HomeMy WebLinkAbout49223-Z Milt 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#: 49223 Date: 5/10/2023
Permission is hereby granted to:
Ott, Maria
301 W 57th St Apt 52A
New York, NY 100193181
To: install generator as applied for.
At premises located at:
1225 Arrowhead Ln, Peconic
SCTM #473889
Sec/Block/Lot# 98.-3-8
Pursuant to application dated 3/31/2023 and approved by the Building Inspector.
To expire on 11/8/2024.
Fees:
ACCESSORY $100.00
ELECTRIC $85.00
CERTIFICATE OF OCCUPANCY $50.00
Total: $235.00
Building Inspector
TOWN OF SOUTHOLD— BUILDING DEPARTMENT
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Town Hall Annex 54375 Main Road P. 0. Box 1 179 Southold, NY 11971-0959
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Telephone(631) 765-1802 Fax (631) 765-9502 tlu '.1:_� wmrr�� �Id. � �ll � ���� �� +
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Date Received
For Office Use Only
IPERMIT NO. L4 Building Insp�eat�rr:,.........._ _.. .. / _
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Applications and forms must be filled out in their entirety.Incomplete �-
'VIA . 3 i 9093
applications will not be accepted. Where the Applicant is not the owner,an
pro-
Owner's Authorization form(Page 2)shall be completed. 4�i"ii1"�t�fi1���1
Date: �w
OWNER(S)OF PR PERTY:
Name:Marla Cecilia Ott SCTM#1000- 9 �p
Project Address:1225 Arrowhead Lane, Peconic, NY 11958
Phone#:917-991-3259 Email:Cecilia.Ott@gmail.com
Mailing Address:301 West 57th St, Apt 52A, NY, NY 10019
CONTACT PERSON:
Name:Andres Meszaros
Mailing Address:301 West 57th St, Apt 52A, NY, NY 10019
Phone#:646-575-3506 Email:Andres.Meszaros@gmail.com
DESIGN PROFESSIONAL INFORMATION:
Name:Mark K. Schwartz, AIA - Architect, PLLC
Mailing Address:P.O. Box 933, Cutchogue, New York 11935
Phone#: 631 734-4185 Email:mksarchitect@optonline.net
CONTRACTOR INFORMATION:
Name:AMS Property Renovations
Mailing Address: 1549 Main Rd, Rivehead, NY 11901
Phone#:631-276-3334 1 Email:amsremodelingcontractors@gmail.com
DESCRIPTION OF PROPOSED CONSTRUCTION
p
ew Structure ❑Additio
n ❑Alteration []Repair ❑Demolition
Estimated Cost of Project:
Other
Will the lot be re-graded? ❑Yes No Will excess fill be removed from premises?Wes ONO
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PROPERTY INFORMATION
Existing use of property: it 5
Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑YesNo IF YES, PROVIDE A COPY.
..._._._....._ _ _....._............._.
Check,Box After V'eadh1g: 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): M ArZ �C' 771 uthorized Agent Downer
Signature of Applicant: Dater
STATE OF NEW YORK)
SS:
COUNTY OF
being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above nam d,
(S)he is the
( ractor,Agent,Corporate Officer, etc.)
of said owner or owners,and is duly autho ized 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 20
Notary Public
PROPERTY OMINER AUTHORIZATION
(Where the applicant is not the owner)
Maria Cecilia Ott residing at 301 West 57th St, Apt 52A, NY, NY 10019
Mark K. Schwartz, AIA- Architect, PLLC
do hereby authorize to apply on
my behaallf to thTown of Southold Building Department for approval as described herein.
e
Owner's Signature Date
Maria Cecilia Ott
Print Owner's Name
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