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Home My WebLink About47750-Z o�SU aK�o TOWN OF SOUTHOLD BUILDING DEPARTMENT a TOWN CLERK'S OFFICE • SOUTHOLD NY ti, of �a 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#: 47750 Date: 4/28/2022 Permission is hereby granted to: Clemens, Gregory 45 E End Ave Apt 18C New York, NY 10028 To: legalize "as built" deer fence as applied for. At premises located at: 475 Alois Ln., Mattituck SCTM #473889 Sec/Block/Lot# 123.-6-4.9 Pursuant to application dated 3/25/2022 and approved by the Building Inspector. To expire on 10/28/2023. Fees: DEER FENCE $150.00 Total: $150.00 Building Inspector U12 ��o�s�EFoc,r�oGy TOWN OF SOUTHOLD—BUILDING DEPARTMENT y. Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 oy • o� Telephone (631) 765-1802:, Fax(631) 765-9502 hltps://www.southoldtownny.gov - Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: LI ,VI ICS MAR 2 5 2022 Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the,Applicant is not the owner,an' BUILDING DPT , ._ TOWN OF SOUTHOL® Owner's Authorization form(Page 2)shall be com. pleted. Date: OWNER(S)OF PROPERTY: Name: ®R. �t.Ea�,ENy— ,� oKe4N � SCTM#1000- I Project Address: 75 ��t5 � ��A� .` �t'uf►� �y ,_t Q� 2, Phone#: IQ 14, Email:_9-r-QA Mailing Address: S � CONTACT PERSON: Name: N�— MailingAddress: .� �— Phone#: 1� —5�'Z�'O0 Email: qv-QA . DESIGN PROFESSIONAL INFORMATIONv. Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION-` Name: VA /A— Mailing Address: Phone#: ` - Email: DESCRIPTION OF PROPOSEDCONSTRUCTION : ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: Other a1 ®q-e.. QY-i bra NIA— Ill le W7the be re-graded? ❑Yes No Will excess fill be removed from premises? ❑Yes El No 1 PROPERTY INFORMATION . 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? ❑Yes ONO IF YES, PROVIDE A COPY. ❑ Check Box After. Reading: The owner/contractor/design professional is responsible for all drainage and storm;water issues as provided by Chapter 236 of the Town Code. 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,Newyork 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 on 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 Newyork State Penal Law. Application Submitted By(print name): ( CA,e— �•I(j ❑Authorized Agent LJOwner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTY OF [S ) S being duly sworn, deposes and says that(s)he is the applicant (Name of in gning contract)above named, (S)he is the Ow .�- (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 1-7-7 day of N au 20aa v00� Notary Public TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK PROPERTY OWNER AUTHORIZATION No.01DW6306900 QUALIFIED IN SUFFOLK COUNTY (Where the applicant is not the owner) COMMISSION EXPIRES JUNE30,?,, C—�_ I, 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 n *AR ® AS N TED DATB.P.#FEE: BY: 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 J. ALL CONSTRUC i,":N SHALL MEET THE REQUIREMENTS OF THE CODES OF NEW YORK STATE. NOT RESPONSIBLE FOR DESIGN OR CONSTRUCTION ERRORS. COMPLY WITH ALL CODES OF NEW YORK STATE & TOWN CODES AS REQUIRED AND CONDITIONS OF R SOff G BOARD TEES �dnioy-ettpY� P S r ar r ®r c2M-�I TT Cha�� wn k 4� In , o ccurs. z Now or Fonwerryy rmothhy Hough 1 N 04°21'50"E 183.82' ' erose uAlf FOR" Monumer Monument le p4� I / N umv . 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THEY ARE NOT INTEND CERTIFICATIONS INDICATED.HEREON ONLY COPIES FROM THE ORIGINAL THE PERSON FOR WHOM THE SURVf 14AUTHORI,ZED ALTERATION OR ADDITION TO OF THIS SURVEY MARKED WITH ON HIS BEHALF TO THE TITLE COMP) A SURVEY MAP BEARING A LICENSED LAND AN ORIGINAL OF LAND AGENCY AND LENDING IIdS1TI UITON ......n.,c.u.c cc er rc a vIfN.ATION OF SECTION SURVEYOR'S EMBOSSED SEAL TO THE ASSIGNEES OF THE LEND]