The URL can be used to link to this page

Home My WebLink About49189-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#: 49189 Date: 5/1/2023 Permission is hereby granted to: McPhillips, _.._............................. .. ............................----------..............._......................................... 18 Coleman Dr East Williston NY 11. _..............._......_......... ........................ �__.__....._..�._...�.._._. .�... To: Construct additions and alterations to an existing single family dwelling as applied for. At premises located at: 3530 Westphalia Rd, Mattituck ..... SCTM # 473889 Sec/Block/Lot# 114.-1-9 Pursuant to application dated 3/29/2023 and approved by the Building Inspector. To expire on 10/30/2024. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $784.40 CO-RESIDENTIAL $50.00 Total: $834.40 _................... — � ..... ................... ................................................................. _. Building Inspector ur 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 lt��,s:/B v >. �� 1-2"� q ....,�.• Date Received BUILDINGAPPLICATION FOR r7l". " PP dam!o I,. ;i• ,� 6°pi:" >,'gip. For Office Use Only q 9 Building Ins ector; I ± SNI ' PERMIT NO. 1 g P � ..m 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: 3 3 c a Ji)1 3 OWNER (S)OF PROPERTY: .�.-��... ..- .�...-... Name —... _ a � .� .� SCTM # 1000 1 , 49 Project Address: j 3 o)CF.)I PH l A t' I A A U& nn A 7 7''7 u u� , tJ-i I r �i'S L TEmail 7Phone#: °. " ;, r = .-- Mailing Address: S ' ., K L S-7 0 I...1 q -r-ti 7 c�Z_i<- N V] l `i r-? CONTACT PERSON: - — Mailing Address: � �; % ' -r --r 44 — .�� _... .. T-E mail Phone#: I�� ,1 _' ,�-� i - ._,.�..�..__ PROFESSIONAL SIONAL INFORMATION: Mailing Address 3�: rbc 17 1a '� Pa ..'l l C ' a """ -- Phone#: E 71-71 mail CONTRACTOR INFORMATION: ._ --- Name: i Mailing Address: Phone#: Email DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure 1K.Addition x❑Alteration ❑Repair ❑Demolitionst of Project: $stim�ate� d Cost r ❑Other - "1 Will the 7 Will excess lot be re-graded. ❑Yes El fill be removed from premises? ❑Yes ❑No 1 PROPERTY]N FORMATION Existing use ofpropert Y• Intended use of property: �•,�n� �- Zone or use district in which premises is situated. Are there any covenants and restrictions with respect to 24 u this property? ❑Yes XNo IF YES, PROVIDE A COPY. 0 heck ter 236 tithe.. _. w ------ El ..... After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by Chapter Town Code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Ione Ordinance of the Town of Southold,Suffolk,Count ,New York and other applicable Laws Ordinances or Regulations,for the construction of buildings" uildm s g, 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 an premises and In buildln (s)for necessary Inspections.False statements made herein are punishable as a Class A 114"eanor pursuant to Section`210.45 of the New York State Penal Law. nuf � ca,� ;�s Application Submitted By(print name): ('yy..1--i _4/A i L_A rjAkis H,L-i.,17i ❑Authorized Agent [AOwner Signature of Applicant: 1vL f c /P Date: 3, STATE OF NEI"v YORV) SS: Suff6l K, COUNTYOF� _rra4-�L ) being duly sworn, deposes and says that (s)he is the applicant (Name o ` ividual signing contract) above named, (S)he is the V „ Contractor, Agent, Corporate Officer, et 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 da of '1 _.. _ Y �� ....._ 20 NeyPublic"-- TPAOIFY I., WE NM Ry Fel SLZ,STATE OF NEW YR PROPERTYEAUTHORIZATIONN . ; W(7,7a 6,900 (Where the applicant is not the owner) cOOUAQFIFD U � NT-Y is ............. 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 Scott A. Mussell SUPERVISOR M[A1�A\�Gr]E��[�EN IF SOUTHOLDTOWNHALL-P.O_Box 1179r r h;" of Southold 53095 Main Road-SOUTHOLD,NEW YORK 11971 ca.� - r YV YV,/G G h/6 LLL CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR L ARGER l — — _ ..... _ ........ _ ..... .. APPL C. I : N �� rolwr- . Wrt��..�, �U ��L ,r� ��tr f°��s�l� �t�.�, " c�...ut, C��ratca�:��:�z.. Other NAME: L L C 0 p % 6 L li- ..�� Da t e: Contact lnformattonr b .. �� w _ if.^Idt �. i iPyihnru Ir Iwrrd _ � a `. Gnu tri Address / Location of Construction Site: S.C.T.M. DO00 ti ic �r Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT ® - Area of Disturbance is less than I Acre. No S.P.D.E.S Pernm{{t rs Requr{ed ! ® - Project does Not Discharge to Waters of the State. No S.P- -E.S- Permit is Reguiced ' Area of Disturbance is Greater than I Acre & Storm-water Runoff Discharges Directly ® to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C. Prio{ to Issuance of a Building Permit Aj ea ff Flows Through Southold Town'sfDistui MS4 Syst{ ce is G�eater ems to Waterstofrt!le State of NemYork . THEfuAPPLICANTMUST OBTAIN a S.P.D.E S. Permit through the Southold Towyn Engmq lin Department Prior to Issuance of a Bu{ld{n® Permit, Rev ed R batt:: - �1S (lr�n{�ai' 7nlq