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HomeMy WebLinkAbout15785-z FOF,,M 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) 15785 Z Permission is hereby granted to' c~.~. ~ .............. ' ............. : .................... at premises located at ...~....'7... . ~.~ ,...~.... County Tax Map No. 1000 Section ..... .~..C?.....~?Z... .... Block ...... $~...~. ...... Lot No.....~....'] ............. pursuant to application dated ..... ...~..~....~...~...~ ................. , 19..~..']., and approved by the Building Inspector. Fee $ ~...~..:.. ~. Rev. 6/30/80 CRON AND CRON Attorneys at Law Main Road · P.O. Box 953 · Cutchogue, New York 11935 (516) 734-5100 TO Town of Southold Building Department Town Hall - Main Road Southold, NY 11971 DATE 3/16/87 SUBJECT Application for Building Permit Gentlemen: Forwarded herewith is Application for Building Permit, together with three (3) copies of survey for premises at Main Road, Cutchogue; Tax map #1000; 102; 6; 7. Also enclosed is our check to your order in the sum of $45.00 to cover the fee. Please forward the Building Permit to Our issued. Thank you for your assistance in this matter. office when same has been Very truly yours, JJC:e Enclosures CRON and CRON, ESQS. FOLD AT (--) TO FIT {)RAWING BOARD ENVELOPE fr EW10P EOAb ... 'FORM NO. 1 .:~' TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined..'.~., .0~.,. Approved ..... .~.) ....19--. Permit No. .1 .~. · .7.~. .~.~. .'~ Disapproved a/c ..................................... (Building Inspector) APPLICATION FOR BUILDING PERMIT March 5 ~.7. Date .................. , 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 ~ 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, buildi,n.,~ code, housing code, and regulations, and to admit authorized inspectors on premises and in buildLng for _necessaw inspec(1,~d~n~. (Sign~t'fir~ bf applicant, or name, if a corporation) Joan M~ Cron N..ow.. S..u .f .fo. 1..k..Ay.e, t. [q~. Suffolk,. NY. 11956 ....... (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. Name of owner of premises .... J. Qcqri .M, .Cron .......................................................... (as on the tax roll or latest deed) If applicant is a corporation, signature of duly authorized officer. .............. NI~ ............................. (Name and title of corporate officer) Builder's License No.. {~..oy-2~.....~.~ .......... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ..... 2.7920. Main Road . . . Cutchoguo ~ Number Street Hamlet County Tax Map No. 1000 Section ...1.0.2. ............ Block .... 6. ............. Lot..7. ................ Subdivision..N/g ................................. Filed Map No. . lq,/A ......... Lot .... IxI/A ....... (Name) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . .O.f.f.i.c.e. l%u~.l.d.iB~..' .~Q. [~-t.d7. ~2.~.v~.~.O-~...~..t./~....~.l..L:~..O.' ~X~)P../'f~..., ....... ........ ?, ,-,. b. Intended use and occupancy Offic.e ]>u:l,o.dJ_.n.g.. / . .b~.~' . ~;~ ,.. ;]~t~a~ ./.~[.. ~'~ ...... ~' ' "2'" ~. / 3. Nature of work (check which applicable): New Building ..... '. ....'Addition .......... Alteration ...~, ...... Repair .............. Removal .............. Demolition Oth~ Workerection or . ' ............... ',;,' · ·: 4 Estimated Cost ~300.0.0 ~ Fee : (to be paid on filing this application) 5. If dwelling, number of dwelling units .... ~./% ....... . 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 . .b .u .~ .i .n .e .~ 0 ............ 7. Dimensions of existing structures, if any: Front...N./.A .......... Rear .............. Depth ............... Height ............... Number of Stories ........................................................ Dimensions of same structure with alterations or additions: Front ................. Rear .................. Depth ................... :... Height ...................... Number of Stories ...................... · '8. Dimensions of entire new construction: Front ~pp1:91~,.45.~ ..... Rear . .N/.A ........... Depthapp.rg.x:..6~' ...... Height a. pp.rq.x....3! ..... Number of Stories N/A 9. Size of lot: Front NrA : Rear.. Depth ...................... 10. Date of Purchase 1967 Name of Former Owner . MiDh~J-, 11. Zone or use district in which premises are situated ..... ¢olltnel:¢iiaJ-. l~rJ- .................................. 12. Does proposed construction vi61ate any zoning law, ordinance or regulation: ....N9 ........................... 13. Will lot be regraded .... ~19..' .................... Will excess fill be removed from premises: ~ No 14 Name of Owner of premises .. ~oan. ~I,. ¢1:9¢ ...... Address lq~!~. ~.u~.~9,l.k..Avg.. ~ ~ ~t~llone No. 7.~4-x5,I,QCl ....... Name of Architect ... [q/A ..................... Address New 8uffolkt ~ .[19,515 ................... rhone ~o ................ Name of Contractor .. ~-~. l~9I:g. F~O9~ ......... Address ...Ngl:.t.h. .Rg.a.d ....... Phone No.2.9.8:-.4777 ........ ~attituckt NY 11952 PLOT DIAGRAM Locate clearly and distinctly all buildings, 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 coruer lot. ~ * See anneXed survey and diagram. STATE OF NEW YORK, COUNTY OF ° '* ~ ~ S.S ............ J. OAtq ~ .C. ROR. ..................... being duly sworn, deposes and says that he is the applicant (Name of individual signing contract) above named. gHe is the ........ qw. rl~r. ........ .................................................................... (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 man~er set forth in the application filed therewith. Sworu to before me this .............. .a.r.c.h. ..........,19.8.7. Notary ' ' ~/ . County ~ornrnl~lon E~4~'M Mamh ~0, ~Je ~