HomeMy WebLinkAbout50979-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
4" 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#: 50979 Date: 7/24/2024
Permission is hereby granted to:
Rontiris, Nicholas
160 Circle Dr
.M .......
Manhasset NY 11030
To Demolish existing shed and construct additions and alterations to an existing
single-family dwelling to include an attached garage as applied for.
At premises located at:
1730 Old Orchard Rd East Marion
SCTM #473889
Sec/Block/Lot# 37.-2-7.1
Pursuant to application dated 5/3/2024 and approved by the Building Inspector.
To expire on 1/23/2026.
Fees:
DEMOLITION $17.20
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $584.00
CO -ALTERATION TO DWELLING $100.00
Total: $701.20
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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 liti�s:0/w r .s qLil—Olcllo "-aI 'O
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT N0, 150 1 - I Building Inspector: M � � y��24
Applications 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)shall be completed.
Date: 3
OWNER(S)OF PROPERTY:
Name: SCTM# 1000-
Project Address: / Q Id 0,,&a-ck -Lame— 0OLPzioA NY 11 q3
Phone#: S�/(7 - 3 /Z — 317+ Email: Ale-b M TI It CI' 0 614111 i ,c c
Mailing Address: 4 0 r-C/ . r,�1 IU4,q �� � O
CONTACT PERSON: �J
Name: d ko l 2
Mailing Address: 160 C(''C (e O vi vr- 1p" 4, /V y 1/Qi d-
Phone#: '�-14 3f2 —39" Email: IVIeCA/17 f'Z Lr (2 644-F/C ,Cc�
DESIGN PROFESSIONAL INFORMATION:
Name: C-0& , C 4 4V 11,4S
Mailing Address: V- L�/ l Z1II4- ,
Phone#: Zf 2- --Z'FC- 00/0 Email: 1/A►�` � /aM 1A2 cgrdb 110, Ca
CONTRACTOR INFORMATION:
Name:
Mailing Address;
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other
Will the lot be re-graded? ❑Yes ❑No Will excess fill be removed from premises? ❑Yes ❑No
PROPERTY INFORMATION
Existing use of property: kesmlence 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 KNo IF YES, PROVIDE A COPY.
Check BOX After Reading: The owner/contractor/design professional is responsible for all drainage and storm water Issues as provided by
1 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 name): /I/,(Ih 0 A �p n >L I/21 j ❑Authorized Agent 40wner
Signature of Applicant: Date: 5-3 a Lf
STATE OF NEW YORK)
SS:
COUNTYOF 3Q��I !� )
IV I cho I(A5 � "� being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the 0 l -)
(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 �" ZCI ..
otary Public
TRACEY L. DWYER
PROPERTY OWNER AUTHORIZATION NOTARY PUBLIC,STATE OF NEW YORK
Where the applicant is not the owner NO.IN
( Pp . ) (1l�ALIFIED 4N 341FFOI.K COUNTY
COMIASSION EXPIRES JUNE 30,2DOP
I residing at
do herebyauthorize
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
NOTE:
LOT NUMBERS REFER TO 'GARDINER'S BAY
ESTATES, SECTION TWO' FILED IN THE SUFFOLK
COUNTY CLERK'S OFFICE ON SEPT-.-23, 1927 SURVEY- OF PROPERTY
AS FILE NO, 275 0 �" AT EAST MARION
TOWN OF SO UTHOLD
SUFFOLK COUNTY; N. Y.
1000-37-02-7.1
N SCALE. 1'=30'
NOVEMBER 15, 2011
DEC. '.2, 2011 (REVISIONS)
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CERTIFIED TO . �„d�`' ,• � `" �� �
NICHOLAS RONTIRIS
ASPASIA RONTIRIS
CHICAGO TITLE INSURANCE COMPANY ",► / ,�
LYONS MORTGAGE, SERVICE, INC. ,� U/G PROPANEis
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STOCKADE
FENCE
■ = MONUMENT
N.Y.S. LI C. NO. 49618
ANY ALTERA77ON OR ADDITION TO THIS SURVEY IS A WOLATIAN
OF SECTION 72090F THE NEW YORK STATE EDUCATION LAW. ECONO EYORS, P.C.
EXCEPT AS PER SECTION 7209—SUBDIVISION 2. ALL CERTIFICATIONS (631) 765-5020 FAX (631) 765-1797
HEREON ARE VALID FOR THIS MAP AND COPIES THEREOF ONL Y IF P.0. BOX 909
SAID MAP OR COPIES BEAR THE IMPRESSED SEAL OF THE SURVEYOR AREA= 9,75O SQ.FT. 1230 TRAVELER STREET 11-222
WHOSE SIGNATURE APPEARS HEREON. SOUTHOLD, N. Y. 11971