HomeMy WebLinkAbout51003-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
Do TOWN CLERK'S OFFICE
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SOUTHOLD, NY
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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#: 51003 Date: 7/30/2024
Permission is hereby granted to:
Schimatz MA 2022 Irry Trust
g y t 1 C
1 Ben a field Dr Ap
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East Williston, NY 11596
To: Legalize "as-built" garage porch roof replacement accessory to an existing
single-family dwelling as applied for.
At premises located at:
1355 Bay Ave, East Marion
SCTM #473889
Sec/Block/Lot# 31.-9-5.1
Pursuant to application dated 6/14/2024 and approved by the Building Inspector.
To expire on 1/29/2026.
Fees:
AS BUILT-ACCESSORY $388.00
CO-ACCESSORY BUILDING $100.00
Total: $488.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
Telephone (631) 765-1802 Fax (631) 765-9502 li Ip :,/W-NNw; s,outllgldt_oAV yov
Date Received
APIPLICA I„ION IIFOR BU111 IDING PERMIT
For Office Use Only
PERMIT NO.c��_1 S/� � Building Inspector:
JUN 1 4 2024
'.
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an BM, DING DEPT.
Owner's Authorization form(Page 2)shall be completed. TOW � µ
Date:
OWNER(S)OF PROPERTY:
Name: r� onvxe ( l, a r SCTM#1000- l ,
Project Address: CJ u r�1,� P
Phone M. A11 ` ��2 '1rH Email:
Mailing Address: ""..
CONTACT PERSON:
Name: tE O .
Mailing Address: 1 ?-3 9
Phone#:� � _403 �-� Email: p►Ix �o ( gv�OS ;
DESIGN PROFESSIONAL INFORMATION:
Name
Mailirt Address: .
4
PhoneA::'z 15'' ' Email: ��Vim' yl Aft
CONTRAQO$ MAifl9 ,�
Mailing Address:Es P
Phone#, Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑Nt ertr tur ❑AddIt` n It ra ior� e ❑
apair Demolition Estl at esto Project:
Stk � ,.+ $ �.
Will the lot be re-graded? ❑Yes�Rvo Will excess fill be removed from premises? ❑Yes , No
1
PROPERTY INFORMATION
Existing use of property: rli�r. `ce�� (. 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 . o IF YES, PROVIDE A COPY.
a Iii gig; The owner,/contractor/design professional is responsible,for all drainage and storm water issues as provided by
apter 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,alleratiorwor.fot 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 Sulirnitted By(print narne):' f''P 0o A F- "Autht riled Agent El owner
Signature of Applicant: 0- Date.
STATE OF NEW YORK)
SS:
COUNTY OF U C-CAJ )
'bE2M1ZR0 A 5 O'A,j®S being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the A6FWf
(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 J '-'l e— , 20
otary Public
AUTHOWL4MINZ110
Not" Stilt dyer►York
d r �,E I i ;�"u 71 k..t" ,. No.O1LA61i12�2
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(Where the applicant is not the owner) QwUfiedin
rdGptc�in l w
Ca Y County
13,ZUf
I'm AEA residing at x V>
do hereby authorize F,94j gi2po l3 �b S to apply on
my behalf to the Town of Southold Building Department for approval as described erein,
2
Owner's Si ature Date
*Audute-�Wt2n��
Print Owner's Name
2
... ........
SURVEY OF PROPERTY
SITUATED AT
EAST MARION
TOWN OF SOUTHOLD
SUFFOLK COUNTY, NEW YORK
S.C. TAX No. 1000-31 -09-5.1
SCALE 1"=20'
131 OCTOBER 21, 2003
00 AREA = 31,500.00 sq. ft.
0.723 cc.
Ta,
ROBERT SCHIMATZ
MARY ANNE SCHIMATZ
PECONIC ABSTRACT, INC.
FIDELITY NATIONAL TITLE INSURANCE COMPANY
OF NEW YORK
CITIMORTGAGE, INC.
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U.DRA.TWRWWN LISTED 4�EREW RNP Alqu PHONE (631)727-2090
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OFFICES LOCATED AT MAVIOG MMLS�
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