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HomeMy WebLinkAbout50574-Z TOWN OF SOUTHOLD jy, q�� 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 #: 50574 Date: 4/22/2024 Permission is hereby granted to: HNF Resorts LI LLC 690 Queen St PO BOX 89 Green port, NY 11944 To: construct 23.2' x 50.7' accessory barn/garage as applied for. At premises located at: 64380 CR 48, Green port, SCTM # 473889 Sec/Block/Lot# 40.-3-4 Pursuant to application dated 3/12/2024 and approved by the Building Inspector. To expire on 10/22/2025. Fees: ACCESSORY $705.50 CO-ACCESSORY BUILDING $100.00 Total: $805.50 Building Inspector TOWN OF SOUTHOLD—BUILDING DEPARTMENT NY 11971-0959 s Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, Telephone (631) 765-1802 Fax (631) 765-950211t s:lJwvv .sc�utlloldtowntl Date Received III APPLICATION FOR BUILDING PERMIT b C , AWE For office Use Only PERMIT NO. Building Inspector, R 1 2 2024 ..�� Appli cations and forms must be filled out in their entirety.incomplete applications will-not be accepted. Where the-Applicant is not the owner,an Owners,Authorization form(Page 2)shalVbe completed. Date. C3 OWNERS)OF PROPER SUM#I 1000- Name: project Address: , Errrail^ " Phone ," � ,. ' Mailing Address: CONTACT PERSON: Name, Mailing Address � s: ,+ . Email- Phone#: ` 68Q� DESIGN PROFESSIONAL INFORMATION; Name: Mailing Address: Email: Phone#: if - CONTRACTOR INFORMATION: Nettie" Mailing Address: Email: Phone#: DESCRIPTION OF PROPOSED CONSTRUCTION Estimated cost of Project: New Structure ❑Addition ❑Alter�ti� ❑Repair Demolition $ A/ - ❑Other premises? ❑Yes &o Will excess fill be removed from Will the lot be re-graded? es DNo 1 PROPERTY INFORMATION Existing use of property: Intended use of property: O17, Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to this property? ❑Yes IKNo IF YES, PROVIDE A COPY. ❑ Check Box After Reading: The owner/contractor/design,professional Is responsible;for al[dralnage and storm water Issues as,provided-by Chapter 236 ofthe Town Code. APPLICATION IS HEREBY MADE to the Build Ing,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 herelmdescrlbed.The applicant'agrees to comply with,all°applicable laws,ordinances,buildingtode, housing,code-and regulationsyand to admit authorized:Inspectors on.premises and Imbuilding(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 name): A" � W � � �'� Authorized Agent ❑Owner ,w � � J ✓ Signature of Applicant: Date: Z A* D2w CONNIE D.BUNCH STATE OF NEW YORK) Notary Public,State of New York No.01BU6185050 SS: Qualifled In Suffolk County COUNTY OF QIAXO�L ) Commission Expires April 14,2 & C 44Z Q. / /e 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 H,4 geC 20� A Notary Public PROPERTY OWNER AUTHORIZATION (Where the applicant is not the owner) I, residing at do hereby authorize to apply on my behalf tokke TVofhold Bul Ing Department for approval as described herein. AOwn r' Date ,j—d " Print Owner's Name will Scott A. Russell ,SOFrQk S'7C'O]RMWAT]EIK SUPERVISOR IM[ANAGIEMIEN T SOUTHOLD TOWN HALL-P.O.Box 1179 p 53095 Main Road-SOUTHOLD,NEW YORK 11971 Town of So u th o l d CHAPTER 236 - STORMWATER MANAGEMENT REFERRAL FORM ( APPLICANT INFORMATION TO BE COMPLETED BY THE APPLICANT ONLY FOR PROPERTIES ONE ACRE IN AREA OR LARGER. ) - - - - - - - - - - - - — - - - - - — - - - - - - - - - - - - - - - - APPLICANT: (Property Owner, Design Professional, Agent, Contractor, Other) , MEN d' elm NAME: A a0? . Q Date: :71P,n n+" ewtl 07 Contact Information: (E Mail&Telephone Number) Property Addr ess ess / Loc ation of Const ruction Site: mm ~y S.C.T.M. #; 1000 DisU lct 40 - Section Block Lot TO BE COMPLETED BY SOUTHOLD TOWN ENGINEERING DEPARTMENT Area of Disturbance is less than I Acre. Nrr S P D.E.S Permit is Required I - Project does Not Discharge to Waters of the State. No S.P,D,E,S. Permit r R uired 2 � - Area of Disturbance is Greater than I Adre & Storm-water Runoff Discharges Directly to Waters of the State of New York, THE APPLICANT MUST OBTAIN a S,P.D.E.S. Permit DIRECTLY From N.Y.S. D.E.C. Prior to Issuance of a Building Permit. - Area of Disturbance is Greater than I Acre& Storm-water Runoff Flows Through Southold Town's MS4 Systems to Waters of the State of New York. THE APPLICANT MUST OBTAIN a S.P.D.E.S. Permit through the Southold Town EnaineerinQ De artment Poor to Issuance of a Building Permit. l Date: Reviewed Byo �✓ �' PnR M # CM(-P-Tr)Q nrtnhcr 'Jn 14 � ecc, q111 a � p M -4 m U~ �:L:,�� W W LZL, � JOB w Z? � J � � .� J �� w co Cc), W� LL J O U O W e m p �p O (n CopT �� X ❑ d z bID � WLa� JcnV OT ( Q ) G O C/] Q "$" JeF�Z UZQ V1co 0 O a_ J ('' moo oQ'' �� � O a 0 co STREET = (Z'Q o 'W a o p z c Lo m , EREU� - 295.20 \ z a Z Z U W .0 M� W 190� 11017110" E m - //� I // Q.k oZ LLJ IM LL- (3 Wo >z �..., U� T all; �/ \ W�ti Q \ - \ LLJ ,," m p W LLJ� ro VL NOLL, \ \ wJ \ qua a \ ,q'� N Z LLJ Q ZLLI O CN O O J T Q O Q — �� � � 3 l wwamuii ¢iiau�°nwmnimp r V m QLfi V " a mLLJ �.. '``.." :i ''� ,�''"y," ^ ✓ .:�aaq »'."'"m`,.» ..""w"a mx v, agq�rspir '°divoyiiuwi �,,^ , i�q"A. T laJ Z Z O aN° `d"'r°opii°u'o° ZOO i LJ LO 03 " tiE' a aim Pliva!,�� -gpwrrnquae�u°m� � ����� gi4u�-' � �� Q Q Z� 4�i O Q m f7 tiU" mrp4mpmu�"pnwm a wlr " du 9i i o � wia ° "a m -w. rm z O� 41 J7 . 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