HomeMy WebLinkAbout50071-Z w. 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 #: 50071 28/2 3
Date: 11/ .®._. -......_ee..
Permission is hereby granted to:
Wells. James
96 Clay St Apt4A
Brooklyn, NY 11222
To: Construct a rear deck addition to an existing single-family dwelling as applied for.
At premises located at:
240 Cedar Dr S
SCTM #473889
Sec/Block/Lot# 31.-3-11.19
Pursuant to application dated 1 1/2/2023 m and approved by the Building Inspector.
To expire on .....5/29/2025.... ..._.. .
Fees:
SINGLE FAMILY DWELLING -ADDITION OR ALTERATION $525.50
CO-ADDITION TO DWELLING $100.00
Total: $625.50
.�... .. .................. ��� _ . .. � ...... �_
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 Iltt :/" rNVW.SOLII�hoidto rn l '.Gov
Date Received
APPLICATION „r
For Office Use Only
PERMIT NO., 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 e�'° 3:na� °"�° '4- e
Owner's Authorization form(Page 2)shall be completed.
Date: CCU rD Z02—
OWNER(S)OF PROPERTY: ) I
Name: SCTM#1000- 3 �_
Project Addre r
Phone#: 90�— L+ l — It 7 Cj
Mailing Address: p��
CONTACT PERSON:
Name: STV VW?l V-1 CC<J
Mailing Address: 154c( M 01 iJ \CCL^ ; ✓C-'Z I+CLA ' t'J
I
Phone#: �S 2�6r� Email: Cfr TV@ aWtG�iC,. CLit^^
DESIGN PROFESSIONAL INFORMATION: C-PT ST U
Name:
Mailing Address: ZC G- I A-,CC.L "J le f UC72 ffe—A'/--'0
Phone#: C✓ �' 2 —2 Cl q 2 Email: C D i I-rOWA S G 3 V-)cL C
CONTRACTOR INFORMATION:
Name: A\/\,.s
Mailing Address: \'�'4 0--� V\/\, 1 RCA 6
Phone#: 63/ --2- (; --lAL Email: CVlK S—kA)t 4f` CG✓`
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair PDemolition Estimated Cost of Project:
leer 2 e P� oz IBC L $ 4— 0
Will the lot be re-graded? ❑Yes ER To--- Will excess fill be removed from premises? ❑Yes CQfyo.
1
PROPERTY INFORMATION
Intended use of property:
Existing use of property. � p p rty. 2 P�
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
this property? ❑Yes C?W6-1-F YES, PROVIDE A COPY.
❑ Check Coy 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 inspector:on premises and in building(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.4S of the New York State Penal Law.
Application Submitted By(print name): C—C„.10$ QAuthorized Agent ❑Owner
Signature of Applicant: Date: 2G23
i
STATE OF NEW YORK)
SS:
COUNTY OF Spa 4041�. )
A"8,Y b&L,uA6 being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the +hv)r\' 4l
( tractor,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
lj! day of U 60LI ' 2013 NA�N�
N uhl
Erin Murphy-Apicello
Notary Public
State of New York
1410PERIFY OWNER At 1 11 '°'F1I01 County of Suffolk
REG#01MU6090387
(Where the applicant is not the owner) Expires April 14,20
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
AISMIS
PROPERTY RENOVATIONS
Tel 631-276-3334
www.amsrenovations.com
Letter of Authorization
To whom it may concern ,
I, Juv►.,es be-115 . allow Stuart Daccus of AMS to act on my
behalf at the building dept for our upcoming project at our property
located at
Signed
Printed / ' /�
JA►MeS h eA G✓ if
Date
74/a 3