HomeMy WebLinkAbout25134-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. 25134 Z Date AUGUST 27~ 1998
Permission is hereby granted to:
LISA REALE
PO BOX 493
FISHERS ISLAND~NY 06390
for :
CONSTRUCTION OF A FENCE AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 010
pursuant to application dated AUGUST
Building Inspector.
MONTAUK AVE
FISHERS ISLAND
Block 0008 Lot No. 001.002
5 1998 and approved by the
Fee $ 35.00
ORIGINAL
Rev. 2/19/98
5TA/I~t4"
'%.
.[~ORH NO. I
TOWN OF SOUTUOLD
I;U11LDING Og PAR'I141[NT
TOWN NALL
SOtlTII01,D, N.~. 1197 I
TEl.: 765-1802
(INdldt~ ll~l~tor)
APPLICATION FOR BUILI)Ih'G PER~II'F
BOARD 0F tlEALTH ...............
3 SgT$ OF [~LAN8 ...............
SURVBY ........................
CI1ECK · ·.... · · ·,. ..............
$I~'t'TIC FORIt ..................
HOT1FY{
CALL ..................
NAIL TO: ....................
· Gage ....... , ' '
IN$'I'RUC'FIONS
a. 'Ibis app~ioutic~ must be eo,pletely filled in by tTpc4witer or
3~Cs of pl~,. at,raCe ploC IRan to ~ale. F~ ~cordl~ to ~le.
t~is a~fl icotio~.
: c. '~,e ~ ~r~ D fids oDlicatl~ my sut be c~ ~for~ is~ oi ~tldl~ ~mit.
d. U~ ~D~oI of fids ~Dl. icatiu~, tim l~lld[~ lus~tor will is~ ~ ~lldl~ ~mtt to tim ~ppll~t. ~d,
~mit droll ~.~pt ~ Om ~a:~all~le for ina~tt~ theft tl~ ~rk.
e, ~ ~ildt~ ~11 ~ ~pi~ or ~ tn d~l~ or In ~rt for
~A~TI~ I8 ~ }~ to tl~ ~flldi~ ~r~nt for ~m
~l~ti~, for ti~ ~t~ti~ of hfildi~, ~lti~ or ~lt~r~tt~, or for ~l or ~lttt~, ~ ~i~
State ~O~r a~ltcant la ~r, les~, '~ent, archit~t, engi~r,'ge~eral ~tr~tor, el~trici~, pl~r or I~dhle
............... ~m~"';V~
........ ~'~ .......... ;= .....................................
.. . ·
~ o~ ~ o~ ~,~. K(~ ..... : ......... ~ ~ ..... . .......... e. ~ ............. ·
..... (~ ~ ~ tax ~1[ or latest ~)
If aMflicant is ~ co~rati~, si~re of duly ~tl~ri~l officer,
and t~tle of corporate offlcer)
l~fildere License No ..........................
Pl~bers ~ce~N~
3, INSULA~
¢ FINAL . CON~U~IO~
~E COMPLETE ~
ALL CONSTRU~O~ ~ ~.
~'~ REQUIREMENTS' OF
gl~tric~ l,tce~ ~ ...................... .{E CONSTRUCTION ~ ENERGY
. / )~S ~OT RESPONSIBLE FOR
I. lmotim of la~ m ~dd~ p~l turk w[lt ~ (m .................. r.; .............................. '
~ .....
t~ ~r Strut
~t7 Tox ~p ~. I~ ~t~ ...... .~ ....... Bl.~k ................
~iv[si~ ...................................... ~t1~ ~p ~ ......... ~s ..... l~t ...............
, Y~ r ......~.~ ...................................
a. F~a~i~ ~ a~ ~y ........ J,~ ~ '
P~, mar~ ~S~d~ ................................
b. ]n~e~ ~ a~ ~ ............ a~,,,~ ..........................
ti~tl,,~t~l ~,t ..... ~,;,,,l ........ ~ 85 '; ~;~ ~{ ~' , :Ill
~. I)h*enafmm o~ entire ~ ~er~rl~, ~c .............. .. t~nr ............... ~pd~ ..............
~. si. o~ lot, ~t ...~..~ ...... ~. ....~J....O/U ..... ~,th .... ~.~,...~: ....
13. ~111 lot Im r~r~ ~ ....... ~, .......... ~kll ~efla fill Im
15, Ts ti $.'jp~rty within ~ f~t ~ a ti(Nl ~tla~? * W~ .....
H,OT DIA~RAH.
Lo,ate clearly and distinctly ~ll Imlldh~s. ttmtlmr ~ladng or pro~. ~ t~tcata alt ~t-i~ dlmnalons
~dmtlmr J.terfor or co~r loc. '
........... imbg duly m~mt, delX)m~a taxi says Lhat I~e la the eppl. itzfll:
(Cmtraetor. eltenl¥ .':orporate ol~l~lcer, etc. )
ol' said t~aer or ~mra~ ,txl in ~bty . ~tl~rt~ tn Imrfom or I,~e Imffor.~l the ~td'~cR a~.l to rake a~xl fll. a this
ti.at the ~rk wlll I~ ~r~l la th' ,amir et ~orth b the a~t. teatlm
~)ra Lo I~ore m