HomeMy WebLinkAbout51058-Z TOWN OF SOUTHOLD
art 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 #: 51058 Date: 8/12/2024
Permission is hereby granted to:
Collado, Arelis
3715 Hortons Ln
Southold, NY 11971
To: legalize "as built" additions and alterations to existing single-family dwelling as applied
for. Additional certification may be required.
At premises located at:
3715 Horton Ln Southold
SCTM #473889
Sec/Block/Lot# 54.-7-23.6
Pursuant to application dated 6/3/2024 and approved by the Building Inspector.
To expire on 2/11/2026.
Fees:
AS BUILT- SINGLE FAMILY ADDITION/ALTERATION $1,920.00
CERTIFICATE OF OCCUPANCY $100.00
Total: $2,020.00
Building Inspector
TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959
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Telephone (631) 765-1802 Fax(631) 765-9502 �t't : �ww.southoidtratn o '
APPLICATION FOR BUILDING PERMIT
For Office Use Only
PERMIT NO. Building Inspector: " UN
2024
Applications and forms must be filled out in their entirety.Incomplete N
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'applications will not beaccepted., Where the Applicant Is not the owner,an ... ,
Owner's Authorization form(Page 2)shall be completed. f
Date:
OWNERS)OF PROPERTY:
Name: A(2- {"S SCTM#1000
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Project Address: 37If
Phone#: 5-1 Email: �(yl ( 1✓
Mailing Address: 49 � L j1d
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CONTACT PERSON:
Name:
Mailing Address:
Phone#: Email:
DESIGN PROFESSIONAL'INFORMATION:
Name:
Mailing Address: 31 i) j hl
Phone#: (3y7) T34- 6-17 f!t1:Email:
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CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#: Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
❑New Structure ❑Addition (Alteration ❑Repair ❑Demolition Estimated Cost of Project:
❑Other $
Will the lot be re-graded? ❑Yes ESNo Will excess fill be removed from premises? Dyes gNo
1
PROPERTY INFORMATION
Existing use of property:4j; a0111 1 Intended use of property: +
�lllrt p p Y 5i(9 . � 'I`y l7wel)id
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
11 this property? []Yes El No IF YES, PROVIDE A COPY.
check Box After Reading: The owner/contractor/design professional Is responsible for all drainage;and storm water Issues as provided by
Chapter ' of the Town code. APPLICATION IS HEREBY MADE to the Building Department for the Issuance of a Building Permit pursuant to the Building Zone
Ordinancee oo f the Totiun of Southold,Suffolk,County,New York and other applicable!alas,Ordinances or Regulations,for theconstructlon of buildings,"
additio*alterations or'for removal or demoiitlon as herein'described.The applicant agrees to comply with all applicable laws,ordinances,bull0ing code,
Dousing code and regulatidns and to admit authorized inspectors on premises and In building(s)for necessarylnspections.False statements made herein are
punishable as a class A misdemeanor pursuant to Section`210AS of the New York State Penal law.
Application Submitted By(print name): /��0 ❑Authorized Agent MOwner
Signature of Applicant: Date:
b0'46eNi D.BUNCH /
STATE OF NEW YORK) Notary Public,State of New York
No.01 BU6185050
SS: Qualified in Suffolk County
COUNTY OF ) Commission Expires April 14,2nxy
being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he 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
day of J 20 ,Q �Q41
1 Notary Public
PROPERTY OWNER AUTHORIZATION'
(Where the applicant is not the owner)
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
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SUFFOLK COUNTY HEALTH DEPARMENT
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Town Southold D EQ20VIR
Building Department
54375 Route 25 -�
Southold, NY 11971 AUG ? 9 2024
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Address: 3715 Hortons Ln, Southold, NY 11971 BUXIMIG DEPT.
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+� Objection Response letter: As per comments dated July 24, 2024,
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1. As per your comment, all work shown on the plans are as-built.
Q 2. As per your comment, one of the rooms has been removed in the finished basement. Please see Sheet
A103.0.
Sincerely, * F OF N��I/
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Franz Seborga
331 Willis Ave. Mineola Suite 200 NY 1 1501
PH: 347-534-5920 rsantana@bozzettoarch.com
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