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Home My WebLink About17972-zTOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PER~IT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N9 017972 Z Perrmss~on ~s hereby granted to: ~._~.~_~ .~...~......~..~4~.. 4..~ .......... · ........... ~t prem,ses located at .. ~,.~...~.. ~,~....~,..~,,....~..~,.,, ............................................ County Tax Map No 1000 Sect,on .L ~, ~ Block ..... .~...~. ........Lot No ~../..~../..~.~ 0 Building Inspector. Fee~..~..~... Building Inspector Rev 6/30/80 FORM NO 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1802 Examined ............... 19 .. Approved .~.~ Disapproved a/c ............................ BOARD OF HEALTH ............ 3 SETS OF PLANS SURVEY CHECK ...................... SEPTIC FORM NOTIFY CALL MAIL TO: TO' ~'~ '%' APPLICATION FOR BUILDING PERMIT Date OcLober 25, I9 INSTRUCTIONS a Tlus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showmg location of lot and of buildings on premises, relationship to adjoining premises or public stree ar areas, and givmg a detmled descmption of layout at property must be drawn on the diagram which m part of this appI cation. c. The work covered by ttus application may not be commenced before issuance of Buddmg Permit. d. Upon approval of tlus apphcation, the Building Inspector wall issued a Bmldmg Permit to the applicant. Such perm 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 Occupanc shall have been granted by the Bmldmg Inspector. APPLICATION IS HEREBY MADE to the Buddmg Department for the issuance of a Bmlding Permit pursuant to tb Building Zone Ordmance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordmances ~ Regulations, for the construction of butldmgs, additions or alterations, or for removal or demolition, as hereto describe, The applicant agrees to comply with all applicable laws, ordmances, buddmg code, housing code, and regulations, and t admit authomzed mspectors on premises and in buddmg for necessary lnspe~ ~.~.~tions~" P...a.. Box .599.,. Ri.v~rhe~d,. N...~ ,. l~9. O~.. (Mailing address of applicant) State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or budde~ Joseph Crenshaw and Charles Gates Name of owner of premises ............... (as on the tax roll or latest deed) If applicant m a corporation, signature of duly authorized officer. (Name and title of corporate officer) No o.. ~ ............. Builder's License Plumber's License No ............... Electrician's License No ................. Other Trade's License No .................... Location of land on winch proposed work wall be done ........................................ Z~ ~ ~ North side Route 25 Laurel House Number Street Hamlet County Tax Map No 1000 Section 125 Block 01 Lot P./O !1.9.0 .0~--.. Subdivision ...................... Fded Map No ............ Lot ............. (Name) 2. State eXlStmg use and occupancy of prermses and intended use dlld occupancy of proposed construction a. Existmg use and occupancy . chain link fence chain link fence I~'~J~'YYJ*~ ~ b. Intended use and occupancy .............................. .~t~s.-. ~ t .......................... of work (check which applicable). New Bu'tldlng ~... ' .... Addition .......... Alte}ang!l~ ...... 3. Nature Repmr ............ Removal ............. Demolition ............ Other Work...~.~--ot'~-.t~.~- (Description 4. Estimatdd Cost ................................ Fee ........................ t(to be pa~d on filing this application) 5. If dwelling, number of dwelhng units ... ~/.~. ........ Number of dwelhng 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. D~menslons of existing structures, if any Front .............. Rear ............ Depth ............ Height ~ .feet .~o. e~~ D.f .build~9., .~l~or~te~ .~ ~t, .IQ .e~4 .Qf..pr. qt~..r~.z: D~rnenslons of same structure with alterations or additions Front ................ Rear .............. Depth ...................... Height ................... Number of Stones ................... 8. Dimensions of entire new construction. Front ............... Rear .............. Depth ............ Height ............... Number of Stones ............................................. 9. Slzeoflot Front $.ae.~i.~q.P.lAn. ...... Rear ..................... Depth ................... 10 Date of Purchase . ~Y. ~.6.,.. !.9.8.3. ............. ~ame of Former Owner M&ttxtuc~k .Hold%O~..C.o..rap 11. Zone or use district in which premises are situated . .B.i ............................................. 12. Does proposed constructlon vlo[ate any zonmg law, ordmance or regulatlon: ............................. 13. Will lot be regraded ............................ Will excess fill be removed from premises: Yes 14. Name of Owner of premises .J. 9.s.e~h. .CF.e. nshaw Address P.O.Box .1{.4.6 .... Phone No. Name of Architect ........ Char. les. IZ.a,~ .... Address . .~.a.t..~..i.t.u.c.k.t..N...~: Phone No ............ Name of Contractor ............ Address 11952 -- ................................ rhone No .............. IS.Is this property located within 300 feet of a tidal ~;etland? ~¥ES .... NO .... *If yes, Southold To~,.-n Trustees Permit may be required. PLOT DIAGRAM Locate clearly mid distinctly nil buildings, whether existing or proposed, and. indicate ail set-back dbnensions fn property lines. Give street and block number or description accordmg to deed, and show street names and indicate whetl interior or corner lot. See slte plan STATE OF NEW YORK, COUNTY OF . .$UF~.O.~ ...... S S .............. J~bll~..G.E;A$ .A ............. being duly sworn, deposes and says that he is the apphc~ (Name of individual s~gnmg contract) above named. l~cle is the agent (Contractor, agent, corporate officer, etc.) of smd owner or owners, and is duly authorized to perform or have performed the smd work and to make and file apphcanon, that all statements contained m this application are true to the best of Ins knowledge and belief; and that work will be perforn~ed in the manner set forth m the application filed therewith. Sworn to before me this 25th day of. October, 19.8.8. Notary Public ........................ Smff~lk County