HomeMy WebLinkAbout49667-Z �o`p'Offal/
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
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#: 49667 Date: 911112023
Permission is hereby granted to:
Smyth, John
29330 Main Rd
PO BOX 909
Cutchogue, NY 11935
To: demolish accessory carport and arbor as applied for.
At premises located at:
29330 Route 25 Cutchogue
SCTM #473889
Sec/Block/Lot# 102.-6-23.1
Pursuant to application dated 8/8/2023 and approved by the Building Inspector.
To expire on 3/12/2025.
Fees:
DEMOLITION $181.90
Total: $181.90
Building Inspector .
�O�gOFFO(,�coGy2 TOWN OF SOUTHOLD—BUILDING DEPARTMENT
ti x 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 https://www.southoldtownny.gov
f
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector: 1ZL R AUG 8 2023
Applications and forms must be filled out in their entirety.Incomplete Building Department
applications will not be accepted. Where the Applicant is not the owner,an Town of Southold
Owner's Authorization form(Page 2)shall be completed.
Date:
OWNER(S)OF PROPERTY:
Name: ' SCTM#1000-
Project Address: /
Phone#: f _ — Email:
_ 3-6----3__ . .v_ _s--_.---- ___..----. _ -C'u .. -.®.V1,14.1, 41644 ,n . ca
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Mailing Address:
CONTACT PERSON:
Name: —
Mailing Address:-f-a-&
Phone#: b _ _ — Email: -
-----------.5..1 3 � -Q-. -..5.- - - _._ _._. 14
DESIGN PROFESSIONAL INFORMATION: .
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR INFORMATION:
Name:
Mailing Address:10fe
Phone#: _ Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alterati n ❑Repair C�molition Estimated Cost of Project:
[--]other 0 F �g �D $ /. 00- L7 J
Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes El No
1
PROPERTY INFORMATION
Existing use of property: Intended use of property:
Zone or use district in which premises is situated: Are there any covenants anj*restrictions with respect to
this property? ❑Yes E� o 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(prin name): ' ,,, ��..�_ ❑Authorized Agent ❑Owner
Signature of Applicant: _ Date:
STATE OF NEW YORK)
SSS:
COUNTY OF U l L )
J0 k Yl S-MN 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
S day of qUS,A— , 203
&0 CLILLI NNA R KI
NO ry Nota Public State ofw Ycrx
NO.01K16424267:
Qualified in Suffolk nty
My Commission Expires O :. 2;255
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
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MAIN ROAD ( S.R. 25 )
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APPR ED AS NOTEDON
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FEE Br
111OTIFY 8 I NG DEPARTMENT AT
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631765-1802 8AM TO 4PM FOR THE "' 313 L.
FOLLOWING INSPECTIONS: �w o
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1. FOUNT116T1 ;& ( t,IldddD COMPLY WITH ALL CODES OFo
FOR POURED CONCRETE 4 NEW YORK STATE & TOWN CODES 9 $
2. ROUGH-FRAMING&PLUI4BING s
3. INSULATION AS REQUIRED AND CONDITIONS OF
4. FINAL-CONSTRUCTION MUST- r YON WE
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BE-COMPLETE FOR C.O.
ALL CONSTRUCTION SHALL MEE S BOARD'
^�e S 2944'00" W 222.613' Y°N
D�/5L1D LAND N/F OF COUNTY OF SUFFOLK
REQUIREMENTS OF THE CODES 0 W VR�i
YORK STATE. NOT RESPONSIBLE OR
DESIGN OR CONSTRUCTON ERRO a
NON S 29"44'00" W 200.15' YON co
LAND N/F OF COUNTY OF SUFFOLK