HomeMy WebLinkAbout48541-Z t TOWN OF SOUTHOLD
BUILDING DEPARTMENT
� TOWN CLERK'S OFFICE
n
SOUTHOLD, NY
N41,sa,
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#: 48541 Date: 11/30/2022
Permission is hereby granted to:
Pi is Nickolas
465 Burgundy,Ct
Southold NY 11971
To: construct unconditioned accessory garage as applied for.
At premises located at:
465 Burgundy Ct., Southold
SCTM # 473889
Sec/Block/Lot# 51.-3-3.14
Pursuant to application dated 9/27/2022 and approved by the Building Inspector.
To expire on 5/31/2024.
Fees:
ACCESSORY $407.20
CO-ACCESSORY BUILDING $50.00
Total: $457.20
Building Ins
4"aTOWN OF SOUTHOLD—BUILDING DEPARTMENT
,
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
f Telephone (631) 765-1802 Fax (631) 765-9502htt s://www.sout�holdtownn ., ov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Onlyll ,� <,,
PERMIT N0, Building Inspector. "J m.
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:9/27/22
OWNER(S)OF PROPERTY:
Name:Cathy Santis SCTM# 1000-5I 3 A4
f
Project Address:465 Burgundy Court Southold NY 11971
Phone#:917-751-5978 Email:NYFIDA@VERIZON.NET
MailingAddress:465 Burgundy Court Southold NY 11971
CONTACT PERSON:
Name:AMP Architecture, Jess Magee
Mailing Address:P.O BOX 152 Mattituck NY 11952
Phone#:631-603-9092 Email:jmagee@amparchitect.com
DESIGN PROFESSIONAL INFORMATION:
Name:AMP Architecture, Anthony Portillo
Mailing Address:P.O BOX 152 Mattituck NY 11952
Phone#:631-603-9092 Email:aportillo@amparchitect.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
RNevv S+ru%ture ❑Add ioP'i ❑Aitcrativii ❑ %epalr ❑Deni oiltivi, E.itimated wSi of Project:
❑Other $
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes RNo
1
PROPERTY INFORMATION,
Existing use of roe Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
%0 N C this property? ❑Yes ❑"6o IF Y'E'S,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 na ): RAuthorized Agent El owner
Signature of Applicant: (Date:
�M
STATE OF NEW YORK)
i
COUNTY OF SUMIL
IL
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the aw Vvt
(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. ,
BARBARA Hw, TANDY
Sworn before me this Notary Public,State Of New York
No, 01 TA6086001
Qualified In,Suffollk County
0?7 day ofA?4 .�...�t� ,20 01 a+ CO
Notary Public "
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
q � 1. S residing at .�, S, � .d'
t
` do hereby authorize AMP ARCHITECTURE to apply on
Orly uenan to the Town of Suuuivia 8uilaing ueparlrneni for approval as described nere iri.
�T _ & 2
O s Signature Date
Print Owner's Name
2
A M P" Architecture Address:10200 Main Road,Unit 3A,PO Box 152,Mattituck NY 11952
Phone:(631)603-9092
Design + Build
November 28, 2022
Re:Santis Residence
El� w E D
465 Burgundy Ct
j 'nL, Ov 2 9 7022
Southold NY
WILDING
Amanda, AWN OF
Enclosed please 4 copies of the updated plans based on your comments.
The garage is unfinished and unheated.
Please contact our office if you have any questions.
Thank you,
Jess Magee
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