HomeMy WebLinkAbout50045-Z �o�soffot,��Gy TOWN OF SOUTHOLD
BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
o • 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#: 50045 Date: 11/20/2023
Permission is hereby granted to:
Williams, John
235 Cemetery Rd
East Marion, NY 11939
To: demolish (2) existing accessory buildings as applied for.
At premises located at:
235 Cemetery Rd, East Marion
SCTM # 473889
Sec/Block/Lot# 31.-10-6
Pursuant to application dated 11/3/2023 and approved by the Building Inspector.
To expire on 5/21/2025.
Fees:
DEMOLITION $337.00
Total: $337.00
Building Inspector
=�O�gUFFO(,pdoG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
�y�o• ��o� Telephone (631) 765-1802 Fax (631) 765-9502 hgps://www.southoldtownny.gov
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Date Received
APPLICATION FOR BUILDING PERMIT y
6 I'M Office Use Only
PERMIT NO. Building Inspector: '_3 NOV 3 2023
-Applications and forms must be filled outin their entirety.Incomplete
applications will not be accepted. Where the Applicant is not the owner,an `F
Owner's Authorization-form(Page 2).shall be completed.
Date: _ -
OWNER(S)OF PROPERTY:
Name: SCTM#1000-
---- - -2 A-nl_otoi- -- hl ----- -- --------- -----...-- ------------ -------
Project Address:._._
Phone#: Email:
Mailing Address:
CONTACT'PERSON:
Name:
Mailing Address:
_.. ._. _. .
Phone#: Email:
- ---- -3-
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address: -
Phone#: Email:
:.CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION'OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Allterattioon ❑Repair ❑Demolition Estimated Cost of Project:
❑Other pedD —no 41-edyfc j 1d S r $
Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes ONO
1
i y
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? Dyes ENO 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 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(pr*nt nam ): S Td ❑Authorized Agent Downer
Signature of Applicant: Date:.----
// 3
CONNIE D.BUNCH
STATE OF NEW YORK) Notary Public,State of New York
No.01BU6185050
SS: Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,2
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 �0VY1 20
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where 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
25 SURVEY OF PROPERTY
A T EAST MARION
E°P SMF TOWN OF SO UTHOLD
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OUNTY, N. Y
-10-06io, 1000-31
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AS REQUIRED AND CONDITIONS OF
�,cPo Fly 3 -` '� `rBY: SOUTHO OWN ZBA
® 35 p oRO�I ° ,a 510 NOTIFY BUILDING DEPARTM �
l0 �P '6 ,�p 0� 631-765-1802 8AM TO 4PM FOR THE SOUTHO TOWN PLANNING BOARD
of ��E1° 60�'� ��,� FOLLOWING INSPECTIONS: SO LD TOWN TRUSTEES
0 S �P ���Gl 1. FOUNDATION-TING RF ._. N.Y. ,DEC
O FE F �, FOR POURED CONCRF
KEY ®,� '00+ 5E1 ���' �ol QD 2. ROUGH-FRAMING&PL--. S OLD HPC
OpR Edo 3. INSULATION HD
RE FE 0' 4. FINAL-CONSTRUCTION MUST
O — LR �� BE COMPLETE FOR C.O. -!=5— ,Yr4,,;
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p0 ALL CONSTRUCTION SHALL MEET THE
= STAKE
REQUIREMENTS OF THE CODES OF NEW t:
YORK STATE. NOT RESPONSIBLE FOR
= TEST HOLE DESIGN OR CONSTRUCTON ERRORS ,
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■ = MONUMENT P�E CER TIFIED TO:
UTILITY POLE Brandon Joseph Stout and Samantha Jozic—Stout
Fidelity National Title Insurance Company N. S. LIC. NO. 051132-01
The location of wells and cesspools shown hereon are y p y r N.Y.S. LIC. NO. 49616
from field observations and or from data obtained from others. PECONIC V&YORS, P.C.
ANY ALTERA77ON OR ADDI77ON TO THIS SURVEY IS A WOLA77ON (631) 765-5020 FAX (631) 765-1797
OF SECTION 7209 OF 7HE NEW YORK STATE EDUCA77ON LAW, peconicsurveygop timum.net
EXCEPT AS PER SEC77ON 7209—SUBDIVISION 2. ALL CER77F7CA770NS P.O. BOX 909
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONLY IF 1230 TRAVELER STREET
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR AREA = 22,000 SQ FT SOUTHOLD, MY 11971 23-006
WHOSE SIGNATURE APPEARS HEREON.