HomeMy WebLinkAbout25076-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. 25076 Z Date JULY 31~ 1998
Permission is hereby granted to:
JOAN W. NORKUS & GAIL W. MOULT
PO BOX 655
MATTITUCK,NY 11952
for :
CONSTRUCTION OF A STOCKADE FENCE 4' MAXIMUM HEIGHT IN FRONT
YARD "AS BUILT".
at premises located at
County Tax Map No. 473889 Section 126
pursuant to application dated JULY
Building Inspector.
7972 GREAT PECONIC BAY BLVD LAUREL
Block 0011 Lot No. 016
30 1998 and approved by the
Fee $ 35.00
ORIGINAL
Rev. 2/19/98
FORH NO. I
TOld~ OF SOUTltOLD
BUll. DING DEPARTHENT
TOI4N II^LL
SOUTIIOLD, N.Y. I 197 I
TEl.: 765-1802
D i ~appr~'ed c ..................................
APPLICATION FOR BUILDING PERHIT
BOARD OF IlEAL'M1 ...............
3 SETS OF PLANS ...............
SURVEY ........................
CIIECK .........................
SEPTIC FORM ...................
.NOTIFY:
CALL ................ ..
HAIl, TO: ....................
INSTRUCTIONS
a. Ibis application trot I~ c~]etely [illed in Dy t-yl~.~riter or in ink ~l ~itt~ to the ~dldi~ Ins~ctor with
; ~ts o[ plans, ack,ate plot plan to scale. Fee acco~i~ to sch~de.
b. Plot plan ~i~ l~atim of lot ~ of Imildi~gs m ~mi~s, relatimship to ~jolning ~i~s or ~hllc
;trots or areas, taxi 8{vi~ a ¢~tail~l (D~ript'{~ of I~,: of p~rty mint Im dram m the dln~ ~lid~ is part of
his 9~1 icati~.
c. ll~ ~rk c~ by this ~licatlm ~ ~t I~ c¢~1 lin[ore ismmme of ~dldi~ Pemit.
d. U~ a~al o[ thls a~licatl*~, the l~JildhB lns~ctor will ]ssm a ~Jildlt¢ ~mlt to the a~llcant.
eonir Mmll ~ kept m tim ~i~s ~ailable for ion~tlm I:hra~a~t the turk.
e. ~ ladldi~ ~mll ~ ~pi~l or ami in ~mle or in l}art for a~ gJr~ ~mtmr tmtll a C~rtlflca~e of
~;I~TI~ IS IE~l~ ~ to tlc I~ildlng l~Dart~at for I.l~e iss~mme of a hdldi~ Pemit pw~nt to the
uildi~ ~ O~im~e oE ~ ~ of ~tlmhl, ~fffolk ~mty, ~* York, ~ other a~llcable l~s, ~i~es or
e~lati~s, for tim ~st~tlm o[ ~ildi~s, a~itlms or alteratlms, or formal or ~ition, as
~ri~. ~e a~lic~t ~s to c~ly wlth'all a~llcable 1~, ordlm~e~ldi~, ~msi~
..............~~'~~)~ '. .~'~' ..... : .......... : ....
/ .... ;3~; :q.-V/ .... ;. .-¢..y--
Cate ~.~[~[..~.~.~.mr, , a~nt, arditt~t, engi~r, ~ral cmtractor, electrician, plier ~ I~ilcer
........... : ~' ~ ' "~' ~. ~ ......... A ' " ~ "~' :~'~. ................................................................................
_ o~ ~ ~.~.~~.,.~o~....ao.~...~.o,c...w..,bt,~.~9.,...o,..~:,~.~ ....
~ i.' .... ' ~* ' 2 ' ~ ' * ' ~ ...... ~t~r~:*~' ~ ' " ~ ..............
~ihkrs LJcen~ ~. '
Pl~rs Lic~ ~. "*' ., e,', (:I ,
gl~tricians Licen~ ~ ......... ~. ............
O~mr ~8 I. icm}~ ~ .....................
. l~aLim o[ la~ ~ ~fich ~1 ~rk ~ill 1~ ~ ......................... , ..... .__., ..................
.............. 2.~ ............. ~~ ...................................................
l~m ~r 8t~t/ l~et
~, ~ ~. ,~ ~,~ .... Z.~ ...... ~,~ ...... /! ....... ,~ ........ Z.~..
~ivi~im ................................... Fil~ ~p ~ ............ I~t . ~ ....
a Existi u~ ~ ~ . . .
. ....., .... ...... . ........... · ....................
. . . ~ -.~ .... -.~x~.~.~j .................................
// ~ ~ o~.~ ,~,~,' ~.. ,~',,,~
'1.
I0.
II.
~3.
I/I.
15.
Iq~ir ............ I~al ,~ ........... , ~.,~(l~ti~s)
E~I: iu~t~l CX~st ............ ' ............ fee .................. ~ ....~'~;~'¥, ~-' ...........
I~ Bflrage, ~d~r of ~at'~ ....................................
If I.mi,mas~ ~mrclal or mi ~1 ~:o~l~c?, ~[~clr~ nfll.tl~e m.I ~xtent of end~ L~I~ of u~e ......................
I)imnMCxss uE ~i~tlng ~En~L,,re~, if any: t~r~st: ................ l~or ............... ~p~h .................
I)i.~nsi~s of entire ,~ ~.sstn.:l'lc.~: Ftcmt ..... , ........... I~.r ............... ~pth ..............
I~t~lt ..................... ' ~I~F of ~torie~ .....................
l~ffe e~ l~Jrdm~ ........... ~ ......... ~s~ off Fonmr ~r ........................................
2zx~ or u~ distrtct i, ddd~ pre. ise. are n{L~tel ..............................................................
~111 lot I~ re~rm~ ....... ; ............. ~ilI em:ess fill I~ res~ Finn pre.l~a: YES
~u~ oF Ardlitee~ .................................... ~lresfl .............................. 1~ ~ ...........
· ~s~ off C~tractor .................................. ~klreflfl ............................... t~c)[~ ~ ...........
lfl Ihifl pmlmr~y within ~) f~C off fl ti(~t ~Llmgl7 ~ YIL~ .......... ~ ..........
PI.OT I) I^('lll^H
clearly etd dlslclnel:iy sll I~dl(llngs, ~etlve;c existing or proposed, end hxltc~l:e sll ~el:~lmck dlmenMons
pro[x~rLy liees, flim 8tr~l:lsr~l block txfd~r or ¢le~erJpt:Jcxi tu:conlln§ I:o deed, e~l eJ~cx~ etreet narefl m~l iwlicnte
whether inter|or or con~r lot.
occe ,^ cY OR
USE"IS UNLA' FUL
WITHOUT CE IFIC^TE
OF OCCUPANGY
--APPIU)V[D AS N~ED ~
, NOTIFY BUll. DING
: ' 7e~.teol Il Aid TO 4 ~ FOR ~E
1 ~ON - ~ REQUIRED
~. ~. ~ & pL~BING
~. FINAL - CON$~RUCTION MUST
BE COMmiE FOR C.O.
ALL CONSTRUCTION ~HALL ~EET
(xXJ~l'( (X' ~,° .~.~.~'(~' i SS THE REQUIREMENTS OF THE N Y.
.................... ~ ~ATE CONSTRUCTION & ENERGY
~.. ~ , CODES. N~ RESPONSIBLE FO~
.~... ~'....~ r ~ ~ ~ ....... ,~,,,, ,,,,,, ,~,,.,,, ,,~,~,,~,,~, ~r~,~
(~sm o1' isxhvidm ~ll~ sl~ (m 'mt)
,,,. ~, ,,,, ...... ...... ~(~ ........ ;, ...... . ,:'":", ..................................................
((k),trnct()r, fll~ent:, corlx)rnt.e orl'i(.er, eli..r)
o1: mlid (~U' or (~mttt, ill~l ill I{h,ly II~llhoI iz(t(I ro ixn',fo.u or liflv(~ ixtl'i()i,x'd Ih(t imhl ~)lk iiiKI Io ii,lice IIIX[ rile Ihin
.ppli(:aL~o~l; (Iml. nil ~tal~f~zll. i ctmtaJm~l iJ) IhJfl nppI icat'iou m'e t tt~ Lo the I~ml: ol~ hi'0 ktx~l~ige ami t.~l
Ilmi Ihe ~)lk witl I~ I~rront~l J, Ihe tw..~r ~t: rorth itt tile applitml:io, filed ti~rc~il.it.
~)ril Io I~rore Im this ~ ~