HomeMy WebLinkAbout48876-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
7 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 #: 48876 Date: 2/7/2023
Permission is hereby granted to
Boody, Margaret
1200 Hyatt Rd
Southold NY 11971
To: Construct addition and alteration to existing single family dwelling as applied for.
At premises located at:
1200 Hyatt Rd, Southold
SCTM # 473889
Sec/Block/Lot# 50.-1-9
Pursuant to application dated 1/10/2023 and approved by the Building Inspector..
To expire on 8/8/2024.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $482.80
CO-ADDITION TO DWELLING $50.00
Total: $532.80
Building Inspector
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 lis:/lwww.soiatholdtownn o
G N
Date Received
APPLICATION
For Office Use Only EC E � VE
PERMIT NO. Building Inspector. JAN 1 0 2023
- ----------- R ED
Applications and forms must be filled out in their entirety.Incomplete BUILDING DEPT. .
i
applications will not be accepted. Where the Applicant is not the owner,an TOWN OFSOURIN D
Owner's Authorization form(Page 2)shall be completed.
Date:01/09/2023
OWNER(S)OF PROPERTY:
Name: . " BOODY /M A R 6 i—r T SCTM#1000-50-1-9
Project Address:1 200 HYATT RD. SOUTHOLD NY 11971
Phone#:917-445-5005 Email:mboody@lookingglasslabs.com
Mailing Address:1200 HYATT RD. SOUTHOLD NY 11971
CONTACT PERSON:
Name:MFeHAN BOODY jY)4 92 C, 4 R ET
Mailing Address:1200 HYATT RD. SOUTHOLD NY 11971
Phone#:917-445-5005 Email:mboody@lookingglasslabs.com
DESIGN PROFESSIONAL:INFORMATION:
Name:VINCENT BENIC ARCHITECT LLC
Mailing Address:PO BOX 92, SOUTHOLD NY 11971
Phone#:917-414-1925 EmaiI:VINCE@VBARCH.COM
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: _ Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
[]NewStructure Addition VAIteration ❑Repair ❑Demolition Estimated Cost of Project:
❑other X700.000
Will the lot be re-graded? 501Yes []No Will excess fill be removed from premises? V Yes ❑No
1
PROPERTY INFORMATION
Existing use of property:Single Family Residence Intended use of property:Single Family Residence
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R-40 this property? ❑Yes XNo IF YES, PROVIDE A COPY.
Check Box ftr Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town code. APPUCATION 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 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 promises and In bulkling(s)for necessary inspections.False statements made herein are
Amisdem anon pursuant
to'Section 210.45 of the.
New York State Penal law.
as'a lass s
punishable
Application Submitted By(print name): }i/4-,,?U �-� na by
❑Authorized Agent Owner
Signature of Applicant: X ' Date: c o
STATE OF NEW YORK)
SS:
COUNTY OF M;�\L. )
being duly sworn, deposes and says that(s)he is the applicant
(Name of i "vidual signing contract)above named,
(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
-day of ZD
Notaryublic
a rr � n Dan,n.ichnson
EfIQP " " LUTI.1 11 N, "'TAw .� Notary j?,bue,State ofNew York
N�01JC,534.4053
(Where the applicant is not the owner) Atd„„,,tl county
C*Oamllssiun Expires ie/ii/20-11
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
WIINI.Wro NL ry+.,rv..w romp sr"r
ox✓um II u'rae x r euwnr,e,o �raro
_ {§ ro,�Rooa oN�wwry EEs +rnwe.wvi r
J 7 Area=
49,013 sq.ft.
r E 1.13 acres
c�\`' f,
(orCOMSE
IOTAW=49,00 V.F7.P? ter ;
j & r MOINCS
ORZT.T!%n%Oi6EWi
j f t07�A
3ARMSaFi.
l ^ice "'-\
/ A
I
17 ?
41
r
1
*R4�� ff
Survey of Property
Southold
J t csrrryc Town of Southold
" as€m4��u4�aoas +- Suffolk County, New York
Tax Map#1000-50-1-9
Scale 1"= 30' December 2422
GRAPHIC SCALE
Ph.—(631)7244632 �
P 0 box I4a8 Sm'iMown N.Y 11]87 ( .n i