liti~, ~ ~in
&~ri~. ~ a~li~e ~s to ~ly ~ all ~li~le l~s, ordi~s, ~ildi~ ~i~ c~,
r~lati~s, a~ to ~it ~ri~ i~tors m ~s ~ in ~i~r ~s~ims. / /
......
(~ili~ ~ o[
State ~r ~li~r is mr~ le~, ~ent, ~ir~t~ engi~r, ~ral cmtractor, el~trici~ pl~r or
......................................... ~ffi~ ~.8~[~ ............
... cess ........... ' .....
,N~ ~ DE~ENT
......................................................... t ~~ - ~ RE~IRED
(~ ~ title of ~rate offi~r)
~ ~il~s Li~ ~ .......................... 4, FINAL * CON~RUCT~N
BE ~ ~ C.O,
Pl~rs Li~ ~ ..................... · .. · - ALL CON~RU~ION SNAL~ MEET
THE REOUIREMENT$ O'F ~ NY
~l~trlci~ Li~ ~ ...................... ~TATE ~ONS~RUCTION · ~N~RGY
O~r ~s ~ ~ ..................... CODES.' NO~
PESIGN O~ CONSTRUCTION
I.~i~ o~ 1~ ~ ~i~ ~ ~ ~il~ ~ ~ ..............................................................
............... ..................... ........................ ...... , .....................
~ ~r $t~t
~ivisi~ ........................... . . . . . .. .. .. Fil~ ~p ~ ......... ... ... . I~t ............ ...
(~)
2. State ~stiq ~ ~ <~ of ~s ~ int~ ~ ~ <~ of pro~ ~t~tion:
a. ~sti~ ~ ~ ~ ........................................
b. ~ ~~ ....................................................
3. P~pairI~'ature of work (checkp~ral~id~ app., [icable): llarolitiouNe~ l~nldmg .... i ~lt ~ .......... ,,--~}erat ~on ..........
............ · . .......... ..... ..... 0~h~ ~ ..._~..-:-~ ,... ,, ......
If gara~, ~r of ~rs
6. If ~i~ss, ~=rci~l or ~ ~, ~ci~ ~ture ~ ~tent of ead~ ~ of
7. Di~nsi~s of ~isting steams, if ~: flint ................ ~ar ~pth
.
~ st~e ~h alterat~s or ~tmns: ~n~ ............... ~ar ...............
Ihi~t ........................ ~ ~r of Stories ..........
........... ~ ........ ~ar .................... ~pCh ....................
lO. ~Ce of ~wdm~ .............. ~ ...... ~ of Four ~r ........................................
.... , ...................... ~ress ......................... ~ ~ ...............
~tr~tor
~ PLOT DIAGRAH
[~ '
1~ 5s the ........................... .~ ......................................................................
(~tractor, a~nt, cOr~rate o[Eicer, etc.)
a~l.imtim~; that att ~tat~nt~ c~ta~ in ~[s a~llcati~ are t~ to ~e ~st o[ h{s k~l~ ~ ~l. ief~ a~
that the ~ will ~ ~rfo~ in the~m~r ~t forth in
BUILDING DEPT.
INSPECTION
[ ] FOUNDATION 1ST [ ] ROUGH PLBG.
[ ] FOUNDATION2ND [ ] INSULATION
[ ] FRAMING [ ] FINAL
[]FIREPLACE&CHIMNEY