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Home My WebLink About50175-Z TOWN OF SOUTHOLD BUILDING DEPARTMENT 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#: 50175 Date: 1/3/2024 Permission is hereby granted to, Procida, Nicole 21 3rd St Brooklyn, NY 11231 To: legalize as-built AC as applied for. At premises located at: 2550 HaMaters Rd, Cutcho ue SCTM #473889 Sec/Block/Lot# 111.-6-19 Pursuant to application dated 12/1/2023 and approved by the Building Inspector, To expire on 7/4/2025. Fees: AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $500.00 CERTIFICATE OF OCCUPANCY $100.00 Total: $600.00 Building Inspector TOWN OF SOUTHOLD —BUILDING DEPARTMENT Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959 Telephone (631) 765-1802 Fax (631) 765-9502 hltp .Wwww suitholdtowtiny. oN Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only D E C E 1J E PERMIT NO. �� Building Inspector-pAI Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the owner,an €17!c-T;i Imo? g ar tme,n Owners Authorization form(Page 2)shall be completed. Town oeovrlklhoM Date: 11/20/2023 OWNER(S) OF PROPERTY: Name:Stephanie Durand and Nicole M. Proc SCTM # 1000- Project Address:2550 HaywaterS Road Phone#:(617) 470-4145ocida@gmail.com Mailing Address:21 3rd Street, Brooklyn NY 11231 CONTACT PERSON: Name: Nicol M. Procida Mailing Address:21 3rd Street, Brooklyn NY 11231 Phone#:6174704145 Email:nprocida@gmall.com DESIGN PROFESSIONAL INFORMATION: Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATIONS Name:n/a Mailing Address: Phone#: Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project: lal Other Permitting previously installed air conditioner $ Will the lot be re-graded? ❑Yes El No Will excess fill be removed from premises? ❑Yes ❑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 and restrictions with respect to this property? ❑Yes ONO 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 bullding(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 ame): Ali,d c , // ❑Authorized Agent ner A Signature of Applicant: �� ✓�w,� Date: / Z/ Zd Z STATE OF NEW YORK) SS: COUNTY OF /K—) C 00c' C' being duly sworn, deposes and says that (s)he is the applicant (Name of individual s fining 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 20 Notary Public Jenice Hernandez @rotr r: Public State Of New York No,01 P6 `i 54 PROPERTY OWNER AUTHORIZATION 'Q,;�91 i�c`�, �l�i��r�d�, ri i.�pl:'es Wnd 025 (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 PROPERTY INFORMATION Existing use of property:residential Intended use of property:residential Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes 19No 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. APPUCATION 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( it me): NicoleProcida ❑Authorized Agent ROwner Signature of Applicant: µCQ 6 &�` Date: IZ G STATE OF NEW YORK) SS: COUNTY OF10, � C I I)CKC jo being duly sworn, deposes and says that(s)he is the applicant (Name of individual igning contract) above named, xc(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 y day of ,ZC -2- Y�- Notary Public Jenice Hernandez Notary Public State Of New York PROPERTY OWNER ALIS- /RIZAITION No.01HE6359254 Qualified in Bronx,Cert.Kings,NY Counties (Where the applicant is not the owner) Commission Expires May 22nd 2025 The UPS Store @ 82 Nassau 2.12.406.9010 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