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HomeMy WebLinkAbout48787-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE w" �w SOUTHOLD, NY '0 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 #: 48787 Date: 1/24/2023 Permission is hereby granted to: Vandenbosch Eu ene PO BOX 362 Cutcho ue, NY 11935 To Construct accessory garage at existing single family dwelling as applied for. At premises located at: 1620 King St, Orient SCTM # 473889 Sec/Block/Lot# 26.-2-42.5 Pursuant to application dated 12/19/2022 and approved by the Building Inspector. To expire on 7/25/2024. Fees: ACCESSORY $814.00 CO-ACCESSORY BUILDING $50.00 Total: $864.00 Building Inspector e TOWN OF SOUTHOLD—BUILDING DEPARTMENT "FTown Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 lits i�s,"Hwww.SOLltl101dtownti l()'\I. Date Received APPLICATION IFOR BUII„,, For Office Use Only PERMIT NO, 4L�7S 11? Building Ins,pec'to r; Applications and forms must be filled out in their entirety. Incomplete WN,Of F313 OUTH applications will not be accepted. Where the Applicant is not the owner,an Owner's Authorization form(Page 2)shall be completed. Date: 19”DEC ASEP, 2-02-'1. OWNER(S)OF PROPERTY: Name: Eugene Vanden Bosch SCTM# 1000-026.00-02.00-042.005 Project Address: 1620 King Street, Orient, N.Y. 11957 Phone#: 631 .484.5036 Email: gvorient@yahoo.com Mailing Address: P.O. Box 362 Cutchogue, N.Y. 11935 CONTACT PERSON: Name: Nigel Robert Williamson Mailing Address: P.O. Box 1758, Southold, N.Y. 11971 Phone#: 631 .834.9740 Email: nigel_architect@hotmail.com DESIGN PROFESSIONAL INFORMATION: Name: Nigel Robert Williamson R.A. Mailing Address: P.O. Box 1758, Southold, N.Y. 11971 Phone#: 631 .834.9740 Email: n!gel_architect@hotmail.com CONTRACTOR INFORMATION: Name: Mailing Address. Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ®New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: ❑Other Will the lot be re-graded? ❑Yes ANo Will excess fill be removed from premises? Dyes *No PRoPO-CE15 34',O- v- S-OwL v- 22:-O' ir1qO '. .. A r I"�9114L � 5C Q , 1 a� PROPERTY INFORMATION Existing use of property: Single Family Dwelling Intended use of property: Single Family Dwelling Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to R80 this property? ❑Yes *No IF YES, PROVIDE A COPY. R Check Box A,fteiirRead lung: 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 name): Nigel Robert Williamson RAuthorized Agent Downer l 2.o2-2— . . Signature of Applicant: Date: 9�.GEmb Il STATE OF NEW YORK) SS: COUNTY OF ) Nigel Robert Williamson being duly sworn, deposes and says that(s)he is the applicant (Name of individual signing contract)above named, Agent (S)he is the (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 ac day ofr-c EJL 20 22 Notary Public , INY0a�m i i CI; in. til COUnty t l''T R 0 P EIII Y OWNE1111JR Aurtiiu i i i � Commission Ex it-s rebruary 13,V (Where the applicant is not the owner) Eugene Vanden Bosch residing at 1620 King Street, Orient N.Y. 11957 do hereby authorize N igel Robert Williamson to apply on my behalf to the ow'n of Southold Building Department for approval as described herein. Owner's Signature ate �� e ISSC e � �c l PhAt Owner's Name 2 D En}_ o 0 z z d `'' o !tr t,.iW 2 Zt N CL. �� > a vuio� a w y Z rn 020 u �.Z ice¢ �cty M Ito ° —rn 00 v0. �vtj nWS �Z o w� � w o Wptn X w O w Z 1 C3 of O Qc`a-m s c8i m >-KC33t 4. - N to K }(f'lQ L'i IJP © ip QWU 2 2�LLJ (A w cn CL< d NO 1a 00 an kn 04 v) !2 N c , IINAMO o• 9 7.0 �w n W � a N 6 o t 4 z z U a Lr. W x r r <ta r -_ r a 9 V+ $P. • p lilt qbl d " x � lax k_t