HomeMy WebLinkAbout51006-Z 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 #: 51006 Date: 7/30/2024
Permission is hereby granted to:
Katehis, Theofilos
157-58 25th Or
Flushing, NY 11354
To: Construct accessory garage at existing single family dwelling as applied for.
At premises located at:
145 Horton Ave, Mattituck
SC-TM # 473889
Sec/Block/Lot # 141.-1-37.2
Pursuant to application dated 5/17/2024 and approved by the Building Inspector_
To expire on 1/2 912 0 2 6.
Fees:
ACCESSORY $3 12.50
CO - ACCESSORY BUILDING $100.00
Total: $412.5 0
Building Inspector
t€x
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 jtt _r + _ ohol3towin -
Date Received
APPLICATIaN FC)R BUILDING PERMIT
For Office Use Only e
PERMIT NO. J100(to Building lnspector_ MAY I f
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:
OWNER(5) OF PROPERTY:
Name: SCTM # 1000-
Project Address: 5 — -HID
F,—V0 14
Phone #: Email:
Mailing Address:
CONTACT PERSON:
Name:
Mailing Address:
Phone # Email:
DESIGN PROFESSIONAL INFORMATION:
Name.
Mailing Address: {�( AS �p 1 It I ��0 y
Phone #: _ 04
Email:
CONTRACTOR INFORMATION:
Name:.
Mailing Address:
Phone #: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
New Structure =Addition =Alteration =Repair =Demolition Estimated Cost of Project:
=Other de' $ ' �t5'
Will the lot be re-graded? =Yes ,�No Will excess fill be removed from premises? =Yes 60NO
1
PROPERTY I1NFC)R1NAA710N
Existing use of property: o-" A--L— Intended use of property: GjA__k 1
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
V_— O this property? OYes &01'N, IF YES, PROVIDE A COPY.
E3 Check BOX After Reading: The owner/contractor/deslgn 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 buildings)for necessary Inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Sectlon 210.45 of the New York State Penal Law.
Application Submitted By (print arise): t F'1 LC) S IG/��C 1-1 7 S [__lAuthOrized Agent MiE] vner
Signature of Applicant: Date:
STATE OF NEW YORK)
SS:
COUNTY OF \r_ )
being duly sworn, deposes and says that (s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the r-
(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
clay of �� . 20
Notary Public
MARIA PRIKAS GANLEY
PROP Q NEB. HOI .It 0 Notary Public- State of New York
NO. 01 PR5003206
(Where the applicant is not the owner) Qualified in Suffolk County
MY Commis ion Exptres Oct 19, 2026
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
Town Hall Annex Telephone(631) 765-1802
54375 Main Road _ Fax (631) 765-9502
P. O. Box 1179
Southold, NY 1 1 971-0959
BUILDING DEPARTMENT
NQTICE OF UTILIZATION OF TRUSS TYPE IC0WSTRLJCTW>N. PRE-EN4GINEERE0
WCX3D CONSTRUCTION AN[ Q TIMBER -ONSTR CTION
Date �1 -2-S ) a-+
Owner:
Location of Property: 44 MIA -TO
Please take notice that the (check applicable line):
IVew commercial or residential structure
Addition to existing commercial or residential structure
Rehabilitation to an existing commercial or residential structure
to be constructed or performed at the subject property reference above will utilize
(check applicable line):
Truss type construction (TT)
Pre-engineered wood construction (PW) JQ
Timber construction (TC) PJ/A-
in the following location(s) (check applicable line): 1
Floor framing, including girders and beams (F)
Roof framing (R)
Floor and roof_fra ing (FR) y`-?l�
Signatur
Name- (person submitting this form):
Capacity (check applicable line):
✓/ Owner
Owner representative
TrussReg16.docx Effective 1/1/2015
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