HomeMy WebLinkAbout48207-Z wit TOWN OF SOUTHOLD
" BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
SOUTHOLD, NY
` BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 48207 Date: 8/25/2022
Permission is hereby granted to:
Kranenbur , Todd
104 2nd PIA t 3F
Brooklyn, NY 11231
To: legalize "as built" outdoor shower as applied for with flood permit.
At premises located at:
2445 Minnehaha Blvd, Southold
SCTM #473889
Sec/Block/Lot# 87.-3-47
Pursuant to application dated 7/13/2022 and approved by the Building Inspector.
To expire on 2/24/2024.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $400.00
Flood Permit $100.00
CERTIFICATE OF OCCUPANCY $50.00
Total: $550.00
Buil Ling Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
a Telephone(631) 765-1802 Fax(631) 765-9502 lett :llvw sola ltolltowtlt o
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Date Received
APPLICATION FOR BUILDING PERMIT (
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For Office Use Only
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PERMIT NO. Building Inspector,
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Applications and forms must be filled out in their entirety.Incomplete
applications will not be accepted. Where the Applicant'is,not the owner,an
Owner's Authorization form(Page 2)shall'be completed.
Date:7/7/2022
OWNER(S)OF PROPERTY:
Name:Christopher Todd Kranenburg =SCTM
#1000-87-3-47
Project Address:2445 Minnehaha Blvd SLflu 1 d
Phone#:631-387-6146 Email:todd.kranenburgCCgmail.com
Mailing Address:104 2nd PI. Apt 3F Brooklyn, NY 11231
CONTACT PERSON:
Name:Christopher Todd Kranenburg
Mailing Address:104 2nd PI Apt 3F Brooklyn, NY 11231
Phone#:631-387-6146 Email:todd.kranenburg@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Earl Bedrick
Mailing Address:3806 Amen Corner, Riverhead, NY 11901
Phone#:516-448-2337 Email:
CONTRACTOR INFORMATION:'
Name:N/A
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
El other Outdoor shower 2,910.34
Will the lot be re-graded? ❑Yes @ No Will excess fill be removed from premises? ❑Yes ®No
1
PROPERTY sINFORMATION
Existing use of property:Residence Intended use of property:Residence
Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to
Residential this property? Dyes No IF YES, PROVIDE A COPY.
8 Check Box After Reading: The owner/contractor/deslgn,professional Is responsible for all drainage and storm water Issues as provided by
Chapter 236 of the Town Code. APPLICATION IS HEREBY MADE to the Building Department for tha`Lssuance 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,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 premisesand lwbulding(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 ofthe New-York State Penal Law.
Application Submitted By nt a e Christopher Kranenburg ❑Authorized Agent @Owner
Signature of Applicant: " Date:" W 7/j 2z,
STATE OF NEW YORK)
SS:
COUNTY OF Southold )
Christopher Kranenburg being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the
ow6LL
(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/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Sworn before me this
�( day of
Notary Public
MOHA N D. BU NI
Notary Public, State of P IIIA III E� " "OWNER AUTHORIZATION IRegistration
N ►York � ��
(Where the applicant is not the owner)
Commission Expires Aug.06.County 2024
4
I, residing at
do hereby authorize to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
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