HomeMy WebLinkAbout25212-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. 25212 Z
Date OCTOBER 6, 1998
Permission is hereby granted to:
SUSAN NORRIS
PO BOX 66
MATTITUCK,NY 11952
for :
ERECT A 4 FT. HIGH FENCE IN THE REQUIRED YARD AREA OF A HORSE FARM
at premises located at 1435
County Tax Map No. 473889 Section 122
pursuant to application dated AUGUST
Building Inspector.
CAMP MINEOLA RD MATTITUCK
Block 0005 Lot No. 004
28 1998 and approved by the
Fee $ 35.00
J Building
InS~e-cto/
ORIGINAL
Rev. 2/19/98
TONN OF SOUTHOLD
BUILDING DEPARTNENT
TONN HALL
SOUTHOLD, N.Y. 11971
TEL: 765-1802
SURVEY ........................
CHECK .........................
SEPTIC FOR14 ...................
NOTIFY;
~tAIL TO'. 2 ...................
INSTRUCTIONS
a. 'his application must be ct~pletely filled in by type~iter or in ink and submitted to the Building Inspector wi
3 sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan shoging locatian of lot and of lmildings on premises, relationship to adjoining premises or public
streets or areas, and giving a detailed description of layout o[ property must be dra~n on the diagram ~/aich is pert of
this application.
c. ~he ~ork covered by this application my not be ca~esced before issuance of Building Perrait.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such
permit shall be kept on the premises available for inspection throngh~t the ~ork.
e. ~o Building shall be occupied or used in ~ole or in part for any purpose ~hatever until a Certificate of
Occupancy shall have linen granted by the Building Inspector.
APPLICATItI~ IS ~ ~ to t~be Building Bupartme~t for the issuance of a Building Permit pursuant to the
l~aildlng Zone Ordinance of the To./of S~thold, Suffolk Cotmty, ~ York, and other applicable L~s, Ordin~ces'or
Regulatiorm, for the ceoztruction of buildings, additions or alterations~ or for rain.al or ao~lition, as herein
described. ~be applicant agrees to conply with all applicable la~s, ordinances, Building code, housing code, and
regulations, and to admit ~atharized inspectors on premises and in Building for necessary inspections.
(llailingaddress of applic~t)
State ~bether applicant is oaeer, lessee, agent,' archxtect, engineer, general contractor, *electr~cxan, plumber or l~llde
........ A: ....... .-.'. .... ;. ....... ....... ....... '----
~ of amer of premise ~-~ ...... ~.~ ..................... :.--;----~-~f~ ..... ]'}~' .......
(Nam and title of corporate officer)
Builders Licease Il) ..........
Ph~abers Lieemse Ilo .
Electricians Lice[me No ................... .. .
NOTIFY BUILDING DE~NT AT
765-1802 9 AM TO 4 IIM FOil THE
FOU.OWINO ~
1 FOONDJOION - lWO II. WIRED
FO. I'MMED CONGNLIll
2, .OUO~ - RIAIMIO & FUJMliNO
(Description)
'
If ~k~lllng, ~t~er of dwelling t~lts ...~.. ' . . l~r of ~lltng ~tts ~ e~ ~r ................
If ~rsge, ~r of ~rs ....... ~ ...............................
If ~i~s~, ~relal or ~ ~, ~ci~ ~ture ~ ~tent of ead~ ~ of u~ ......................
Di~nsi~8 of ~mting ~t~, if ~: ~t ................ ~ar ............... ~pth .................
I~i~t ............. ~ ~r df 8torles .......
'~al ' ' '
Di~nsl~ of ~ mt~ mt terat~s or ~txons: ~nt ............... ~ar ...............
--
~pth ........................ ~r o~ Stories .............
Di~nsi~ of entire ~ ~st~t~: ~ ....... ..... . . .. ~ar..... ....... · .. ~ ~ ..............
[~i~ ........................ !~r oP BtOrleS .....................
S o[ lot: ~t ..... ~ar .................... ~pth
~re f h~rd ~ of Fomr ~r .........
~ or u~ district in ~i~ prelim a~ si~t~ ..............................................................
~s ~ ~t~ti~ vlola~e a~ ~i~ 1~, o~i~e or re.latin: ........................
Will lot ~ ~ ........... ~ ........ Will ~ess fill ~ r~
~s of ~r of i~M~s ........................... ~ress .............................. M~ ~ ...............
~ of ~dt~t ....... ~ .............. ~rese ..................
' ~ress
~ of ~tr~tor ' · .................................
PLOT DIAGRAM
I~cste clearly and distinctly al~ b~ildings, ~i~ether existing or proposed, and indicate all set-back dim~sions
~ property lines. Give stmeet and block ma~ber or descriptio~ according to deed, and show street n~nes taxi indicate
Imther interior or corner lot. i 1~) ~
--_' '-I ------.
~ ................ '..l~i~ d~iy ~m, de~s and my~ that h~
(~tractor, a~n~, cor~rate o~cer, e .)
of ~id ~r ~ ~rs, a~ is ~ly ~th~ri~ to ~rfo~ or h~ ~rfo~ fl~e ~id ~ m~ to ~ke a~ file thi~
a~l. matl~; that all stat~nts c~t t~ m ~is a~licati~ are t~ to ~e l~t of his k~l~ and ~llefi and
that the ~rk will ~ ~rfo~ i~ th~ ~r ~t forth i~ ~e a~l, icati~ fil~, ~ t~.
Not~biic~tate of NOwYo~ (Si~mre of A~l. mmt' ~ ' )
N~52246, Suffo~ COu~
Expir Jun lZ
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