HomeMy WebLinkAbout50051-Z SUFFoI,� TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
CA
oy • o�� SOUTHOLD, NY
diol� �a
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#: 50051 Date: 11/20/2023
Permission is hereby granted to:
McCloskey, Thomas
PO BOX 223
New Suffolk, NY 11956
To: Install deer fence at existing single family dwelling as applied for.
At premises located at:
15305 New Suffolk Ave, New Suffolk
SCTM # 473889
Sec/Block/Lot# 117.-6-15
Pursuant to application dated 10/31/2023 and approved by the Building Inspector.
To expire on 11/19/2024.
Fees:
DEER FENCE $100.00
Total: $100.00
Building Inspector
%%f Nth,oG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
oy�o ao� Telephone (631) 765-1802 Fax (631) 765-9502 https://www.southoldtowmy.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. DJ� Building Inspector: _J '
OCT 3 1 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 7.,C or 6 DF-t
,Owner's Authorization form(Page 2)shall be completed. R:'!";,.";'a ;: w'
Date: /-0/31 3
OWNER(S)OF PROPERTY:
Name: 1000- ) )
--
Project Address:
Phone#: b 5 Email: a r Flo e,t`4 C o 0;171 Oe--V1ea`
Mailing Address: kZ5 Coy Cly
CONTACT PERSON: -
Nam e:
ERSON: ..Name:
- - ----- Lt.rv�'z-- Gt S-- -
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL INFORMATION: _
Name:
Mailing Address: Cq�UL� 3��;L b In adlc Co o<<9----
Phone#: <i Email:
CONTRACTOR INFORMATION:,
Name: Y
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? ❑Ye 'KNO Will excess fill be removed from premises? ❑Yes J 'ho
PROPERTY INFORMATION
Existing use of property: Intended use of property:
-----------
Zone or use district in which premises is situated: Are there any covenaWntsao d restrictions with respect to
--
---- ----
this property? E]Yes 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,Coqniy,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-AS of the New York State Penal Law.
Application Submitted By(print name): 0411, M6LCCt,�al) ElAuthorized Agent 196wner
Signature of Applicant: Date: /V/?1/13
STATE OF NEW YORK)
SS:
COUNTY OF,51A I K
C-1 «i � M a rc K� "n being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 0 Wy-rt 9,
(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
SJ day of pr+()�e 202-3
Notary Public
TRACEY L. DWYER
PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC,STATE OF NEWYORK
NO.01 DW6306960
(Where the applicant is not the owner) QQALIFIED IN SUFFOLK COUNTY
COMWSSION EXPIRES JUNE 30,ZI-6
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
5UR VEY OF Pf;ZOPERTY N
SITUATE: NEW SUFFOLK
TOWN: SOUTHOLD W E
SUFFOLK COUNTY, NY
SURVEYED 05 - II - 2011 S
SUFFOLK COUNTY TAX #
1000 - 117 - 6 - 15
LOT
MAP OF "KOUROS ACRES" /
CERTIFIED TO: i FILED JUNE 20, IG-78 FILE #6682
THOMAS MCC LOS L EY I
MIIC1H[EII LE MccCLOSK EY
CONTINENTAL HOME LOANS
FIRST AMIERIICAN TTII'1L.lE INSURANCE ® Sv/°51'W� � 181.16'
COMPANY OF NEW YORK(TITIZ NO.3001-352QB) � � /
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NOTES:
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MONUMENT FOUND ��t� — '- ;l and do Ne tMMli b the IQb<eepnq
\ AND /.� toi agercy m.a brotg wtrtkm ieend fe.em.man
to tb®etjbea d tM larieng WlRuttpi. ferlli�d-
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AREA = 20,122 5.F. or 0.46 AGRE5
FLOOD ZONE X JOHN C. EHLERS LAND SURVEYOR
GRAPH I G SCALE I"= 30' 6 EAST MAIN STREET N.Y.S.LIC.NO.50202
RIVERHEAD,N.Y. 11901 369-8288 Fax 369-8287
REF.-C:\UsersUohn\Dropbox\04\04\04-310 updated 05-11-201 Lpro