HomeMy WebLinkAbout46803-Z �o�sUFFoa,��o TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
�y • SOUTHOLD, NY
f�
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 #: 46803 Date: 9/10/2021
Permission is hereby granted to:
Pettit, Anne
PO BOX 78
Southold, NY 11971
To: Install deer fence at existing single family dwelling as applied for.
At premises located at:
515 Maple Ln, Southold
SCTM #473889
Sec/Block/Lot# 64.-1-26
Pursuant to application dated 9/2/2021 and approved by the Building Inspector.
To expire on 9/10/2022.
Fees:
DEER FENCE $75.00
Total: $75.00
Building Inspector
o��gpfFO(,t TOWN OF SOUTHOLD—BUILDING DEPARTMENT
h x Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax(631) 765-9502 hgps://www.southoldtowM.jzov
Cal Date Received
APPLICATION FOR BUILDING PERMIT � r � ,,✓ -�
For Office Use Only i f
SEP - 2 2021
PERMIT N0. &8-06 Building Inspector:
Applications end'forms'must be=fill'ed'out in-tfieir`entire`ty: Incomplete P1 H'3) 7G £1 °
TV
Kapplications,will 'not be.accepted..}WFiere,,tFie,Applicant is;not`tfie owneran ;,,=,, 44�j z
Owner's Author'iiatioh.form(Page=2)shal"I.be completed. .?
Date:
-6WNER(S)-OF>PROPERTY:
Name: SCTM#1000- — I —
Project Address
Phone#: _.g� �- Email:
Mailing Address: Ll
`
CONTACT,PERSON:,:, :_ k' „liL1. .
Name: }�
Mailing Address: -- - 2J�. .11
Phone#: Email: �e a
DESIGN PROFESSIONAL INFORNIATI'ON: - - '
Name-
Mailing Address:
Phone#: 8 Email:
CONTRACTOR INFORMA
Name: '
-.---- ----------- - ---
Mailing Address:
Phone#: .3 3 Email:
DESCRIPTION•OFP,ROPOSED CONSTRUCTION•;
El New Structure Addi n Alteration OR r ❑Dem (tion Estimated Cost of Project:
❑Other ,$
Fill
the lot be re-graded? ❑Yes No Will excess I be removed from premises? ❑Yes o
1
%
PROPERTYzINFoli MATI'0N',,- --
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? OYes El No IF YES, PROVIDE A COPY.
❑'Ch-eck Bok-After,Rdading:,'Th6 owner/contractor/design professional-is responsible for all drainaie,and itorm,water issues as provided by:
Chapter 236 of thb TdW-n,Cbde. APPLICATIOWS HEREBY MADE to the Building Department for theIssuance oUa,Buildihg Permit pursuant to the Building Zonee--
ordinance Town.,of souihold,Sdffolk;County,'New York and other applicable`Laws;Ordinaride'sor-Reg-u'la'tions,for the construction of buildings,
terations-or 6rremoval- demolition-as'hereii described.The applicant agrees-tolcoi-hpij with ail applicabli laws,ordinances,building code,',
:additionsial f or
-9, regulations'and _rize -inspectors on premises and in Vu"Icli j(
hou�in"codea4 -" Ad di "'pre i in Q16r necessi�j inspections.Fali6'statemients rmicle 6 her irVar
ei e -
- misdemeanor"pursuant p,urs6nt tcS
ptihiphablq��s,�`C16.sA—I a- �'ecti6n'210.45'of the,New York State Pena Law.
Application Submitted By ri t name): DAuthorized Agent J Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTY OF QU�SrS:I
�A al'I a- 'R . R Q WI being being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contrac ) above named,
(S)he is the Dl. reg
(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
�P-day of 20
Notary Public U
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION NO.01 DW6306900
QUALIFIED IN SUFFOLK COUNTY
(Where the applicant is not the owner) COMMISSION EXPIRES JUNE 30,2P2_,3I_
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
2
OCCUPANCY OR
APPROVED AS NOTED USE IS UNLAWFUL
DATE: B.P.# �� WITHOUT CERTIFICATE
FEE:$ OD BY: OF OCCUPANCY
NOTIFY BUILDING DEPARTMENT AT
765-1802 8 AM TO 4 PM FOR THE
FOLLOWING INSPECTIONS:
1. FOUNDATION - TWO REQUIRED
FOR POURED CONCRETE
2. ROUGH - FRAMING & PLUMBING
3. INSULATION
4. FINAL - CONSTRUCTION MUST
BE COMPLETE FOR C.O. COMPLY WITH ALL CODES OF
ALL CONSTRUCTION SHALL MEET THE NEW YORK STATE & TOWN CODES
REQUIREMENTS OF THE CODES OF NEW AS REQUIRED AND CONDITIONS OF
YORK STATE. NOT RESPONSIBLE FOR
DESIGN OR CONSTRUCTION ERRORS. SOUTHOLD TOWN ZBA
SOUTHOLD TOWN PLANNING BOARD
SOUTHOLD TOWN TRUSTEES
N.Y.S.DEC
Y
MAIN ROAD
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MAP OF DESCRIBED PROPERTY
SITUATE'AT SOUTHOLD
TOWN OF SOUTHOLD
SUFFOLK COUNTY,NEW YORK
CERTIFIED TO:DAVID FRAWLEY
BERNADETTE FRAWLEY
FIDELITY NATIONAL TITLE INSURANCE COMPANY
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0o NOT ease Pg7CE8.OFF9MT8 9ubMRCEDE YEe ooRuq+M No MaLAR SURVEYED:MAY 25,2021
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LAND SURVEY LONG ISLAND.COM of IV
WARD BROOKS LAND SURVEYOR :���� a
11 OCEAN AVENUE
BLUE POINT, NY. 11715
(631) 576-7794 (631) 363-3179 r arsl
WARDB ROOKSO@GMAIL.COM
FILE#11118