HomeMy WebLinkAbout50090-Z =ry TOWN OF SOUTHOLD
° BUILDING DEPARTMENT
a
r' 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 #: 50090 Date: 12/6/2023wwwww„_ ITmm
Permission is hereby granted to:
McDonald, Kenneth
280 Shipy q.,Ln
East Marion,. NY 11939
To: Construct an accessory shed (14 x 22) to an existing single-family dwelling as applied
for.
At premises located at:
280 Shipyard Ln, East Marion
SCTM #473889m
Sec/Block/Lot# 35.-8-5.6
Pursuant to application dated 5/23/2023 and approved by the Building Inspector.
To expire on 6/6/2025.www--
Fees:
ACCESSORY $279.00
CO-ACCESSORY BUILDING $100.00
Total: ........... ............. $379.00
Building Inspector
° TOWN OF SQUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 ain Road P. O. fox 1179 Southold,NY 11.971-0959
Telephone (631) 765-1802 . Fax(631) 765-9502 ht!ps://www.southold.towniiy-.gov
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
k
5`DO_� 2
MAY Building Ins'pectoi c W 4,
PERMIT N0. °"
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an '
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: SCTM#1000-
Project Address: ya— Y), N
Phone#: Email:
Mailing Address:
CONTACT PERSON:
Nam �na_ CIS", SVIe8 CA .
e:
Mailing Address: Ilb
Phone#: Email: Y1r�q� • CO►'�
DESIGN PROFESSIONAL INFORMATION:
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name: S
Mailing Address:
Phone#: 1 W 5- ""�' Email: NJ co al
DESCRIPTION OF PROPOSED CONSTRUCTION
a� ���
ew Stru Lure ❑Addition ❑Alteration ❑Rep air ❑Demolition Estimated Cost of Project:
❑Other S X
Will the lot be re-graded? ❑Yes�!o Will excess fill be removed from premises? ❑Yes'ONO
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:51
�j
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes LZVo 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 Cass A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print name): " aY\.A $Authorized Agent ❑Owner
y
Signature of Applicant: Date: 5
STATE OF NEW YORK)
SS:
COUNTY OF
V"V(& being duly sworn, deposes and says that(s)he is the applicant
(Name of incilvidual signing contract) above named,
(S)he is the OvTkaC6
(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
`
20 3
da of �—
Notary Vubict
CarolH. �....M..
ydell
NOTARY PUBLIC,STATE OF NEW YORK
PROPERTY OWNER AUTHORIZATION Registration No.01HY6189695
Where thea applicant is not the owner
Qualified in Suffolk county
pp ) Commission Expires 06f30i20
P-0ll t a residing at EMe,(('
Ndo hereby authorize Mto apply on
my behalf to the Town of Southold Building Department for approval as described herein.
wner's Signature Date
Wne mrj )wa 1A
Print Owner's Name
2
I
Young etc Young, Land Surveyors oil
• 400 Oetrcmaor Avanue RivorhaatL Nrw York i 1901
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NOTES:
` 1. SUDOt7nsaj MAP FILED IN THE OFFICE OF THE CLERK OF f
I SUFFOLK COUNTY ON NOV,22.1993,AS FILE N0.9426. 24
la
2 ELEVATIONS SHOWN HMSd ARE FROM TOPOGRAPHICAL MAPS _�8
PREPARED
BY US RUTMIZED 740 MEAN SEA SUBLEVEL DATUM
,ECT TO FIELD VERIFICATION
AND ARE
'3 3.0 STAKE SET
\ �# F SUFFOLK COUNTY DEPARTMENT OF HEALTH S_RViCES CERTIFICAT10t4
l AV FA V NT1 TMC STMMPDS FOR ACPHOVAL AIN
Q OVs1RUe UCTIOV OF 41RWRFACL'C
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SURVEY FOR: Ila
GUSMAR REALTY
Py t C�4
LOT NO. 2 "SUMMIT ESTATES, SECTION 1"
q
, �.� At: EAST MARION Town oF. SOUTHOLD °
Suffolk County, New York
� \ r
V - Suff. Co, Tax Mop: , 7000 35 B 56it
e \ b
DATE ;MAR, 7, 1997
SCALE =1'= 40'
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DWG.NAME:
PLANS
DWG.NO.:
A-2
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