HomeMy WebLinkAbout49279-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 #: 49279 Date: 5/19/2023
Permission is hereby granted to::
O'Hara, William
265 E 66th St#2G
New York NY 10065
To construct accessory shed as applied for.
At premises located at:
165 Rogers Rd, Southold
SCTM # 473889
Sec/Block/Lot# 66.-2-22
Pursuant to application dated 4/19/2023 and approved by the Building Inspector.
To expire on 11/17/2024.
Fees:
ACCESSORY $164.00
CO-ACCESSORY BUILDING $50.00
Total: $214.00
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 h tM //anwwvgsou th.o1dtgwnn ora
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Date Received
APPLICATION F, R 1 DING 1)"El"M I,
For Office Use Only [p17' 44
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PERMIT NO. Building Inspector:� P 182023 G ?
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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:2/15/2023
OWNER(S) OF PROPERTY:
Name:Billy O'Hara SCTM#10004CQ
Project Address:165 Rogers Road, Southold NY 11971
Phone#:201-424-3481 Email:billy@buythesell.com
Mailing Address:165 Rogers Road, Southold NY 11971
CONTACT PERSON:
Name:Billy O'Hara
Mailing Address:165 Rogers Road, Southold NY 11971
Phone#:201-424-3481 Email billy@buythesell.com
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $7,000
Will the lot be re-graded? ❑Yes ®No Will excess fill be removed from premises? ❑Yes ®No
1
PROPERTY INFORMATION
Existing use of property:Residential Intended use of property:Residential
ZZI Vone or use district
in which premises is situated; Are there any covenants and restrictions with respect to
Southold Y this property? ❑Yes LL No IF YES, PROVIDE A COPY.
., il;'^:;'k 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.
1
Application Submitted By(print name):B i l ly r ❑Authorized Agent NOwner
Signature of Applicant: � �- � Date: L/l l .�c�
CONNIE D.BUNCH
23
NotaryPublic,State of New York
STAT€ CF NEW Y^vRK) No.01BU6185050
SS: Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14, 2�Q
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual 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 "" �" l.a /•
�c
Notary Public
4 .° m P „ orf°L r a y °,ia
.m(Where
..,_. _... _..___..,4,k"
the applicant is not the owner)
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
S.C.T.M. NO. DISTRICT. 1000 SECTION:66 BLOCK:2 LOT(S):22
ORCHARD ROAD
-T- -LOT I DWELLINGS
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FINE SURVEYoF. LOT 12
SANDOF we', CERTIFIED TO: WILLIAM M. OHARA;
16.7' MAP OR BEIXEDON ESTATES
KAREN M. O'fbkR7k-
WATER INFILED: MARCH 16, 1946 No.1472 WELLS FARGOF BANK. N.A.;
SID PALE Fl TY NATIONAL TITLE MuRANCE
BROWN SITUATED AT.SOUTHOLD
FINE SEWCES, LLC,
SAND 17' Tom OF.SOUTHOLD KENNETH M WOYCHUK LAND SURVEYING, PLLC
SUFFOLK COUNTY, NEW YORK 0 0aa Professional Land S�eyang and Design
02-11-22 u 1-.0* Box 153 Aquebogue, New York 11831
Mc DONALD GEOSCIENCE 111 15—34 SCALE:I"=20'DATE:MAY 5, 2=0 15 PHONE(631)296-1556 FAX(631)2N-1588
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