The URL can be used to link to this page

Home My WebLink About49397-Z : t TOWN OF SOUTHOLD BUILDING DEPARTMENT n 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#: 49397 Date: 6/20/2023 Permission is hereby granted to: DeLon , Todd 1280 Leslie Rd Cutcho ue, NY 11935 To: install new windows to existing single-family dwelling as applied for. At premises located at: 395 Laurel Ave, Southold SCTM # 473889 Sec/Block/Lot# 56.-2-6.1 Pursuant to application dated 5/15/2023 and approved by the Building Inspector. To expire on 12/19/2024. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $200.00 CO-ALTERATION TO DWELLING $50.00 Total: $250.00 Building Inspector ,rrrs.araa:,ry aau TOWN OF SOUTHOLD—BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtow�tinv.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only PERMIT NO. Building Inspector:, WAY 15 2023 Applications and forms must be filled out in their'entirety. Incomplete ISI `li i n`will nvt be acce ted. Where'theAlicant is not the ownef,anW 090 l D app cat o s p PP Owner's Authorization form(Page'2),'hall be completed, Date: ly 2023 OWNER(S)OF PROPERTY: Name: Ob't' SCTM # 1000- 0S6OC3DZ =(,00 1 Project Address: 39 — Lar,2�1 Av(.. &.JtiW 1 "/. I�� I Phone#: (G 31) T07- S$ZJ Email: r-Ion d rhe, C—aAL Mailing Address: CONTACT PERSON: Name:. � D Mailing Address: 1?—Eu LcsYie -2j�. 'cam J\Jy "935_ Phone#: �631� 907-3Sc9T Email: 4c4c1� 0 /19C.C.pM DESIGN PROFESSIONAL INFORMATION: Name: N .L.�Z !! SSOCIor Mailing Address: S"175- "17 Nvi fl jz( 0' 7505e J w �193s Phone#: 3 I 73w yl$5 Email: n�1sa�eckl'kc� o /)ne •R c�- CONTRACTOR INFORMATION: Name: Mailing Address: IZVO (.xcs)ic C. -ci4o VC �,3( 1) 93 Phone#: 631 E07-399Y Email: ?'de%a n+e l cam DESCRIPTION OF PROPOSED CONSTRUCTION ❑ONew ther [--]Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: �0ther uctu ❑A� C.h1S�i l�.iinow ^ = . Will the lot be re-graded? ❑Yes XNo Will excess fill be removed from premises? ❑Yes o 1 PROPERTY INFORMATION Existing use of property:ReS ov Intended use of proper SI ou5 I �l-'ally Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes XNo IF YES, PROVIDE A COPY. Check 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 Dgpartment for the issuance of a Building Permit pursuant to the Building Zone. Ordinance of 4 ` he 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): ❑Authorized Agent XOwner Signature of Applicant: Date: 15.1gD"13 STATE OF NEW YORK) SS: COUNTY OF 'ter-Oi—V ) -FO D P& Lo 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 MAy � 20 Z Notary Public CAROLINE M HUR PROPERTY OWNER AUTHORIZATIONE.- - ary Public-state oflNowYork N0.0j A6364635 (Where the applicant is not the owner) %wifiedinSuffolkCounty ommtwon Expires Dec tY,2026 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