HomeMy WebLinkAbout50989-Z a " 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 #: 50989 Date: 7/26/2024
Permission is hereby granted to:
Dimiero, Katherine
242 Lafayette Ave
y ._ � ....
Brook) n, NY 11238
To: Legalize a fourth bedroom to an existing 3 bedroom single-family dwelling as applied
for per SCHD Septic Certification.
At premises located at:
1075 Moores Ln N, Greenport........
SCTM # 473889
Sec/Block/Lot# 33.-2-32
Pursuant to application dated 6/6/2024 and approved by the Building Inspector.
To expire on wawa 1/25/2026.
Fees:
SINGLE FAMILY DWELLING-ADDITION OR ALTERATION $250.00
CERTIFICATE OF OCCUPANCY $100.00
Total: __..�.._ $350.00
Building Inspector
o
r TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone(631) 765-1802 Fax (631) 765-9502 hqps-//www.southoldtownny-jzoy
Date RZetved
APPLICATION FOR BUILDING PERMIT
p� (� For Office use On /� L12"_"
PERMIT NO. 50 l I Building inspector: '
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24
Date:6.6.24
Name:Brendan Clifford SCTM#1000-33.-2-32
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Project Address:1075 Moore's Large forth Green art N ,�
Phone#: _ 45 Email baclifford r11aIl.COrn
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Mailing Address: ,
Name:
TDB rl Chamber
s
Mailing Address:RO BOX 49 Southold NY 11971
Phone#:631.294-4241 -- m Email:ioa iarnberS10@ r13ail,.com
BEENE
Name:LOu Schwartz
Mailing .dress:? RidgpWPCld St Se Shore NY 11706
Phone#, P1 41 - 633 Email tiderunNererl@wIII ENSURE:
�ral.com
Name:
Mailing Address:
Phone#: Email:
REOPEN. NXIMMAM), w. Rog
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❑New Structure ❑Addition El' Iteration ❑Repai'r ❑Demolition Estimated Cost of Project:
lother 9e uae of room
Will the lot be re-graded? ❑Yes l@No Will excess fill be removed from premises? ❑Yes NNo
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Existing use of property, .I 11 0 r ... . i��iw'ide use prop uigym(" .s.1 ntl al,
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
4 ___ _.. .. PROVIDE A COPY
�, this property? OYes @No IF YES, _ �
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Application Submitted By(print name):Joan Chambers @Authorized Agent ❑Owner
Signature of Applicant: Date:
Notary P� I�I�D.BUNCH
ublic,State of New York
STATE OF NEW YORK) No.01 BU6185050
SS: Qualified.ln Suffolk County
COUNTY OF ) Commission Expires April 14,2 �
Joan Charnlber$ being duly sworn,deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the Agent
(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
Notary Public
PROPERTY OWNER AUTHORIZATION
(Where the applicant is not the owner)
I(enAll residing at 1,07c Ye
�re �- Joan Chambers
,�,,�e; v1� do hereby authorize to apply on
my behalf to t e Town of Southold Building Department for approval as described herein.
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owner's,Si atdre Date
Print Owners Name
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STOOP PLAN
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FIRST FLOOR PLAN ROFESSIONP
NOTE:
DIMENSIONS WERE TAKEN FROM PRIOR PLANS. PLEASE
VERIFY ON SITE.
JOAN CHAMBER
(631 )294-4214
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2'-4"x3'-6" 2'-4"x3'-6" 2'-4"x3'-6" 2'-4"x3'-6"
SECOND FLOOR PLAN _ __ _
1 /4" = 11_011
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SIO�P
OAN CHAMBER%
(631)294-4214
Frank Wolfgang Uellendahl Architect
123 Central Ave POB 316 Greenport, NY 11944 t.631.477.8624 e:frank@frankuellendahl.com
October 19, 2009
Owners:
Ellen Goldstein and Etta Siegel
61 Jane Street, Apt. # 6b
New York, NY 10014
Project:
Addition to the Goldstein/Siegel Residence,
at 1075 Moores Lane North in Greenport
SCTM# = 1000-033-002-032
LETTER OF CERTIFICATION - EXISTING SEPTIC SYSTEM
According to the owners of the above referenced residence the original block septic pool
broken and was in imminent danger of collapsinessg. p was
new 1000 gallon concrete septic tank and a cesspool whchChasaodiam teServiceo 8 Inc. installed a
total depth of 12'. f 8 feet and a
Mr. Morris stated that the leaching
was placed on very
The exact location of the septic system1 is indicated on the ttaoheda site plan.
Based on the Department of Health Services regulations the replaced septic s
sufficient for a 4-Bedroom Residence. system is
kI hereby state that the information provided above is true to the best of my knowledge.r g .
r�ankUellendahl