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Home My WebLink About51062-Z --. — TOWN OF SOUTHOLD BUILDING DEPARTMENT _ TOWN CLERK'S OFFICE ' SOUTHOLO, NV BUILUINO 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 #: 51062 Date: 8/12/2024 Permission is hereby granted to: Walsh, Jeremy 3460 Camp Mineola Rd Mattituok, NV 11952 To Replace windows / doors at existing single family dwelling as applied for, with flood permit. At premises located at: 200 Fay Ct, Mattituck SCTM # 473889 Sec/Block/Lot # 123.-5-12 Pursuant to application dated 6/20/2024 and approved by the Building Inspector_ To expire on 2/11/2026. Fees: SINGLE FAMILY DWELLING - ADDITION OR ALTERATION $250.00 CO - ALTERATION TO DWELLING $100.00 Flood Permit $150.00 Total: $5 00.00 Building Inspector 1 � TOWN OF SOUTHOLD — BUILDING DEPARTMENT } Town Hall Annex 54375 Main Road P. O. Box 1179 Southold, NY 11971-0959 .4 Telephone (631) 765-1802 Fax (631) 765-9502 htt]2s://xvww-so-LLtli�oldtowniiy.gov Date Received APPLICATION FOR BUILDING PERMIT For Office Use Only 3+.,,. PERMIT NO. ar/o&cg- Building Inspection- Applications and forms must be filled out in their entirety. Incomplete applications will not be accepted. Where the Applicant is not the own17an 0 _F S-arv--rt 4_ Owner's Authorization form (Page 2) shall be completed. Date: iCt Zc� OWNER(S) OF PROPERTY: Name:TARA AND JEREMY WALSH SCTM # 1000-123.-5-12 Project Address:200 FAY COURT MATTITUCK Phone #:347-834-2757 Emaii:JEREMYWALSHLAW@G MAIL.COM Mailing Address:200 FAY COURT MATTITUCK 1 1952 CONTACT PERSON: Name:JEREMY WALSH Mailing Address:200 FAY COURT MATTITUCK 11952 Phone#:347-834-2757 Email:JEREMYWALSHLAW@G MAIL.COM DESIGN PROFESSIONAL INFORMATION: Name:AS ABOVE M tiling Address: Phone #: Erriail: CONTRACTOR INFORMATION: Name:AS ABOVE Mailing Address: Phone #: Email: DESCRIPTION OF PROPOSED CONSTRUCTION =New Structure =Addition ®Alteration =Repair =Demolition Estimated Cost of Project: =Other 31 00.00 Will the lot be re-graded? =Yes 59No Will excess fill be removed from premises? [--]Yes ONo PROPERTY INFORMATION Existing use of property:2 1 Q. 1 intended use of property:2 1 Q.Q Zone or use district in which premises is situated: Are there any covenants and restrictions with resjed this property? OYes ®No IF YES, PROVIDE A CO i_Q Check BOX After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues pass providChapter 236 ofthe Town Code. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the BOrdinance of the Town of Southold,Suffolk,County, New York and other applicable Laws,Ordinances or Regulations,for the construction of buildadditions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,buildihousing code and regulations and to admit authorized inspectors on premises and in buitding(s)for necessary inspections.False statements made punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law. on Application Submitted By (print m - .J E RE MY WALS H pAuthorized Agent Owner Signature of Applicant: Date: 06- 19-2024 STATE OF NEW YORK) SS: COUNTY OF NASSAU J E FREMY WALS H being duly sworn, deposes and says that (s)he is the applicant (Name of individual signing contract) above named, (S)he is the OWN E 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 therewi Sworn before me this 19 f J U N E 2024 .� day o mm otary - e' -� STATE . _ oil 0 1RoRSlzaTioni OF ARK � �1t�TFsR' PUBLIC (Where the applicant is not the owner) 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 OF SOUTHOLD — BUILDING DEPARTMENT To-Am Hall Annex 54375 Main Road P. O. Box 1 179 Southold, NY 1 1971-0959 �. Telephone (631) 765-1802ttavv_s , zthtov. cv Floodplain Development Permit Application PROPERTY INFORMATION: I Flood Zone:AE FIRM Panet:09-25-2009 SCTM # 1-000-05.00-012.01 Address:200 FAY COURT city:MATTITUCK NY zip: 11952 CONTACT PERSON: Name:JEREMY WALSH Phone #:347-834-2757 Mailing Address:200 FAY COURT MATTITUCK NY 11952 PROJECT DESCRIPTION: REPLACE WINDOW WITH PATIO DOOR AND REPLACE HEATING AND COOLING UNIT TO ACCESORY STRUCTURE SECTION A: STRUCTURAL DEVELOPMENT (CHECK ALL THAT APPLY) Type of Structure Type of Structural Activity kEig Residential (1 to 4 families) O New structure Residential (more than 4 families) 0 Demolition of existing structure 0 Combined'use ® Replacement of existing structure 1=1 Non-residential 0 Relocation of existing structure O Elevated = Addition to existing stricture O Flood proofed(attach certification) 0 Alteration to existing structure Manufactured Home 0 Other: 0 Located on individual lot O Located in manufactured home park SECTION B: OTHER DEVELOPMENT (CHECK ALL THAT APPLY) 0 Clearing of trees, vegetation or debris Q Mining O Grading O Drilling C=l Dredging O Connection to public utilities or services Q Paving [=] Placement of fill material 0 Drainage improvement (including culvert work) = Roadway or bridge construction 0 Fence or wall construction ID Watercourse alteration (attach description) E:1 Excavation (not related to a structured development) Q Other development not listed (specify): By signing below I agree to the terms and conditions of this permit and certify to the best of my knowledge the information contained in this application is true and accurate. I understand that no work may start until a permit is issued.The permit may be revoked if any false statements are made herein. If revoked, all work must cease until permit is re-issued. Development shall not be used or occupied until a Cert. of Compliance is issued. The permit will expire if no work is commenced within one year of issuance. Other permits may be required to fulfill regulatory requirements. Applicant gives consent to local authority or representative to make reasonable inspections to verify compliance_ Application Submitted By (print earn ERE MY WALS H Signature of Applicant: ZZDate:O6-19-2024 1000-123.00-M.00-011.000 IM NOW OR FORNMY NAB]ORM DUNN 100.O0 f N 85012'00" E . IAN Cm OAN O 0.1W / o r. r$ I W l o ' 6I replacement hvac o for accesory O m structure i Stoop in f/o new `patio sl dn0 door .Of 7 7 t 7, 11.0 �.- o Cm , F e Q, I ,r, Igo h f O t � o I CD co d' o r _ P OJI co 100.00 0.$ f . _ S85,12'00" W 0,2B 1000-123.00-0 ,00-013.000 UND NOW OR FORMMY v-4 WBI]AY F. YWJ3 &WB1]Al1%RUS NOTES: .BmWO OF ANY USMWM MOM BR VIIEW BY A C010'M TIDY SPARCS Q •SURVEYOR 13 NOT HIMONSIM FOR UNDBBGROUND U'M=OR S OCIVEM _ e .> PREPARED FOR: SCALE: 1"=20' Jffi:EMY 1fAISH DRAIIN BY: D.P.L. FILE No.: Q124-22 USA McQUEUKIN DATE: JULY 13, 2022 + LAND SURVEYWG SURVEY OF DESCRIBED ROPE 274 EAST MAIN STREET AT MATTITUCK, TOWN OF SOUTHOLD, AREA: 10 0 Sq.Ft. EAST ISUP, N.Y. 11730 SUFFOLK COUNTY, NEW YORK 0.229E ACCRESRES TEL: 631-277-3605 SCTM: 1000-123.00-05.00-012.000 ZONED "R-40" RESIDENCE FA%: 631-277-3906 ELEVATIONS IN NAVD88 DATUM lira®lon&landsurveyor.com umvmown ammml OR ADDITION TO TES MU IS A YWGTION W MMON 7209 Of=N@r YORE SWR RDUC►UON UT.COPW Of SURPRT WP NOT DUNNc nE wm SU MORS DOODJ oR&®0�0 Sm ARR NOT c0l6mlOVm TO m A Im YAM COPY.DFUNCRS SROUN PROP PROPADY I=TO mmNO sTRu=m Age POR A SPRClP1C Puma AND USR AND An NOT MfE00)BD TO OUms DI T�AE1710N oP raw OR OT1UOt SiRULTUAS.cQIm=oN INDRCm((AEON sew.RUN oRaY To Tu msm Pm im Tig SU m is PmA®AND ON Ris gmf,To TA:CORFANY OR AGDKM um MW AND TO 7aa I�ICNAS OP TU LPOM DbYRUTION.CPBRMUUM VE NOT TBANSY�IU TO ADDMONAL D11lTMmNS 09 S011RWW GYM. - _ 3460 CAMP MINEOII ROAD, MATMUCK