Loading...
HomeMy WebLinkAbout48578-Z u �« TOWN OF SOUTHOLD ra BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, NY BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES WITH ONE SET OF APPROVED PLANS AND SPECIFICATION'S UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 48578 Date: 12/9/202....._����..... ... Permission is hereby granted to: Pizzin rillo. Joseph..... ... ���. A. _ _ 110 Brompton Rd _ . Garden Ci , 115302704 __....ANY.. ... .... ....... _.. _. _ ..... ._ ....... ..... To: Construct additions and alterations to an existing single family dwelling as applied for. At premises located at: 850 Smith Rd., Peconic SCTM # 473889 Sec/Block/Lot# 98.-3-30 Pursuant to application dated 10/4/2022 and approved by the Building Inspector. p 6/9/2024. To ex ire on Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $1,675.20 CO-RESIDENTIAL $50.00 Total: �������ITITmmmm $1,725.20 ........ _. ... .���� _ . m__ Building Inspector ri't'Ca'r. 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:/www soul.ho)dtownnY.go Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. " Building Inspector: s, 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:10/04/2022 OWNER(S)OF PROPERTY: Name:Joe and Mary Pizzingrillo scTM # i000-098-3-30 Project Address:820 Smith Road, Peconic Phone#: Emaif:'ose h izzin rillo alley am.com 646-678-�27 J P •P 9 @ 9 Mailing Address E12 Smith Road,WoniC, NY 11958 CONTACT PERSON: Name:Mike Hand Mailing Address:PO 1256, Mattituck, NY 11952 Phone#:631-965-1947 Email:michael@mchdesignservices.com DESIGN PROFESSIONAL INFORMATION: Name:James Deerkoski, PE Mailing Address:260 Deer Dr, Mattituck, NY 11952 Phone#:631-774-7355 Email:jamesdeerkoski@yahoo.com CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure RAddition RAlteration ❑Repair ❑Demolition Estimated Cost of Project. ❑Other $300,000 Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? Dyes RNo 1 PROPERTY INFORMATION • Intended use of property:Single family dwelling FEne of property:Single family dwelling e district in which premises is situated: Are there any covenants and restrictions with respect tothis property? ❑Yes No YF YES, PROVIDE A COPY. ox After°Reading„ The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by issuance of a f the Town Code. APPLICATION IS ER Ne M Ark and other ato the ADEdppgcabpe Laws,�0 ordinances or Regulations,for the co st1 radion of buildings, ane Ordinance of the Town of Southold,Suffolk,County, 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. G, 100 0A uthorized Agent []OwnerApplication Submitted By(pri n,,. !e): Avo ,•/ Signature of Applicant: Date: C 0 I® y/2 O,ZOZ �, STATE OF NEW YORK) COUNTY OF ) ��emr being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, S he is the (S) (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. Swo before me this day of 20otairy rib D ,BARCZAK Noloy Public,State of N"yo W.f)113AF95� " M ..� 1 ) ( b ' ) ( ... Ouallfied in Suffolk Co unt I (Where the applicant is not the owner) C,rz MI slon ExpIrgs Feb.22,20 - I, residing at to apply on do hereby authorize my behalf to the Town of Southold Building Department for approval as described herein. Date Owner's Signature Print Owner's Name 2 Building Department Application AUTHORIZATION (Where the Applicant is not the Owner) I, `Q a , l residing at (Print property owner's name) (Mailing Address) � RS _ do hereby authorize Bim, (Agent) to apply on my behalf to the Southold ui:ldi:ng Department. T i (Owner' nature) (Dat4) 31.01 ;XY�Si22=LM4(2-P (Print Owner's Name)