HomeMy WebLinkAbout28875-ZFORM NO. 3
TO~ OF SOUTHOLD
BUILDING DEPARTMENT
Town Hall
Southold, N.Y.
BUILDING PERMIT
{THIS PERMIT MUST BE KEPT ON THE PREMIS
COMPLETION OF THE WORK AUTHORi
UNTIL PULL
PEP34iT NO. 28875 Z Dat~ 30, 2002
Permission is hereby granted to:
JEFFREY & MARY~LLEN GATZ
1645 ELIJAI{S ~
MATTITUCK,NPZp1952
for : ~T
CONSTRUCTION OF ADDITION ANID ALT ION TO AN EXISTING SINGLE
/
FAMILY DWELLING AS APPLIED FOR~HIS PERMIT REPLACES EXPIRED BP~ 27073Z
/
/
at premises located at /1645 ELIJAHS LA
/
County Tax Map No. 47388/Section 108
/
pursuant to applicatio~ dated OCTOBER
/
Building Inspector to/expire on APRIL
/
Fee $ 218.7'/0
MATTITUCK
Block 0004 Lot No. 007.009
30, 2002 and approved by the
30, 2004.
Authorized Signatur~
ORIGINAL
Rev. 5/8/02
(THIS
PERMIT NO.
TOWN OF SOUTHOLD / ' -~",~
BUILDING DEPARTMENT ~Df'~ ~
Town Hall -~ ~
Southold, N.Y. ~ ~
BUILDING PE~IT
PERMIT MUST BE KEPT ON THE PREMISES ~TIL PULL
COMPLETION OF THE WORK AUTHORIZED)
Permission is hereby granted to:
JEFFREY & MARY ELLEN GATZ
1645 ELIJA/~S LA
MATTITUCK,NY 11952
for :
CONSTRUCTION OF ADDITION AND ALTERATION TO EXISTING SINGLE FAMILY
DWELLING AS APPLIED FOR.
at premises located at
County Tax Map No. 473889 Section 108
pursuant to application dated NOVEMBER
Building Inspector.
1645 ELIJAHS LA
Block
27, 2000
MATTITUCK
0004 Lot No. 007.009
and approved by the
Fee $ 121.00
Authorized Signature
ORIGINAL
Rev. 2/19/98
FO§~DA~ ION ( ]ST)'
:
FOUNDATION (2ND)
ROUGH FRAME &
PLUMBING
INSULATION PER N. Y .'
STATE ElqERG~I
CODE
II
II
fl
com~rrs
ADDITIONAL COI~ENTS:
· I;ORM NO.
TO;~N OF SOUTUOLD
BUILDING DEPARtmENT
TOm; HALL
SOUTHOLD, N.Y.
TEL: 765-1.802
3 :SETS OF PI~ANS ......... ' ......
SURVEY ........................
CHECK .........................
sEPtIC FORM ..................
DEC ...........................
TRUSTEES ......................
NOTI~f:
Dishpproved a/c ..................................
(B~ilding Inspector)
APPLICATION FOR BUILDING PERMIT
INSTRUCTIONS
MAIL TO: .................
a. 'Ibis applicacic,a ~t be om~pletely filled in by typ_~c~iter or in ink and submit~d zo the B~ilding Insp~cco'
3 s~ts of pla~s, aCCtLrate plot plmn ¢o ~ale. ~ ~ording to ~le. ... .
b. Plot pl~ ~ lmtim of lot ~ of ~ildi~s ~ ~s, relatio~ip Co Mjoini~ pr~s or ~lic
s~r~ts or are~, ~ givi~ a ~tail~ ~aip~ion of layer of pro~
th~s appli~[i~.
c. 'file ~ c~r~ ~ ~is a~li~ti~ ~y ~ ~ c~ ~fore isle of ~ildi~
d. U~ appeal of ~is applI~i~, ~ ~ildi~ Yns~c~or will is~ a ~ilding Pemi~ to the appli~n[.
~mit ~all ~ ~pt ~ ~ ~s ~ail~le for in~i~ thr~]~ the ~rk.
e. ~ ~ildi~ ~11 ~ ~i~ or ~.in ~le or ~n ~r~ for ~ ~ ~at~er mtll a ~rtifJcace of
~y ~all ~e ~n ~ by ~ ~ildi~ I~tor.
~I~ IS ~ ~ to t~ ~ildi~ ~n~ for ~e is~ce of a ~ilding Pe~t ~ [o the
~ildi~ ~ Ordi~ of ~ T~ of ~ld, ~ffolk ~, ~ Yo~, ~ o~er a~li~le ~s, ~di~es or
~la[i~s, 'for ~ ~ti~ of ~ildi~s, ~iti~ or alteration, or for r~al or d~liriou, ~ ~in
~ri~. ~ ~a~li~t ~s to ~y ~ all a~li~le I~a, ordi~s~
r~la,ti~]s, ~ co ~c m~rJ~ i~tors ~ ~s ~ in ~ildi~ for ~ces~ ins~ti~s,
.. ............
(~ili~ ~ress of ~lin~r)
Stale ~4~r a~lic~ is ~r, lesa, ~en~, a~it~, engi~r,' gemral cont~c~or, el~tricia, pl~r or
~.v.v.h.Co.u.t..~.~...o.~..e~c
.................................
............ ,..__.,__ ...................
(~ m ~ t~ roll or la,esr d~)
/
If aM)licit is a ~atiom, si~e of duly ~ri~ officer.
(~ ~d title of corpora're officmr)
3. W. ature of ~rk (dmck whid~ applicable): New lluildirg .......... tzkiltio~ ......... Alteration .......... "'~" '
If garage, ~r of ~rs ............ + ............... ~ .........
Di~ms{~ of ~ st~:~e ~th alterati~s or ~itions: ~nt ............... ~ar ...............
~p~h .................... }~i~t .................... l~r of Stories ...............
~ ~ of ~tr~tor ................................... ~ress ............................... ~r~ ~ ............
PLOT DIAG~
~ 9r~r~ li~s. Gi~ st~t ~ b]~ ~r or ~scrlpti~ acco~ing .to ~, ~ ~ strut ~s ~l i~icate
7
; ~r~rate officer, eec.)'
of ~id ~r ar ~rs, a~ is ~uly ~horiz~ to ~rfo~ or have I~rfo~ ~e ~id ~ a~ to ~ke
a~l. lca~im~; ~ha~ ail stations c~a~ in ~is a~].ica~i.~ are t~ ~o ~e 1~[ o[ his ~l~
[ ~ t.h~ the york wl].~ I~ ~rfo~l i.n the ~m~r sat forth in a~e a~li~clm fii~
~'}~ - ....... ~ '
..........................
~ ~
;{ No. 01~601~16 -
~; ~a~ in Su~k