HomeMy WebLinkAbout50331-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
id TOWN CLERKS 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#: 50331 Date: 2/12/2024
Permission is hereby granted to:
Magenta Cap M mnt LLC
520 E 86th St
New York, NY 10028
To: install generator as applied for per Planning approval.
At premises located at:
13945 Ore on Rd, Cutcho ue
SCTM # 473889
Sec/Block/Lot# 83.-2-9.3
Pursuant to application dated 1/26/2024 and approved by the Building Inspector.
To expire on 8/13/2025.
Fees:
ACCESSORY $125.00
ELECTRIC $100.00
CERTIFICATE OF OCCUPANCY $100.00
Total: $325.00
B ` 'ing Inspector
NNx E
' TOWN OF SOUTHOLD—BUILDING DEPARTMENT
a
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 lI : �ww . otiflaold�o �� •��o
Date Received
APPLICATION FOR BUILDING PERMIT
�
� '
� For Office Use Only �-� �+ i,�
PERMIT NO. Building Inspector.
.02
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: I Z r Z L3
OWNER(S)OF PROPERTY:
Name: r'�a ( M -f- LL.L SCTM#1000- 9 3LAJe
Project Address: / �Lt-7�1 O I't'e
Phone#: Email:.
Mailing Address: .5-c2-0 g6t4l 57- I QD02
CONTACT PERSON:
Name: kA-A )eevtJ"
Mailing Address: .5-R2p E 86 S 9'� Y,
Phone#: - � cje ro
q/ 30 ! $oy3 Email: Ka- ccs S (�? me- . cot"
DESIGN PROFESSIONAL INFORMATION:
Name: /i ro STi'kJ i� 5w'k o20
Mailing Address:
175 / o QK 1d
1
Phone#: 96 p /6 Email: i�'�Z7 � i ro
CONTRACTOR INFORMATIOON:
Name: --n L wak- ,-MCC 1-I "` :. 3'7�
Mailing Address:
Phone#: S/6 Sol -2 . E Email: 9 dt • CQ
DESCRIPTION OF PROPOSED CONSTRUCTION
evw+Structure ❑Additio ElAlteration ❑V Re,p air ❑Demolition Estimated Cost of Project:
QOther Wco► $ JJf10 �av
Will the lot be re-graded? ❑Yes 040 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 No IF YES, PROVIDE A COPY,
('
.,°,)tel*Box Aft,CI"Readhlg. 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(print nam �?
: o<< /1�,,����y-� �� /Z�� uthori/zed Agent ❑Owner
Signature of Applicant: „ / Date: 1125712-
STATE OF NEW YORK)
SS:
COUNTY OF
� "" A,4444 being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) Aove named,
(S)he is the
(Con actor,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
�o day of
��
Notary Publi
ROrf,=RT A MAZZAFERRO
NOTARY PUBLIC-STATE OF NEW YORK '
NO.01 MA6207376
UALIFIED IN SUFFLK CUNTYz,
GROPE I i Y IN IJ R ���I� T "H�� M��� �'1 ��� COMMISSIONEXPIRES®UNE OS„ 20
(Where the applicant is not the owner)
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