HomeMy WebLinkAbout49608-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#: 49608Date: 8/22/2023
Permission is hereby granted to:
Smith, Alistair
........ .. ....... ..__.._. .... _ ... _ __....
........
1 Hudson St FI 6
New York_NYmm 10013 __._._ ... ...v_ mm_.-----_._._
To: Construct a 24 x 24 accessory garage to an existing single-family dwelling as applied
for.
At premises located at:
.Oceanview Ave, Fishers Island
SCTM # 473889
Sec/Block/Lot# 9.-6-8.3
Pursuant to application dated 7.../12/2023 and approved by the Building Inspector.
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To expire on 2/20/2025.
Fees:
ACCESSORY $330.40
CO-ACCESSORY BUILDING $50.00
Total: $380.40
49.b
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 httD,s://www.southoldtowiiny.go_v_
Date Received
PERMITAPPLICATION FOR BUILDING
For Office Use Only r
PERMIT N0. 4 q(VBuilding inspector; JUL 12 2023
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an BUILDNG DEPT.
Owner's Authorization form(Page 2)shall be completed. TOV-N
Date:15 June 2023
OWNER(S)OF PROPERTY.
Name:Alistair Smith SCTM # 1000-9. __ 6 -- 8.3
Project Address:537 Halcyon Avenue, Fishers Island NY 06390
Phone#:631-788-7593
Email: '��� ..�1,'� � ; � • ., ��`� ,��ti; �;' .
Mailing Address: 1 Hudson St. FI., 6 New York, ,
CONTACT PERSON: '
Name:Sam Fitzgerald
Mailing Address:15 E. Putnam Avenue, #234, Greenwich, CT 06830
Phone#:860-287-3808 Email:sam@sfapc.net
.,DES1GN'Pk4FESSIONAL INFORMATION:
Name:Sam Fitzgerald Architect, PC
Mailing Address:15 E. Putnam Avenue, #234, Greenwich, CT 06830
Phone#:860_287_3808 Email:sam@sfapc.net
CONTRACTOR INFORMATION:
Name:C/o Owner
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
@New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? Dyes @No Will excess fill be removed from premises? WYes []No
1
PROPERTY INFORMATION
Existing use of property:Single Family Residential Intended use of property:Single Family Residential
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
sproperty? ❑Yes WNo IF YES PROVIDE A COPY.
R-8� this � I
R 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 r.own.Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ord inance,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 inbuilding(s)for necessary inspections.False statements made herein are
punishable as"a Class A misdemeanor pursuant to Section 230.45 of the New York State Penal Law.
Application Submitted By(print name):Samuel W. er
Fitz ald g
g Authorized Agent ❑Owner
Signature of Applicant: Date:
STATE OF NEW YORK)
COUNTYOF Itillolk )
�• being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the A4gq
(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.
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Sworn before me this
w
day of u 20 93 .�a
-JP.•]tiaN IIc � � 4- V
Qualified in SutfolK,County
d fCl3f'y Pubiic-Si0',p of l•e�`.`i l�vY?s ��• �' QA �;
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.a ( n1 U6 3 1 45 4
J
PROPRTY OWNER AUTHOR
(Where theapplicantis not the owner) +4
1, 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