HomeMy WebLinkAbout48789-Z TOWN OF SOUTHOLD
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#: 48789 Date: 1/24/2023
Permission is hereby granted to:.
Mecca, John
130 E 18th St Apt 16G
New York, NY 10003
To: Legalize as-built finished basement at existing single family dwelling as applied for.
Additional certification may be required.
At premises located at:
40100 Route 25, Peconic
SCTM # 473889
Sec/Block/Lot# 86.-4-1.5
Pursuant to application dated 12/19/2022 and approved by the Building Inspector.
To expire on 7/25/2024.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $968.80
CO-ALTERATION TO DWELLING $50.00
Total: $1,018.80
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y" Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax(631) 765-9502t Iw�w°v southoldtowii�n .,(_v
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Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only Lh
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PERMIT N0. 4�fl Building Inspector: DEC�w _ 191 2022
Applications and forms must be filled out in their entirety.Incomplete IINGOE
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applications will not be accepted. Where the Applicant Is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:12/16/2022
OWNER(S) OF PROPERTY:
Name: JOHN MECCA (FORMERLY VOLPE-KNEUER) SCTM#1000- 86-04-1 .5
Project Address: 40100 MAIN ROAD, PECONIC, NY 11958
Phone#: 516 551-0750 Email:john.mecca@gmail.com
Mailing Address: 130 East 18th Street, Apt.# 16G, New York, NY 10003
CONTACT PERSON:
Name: Frank W Uellendahl, RA
Mailing Address: 123 Central Avenue, POB 316, Greenport, NY 11944
Phone#: 631-680-0041 Email: frank.uellendahl@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name: see above: Frank Uellendahl
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: TBD
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition Alteration ❑Repair ❑Demolition Estimated Cost of Project:
DOther As-Built Finished Basement 6K
Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? RYes ❑No
1
PROPERTY INFORMATION
Existing use of property: RESIDENTIAL DWELLING Intended use of property: DWELLING wi FINISHED BASEMENT
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes *No IF YES, PROVIDE A COPY.
JR: 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(prin aN W'UELLENDAHL,ARCHITECT @Authorized Agent ❑Owner
Signature of Applicant: IDate: 12/16/2022
CONNIE D. BUNCH
STATE OF NEW YORK) Notary Public,State of New York
SS: No. 01 BU6185050
COUNTY OF SUFFOLK ) Qualified in Suffolk County
Commission Expires April 14,2 av_l
Frank W Uellendahl, Architect being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Architect
(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
o
day of b5�r , 20 22—
Notary Public
PRORIE11TY OWNER AUTI 10RII2 "'r10
(Where the applicant is not the owner)
JOHN MECCA residing at 130 EAST 18TH STREET, APT#16G
I,
NEW YORK, NY 10003 FRANK UELLENDAHL RA
do hereby authorize to apply on
my behalf to th Town.o Southold Building Department for approval as described 'herein.
12/17/2022
Own k
s Signaturel Date
Print Owner's Name
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