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HomeMy WebLinkAbout48386-Z � TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE mSOUTHOLD, NY �01 00 �' 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 #: 4838622 Date: 10/11/2022 Permission is hereby granted to: Ball, Barry._...... _ _ .. ... �.a� .. _. . _ . _........ .... 303 E 60Th St Apt 39J .. .. _. ......_ ....... ..... .... .... New York, NY 10022wwwwww To: Construct a deck addition and interior alterations to an existing single family dwelling as applied for per FEMA requirements. At premises located at: 39550 uRoute 25w,_wwOnent SCTM # 473889 Sec/Block/Lot# 15.-8-26.8 Pursuant to application dated 8/15/2022 .m and approved by the Building Inspector. pi .04 To expire on �4/11/22 .m� Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $276.40 CERTIFICATE OF OCCUPANCY $50.00 Flood Permit $100.00 Total: $426.40 Building Inspector a 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 htt s.Hwww.southoCdtownn o Date Received APPLICA"'riON FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector: [.J Applications and forms must be filled out in their entirety. Incomplete 1 5 2922 applications will not be accepted. Where the Applicant Is not the owner,an BUILDING DEPT Owner's Authorization form(Page 2)shall be completed. 706 ,,G, Date:August 8, 2022 OWNER(S)OF PROPERTY: Name:Kimberly Van Zee and Barry X Ball IsCTM#1000-15-08-26.8 Project Address:39550 Route 25, Orient, NY Phone#:646-283-6595 Email:vanzeek@gmail.com Mailing Address:303 East 60th Street, New York, NY 10022 CONTACT PERSON: Name:Frank W Uellendahl Mailing Address:123 Central Avenue, POB 316, Greenport, NY 11944 Phone#:632-680-0041 Email:frank.ueliendahl@gmail.com DESIGN PROFESSIONAL INFORMATION: Name:same as Contact Person above Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name:Dennis McMahon Mailing Address:133 Central Avenue, Greenport, NY 11944 Phone#:917- 921-6984 11Email:mcmahonbrosltd@gmail.com DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure Addition ®Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other $95K Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ANo 1 PROPERTY INFORMATION Existing use of property:Residential Intended use of property:Residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to 8-200 this property? ❑Yes ®No 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 B ).Frank W U e l l e n d a h l iRAuthori ed Agent ❑Owner Signature of Applicant: i Date 6124 STATE OF NEW YORK) SS: COUNTY OF SUFFOLK ) Frank Uellendahl being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the Arch iteCt (Contract (A,gen , Corporate Officer, etc.) of said owner or owners, and is duly authorized to pe or'm 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 j5K day of AUL , 2C Notary Pu i TRACEY L. DWYER NOTARY PUBLIC,STATE OF NEW YORK PROPER I, OWNERLJ11 0MZ IION NO.01DW6306900 __..W h er ��� .� ....... s �„�, _ . (Where the applicant is not the owner) QUALIFIED E)PiFI S,JU C uN2�A& COMMISSION t.�t'CC���. JUI�I� 0,2 we Kim Van Zee and Barry X Ball residing at 303 East 60th Street, Apt 30J I, I New York, NY 10022 do hereby authorize Frank Uellendahl to apply on my behalf to the Tow,rmf So Building Dep rtment for approval as described herein. 13 L2 Owner's Signature Date Print Owner's Name 2 LLJ z� W P� z w o — w � 'tIlNB 381 01 A13NSMO83 O30N3011 SI SNYId 3S3H1 AONJ WINOU 3NO A1NO ONG 011HOIN 3H1'Y8 1HVON3i30'M)WM d0 AU33dOHd 3105 381 RV SNOIS3O"ONV SNVId TN'MVI 1HOMMOO M30 83ON0 03131nd 38V SNMVA313 ONV SNVId 80013 TN V'8 IMOBA'M NNVY3 ZZOZ 1HOMO(2) z cWn cn co U') tZ o t= C>0 CD C/, oOZ Z¢0 00 f-- N O Ly O c~n= cow ODO N N w m I w CSD. �©D W it Q w � w ,T m r cq N U-3 fI�HELt O CV � O Z Q z. �9Z'apVSt'OOOt _$�01 N C9t-80-St�49�t � ,BS'OS p1,y1.1y0U3, � p8 H8818�b038