HomeMy WebLinkAbout51025-Z TOWN OF SOUTHOLD
BUILDING DEPARTMENT
u 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#: 51025 Date: 8/1/2024
Permission is hereby granted to:
DiSalvo Family Irry Trt
6 Manor House Ln
Milford CT 06041
To: Legalize as-built roof over existing deck as applied for.
Additional certification may be required.
At premises located at:
455 W Shore Dr, Southold
SCTM #473889
Sec/Block/Lot# 80.-2-1
Pursuant to application dated 6/20/2024 and approved by the Building Inspector.
To expire on 1/31/2026.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $780.00
CO-ALTERATION TO DWELLING $100.00
Total: $880.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
;ag Telephone (631) 765-1802 Fax (631) 765-9502 lmtt s://wwNv.� ►u�f1l )dtowniiy.
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0
Date Received
APPLICATION FOR BUILDING PERMIT EJ: EJV E
For Office Use Only
PERMIT NO. �, Building Inspector
Incomplete
B
uilding Oepartm�nt
in their entired
must be filled outI muo
Application
s and formstY
applications will not be accepted. Where the Applicant is not the owner,an Town of Sout
Owner's Authorization form(Page 2)shall be completed.
Date: : � TL)-nJ� ]0711
OWNER(S)OF PROPERTY:
Name: DiSalvo Family Irrv. Trust SCTM# 1000-080.00-02.00-001 .000
Project Address: 455 West Shore Drive, Southold, N.Y. 11971
Phone#:203.526.7510 Email:calexghee@yahoo.com
Mailing Address:6 Manor House Lane, Milford, CT 06041
CONTACT PERSON:
Name: Nigel Robert Williamson
Mailing Address: P.O. Box 1758, Southold,N.Y. 11971
Phone#: 631 .834.9740 Email: nigel_architect@hotmai1.com
DESIGN PROFESSIONAL INFORMATION:
Name: Nigel Robert Williamson R.A.
Mailing Address: P.O. Box 1758, Southold, N.Y. 11971
Phone#: 631 .834.9740 Email: nigel_architect@hotmail.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair UfDemolition Estimated Cost of Project:
NOther As-built roof over existing deck 285 Sq. Ft. EXr4_ cwjopLi D0-wLISNED20'E $
Will the lot be re-graded? ❑Yes No Will excess fill be removed from pre ises? ❑Yes ❑No
1
PROPERTY INFORMATION
t
Existing use of property:Single Family Dwelling Intended use of property: Single Family Dwelling
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
R40 this property? ❑Yes ®No IF YES, PROVIDE A COPY.
e Check,Box AfteOr e inig° 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 inspectors on premises and In buflding(s)for necessary Inspections.False statements made herein are
punishable as:a Class A misdemeanor pursuant to Section 210A5 of the New York State Penal Law.
B (print name): Nigel Robert Williamson ®Authorized Agent Downer
Submitted
Application )
Y(p
Signature of Applicant: - ~" "" Date: V V j>✓ �
STATE OF NEW YORK)
SS:
COUNTY OF
" being duly sworn, deposes and says thatjhe is the applicant
(Name of individual signing contract) above named,
(Vhe is the
(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 p
17 day of ZV4C 2024
N ary Pu ,AID J.JANNUZZI I
NOTARY PUBLIC,STATE OF NEW YORK'
Registration No.02JA60525a5
Qualified in Suffolk County
PROPERTY OWNERTVI RI IIFI IYI Commission Expires February 13,
(Where the applicant is not the owner)
DiSalvo Family lrrv. Trust residing at6 Manor House Lane
Milford, CT 06041 do hereby authorize Nigel Robert Williamson to apply on
my behalf t the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
Print Owner's Name
2
�. BUILDING DEPARTMENT- Electrical Inspector
TOWN OF SOUTHOLD
Town Hall Annex - 54375 Main Road - PO Box 1179
Southold, New York 11971-0959
Telephone (631) 765-1802 - FAX (631) 765-9502
w�
iamesh@southoldtownny.gov —sea nd southoldtownn ov
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APPLICATION FOR ELECTRICAL INSPECTION
ELECTRICIAN INFORMATION (All Information Required) Date:
Company Name:
Electrician's Name:
License No.: Elec. email:
Elec. Phone No: ❑I request an email copy of Certificate of Compliance
Elec. Address.:
JOB SITE INFORMATION (All Information Required)
Name: DiSALvo Am, iL leek Tw
Address: 4 War 51-w .s for lep N� Ile/ 1
Cross Street: PFtf.DC>Q bell v
Phone No.: 2o3. 5-26 . 7510
Bldg.Permit#: p email: ca.lex, hee p koo. com.
Tax Map District: 1000 Section: 08O.00 Block: 02-.00 Lot: 00 1.000
BRIEF DESCRIPTION OF WORK, INCLUDE SQUARE FOOTAGE (Please Print Clearly):
As- Eu i LT Root, OvEQ. &,curi u4 DI✓ck- 2B5 Sa, Fr.
W i rH 76ic> C,E)Li fJ 4 F40S .
Square Footage:
Circle All That Apply:
Is job ready for inspection?: YES F'� NO [:]Rough In Final
Do you need a Temp Certificate?: El YES 0 NO Issued On
Temp Information: (All information required)
Service SizeEl1 PhE]3 Ph Size: A # Meters Old Meter#
❑New Service[]Fire Reconnect❑Flood Reconnect❑Service Reconnect❑Underground❑Overhead
#Underground Laterals 1 M2 0 H Frame M Pole Work done on Service? Y N
Additional Information:
PAYMENT DINE WITH APPLICATION
Pre red In,accordance with lire rnlnlmy
stapdards for iltle surveys as established
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MAP OF CERTIFIED Toy
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SOUTHOLD SAVINGS SANK
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`PAr BA Y VIEW
TOWN OF SOUTHOLD
SUFFOLK COUNTY. x y of��
000 - 80 - 02 - 0l
Scale 1" = 20.' � -
A ug x 1988 . L 9
Aug. 9, 990(found. loc.)
Dec. 10, 1990-(final) - PEO0N1C RVE 44a
7AN.3l,2006 PROP. ►-OOP (819)788E 5020
P. 0. BOCK' 909
MAIN ROAD tAND
__ _ SOUTHOLD, N.Y. 11971