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Home My WebLink About49417-Z , r TOWN OF SOUTHOLD * � BUILDING DEPARTMENT � TOWN CLERK'S OFFICE o SOUTHOLD, NY nBUILDING 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 #: 49417 Date: 6/23/2023 Permission is hereby granted to: Rieger, Ellen 65 Arbutus Rd Greenlawn, NY 117401127 To: legalize "as built" enclosed porch space to living area as applied for with flood permit. Additional certification may be required. At premises located at: 4235 Camp Mineola Rd, Mattituck SCTM # 473889 Sec/Block/Lot# 123.-5-25 Pursuant to application dated 5/22/2023 and approved by the Building Inspector. To expire on 12/22/2024. Fees:. AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $579.20 CO-ALTERATION TO DWELLING $50.00 Flood Permit $100.00 Total: $729.20 Buil+� ng Inspector � TOWN OF SOUTHOLD—BUILDING DEPARTMENT � Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 1 01 Telephone(631) 765-1802 Fax(631) 765-9502 htips://www.sotitlioldtoNviiiiy.g—ov Date Received PIILI CATION FOR BUILDING S' IE R III'Ir' For Office Use Only E C I PERMIT NO. Building Inspector. MAYai: ' 3 Applications and forms must be filled out in their entirety.Incomplete applications will not be accepted. Where the Applicant is not the owner,an TOWNICIPS0137NOLD Owner's Authorization form(Page 2)shall be completed. Date: MayJk2023 OWNER(S)OF PROPERTY: Name: Ellen Rieger SCTM#1000- 123-05-125 Project Address: 4235 Camp Mineola Road,Mattituck,NY 11952 Phone#: 917-865-3384 Email: johnrieger@msn.com Mailing Address: 65 Arbutus Road,Greenlawn,New York 11740 CONTACT PERSON: Name: John Rieger Mailing Address: 65 Arbutus Road,Greenlawn,NY 11740 Phone#: 917-865-3384 Email: johnrieger@msn.com DESIGN PROFESSIONAL INFORMATION: Name: Frederick R Weber,Architect Mailing Address: 41 East Maple Rd.,Greenlawn,NY 11740 Phone#: 631-754-5555 Email: fweberarchitect@yahoo.com CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition LN]Alteration ❑Repair ❑Demolition Estimated Cost of Project: [N Other: Legalize removal of wall to expand living space into enclosed porch 3,500.00 Will the lot be re-graded? Dyes ONO Will excess fill be removed from premises? Dyes NNo 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 this property? Dyes ®No IF YES, PROVIDE A COPY. 99 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 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): John T Rieger l3Authorized Agent ❑Owner Signature of Applicant: Date: May I ,2023 STATE OF NEW YORK S COUNTY OF Suffolk John T.Rieger being duly sworn,deposes and says that(s)he is the applicant (Name of individual signing contract)above named, (S)he is the Agent(Husband) (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 May day of y 20 23 X1/1 Notary Public ANGELA FULGIERI rk PROP ,111 OWNER J J'I I III IO NOTAR M11"Safr counC:State of New ty (Where the applicant is not the owner) Tem ZqA ""` I'° „:02 s I, Ellen W.Rieger residing at 65 Arbutus Road,Greenlawn,NY 11740 do hereby authorize John T.Rieger,my husband, to apply on my behalf to the Town of Southold Building Department for approval as described herein. Owner's Signature Date Ellen W.Rieger Print Owner's Name 2