HomeMy WebLinkAbout17976-z FORM N0, 4
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Office of the Building Inspector
Town Hall
Southold, N.Y.
CERTIFICATE OF OCCUPANCY
No Z-17920 Date APRIL 3, 1989
THIS CERTIFIES that the building OFFICE BUILDING
Location of Property 6865 ROUTE 25 LAUREL NEW YORR
House No. Street Hamlet
County Tax Map No. 1000 Section I25 Block O1 Lot 19.1
Subdivision Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore
filed in this office dated OCTOBER 26, 1988 pursuant to which
Building Permit No. 17976-Z dated MARCH 31 1989
was assued, and conforms to all of the requirements of the applicable
provisions of the law. The occupancy for which this certificate is
issued 1s OFFICE BUILDING - "AS BUILT"
The certificate is issued to JOSEPH CRENSHAW & CHARLES GATES
(owners)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL MA-32 - AUG. 19, 1986
UNDERWRITERS CERTIFICATE N0, N-673078 - JAN. 3, 1985
PL[IAIDERS CERTIFICATION DATED FEB. 6, 1989 - FRANK J. MEYER
Buildinng Inspector
Rev. 1/81
srosac xo. s
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOUTHOLD, N. Y.
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL
COMPLETION OF THE WORK AUTHORIZED)
No 917976 Z Date ....~~(•~••........1...I 19..~~
Permission is hereby granted to•
f..~~+,..~~~....-........ .
la ..........~//........../y~% _ .
cY premises located at ........~l..~.flJ...,S..~.../.'.~.. ~7~K.. .0..4.~
.
County Tox Map No. 1000 Section ..~.,q~.,~.-:.. Block Lot No...~..~,.!.
G•
pursuant to application doted 19~~ and approved by the
Building In~sypector./
Fee u. ~i..L~J..(/
i-IN..I/'il,rl.... L/... rll.-lam. .
Building Inspector
Rev 6/30/80
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
SOIITHOLD, NEW YORR 11971
765 - 1802
APPLICATION FOR CERTIFICATE OF OCCIIPANCY
DATE.April_3,,~9$9,,,
X
NEW CONSTRIICTION .......OLD OR PRE-E%ISTING BUILDING......vACANT LAND..._._..
Location of Property......NO>rtk1.S]-L1@.4~.R44~~.~~~.~r$411'@~
HOUSE NO. STREET HAMLET
Owner or Owners of Pro ert Joseph.Crenshaw.and_Charles Gates
P y.........
County Taa Map No. 1000 Section ....125Block ..01._. Lot ..19.....
Subdivision.......T1~`3 Filed Map ........Lot..........
/ pJ Joseph Crenshaw by
Permit No. ~.~.~./.~?~ate of Permit ~j~,(,[ ~?Applicant Scheinberg, Schneps,
/ / DePe~iis'&'bePe~ris
Health Dept. Approvall'es-A gust 19f.1986 Underwriters ApprovalYes=Jan:_3:_198'
Planning Hoard Approval ..YC',s:NOV:.19:.1985
Request for Temporary Certificate Final CertificateX for Office Bu11di
Fee Submitted: $_._101:60._
JOSEPH CRENSHA~
APPLICANT....... .~X/
BY: Janet Geas sq., off'
Scheinberg, Schneps, AePetris & DePetris
N o~Il~l~6
rev. 10/14/88
TEL. 765-1802
o
`~~Ff~~~O~ TOWN OF SOUT~OLD
, ~c OFFICE OF BUILDING INSPECTOR
~ ~ ',~T P.O BOX 728
o TOWN HALL
0~~~ ~~0~ SOUTHULD, N.Y. 11971
1
C E R T I F I C A T I O N
Date ~~rua-~, ~T/~o 7
Building Permit No. j 'j - i
Owner Joseph Crenshaw and Charles Gates
(please print}
Plumber Frank J. Meyer
(please print)
I certify that the solder used in the water supply system
contains less than 2/10 of 1~ lead.
- (plumber' signature
Sworn to before me this
~ day of ,
19~. Notar_y~
Notary Public, S'~ County NOTuarpUHMBAIitC,STATEOFNEWYURN
CUMMISSIUN !,(PIKES JAN.3,19~
~ La Yit+~ ? 1--~ ~ A ~ °n °cx °m a ~ a = ~ C
FF k- ~ a~ G `s N
v o m n O
O ~ ~ f] ~ 'a s O ~ ~ F N m n ~ ~ N
C ~ *'~1 F ~"j ~ FJ N Z Q 1..Jj y a Q` 2 T G.
p ~ ~ ~ ~ ~ r. ~zy r x ~ w ^ R ~ ~ m
C v c! e:` a y a R ro" 2 ~
O ~ ~ ~p ; m ~ n ~ O ~ a ~ ~'PI
00 ~ C t7~ ~ s:C ~ p N W 7 ~ ~ z
a ~ ~ ~ Y F /F* C m i. P Cn
~ c f. ~ ~ i F R Qe 'y UI
3 ~ G ^ r„,
Z ~ ; ~ $ ; Ado y
'a m m C ti N p
-1 c F a n p ~ 2
~ ~ ~ CS u,
S 3 ~ o > ~ a" a -t
rn g f ~ po'" ? m c GO
~ ~ ~ N ~ m 3~ a ? 0. R im
1 e~ F °m aY a 7 c" 2 C
C7 0 ~o m e ~ C t~ o f ~ d
1 m n ~ ~
~ T c s ~ b ~ m O
'rr m
D ° \ os ~e ~ Y F 'm^ C V n Z~ TI
~~r+ g° ~ f
C o F'~ ~ ~ n ~ x ~ GO ~ 17'1
~ y ~ - ~ < ~ R ~ F ~ ~
y~ w ac O a~ ~j
Q ~ Y ~T F x ~ ~ 2 \~~lG G
B 4,, D m ~ ^T C Vp ?
m o $ ' g W fl7
D c y p ~ ~
m 3 ~ --Zi m ~ ~ r~
a o ~ m Z
s .n 3 c"
O n~ zF e m F ? a ~
a O ~J
Z a z N O O a -1
Z --^i, p m pKC ~ _ ~ ~ ~ ~ m
< m N~ N O y £
~ ~ ^ c m~^y F p a 7
Z T~ ~ ~ N 0. T
N m h 2
x n
S ^ cz> 3 ~ C ~ Q
C t Q fcil j N Fr x s a
IriO v N v.
BOARD OF REALTH
3 SETS OF PLANS
FORM NO 1 SURVEY
TOWN OF SOUTHOLD CHECK ~ f~,$S .
BUILDING DEPARTMENT SEPTIC FORM
TOWN HALL
SOUTHOLD, N.Y 11971 NOTIFY
TEL.. 765-1802 CALL
Examined , 19 MAIL T0:
Approved 19~~Pennit No t< 7!. 76.Z
Disapproved a/c
(Building Inspector)
APPLICATION FOR BUILDING PERMIT p pp~'
Date .~k~4~~ 194>z
INSTRUCTIONS
a. Tlus application must be completely filled in by typewriter or in ink and submitted to the Budding Inspector, with
sets of plans, accurate plot plan to scale. Fee according to schedule
b. Plot plan showing location of lot and of buildings on premises, relafionship to adjoining premtses or public stree
or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appl
catron.
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 perm
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occupan~
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 ti
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances
Regulations, for the consttvctron of buildings, additions or alterations, or for removal or demolitron, as herein descnbe~
The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and
admit authonzed inspectors on premises and in building for necessary inspections
(Signa r ot~ apph n , or name, if a corporation)
JANE ASA
.
(Mailing address of applicant)
P.O. Box 599, Riverhead, NY 11901
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
.ABex>t<. .
. .
Name of owner of premises .JOSEPH, CRF~NSHAW and CHARLES GATES
. . .
(as on the tax roll or latest deed)
If applicant is a corporation, signature of duly authonzed officer
. . . . .
(Name and title of corporate officer)
Builder's License No Self , ~ 18025) , , , . , , .
Plumber's License No
Electrician's License No
Other Trade's License No. .
1. Locatton of land on which proposed work wIl! be done N/S Route 25 , Mdt•ti,tu4k , ~Iew Xgrk ,
r Route 2.5 Laurel
House Number Street Hamlet
County Tax Map No 1000 Section 125 Block Lot . ,19 .OD 1 .
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 Pi:.fice..huilding• • • • • •
b. Intended use and occupancy of ~ ice, )?p~.7,d1-;z9 -..;..,9 . . . . . . . . . . . . . .
`~.iaiw0
-.t3:roe~'
3. Nature of work (check which applicable) New Budding $ Addition Alteration .
Repair Removal Demolition Other Work .
(Description)
4 Estimated Cost $10 , D.O,t1, 0 A.... Fee d ~ .
(to be paid on filing this apphcatlon)
5. If dwelling, number of dwelling units . 1`?~A Number of dwelling units on each floor .
. . . . . .
If garage, number of cars • • • • • • • • .
6. If bust pancy, specify nature and extent of each type of use $us•i,ngss , , . , , , ,
7. Dtmen e t tt t e ny Front ply?.. Rear .Depth . .
Height fStones .
Dunen d cy,1LG w "alteratrons or additions Front .Rear .
Depth i~.~ ~ Hetght . .Number of Stones .
.
8. Dinten ons f e tre new constrµction Front . Rear .Depth .
>w.e„
Hetght 3rs Number of Stones . .
9. Size of ~.i,te P.I.~n.... Rear Depth .
10 Date of Purchase .May. 2.6, .19.$3. .Name of former Owner Matti:l-.uck. Holding .Compare
11. Zone or use district to which premtses are situated .$-1. .
12. Does proposed construction violate any zoning law, ordinance or regulatton• NA... .
13. Will lot be regraded Will excess fill be removed from premtses Yes N~
14. Name of Owner of premtses Jos,~gh. Crenshaw. Address P.•.O; ,Box, 1446 , • ,phone No 14..
Name of Architect Cbdx7.es. C,dteS .Address MattlkuC>~119s~2 .Phone No ...K .
Name of Contractor ..................Address .Phone No....... .
15.Is this property located within 300 feet of a tidal wetland? *YES....NO X
*If yes, Southold Town Trustees Permit may be required.
PLOT DIAGRAM
Locate clearly and distinctly all buildings, whether existing or proposed, and, indicate all set-back dimensions from
property fines. Give street and block number or description according to deed, and show street names and mdtcate whethe
interior or corner lot.
See site plan
STATE OF NEW YORK S S
COUNTY OF . , , . ~__foo--~.
• • • • • • • • • ~9r•""V - , , being duly sworn, deposes and says thatshe is the appltcan
va ~u.S IC'1C1T1 Ji~If~VCfiYC~ypt~'
above named
SIIe is the Agent .
(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 thi
apphcatlon, that all statements contained in this apphcatlon are true to the best of }us knowledge and belief; and that th
work will be performed m tfte manner set forth m the application filed therewith
Sworn to before me this
......1.1th. day of. .AUqusfn ...,19.88
Suffolk
Notary Public, . . County
14~KA~Ogq
~y~.
~,332~"'Y0~ JAN `T GEASA ~ (Signature of apphcan'
m tweak ca,~t;.
st+c ao, s~