HomeMy WebLinkAbout50666-Z .�SUFF^tea �� TOWN OF SOUTHOLD
ay BUILDING DEPARTMENT
y x TOWN CLERK'S OFFICE
"o • � 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#: 50666 Date: 6/13/2024
Permission is hereby granted to:
McGunnigle, Thomas
30255 CR 48
Peconic, NY ,11958
To: Install deer fence as applied for.
At premises located at:
30255 CR 48, Peconic
SCTM # 473889
Sec/Block/Lot# 74.-1-37.3
Pursuant to application dated 4/29/2024 and approved by the Building Inspector.
To expire on 5/13/2025.
Fees:
DEER FENCE $100.00
Total: $100.00
l
Building Inspector
o�OgUFFO(�coG TOWN OF SOUTHOLD—BUILDING DEPARTMENT
=Z y2
y Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971-0959
�y�o• �ao�� Telephone(631) 165-1802 Fax(631) 765-9502 https://www.southoldtownny.gov.
Date Received
APPLICATION FOR BUILDING PERMIT
For Office Use Only h
PERMIT NO. Building Inspector: 4 {x APR 2 9 2024
Applications and forms must be filled out in their entirety.Incomplete.
applications will not,be accepted. Where the Applicant is riot the.owner,an.
Owner's Authorization form.(Page 2)shall be completed.. , `�'"� �'' i,.rt rr,">rpid
Date:
'bWNER(S).OF.PROPERTY:
Name: r , SCTM#1000-
Project Address:
Phone#_ /, _ 5, -NTT- _- Email:
Mailing Address: 2
,CONTACT PERSON.
Name:
(n
Mailing Address:
-Cv 4 -t`9--- -r-- -- --_- -- - - -
Phone#:_. Email:
DESIGN PROFESSIONAL INFORMATION: _ - .
Name:
Mailing Address:
Phone#: Email:
CONTRACTOR I N FORMATION:.:
Name- - -+SW�� - - -
Mailing Address:-
Phone#: Email:
DESCRIPTION OF.f ROPOSED CONSTRUCTION
❑New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition Estimated Cost of Project;
N70ther
Will the lot be re-graded? ❑Yes XNo Will excess fill be removed from remises? ❑Yes-kNo
1
PROPERTY INFORMATION
Existing use of property: 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 ❑No IF YES, PROVIDE A COPY.
Check Box After-Reading: The owner/contracfor/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;forthe 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 necess•ary•inspections.False statements made herein are
punishable as i Class A misdemeanor pursuant to Section 210AS of the New York State Penal Law.
Application Submitted By(print na e . ___A
N Authorized Agent ❑Owner
Signature of Applicant: _ Date: Y 200 z02, L/
STATE OF NEW YORK)
SS.
COUNTY OF
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract)above named,
(S)he is the G �-wl—
(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 AV I , 20,
Not Public
LORETTA IAMB
Notary Public,State of New York PROPERTY OWNER AUTHORIZATION _
#01 LA6179883 -
Oual'rfied in Suffolk County (Where the applicant is not the owner)-Ter __-
Expires December 31,20Z7
I, 3DAL4 v-1 residing at "$0 2 S 12"i �I H2Lnr tl I,gS g
do hereby authorize t__1 to apply on
m_ y behalf to the Town of Southold Building Department for approval as described herein.
Owner's Signature Date
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Print Owner's Name
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