HomeMy WebLinkAbout46622-Z 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#: 46622 Date: 7/27/2021
Permission is hereby granted to:
Perinuzzi, Linda
20-62........__ ..._S- ..._ .....____..... _..... �.._-_-__ _.
48th St
. stor.. _..—....w_ .._ ..________- .. ........__.www..__
-----------
Astoria NY 11105
To: Legalize as-built finished basement and new windows at existing single family dwelling
as applied for. Additional certification may be required.
At premises located at:
740 Bayk. .r... Ln, Greenport „
SCTM # 473889
Sec/Block/Lot#„52.-3-17.................................._....... _....................................._....._w......__ .w.w_
Pursuant to application dated 9/2021 and approved by the Building Inspector,
m_ww7/1ww ...._.
To expire on __1/26=23.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $1,468.00
CO-ALTERATION TO DWELLING $50.00
_
Total: $1,518.00
Building Inspector
nh TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 la
Date Received
APPLICATION FOR BUILDINGPERMIT
a�
For Office Use Onlyn
//�� ^
PERMIT NO.. _ (f c� _._ Building inspectar .._..__ _M._�..ww...
I '1 2021
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: ::A
OWNER(S)OF PROPERTY:
Name: •® sCTM# 1000- 0052 - 0003 - 017
Project Address: 740 Bayberry Lane, Southold, N.Y. 11971
Phone#: Email: L
Mailing Address:
CONTACT PERSON:
Name: Nigel Robert Williamson
Mailing Address: P.O. Box 1758, Southold, N.Y. 11971
Phone#: 631 .834.9740 1:Email: nigel_architect@hotmai1.com
DESIGNI INFORMATION:
Name: Nigel Robert Williamson R.A.
Mailing Address: P.O. Box 1758, Southold, N.Y. 11971
Phone#: 631 .834.9740 Email: nigel_architect a@hotmail.com
INFORMATION:CONTRACTOR
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION CONSTRUCTION
❑New structure ❑Addition LRAlteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other f $
Will the lot be re-graded? ❑Yes ❑No 01A Will excess fill be removed from premises? ElYec ❑No
1
PROPERTY INFORMATION
Existing use of property: Single family dwelling Intended use of property: Single family dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
P,-Ao this property? E]Yes *No IF YES, PROVIDE A COPY.
Ch(f,,,,.ck Box 6Ut&,,' Readiri�g,', The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APP TI 15 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,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 an premises and in building(s)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): Nigel Robert Williamson @Authorized Agent DOwner
Signature of Applican Date: A 7 t 2,0 Zj)
STATE OF NEW YORK)
SS::
COUNTY OF
Nigel Robert Williamson being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he 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 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 "�J
20
Notary Public
BRIAN A. ANDREWSE16dri A.Andrews,PLLC
�40t`QrY Public, State Of New Yoofitorn.,at Law
.(09
............... mounty
1,"R 0 P E RTY 0 W N E��:F61k t 01A WAIN 13235 Ma4n Road
(Where the applicant BOX 43
I low
Z-�2-� residing at r
do hereby authorize Nigel Robert Williamson to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature ---- Date
n
Print Owner's Name
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