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HomeMy WebLinkAbout48724-Z TOWN OF SOUTHOLD �v � y 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 SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit#: 48724 Date: 1/12/20-23,111,111,11 ,"""""",—...— Permission .—a—Permission is hereby granted to: CrosserJohn— �.. . _�._........ _ ._ ............. ......... 2010 N Bayview Rd_Ext Southold,_NY 11971 To: Construct an accessory 22 x 14 detached garage to an existing single family dwelling as applied for. Garage must be in rear yard and requires minimum setbacks of 20 feet. At premises located at: 2010 N Ba v� iew Road ,Ext Southold ......A ....._..... _ _..._ ...�. SCTM # 473889 Sec/Block/Lot# 79.-6-3.6 Pursuant to application dated 11/22/2022 and approved by the Building Inspector. ------------- To expire on 7/13/2024. Fees: ACCESSORY $223.20 CO-ACCESSORY BUILDING $50.00 Total: $273.20 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT µ Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 lett s://-% " . out:l oldtorviii) Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only y PERMIT NO. V Buildinglnspector,� 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: it )1 OWNERS)OF PROPERTY: Name: SCTM# 1000- Project Address: ' of l i GL, K0 l '50rTW Phone#: "" ) Email: 501.0 SM N 6,M -� , a^ Mailing Address. )-V(® Ad 8kell'tw RLcZ)CT- t 19 1 t CONTACT PERSON: Name; Mailing Address: )01rd �� Phone 4631) a )® 1700 Email: CI�oSS r"► ��(y 6&1t+q DESIGN PROFESSIONAL INFORMATION: Name: S& J4166 a eii Mailing Address: 45-0 ►0 im 1` r ptT L- t ' ' Phone#: I� � '^ Z)JS _ '�'�S� Email: CONTRACTOR INFORMATION: Name: < Mailing Address: AA Phone#. y , Email: W f*1VJ DESCRIPTION OF PROPOSED CONSTRUCTION ONew Structure ❑Addition ❑Alteration ❑Repair El Demolition Estimated Cost of Project: ❑Other "t „r X 22 $ D D•��+ Will the lot be re-graded? Dyes VJNo Will excess fill be removed from premises? Dyes ©No 1 PROPERTY INFORMATION Existing use of property: �l�S I d1�.�'�l Intended use of property: Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to q, O� this property? ❑Yes ®No IF YES, PROVIDE A COPY. ❑ Check Box After Reading" The owner/con ractor/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 : SO N P 6,RaSSCA ❑Authorized Agent 12fowner Signature of Applicant: Date: STATE OF NEW YORK) SS: COUNTYOF 50 H-P being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract) above named, (S)he is the d L-�- (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 DLX/4A /L , 20 �*,/u tary Public N L.HARNED; Notary Public Static of Now York ONo, 6 48 PPE AUTHORIZATION QuallfrdiInnutfolkCounty -12 (Where the applicant is not the owner) Commission EVIG'March 3'. 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 AIS'6M!ABNAAV'dO I ==„S GIVOS SWZMS;31VO ML-t99 4£VXd 889L-LR9 6£9`Hd 0£LWKN dl-ISI 1SV3'3nV WiM3 IVO M GIOw6gio,84O a OL :9.ck30�tNIGT�19�9a .3.d'S” III SNOWWIS'2l Minim .��,.,.. gtrtb05'ON 3-11J r > dd(iS-£LZZL-904L-4L#3111.1 ANVdN00 30Nv8nsNi 311111VNOIIVN A111301d 31ONN ANVIiIHE'8 HASS080 NHOr :01 AJUH30 h j M,„pZO�� NOtl y�N�S�M NOtl b3Zt wti jP",so SSL r fr o �. 0 �J' � � A A d^{ Jctµ ,.h��,.y�'r• n f p �PAO 011as ob�uel pN ,� ski � �� r✓Z �,''' �' tr rt ,ff w f/ rlp41 *ozb ff m '�d•Wtl�`'- sp0y vF ff M3/ jos f cD �oN „0'o p 9'C0-90-6L-000 0 'W'1'0'S ,0£ G 91b0S NMOHS SV :JO dVN (1:19N0S30 SI :lO-1 AN'00'_1jns `a-lOHinos OIl`M3IA kVg :iV Q31V00-1 310NN AN`diiNg 'R 1:13SSO�10 NHOr:2JOJ dDA3n,ijns