HomeMy WebLinkAbout24711-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. 24711 Z Date FEBRUARY 24 98
Permission is hereby granted to:
HARVEY I. SLADKUS PC
425 PARK AVENUE
NEW YORK,NY 10022
for :
CONSTRUCT A SPLIT RAIL FENCE IN THE FRONT YARD OF A SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 128
pursuant to application dated FEBRUARY
Building Inspector.
6540 GREAT PECONIC BAY BLVD LAUREL
Block 0002 Lot No. 001
13 98 and approved by the
Fee $ 35.00
ORIGINAL
Rev. 2/19/98
FORH liD. I
TO~4N OF SOUTIIOL1)
BUll.DING DEPARTMENT
TOWN HALL
SOUTIIOLD, N.Y. 1197 I
TEl.: 765-1802
Exanined ................. , 19
Approved ................. , 19 .... Pensit No. ~.'~.~ J.].L .....
Disapproved a/c .............................. . · · ·
[1 !- · .... :'- -
BLDG. DEPT.
TOWN OF SOU[HOLD INSTRUCTIONS
BOARD OF HEALTH ...............
3 SETS OF PLANS
--SUHWY .... ~ ..................
----CtlECK ..... ~- ..................
SEPTIC FORH ...................
a. 'lhis applicatino m~st be c~npletely filled in by typewriter or in ink and auhnitted to the P~dlding Inspector wit[
3 .sets of plans, accurate plot plau to scale. Fee accordiag to sche~hfle.
h. Plot plau ~o~ing location of lot and of buildings on premises, relationship to edjoining premises or public
streets or areas, end giving a detailed description of layout of properly must be dra~n on the diagrem ~hld~ is Part
this applicatino.
c. 'the work covered by this appllcatino r~ay not be ccrmuencexl hefore issuance of Ikfilding Permit.
d. Upon approval of this appllcatle~, the Buildlng Inspector will issue a Buildlng Permit to the applicant. Such
permit shall be kept on the premises availabte for inspection thronghont the ~ork.
~% e. No Imilding slmll be oocupied or used in ~hole or in part for airy purpose ~hatever until a Cmrt{ficate of
Occupaucy shall have l~-en granted by the Buildi~ Inspector.
J APPI.ICATIClq IS It~I~A~Y t4b/g to the Building Department for the issuance of a Building Permit pursx~ant to the
Building 7~ae Ordinance o[ Lira ~o~n of SeuthoId, ~uffolk County, ~ York, and other applicable l.a~s, Ordinm~es or
Regul~'ions, for the construction of I~ildlngs, ~lditions or alteratinns, or for re~x~al or demolition, as herein
described. Tim appllcant agrees to c~ly with all applicable la~s, ord!nasc~s, building cnder41iii~ing code, and
re$~aticus, ~1 to admit authorized inspectors no premises and in buildin~r necessary ipsl~tiofls.
.......... [ ~Sxgnature ot a~p~cant, or ~ration)
(Hailing address of applicant)
SLate ~tmtimr applicant is ma~er, lessee, agent, architect, engineer, geoeral contractor, electrician, pluff~er or bulhler.
.
(as on tim tax roll or latest deed)
If appiicaut is a corlx~ratino, signature of duly antberized officer.
(H~ne and title of corporate officer)
Builders Licensc No ..........................
Plembers License LID .
Electricians License NO ......................
............. I~P~RIIY£1~Ik~ NOTED .............
NOTIFY BUI~IHG ~ AT
765-1~2 9 AM ~ 4 ~M FOR THE
FOLLOWING INSPE~ONS:
1. FOUNDATION - ~0 REQUIRED
FOR POURED CONCR~
2, ROUGH - F~MING & P~MBING
3. :NSU~ON
4. FINAL CONSTRU~[ON MUST
BE COMP~ FOR C.O,
ALL CONSTRUCTION SHALL MEET
Otter Trnde's License Ha ..................... Z~ ./~..~.,R~QUIIj~I~F~TS~F,/~.E N.Y.
l. l~catino of land m ~hich proposed ~rk will be done...~..~. ........ ~...~. ~X'I~I~f.~ON'I~ldC~II~..~.'I~t~RGY .......
Z ~.~Z~ CODES. NOT RESPONSIBLE FOR
/~% /~ / // ................... nEst~.oa.ce~muc~EaaO~S .......
llouse Humber Strut
~ivlsi~ ...................................... Fil.~ ~p ~ ................ l~t ...............
(~)
2. State ex~sCx~ ~ ~ ~y of Pr~s ~ 2nte~ use m~ ~cu~ of pr~l consC~ct~on.
- ................
..... .........
b.
Inte~
I{ei~dr ............ l~laval ........... Dc~litic~l ............ Other l/ork . ' ..... , .......... ~ .....
(t'o Im paid ~ filing th{8 a~licaCi~)
aelli,~, ri,der of a~tli~g units . ~[.~7 ..... tt,d~r of t~lling traits ~ ead~ H~r ................
lalsi~msa, ~nmrctal or mi~l ~Jlmr~, n~cif~ ~/:ure a~l ~tent of each ty~ of u~.
Din~nM~m o~ ~isting 8tn~tt~ea~ i~ any: l~r ............... ~ar ............... ~pth .................
DJa~n~i~m of sam ~tnmture ~th alteratifms or ~iCiona: Front ............... ~ar ...............
l~pth ............... IhiO~t K~l~r of Stories
~.~, 4~~~) ~ '" _. ...........
Ihi0~t ~/...~ .... ). ~dmr of Stories ........ fi<.' .......... .
.................
I~s propel c~m[n~ri~ vio~a[e any ~ing 1~, o~li~m~e or resula~t~: .... .~ ...............
~il[ lot Im r~r~ ...... ~t .......... ~ill e~ess fill Im r~ fr~ w~i~s:
~ of Ardtlteet ................................... ~reaa .............................. H~ ~ ..............
· ~ of f~tr<tor .................................. &klresfl ............... ~ ........... H~)~ ~ ..............
this p~rty within ~ f~ ~] of a riehl x~tla~l~ a ~kq .......... ~ ..~ .......
PI,OT DIAORA. ~ ~<
I~aLo clearly m~ dinti~tly fill ladldings, ~mtlmr ~iating or pro~, n~ itxllcnto all ~t-I~k dimmiona
pro~a. Gi~ at~t a~ bl~ a~i~r or cbacripti~ acco~ing to ~, a~ ~1~ street ~s ami imlieate
co~r lot
duly ~om,
(Cimtractor: age,l:,~ eorporate officer, el:c.)
of aaid ~mr or ~mrs, atzl is (hdyl~thociz~l to ~rfonn or h~e l~rFonl~l the ~[d turk omi to nnke ami fil,e Lllin
apl)l icatioTI; that aH. stal:a~nts c~ta[~ in this alii. leaL'kin are the to the treat of his kt~l~ga m~ Imliefj arxl
that the ~rk wi ti. I~ ~rfonTml in t :se immmr ~t forth in ti e al~l matron fil~l tlmr~tth.
........ ...
~tary hd~[ic . .. ~ ........
~.O1KO604502b ~
~1~1~ in Kings County fi~