HomeMy WebLinkAbout47827-Z o�SUFF01Ir TOWN OF SOUTHOLD
BUILDING DEPARTMENT
1 x TOWN CLERK'S OFFICE
o . 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#: 47827 Date: 5/18/2022
Permission is hereby granted to:
Barry, Leanne
395 King St
New Suffolk, NY 11956
To: install deer fence as applied for.
At premises located at:
1145 Donna Dr., Mattituck
SCTM #473889
Sec/Block/Lot# 115.-16-11
Pursuant to application dated 4/15/2022 and approved by the Building Inspector.
To expire on 11/18/2023.
Fees:
DEER FENCE $75.00
Total: $75.00
Building Inspector
�o�SufPol��o
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
oy • ag Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtoLvmX.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
APR 15 2022
PERMIT NO. Building Inspector:
BUILDING DEI'"C
TOWN OF SOUTHOLD
Applications and forms must.be filled out in their entirety.Incomplete ,
applications Wilf•not be,accepted:,Where the Applicant is not the owner,an
Owner's Authorization'form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: . � SCTM#1000- !!5, 1(o—1l
Project Address:
Phone#: (020` Email: ��
Mailing Address: L�Qs
CONTACT PERSON:
Name:
Mailing Address: S vonM -0Y
Phone#: l50-\5 cpEmail•
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
'CONTRACTOR INFORMATION:
Name: r1�1(JL
' Mailing Address: t-Tj ��1 x2d r\ .
Phone#: 1 �. Email:
DESCRIPTION OF'.PROPOSED,CONSTRUCTION
❑New Structure ❑Addition ❑Alteration f❑JRepair ❑Demolition Estimated Cost 6Project:
]Other 0.1" p Ing�j 1a��� $ �"( O eO0
Will the lot be re-graded? Dyes' V0 Will excess fill be-removed from premises? ❑Yes PO
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 L o 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,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 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 New York State Penal Law.
Application Submitted By(print name • `K��t� �'� ❑Authorized Agent -lymner
Signature of Applicant: Date: 6 C�— —do
STATE OF NEW YORK)
SS:
COUNTY OF 5UC oI kr )
(V— being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing cont )above named,
(S)he is the 0 l brK t�
(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 ,20VeA
ary Public
TRACEY L. DWYER
NOTARY PUBLIC,STATE OF NEW YORK
NO.01 DW6306900
PROPERTY OWNER AUTHORIZATION QUALIFIED IN SUFFOLK COUNTY
(Where the applicant is not the owner) COMMISSION EXPIRES JUNE 30,2�.4_
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
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GO iPLY WQH ALL ODES OF
NEW. ORK STATE & T WN CODESL o f 6 2 APPROVE®AS NOTE®
AS RE UIRED AND CO DITIONS OF DATE-, P # 7�
'In,01L I I ox ��� I FEE: J/) BY:.
NOTIFY BUILDING D' PARTh�EPJT A
ovulli"41-u No rE: ARD 765-1802 8 AM 1'C' ; FOR THE
'�6' 18 �RUS3iEF"MONUMENT FOLLOWING INSPECTV0I\'S:
NY r te— ❑ = STAKE 1. ) AS N - TWO REQUIRED
_ SUBDIVISI ON MAP FILED IN r -0g
H F
OF THE CLERK OF SUFFOL C �� FD CONCRETE
IAN. 26, /965 AS FILE NO. z. �� ��HTT FR%'1MIf�G & PLUMBING
THE LC CAT/ON OF WELL, SE T/ W19NCESSPOOLS SHOWN HEREON
``�j - REFROM FIELD CBSERVAT/ NS' t7gM p�p,7?4 f4f4 ,rSj M OTHERS.
® E V BE COMPLETE :-,�; VJ � OF
ALL CONSTRUCT!
REQUIREMENT -,ALL MEET
APR 1 5 2��� �-;Ern _
vlsloNs DESIGN OR CES�LON�TIt�kJ _E �o
BUILDING DEPT. n
TOWN OF SOUTHOLD .4 0 0 0 S T R A N 11 t 9F l�15 iT�ONi vEIRIR p�` N t w 4K
F. ALDEN W. YOUNG HO.. . . YVt N,= —
/•TI(�rF.SS10NAL F:N.:INF.FA AND , A1*1 ctmveyorp
LAND SURVEYOR. N.Y.!:. I IC. N!',• 1:"A' ---� ��� Y0• I45$9''' •�� -_
SURVEY FOR:
•J%AIIIRDR.ZfD ALTERATION OR ADD+11pN TO WiD sua
I./IS SURVEY IS A VIOLATION OF CIrTICN DOUGLAS M. MOORE B MARY D. MOORE
•.ry' Of 'Flit. NEW YORK STAIC FDIiCAT10N
LA" LOT 63 11 DEEP HOLE CREEK ESTATES "
;..PIPS CIO 11,1I5 SURVEY VAP Nl1T REANIN11 '
1•,T !AND .URVEIOR'S INKED ST.AL ^R -- - '
TMRORSLR REAL SHALL NOT RE CUN"OFRFII
IC BE A VALID TRITE COPY Al MATTI TUCK G""'�""'FET'
. AMER/CAN 17TLE INSURANCE CO.
:,.ARAN I F!S IIIII'ICATED HEREON SIIALL RUN SOUTHOLD SA VINGS BANK
+..Y 7(11..E P(A%ON ION WHOW 11IE TOWN of 0UTH0 LD
S 1•V6 T IS PRI PANE D,ANU CIN TUC AF.HJALr
1.•E T1t,E COMPANY,G(.VERIIMENTAI
1--%'AANI. IIN:IIHG IN$I.IlIT10N LISTED SUFFOLK CO., N.Y. �Y- � j `
eT N�,:N, A^ID 10 tllE ASSIONLI'S OF TNF•
.tN1•,NG INSTITUTION GUARANTEES ARE. •___---
` 411 IIIA 'I CNABIF IU AODITIrp1A1 SCALE: 11 1 DAT F.• N(�•
p .NSfl1•J .. I = 40 I FEB. 9 , 1979 I h .79-61
TIONS on %tiOSEQUENI OWNER _
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