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Home My WebLink About12320-zFIELD IN, S?ECTION ~' ...... FOUNDATION (Ist) F'OUNDATION 2. (2nd) ~OUGH FRAME & PLUMBING INSULATION PER N. Y. STATE ENERGY G,ODE FINAL ADDITION,A~L Cg.~MENTS: ~0~ NO. ~ TOWN OF $OUTHOLD BUILDING DF. PARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDIHG Fq: Po~AIT (THIS pEP-OVUT MUST BE KEPT ON THE PREMISES UNTIL FULL CCqMPL~'rlON OF THE WORK AUTHORIZED) N? 12320 Z Date ....~ ........................... , 19. Permission is hereby granted to: pursuant to application dated .... ¢~g..~'.....~.g~. .................... , 1~..~, and approved by the Building Inspector. Building Inspector Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN HALL $OUTHOLD, N.Y. 11971 TEL. 765-! 8O2 This is to advise you that the job under building permit no. 12320Z issued to W.C. Mole on _~/fl_~/8~3 ........ for Access~ory is completed a f[nnl inspection has ( ) has not ( ~--Y--been done. and In order to complete this file, it is necessary that a Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $10.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is unlawful without a Certificate of Occupancy. Please. help us to clear up this matter so that legal action does not have to be taken. .: Thank you for your prompt attention. Very truly yo~, Victor Lessard Executive Administrator VL:gar encl. FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined. ~/~... ??...., 190~. Disapproved a/c ........ ~ ............... (...../ ........ (Building Inspector) APPLICATION FOR BUILDING PERMIT DateApril 20, 1983 19 INSTRUCTIONS a. This application must be completely filled 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 property must be drawn on the diagram which is part of this appli- cation. c. The work covered by this 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 B~lding Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other fipplicable 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 authorized inspectors on premises and in b~uilding for necessary insp/ecJjons. ,/ -/'~/. ,7~ . . . . . . : ....... ~ ' {u~4gfifit[re of_ap-p~Lciht~.or naxn~e~ ifad corporation) /- P.O. Box z~ ../ ........... a..~..e.s.~ .o.r.~.,..~. ,. X:..1 .~ .9.47 ...... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. OWNER Name of owner of premises ...WAL. L..Ag.E..0. ,..M.Q .LE..a.n.d...~.I.L.L..I..~.N..~.:..M.Q .L.E .............................. (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corpora~ Builder's License No ...... ~ ........ Plumber's License No ........... ~W ............ Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. House Number Street Hamlet County Tax Map No. 1000 Section ... 925. ........... mock . ..05 .............. [ot...91. .~ ............. Subdivision..$Oll.th .Hat. bot. Ho. roe~ .............. Filed Map No...4.09.6. ' Lot ...1.4 ........... (Name) 2. State existing use and occupancy of premises and intended use ar~l. oc. cupancy.~_: fi7 of proposed construction: a. Existing use and occupancy ... Itesidenea ~ .~7..~¢~&.4 .~ b. Intended use and occupancy . .. :BC~4a.~ ...... bdt [ Zk.~..¢ ./<~.0C~' ........................................ 3. Nature of work (check which applicable): New Building .......... Addition .......... Alteration ........... Repair .............. RemoVal .............. Demolition .............. Other Work ............... .0 1 OX9' Storage building (Description~ 4. Estimated Cost 30 ~ d.. · '' ........... ......................... Fee ...... /..0. ......................... , (to be paid on filing this application) 5. If dwelling, number of dwelling dnits ............... Number of dwelling units on each floor ................ If garage, number of cars ........................................................................ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ..................... 7. Dimensions of existing structures, if any: Front ............... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ' Height Number of Stories 8. D~menslons ofent~re new constructton: Front ............... Rear ............... Depth ............... Height ............... Number of Stories ........................................................ 9. Size of lot: Front ...........: ..... ...... Rear ...................... Depth ...................... 10. Date of Purchase ........... ,i .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ..... i ................. Will excess fill be removed from premises: Yes No 14. Name of Owner of premises ..................... Address ................... Phone No ................ Name of Architect .......... i ................. Address ................... Phone No ................ Name of Contractor ......... : ................. Address ................... Phone No ................ PLOT DIAGRAM Locate clearly and distinctly all ibuildings, whether existing or proposed, and, indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and show street names and indicate whether interior or corner lot. STATL OF NEW YORK, _ _ CouNtY OF ....... : ......... ' ........ ~./<24 .L~..C4~.:...ff.:. ~. ,f.O.Z..~. .............. being duly sworn, deposes and says that he is the applicant (Name of individual sign!ng contract) above named. He is the ...................... : ................................................................... : (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the manner set forth in the application filed therewith. Sworn to before me this . . ~ day of, &/g.. It.-- . , 19 L blOTARy PUBliC, State of flow ¥or~ ..................... No. 52-4524971 (Signature of applicant) (~uaJffied in Suflol~ County .~/lltnjssioll Expires Mairch