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HomeMy WebLinkAbout49778-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT G TOWN CLERK'S OFFICE SOUTHOLD, NY "s,60h 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 #: 49778 Date: 9/26/2023 Permission is hereby granted to: Robertson, Bonnie 55 Dickerson St PO BOX 188 Peconic, NY 11958 To: legalize "as built" screened porch to existing dwelling as applied for. Additional certification may be required. At premises located at: 55 Dickerson St Peconic SCTM #473889 Sec/Block/Lot# 67.-3-10.1 Pursuant to application dated 9/1/2023 and approved by the Building Inspector, To expire on 3/27/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $641.60 CO-ADDITION TO DWELLING $50.00 Total: $691.60 g Building Inspector TOWN OF S TJTHOLD—BUILDING DEPARTMENT Al Town Hall Annex 54375 1N4ain Road P. O. Box 1179 Southold, NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 htt :llvwwOlatl 101dt 4191 '. O—V rr;„,cxa k APPLICATION FOR BUIL-DING PERMIT Date Received 1 3 cW7[2 f' ',,� ' or Office Use Only T7� V PERMIT NO, Building Insp ctor: Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted rr Where the Applicant isnot the owner,an Bl ,D� dwner's Authorization form(Paid 2)shall'be cor�npleted. Date:. OWNER(S)OF PROPERTY: Name: ALi 0I SCTM# 1000- 6-1 Project Address: "5 C, , 54195t . Phone#: 5 ( 8 mail R Chu S 18 9 n.c j , Ca m Mailing Address: O 1 8 8 ��LOf11C. iY l 1`1 ri 8 CONTACT PERSON: Name: 5�rnl:� cLS Ci�dcltii Mailing Address: Phone#: Email: DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: 5 S 5 `60 „G� �,� �oJt,o(A K)LfI I R'1 I Phone#: 6`� ( .`"►6 - 6' 63� --t�,5.c � t Email: CONTRACTOR INFORMATION: Name: Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION [--]New Structure Addition ❑Alterati Other 1 on ❑Repair ❑Demolition Estimated Cost of Project: Will the lot be re-graded? ❑Yes LINO Will excess fill be removed from premises? ❑Yes P�No 1 PROPERTY INFORMATION Intended use of property: �i�Z��t Existing use of property: �����, district in which premises Is situate Are there any covenants and restrictions with respect to - situated: Zone or used this property? ❑Yes il_bNo IF YES, PROVIDE A COPY, Department for the issuance of a Building Permit pursuant to the Building Zone Check Box After Reading:.. Theowner/wntractor/design professional is responsible for all drainage and storm water issues as provided by laws,Ordinances or Regulations,for the construction of buildings, Chapter 236 of the Town Code.,APPUCATION h HEREBY MADE to the Buildingapplicable laws,ordinances,building code, Ordinance of the Town of Southold,Suffolk,County,Newyork and other applicable agrees to comply with all app' additions,alterations or for removal or demolition as herein described.The applicant housing code and regulations and to admit authorized on 210.45 of the New York State Pinspectors on premises and in enal La necessary inspections.False statements made herein are punishable as a Class A misdemeanor pursuant to Sect "Authorized Agent ❑Owner Application Submitted By(print name): A T)oe Date: Signature of Applicant: OnWa, , CONNIE D. BUNCH Notary Public,State of New York STATE OF NEW YORK) No.01 BU6185050 Qualified in Suffolk County COUNTY OF SS: Commission Expires April 14,2_C�DV 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.) and ake of said owner or owners, and is duly authorized to perform or have performed the said work knowledge m and and file and this application;that all statements contained in this application are tri cation fie to the le thereest of with.. that the work will be performed in the manner set forth in the app Sworn before me this day of. µ .,, (/J .�`®.. , 20Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) residing at Ir to apply on do hereby authorize my behalf to the Town of Southold Building Department for approval as described herein. Date Owner's Signature Print Owner's Name 2 - URV EY OF LOTS & 1 62 "MAF NO. 2 OF FEGON I G SHORES" FILED SEPTEMBER 15, Ig30, FILE No. 654 51 TUATE: FEGON I G TONIN: 5OUTMOLD 5UFFOLK GOUNTY, NY SURVEYED 06-01-2005 UPDATE 0-7-I5-2010 REV I SED 11-18-2010, 2-18-2013 SUFFOLK COUNTY TAX # 1000-6-7-3-10 ]Bonnie Jen RoberLson Lwd America Commonwealth B�I?°t4 dam# • � _ f6[7�3137'3�fit` �T.A3F1� 00 to �� �• AD ° - - -� c _- - - - - `r fi c' I 1 I OI ° r r I -�r• - APPROVAL OF STORMWATER MANAGEMENT CONTRO PtA -T Code C I Date. Approved WETL4ND5 I Fr 5hwater kaetland!5 da delineated ! R. Fox on 2/2010'7, shopm on las � John Ehl r , L-5., dated 1211 110'1, and verified o the ( r Mated frestivvat r �� v4 tjond5 ovndo R Mor i, D. l� i O a N Y4r 54 le etc— [ orad K. Jennings, /vo 1 Lh F ak at 4- e[�-�gN B...� 664 ta�€a443ati� .�3 NOTES: °Cerllika8 YmliceeRn4 ae'4on aigei4y Ihul Sha Irl ILJ MONUMENT FOUND Lf uaf m#x t a�iNb � il AREA = 10,338 S.F. or 0.24 ACRE [ JO O. � RS LAND SURVEYOR GRAPH I G 5CALE 1"= 30' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202 -- RWERBRAD,N.Y.11901 369-8288 Fax 369-8287 REP:C-\UsersUohn\Dropbox105105105-211.pro i;XT t?IDtZ FACE OF FOUN DAT ION WALL OF HOUSE t II CALLED �� q t it+ r n i ,� n ,t ,rt It , It t II n n J�.� NO�'Tj{ 4'-72 5. 2 . 4 -7 �I' -5 2 2 q- I� y -5 ±Ea 7 Z4 --� ——F t••--1 t.1 r— � I I f (- GNAW L f ✓HAGS - (UNEyVAftD� :} CUNHl;ATED� I i I I I— - , " I ,, — — -- Nei �. ALL• GvNbITUNS 5Ff0WW A� I�XISTINC� AWV ARE • _--t !_ J �..- -� L � �..° ..1 . 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