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Home My WebLink About12444-z ~O~ NO. ~ 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) N? 12444 Z Permission is hereby granted to: .~ (~ / ~,../../.~ ~; _9o~ ..... .~..~.....~ ............................................ ..... ~...,~.~./.-~..~....~.~..~C....z:~.2....~ ~o ................ ~...,..~.~......,.~.~,~.~.~.....~...,~.~.~....~.~ ....... ~.~ ........ ~ ....... ~..~.~..~.:...~.~...~.~.~.~ ,. ~i pi~i~s ,ocated'~; i.i.i~..~..~......~.....~..i~...~..~.-'/'~'· ~.'~.....~...~ ........ !...~....~ .. ~.~C....~........,W~. .... ~ ........................... .~.......~.. .... County Tax Map No. 1000 Section ...~...//.~ ...... Block ....~.~:~ ......... Lot No.....~....~ ....... pursuant to application dated ...... ~.~.~ ....... '~'"Z .............. . 19.~....~.~ and approved by the Building Inspector. Fee $,..../.....~..~ .... Rev. 6/30./80 FIELD ~PECTION 1. COMMENTS FOUNDATION (1st) FOUNDATION 2. (2nd) ROUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY ~DE FINAL ADDITIONAL COMMENTS: TOWN OF SOUTHOLD OFFICF~ OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL SOUTHOLD, N.Y. ! 1971 TEL. 765-I 802 TI, la in to advise you that the job under building perrait no,1~444~ .... issued to Arthur hutz on .~/~_~_~ .... for .~c__c_9~r¥ is completed ~, final inspection has ( ) }las not (X)''been done. and rn order to complete this file, it is necessary that a Cortlf[cate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a cheek for $10.00 payable to the Town of Southold. Please indicate to Whom tile Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or uae in t, nlawful without a Certlfieate of Occupancy. l'[eat~e, help ua to clear up thla. matter so that }esal action docs not },ave to be taken. Thank you for yo.r prompt attention. VL:gar enc{. FEB 2'- 198T Very truly Victor Lessard Executive Administrator FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS Application No .................. Date ....¢.? ........ ,19oe.~ a. Tins application must be completely tilled in by typewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of layout of properW must be drawn on the diagram which is part of this appli- cation. c. The work covered by tins application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authotized inspectors on premises and in building for necessary ij~spections. . . . . . . ..... (Signature of aFl51icant, or name, if a corporation) . ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, en~neer, general contractor, electrician, plumber or builder. ................................ e:. .,q. ......................................... , ..... Na~e of owner o f premises ....~. :..~ ~)~. ~l~~tiS).~.(~'.(~ .'4....{h~.. If applicant is a corporation, signatjJ4'e of duly authorized officer. · ' (Name and title of corporate oftlcer) Builder's License No ....... .~. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ~.~.~.'.../q~ ?./~..'... v/~..' ............... House Number Street Hamlet County Tax Map No. 1000 Section ..... :~X.~ ........ Block ..... ~ ~ ....... Lot...~... Subdivision.. ~.r~(~¢~. ~~./~'Filed Map No...~ ..... Lot (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy .... ¢~ .... ¢~('/y .... ~.~'~[dr~ ~ ............................. b Intended use and occupancy ~6~ ~(~ .~.q~... ~<~. :. 3. Nature of work (check which applicable) New Building .......... Addition .......... Alteration .......... Repair .............. Rembval .............. Demolition ... Other Work .~..O.~ ~ (Description) 4. Estimated Cost ........ ~ t? ~. ~R.,.~. .o. Fee ~7~ ]~. .~. ./~. . .-- (to be paid on filing this application) 5. If dwelling, number of dwellinglunits .......... . ..... Number of dwelling units on each floor .............. if garage number of cars ' 6. If business, commercial or mixeld occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front....~ ........... Rear .............. Depth ............... tteight ............... Number of Stories ........................................................ Dimensions of same structure ~ith alterations or additions: Front ................. Rear .................. Depth ................... ~.. Height ...................... Number of Stories ...................... 8. Dimensions of entire new construction: Front ............... Rear ............... Depth ............... tteight ............... Number of Stories ........................................................ Size of lot: Front i Rear Depth Date of Purchase .......... ~ .................. Name of Former Owner ............................. Zone or use district in which pr~mises are situated ..................................................... Does proposed construction violate any zoning law, ordinance or regulation: ................................ Will lot be regraded ............................ Will excess fill be removed from premises: Yes No Name of Owner of premises .................... Address ................... Phone No ................ Name of Architect ........................... Address ................... Phone No ................ Name of Contractor .......................... Address ................... Phone No ................ 10. 11. 12. 13. 14. PLOT DIAGRAM Locate .clearly and distinctly al! buildings, whether existing or proposed, and. indicate ail set-back dimensions from property titles. Give street and blockinumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW ~)RK, , .,t~ '~' S COUNTY OF ~... !~' , (Name of individual signing contract)" above named. 1 He is the ~ ~..//-',~ ~',,~ (Contractor, agent, corporate officer, etc.) of said owner or owners, ~ is duly authorized to perform or have perfo~ed the said work and to m~e and file this application; that all statements contained ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~ne~ set forth in the application filed therewith. Sw~m to be,fore me this ....... ~..~ ...... 'flay of~...~ ~ ......... . ~Lm~ ~U~ ~ ~ / r (Signatu~ of applicant) ~O~Y PU~UC, State of New Ye~8 No, 52-8125850, Suffolk Co~ ~%rm Expires March 30, Lof 6 Lot 7 // NOTE: · = MONUMENT SUBDIVISION MAP FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY 1~ /~t/. /_.AT-t_ SURVEY FOR ANDREW d. HINES & MARY HINES OF LOT NO. 9 & PART OF LOT NO. IO "MATTITUCK ESTATES, INC." MATTITUCK TOWN OF SOUTHOLD ~