HomeMy WebLinkAbout50766-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
v 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 #: 50766 Date: 5/30/2024
Permission is hereby granted to:
Meyer, Sandra
31025 Route 25
PO BOX 1168
Cutcho ue, NY 11935
To: construct a roof addition over an existing patio as applied for.
At premises located at:
31025 Route 25, Cutcho ue
SCTM # 473889
Sec/Block/Lot# 102.-2-23.6
Pursuant to application dated 4/19/2024 and approved by the Building Inspector.
To expire on 11/29/2025.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $346.00
CO-ADDITION TO DWELLING $100.00
Total: $446.00
Building Inspector
ryy'AI'i
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
s, Telephone(631) 765-1802 Fax(631) 765-9502 htt : � � , oufholdtow� �� o
1"16,s au'dX+
Date eceived
BUILDINGAPPLICATION FOR
a e
For Office Use Only
PERMIT NO. Building Inspector: APP ?024
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:4/17/24
OWNER(S)OF PROPERTY:
Name:Sandy Meyer sum #Z000-102.-2-23.6
Project Address:31025 Main Road Cutchogue, NY 11935
Phone#:631-734-6278 Email:
Mailing Address:P.O.BOx 1168
CONTACT PERSON:
Name:M011y Jernick
Mailing Address:P.O.BOx 315
Phone#:631-765-4900 Email:amosmeringerbuilder@yahoo.com
DESIGN PROFESSIONAL INFORMATION:
Name:Joseph Fischetti
Mailing Address:1725 Hobart Road Southold, NY 11971
Phone#:631-765-2954 Email:wingman@optonline.net
CONTRACTOR INFORMATION:
Name:Amos Meringer
Mailing Address:P.O.Box 315 Mattituck, NY 11952
Phone#:631-765-4900 Email:amosmeringerbuilder@yahoo.com
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New S tructure ❑Additi on %Alteration ❑Repair ❑Demolition EEstiii�mate�d Cost of Project:
❑Other U b 5
Will the lot be re-graded? ❑Yes ig No Will excess fill be removed from premises? ❑Yes W No
1
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 ®No IF YES, PROVIDE A COPY.
@ Check Box After Read!rig: 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 210AS of the New York State Penal Law.
Application Submitted By(print name): ��1, �ter),) VAuthorized Agent ❑Owner
Signature of Applicant: �. " � ✓ �; 1 ( lql�
�" � .� Date:
CONNIE D.BUNCH
' -" Notary Public,State of New York
STATE OF NEW YORK) No.01BU6185050
SS: Qualified In Suffolk County
COUNTY OF SV 140\V ) Commission Expires April 14�,b)�K
1" -y'r-ri'Ok 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
j�4" 'dayof 20a `l
Notary Public
PROPERTYR AIJI 1JORIZATION
(Where the applicant is not the owner)
residing at L � M��n �LOc�•�
-U�-t✓ko ��1 erni(t rbP— oapplyon
do hereby authorize
my behalf to nTown of Souitho'd Building Department for approval as described herein.
Owner's Signature Dat
Print Owner's Name /
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31025 Main Road co
Project number 41524
Professional Engineer Town of Southold,
Al1725 Hobart Road NY Date 4/15/24
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Date 4/15/24 A2
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31025 Main Road
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