HomeMy WebLinkAbout25311-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. 25311 Z
Date NOVEMBER 6~ 1998
Permission is hereby granted to:
CARL HOLTHAUSEN
36050 CR 48
SOUTHOLD,NY 11971
for :
ERECTION OF A 6' HIGH STOCKADE FENCE IN THE SIDE AND REAR YARD
AREA AS APPLIED FOR.
at premises located at 36050 CR 48 SOUTHOLD
County Tax Map No. 473889 Section 069 Block 0004 Lot No. 006
pursuant to application dated SEPTEMBER 23 1998 and approved by the
Building Inspector.
Fee $ 35.00
Building
ORIGINAL
Rev. 2/19/98
FOR~4 NO. !
TO~/N OF SOUTItOLD
BUILDING DEPART~IENT
TOI~ HALL
SOUTBOLD. N.Y. 1197 I
TEl.: 765-1802
BOARD OF HEALTH ...............
3 SETS OF PLANS ...............
SURVEY ........................
CHECK .........................
SEPTIC FORN ...................
NOTIFY:
CALL ............... ...
NAIL TO: ....................
Disapproved a/c ......
11:4, --- I~1~ APPLICATION FOR BUILDING PERHIT
""'lljl.,1 ~:')23 IggB__j!~ 'D~te ................. ]9 ....
a. '~i: a~li~ti~ ~t ~ ~le/ely fill~ in by ~iter or in i~ ~ ~itt~ to ~ ~ildi~ In--for
3 ~ts of pl~, ~ate plot pl~ co ~le. F~ ~o~i~ to ~le.
b. Plot pl~ ~ l~ti~ of lot ~ of hildi~s ~ ~s, relati~ip to ~jolni~ pr~s or ~lic
struts or ~e~, ~ givi~ a &ail~ ~ripti~ of l~t of p~ ~t ~ dr~ ~ ~ diem ~i~ is ~rt of
this appli~ti~.
c. 'Hm ~ ~r~ ~ ~is a~li~ti~ my mt ~ ~ ~fore isme of hildi~ Pe~t.
d. ~ a~al of ~is a~licati~, ~ hildi~ Im~cror will is~ a hildi~ Pe~t to the applimt.
~t ~11 ~.~pt ~ ~ ~s avail~le ~r i~ti~ thr~t ~ ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ or ~ in ~le or in ~rt for ~ ~ ~C~er mtil a ~rtificaCe of
~ ~I~I~ IS ~ ~ to t~ ~ildi~ ~nt for ~ isle of a ~ildi~ Pe~t ~mr to t~
~ildi~ ~ ~i~ of ~ T~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~er a~li~le ~s, ~di~es or
~lati~, for ~ mt~ti~ of ~ildi~, ~iti~ or alterati~, or for ~al or ~liti~, ~ ~rein
~ri~. ~ a~li~t ~s to ~ly wi~ ~l a~li~le l~s, ordi~es, ~ildi~ c~, ~i~ c~
..............
(Si~tme of ~llmt, or ~, ~f~ ~ a co~rarlon)
..... ....................................
State ~m~ a~l.iat~it ~4es~, ~i~t, e~i~r, gemral ~ntr~tor, el~tricia, pl~r or ~il&~
~ ~ -. ~,'~ ~.~ "~q ..............
.... ~ ~:-~. ~'~'~'. .... =., ..... ="= :~., .............................................................
If a~)lic~ is a ~Ci~t3~l~l~ly ~fl~ri~ officer.
................................ ~O~P~! ..~. ..........
El~tri~i~ Li~ ~ ......................
O~r ~'s ~ ~ ..................... ~ ~ ~'
-
~iv~ ................ ~fl~ ~ ~ ...... I~ ........
3. Rature of ~ork (check ~hidt appticable): Ne~ l~filding .......... Addition ..... ~ .... Alteration ..........
/
(to ~ ~id ~ filing this a~li~i~)
If ~ra~, ~r of ars ,
6. If ~i~ss, ~a,ercial or ~ ~ ~i~ ~ture ~ ~tent of ead~ ~ of u~ ......................
7. Di~nsi~s of ~stlng st= s, ~f a~. ~t.. ~ar ~pth .................
Ibi~t ........................ .~ ~r of Stories ......................
Dl~ns~ of
~ ~ ~p~
8. Bi~nsi~s of entire ~ ~st ti~: ~t ................ ~ar ........... : .................
~of~tr~tor....~&.{~ .............. . .. . .. ... ~ress ........... .................... ~ ........ : ......
PLOT BIAO~H
~r interior or
APP VED AS
76B-1~2 ~ AM TO 4 PM FOR ~
FOLL~ING INS~ONS:
1 FOUNDATION - ~0 REQUIRED
FOR POUNED ~NCR~E
4. FINAL . CONSTRUCTION MUST
BE COMPL~E ~R C.O.
ALL CONSTRUCTION SHALL MEET
THE REQUIREMENTS OF THE N.Y.
, STATE CONSTRUCTION & ENERGY
SFA'IE CF ~ Y(~, ssi CODES. NOT RESPONSIBLE FOR
~I'Y (~ ....................... I DESIGN OR CONSTRUCTION ERRORS
.... ~?..l.. .~.~..~..~.~.~..x:.e../..c~_. ...................... I~in8 duty ~m, delm~s aal ~ys Lime he is tim a~li~nt
(~ of iMivi~ sl~itg c~tract)J
l~ is Lhe ~X~ . .. , ............
(~tractor, a~nt, :or,rate officer, etc.)
of ~id ~r or ~rs, a~ is &~ly .~Lhori~ to ~rfo~ or h~ ImrEo~ Llm ~id ~ m~ to ~ke a~ file Lifts
a~licati~q that all stat~nts c~t d~ in ~is a~l. icati~ are t~ to H~e ~st of his k~l~ a,g ~[iefl a~
that the ~rk will ~ ~rfo~ in th. ~mr mt forO~ in ~e a~l. icati~ fil~l ~.
~m to ~fore ~ this
...... .........
~' (S]~almre of h~llc~t)
Vg~j~i3H,i' jiOIN
o
~r~C
~c~
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