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Home My WebLink About50564-Z era 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 PLAINS AND SPECIFICATIONS UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Permit #: 50564 Date: 4/18/2024 Permission is hereby granted to: lannone, Patricia 225 Wood Ln Green ort, NY 11944 To: install new window and door replacements to existing single-family dwelling as applied for. At premises located at: 225 Wood Ln, Green port SCTM # 473889 Sec/Block/Lot# 43.-4-25.2 Pursuant to application dated 3/12/2024 and approved by the Building Inspector. To expire on 10/18/2025. Fees: SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00 CO-ALTERATION TO DWELLING $100.00 Total: $350.00 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 htt s://www.southoldto ov Date Received APPLICATION FOR BUILDING PERMIT �j For Office Use Only I Af'"z PERMIT NO. �µ Building Inspector: A/" _ 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: 2 OWNER(S)OF PROPERTY: Name; r l° SCTM#100Q_ � - - Project Address: Phone#: 70 7 003 Email: C�J'Ca ✓ J0 v16(Pd,0f7;0J0 ,.*J P1 Mailing Address: 3/ �v e' '. V ,,e + I / 1235 I CONTACT PERSON: I Name: �1Oa Mailing Address: Phone#: ® Email: 1 k10 CAI ; U DESIGN PROFESSIONAL INFORMATION: moo l/Ca hke Name: Mailing Address: Phone#: Email: CONTRACTOR INFORMATION: Name: Mailing Address: Ve Phone#: 63f —156 g Email: DESCRIPTION OF PROPOSED CONSTRUCTION ❑New Structure ❑Other ❑Addition ❑Alteration "Repair Demolition Estimated Cost of,Project: P ' j , Will the lot be re-graded? ❑Yes RNo Will excess fill be removed from premises? ❑Yes GiNo 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 "re eo this property? Dyes Pr No IF YES, PROVIDE A COPY. sr 1XCheck 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 l Y rint name): " ACOY i \J 61>/7U lah U []Authorized Agent Ekwner Signature of Applicant: Date: l j CO►NNIE D.BUNCH Notary Public,State of New York STATE OF NEW YORK) No.01BU6185050 SS: Qualified in Suffolk County COUNTY OF ) Cor MISSIon Expires April 14,2�� 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 day of 20,;l fv`O I Notary Public PROPERTY Elf ,, I . I ION (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 i/g% / it b r Uffolk C i , , ✓ /� i Ounty"r In9f Cons, i I............. Umer Aff ENT e i i [G.,U E L A P, ,/,,A,LENC, Dyli� 1 lim Horne, Impro,vsIlx,., �d Number H , 0 (12,l (V3 , r ll i ' i� �� INSURANCE BINDER DATE INSURANCE 119MIDO/Y 4 15/202 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT SUBJECT TO THE CONDITION'S SHOWN ON PAGE 2 OF THIS FORM. AGENCY COMPANY BINDER A Lloyds of London B2421S13914 MrMann Price Agency, Inc. 628 Front Street R&rE EFFECTAfE TIME EXPIRATION EME Greenport NY 11944-0876 2/1.8 2024 1 12:01FAX PM 4 19/2024 NOON O N 6' ".I,. 4`77.- ,680. •(631 497-8930 THIS ROMER IS KSIJED TO EXTEND COVERAGE.IN THE ABOVE NAMED COMPANY CODE: 85408 SUB CODE: PER ExPmm POLICY S,QuOTZ N 2 11 4 11 1213 CU &D• 0000*1...648 DESCRIPTION OF OPERATIONS I VEHICLES I PROPERTY Uncleeing Lotamn) INSURED ANDMACUNG ATlOF933 LOCII 0001 Patricia Lannon 225 Wood Lane Greenport, NY 11944 31 Sweet Meadow Ct Cutchogue NY 11935 COVET I7ES LIMITS TYPE OF MURANCE COVERAGE I FORMS DEDUCTIBLE COINS% AMOUNT PROPERTY CAUSES OF LASS Dwelling with 100$ Replacement Cost 2,500 327,600 BASIC 0 BROAD SPEC Other structures 32,760 GENERAL LIABILITY.... EACH OCCURRENCE. 3 $00 000 OomMERCL0.L GENERAL LiABq'UTY S CLAIMS MADE D',,OCCU'R.. MED EXP ft one V. S 5000 Liability PERSONAL&ADVINJURY S GENERAL AGGREGATE $ RETRO DATE FOR CLAIMS MADE: PRODUCTS-COMPIOP AGG $ VEHICLE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO BODILY INJURV,IP S ALLONMEDAUTOS BODILY INJURY(Per madeLQ S ..SCHEDULED AUTOS PROPERTY DAMAGE S HIRED AUTOS MEDICAL PAYMENTS S NONAWNEDALROS PERSONAL INJURY PROT S UNINSURED MOTORIST S S VEHICLE PHYSICAL DAMAGE DED ALL VEHICLES SCHEDULED VEHICLES ACTUAL CASH VALUE COLLISION: STATED AMOUNT S OTHER THAN 001- GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S. ANY AUTO OTHER.THAN AUTO ONLY; ••„ EACH ACCIDENT S AGGREGATE S EXCESS LIABMY EACH OCCURRENCE. $ UMBRELLA FORM AGGREGATE S OTHER THAN UMSRELI.A.FORM REMO DATE FOR CLAIMS MADE SELFJNSURED RETENTION S PER STATUTE WORKERS COMPENSATION .^••T,M ,,, E.L EACH ACCIDENT S AND ..-......�.......... . - EMPLOYEWS LIABILITY E.L DISEASE-EA EMPLOYEE S E.L DISEASE-POLICY LIMIT S SPECIAL Hurricane Dad: 5.00% ($6552) FEES $ Znc1 CONDMONS I Full Policy Term 02/18/2024 to 02/18/2025 TAXES S Iacl OTHER COVERAGES 4014.36 ESTIMATED TOTAL PREMIUM S GAME&ADDRESS R ..MORTGAGEE ADDITIONALINSURED NewRez LLC LOSS PAYEE ISAOA / ATII4A LOANT 0686943143 PO Box 7050 AT ZR9PRES&NTATWZ,,� Troy, MI 48007 Page•I of 2 01993-2013 ACORD CORPORATION. All Tights reserved. ACORD 75(2013109) The ACORD name and logo are registered marks of ACORD INS075(2DI3os)