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HomeMy WebLinkAbout12927-z~FtF~D INSPECTION COMMENTS FOUNDATION (1st) FOUNDATION (2nd) o ROUGH FRAME & PLUMBING INSULATION PER N. STATE ENERGY C,ODE FINAL ADDITIONAL COMMENTS: FOB~ NO. ~ TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 12927 Z Permission is hereby grantedd.te:.~2 ~ , ......... 6:., ...... ~....~.~ ......................... ........... : ................. ~b'T':'"")'i'"~'~' ................ ~ ~.~~.~ .......... ~.~; ...... .............. 1 ........... ~ , ~ ....... .~.....©.A~....~, ~ ......... ~.~/~,~ ............... ~ ......................... ~~,.~. .................... ~-~ ~,.~.~,.....~i~i~,,~ ~-, ............................................................................. .. .. at premises located at .~. :.....:...~....;......~.~:......-~.'.~....~......,..~,..~-.~...~......-:d.~ ...... ~~....~-~-. .... ~/XI ~,~ ~ i~-~ ............ ...,, .......... ~;..! ...... x,.....**~........~ ...................................................................................... County Tax Map ]No. 1000 Section ..... ~ ................ Block ......... b ......... Lot No ....... k...~.. .......... and approved by the Building Inspector. Rev. 6/30/80 TOWN OF SOUTHOLD OFFICE OF BUILDING INSPECTOR P.O. BOX 728 TOWN ItALL SOUTHOLD, N.Y. 11971 TEL. 765-1802 This is to advise you that the job under building permit no. 12927Z issued to Gregory M Powers on __331~/84 for Addition' is completed and a final inspection has ( ) has not ( x ) been done. fn order to complete this file, it is necessary that n Certificate of Occupancy be issued. Please fill out the enclosed form, return same to the above office with a check for $25.00 payable to the Town of Southold. Please indicate to Whom the Certificate of Occupancy is to be mailed, and arrange with this office for an inspection date Occupancy or use is nnlawful without a Certificate of Occupancy. Please help ns to clear up this matter so that legal action does not have to he taken. Thank you for yo~r prompt attention. Ver! truly~, Victor Lessard Executive Administrator VL:gar encl . SOUTHOLD, N.Y, I HOMEIMPROVEMENT$ 765-5772 - ~ used ~or wotor distributing ..... shall be syS~em~ p~pmu of tYPes K or L only __ ,,.J ,2032 NOTIFY BUILDING DEPARTMENT 765-1802 9 AM TO 4 PM FOR FOLLOW~N~ IFJ~>ECTIONS: F~D P'~URFD CONCRETE D[~ C"F,~P~ ;:TE FOR C. O. ALL COHqTR*~C'TION SHALL TH~ ~O[~rM'EN'FS OF TH~ N,~ STATE CONSTRUCTION & ~ES. NO~T RESPONSI6~E DESI~H OR CONSTR~JCTION Examined...~..o,~. ¢~..~.~., FORM NO. 1 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 11971 TEL.: 765-1803 ., 19~ .~. Permit No..I..~..~..~-..~..-~. Application No .................. Disapproved a/c ..................................... ' ...... .~ ...... ~ ..... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate 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 issue 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 authorized inspectors on premises and in buildings for nec~pectio~~ (Signatur_e of appq~ant, or ~ame, if,~ corporation) (Mailing address of applicant) State whether applicant is owner, lessee, agen~gineer, general contractor, electrician, plumber or builder. Nameofownerofpremises ...................... ~~~.~..~~~~~~`~ .~.'~.~. ~t~ ~g,O~o~_~ (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No....~2...~..7. ............... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done. ........... ............ A/ .................... House Number Street Hamlet County Tax Map No. 1000 Section ....O..7..O. ........ Block ...... ~. .......... Lot .... ./..'-~.. ........... Subdivision ..................................... 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 .....'~.~(,I,,~//..~..e~ ................................................. b. Intended use and occupancy......'~)'~-"'~'[//7......"/'l(J~'~ .............. ~:~:. ~.i ~ ,~,,':~',: '~: ': ...................... Nature of work tcheek which avplicablej: New Buildingt "~ .,. Addition Alteration ........... Repair .............. RemOval .............. ' Demoh~ion . .,.' ' ........... Other Work ............... .~.,/~ ~ ~ ,:~/, ~ (Description) 4. Estimated Cost ........ ' .................. vee ...................................... (to be paid on filing this application) 5. If dwelling, number of dwelling ~nits .. ~ Number of dwelling units on each floor. If garage, number of cars ........................................................................ 6. If business, commercial or mixe, [ occupancy, specify nature and extent of each type of use ..................... 7, Dimensions of existing structures, if any: Front..../~. ~. ........ Rear . ./. ~.; ........ Depth .. tqt~.' ......... Height ............... Number of Stories ..... /..//.~.. ............................................ · r)imensions of.t~'same/structure w!th alterations or ad~tions: Front ../~..t .......... Rear../, .~. ~ ............ Depth ...... ~f'2' .......... . . Height ........... . ........... Number of Stones .../. ............ '8, Dimensions of entire new construction: Front .... /..~..(.. ~.... Rear ...Z ~. / ........ Depth .~..' ........... Height ............... Number of Stories ......... .~'. ............................................. 9. Size of lot: Front ...........! ........... Rear ...................... Depth ...................... 10. Date of Purchase ........... . .................. Name of Former Owner ............................. 11. Zone or use distxict in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: . ...... 13. Will lot be regraded ~ .... Will excess fill be removed from premises: Yes No fp 14. Name of Owner o remises .... ................. Address ................... Phone No ................ Name of Architect ........ ! ...... , .......... Address ..... .; .... ;z 2~ ' · · Phone No ................ Name of Contractor .(~..~~i ........ Addres~'t~/~O~' Ph°ne $°7~f'f' ''''~' ~'~''~'''' PLOT DIAGRAM Locate clearly and distinctly all! buildings, whether existing or proposed, and~ indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW t~0RK, -/ ~S S ......... :..7~.~ .... ~. ~. J}f, ~. O..t. ef~ ......... being duly sworn, deposes and says that he is the applicant (Na~ of individual sitning cont~t) above named, l He is the ..................... ; :;'. .....~ .................................................. ' [ ~ (Contracto[t.)gent, corporate officer, etc.) of said owner or owners, ~d is duly au~-to-'g~f~orm or have perfo~ed the said work and to m~e ~d file this application; that all statements cont'ained ~ this application are true to the best of his knowledge and belief; and that the work will be perfomed in ~e m~n~r set forth in the application filed therewith. Sworn to before me this ........... f~..day o~, , (..~ ¢~.39~ ~B~ ~ N[~ (Signature of applicant) I